Neurogenic Communication Disorders: Life Stories and the Narrative Self

Overview

Although there is currently considerable focus on psychosocial issues for person with aphasia and their significant others, there has been little unifying work that attempts to bring diverse interdisciplinary perspectives together to understand the impact of aphasia on the social construction and mediation of self or identity. In this book, the authors explore the ideas of social construction of self and/or identity as they apply to treatments for aphasia, interventions for significant others and other ...

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Overview

Although there is currently considerable focus on psychosocial issues for person with aphasia and their significant others, there has been little unifying work that attempts to bring diverse interdisciplinary perspectives together to understand the impact of aphasia on the social construction and mediation of self or identity. In this book, the authors explore the ideas of social construction of self and/or identity as they apply to treatments for aphasia, interventions for significant others and other neurological disorders that affect adults, their premise being that different disorders have a profoundly different impact on one's perception of self and one's ability to negotiate the social reconstruction of self in the context of a neurological disorder. They present theoretical grounding for using the concepts of self and the idea of a social and cultural tool kit that enables clients to interact with others and to define themselves in the context of those around them.

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Product Details

  • ISBN-13: 9781597561365
  • Publisher: Plural Pub Inc
  • Publication date: 7/1/2008
  • Pages: 257
  • Product dimensions: 7.00 (w) x 9.90 (h) x 0.60 (d)

Table of Contents

Preface xi

Acknowledgments xv

Introduction to Section I 1

Chapter 1 Clinical Practices and the Narrative Self 3

What Is Narrative Self? 3

Theoretical Foundations 5

Perspectives on Self and Narrative 5

Evolving Clinical Perspectives on Person and Function 7

Establishing Our Framework for Narrative Self 9

The Concept of Self 9

Human Narrative and Narrative Self 10

Communicative Processes and Narrative Self 12

Narrative Self and Neurogenic Communication Disorders 13

Summary and Caveats 14

Chapter 2 Neurogenic Communication Disorders 17

The Illnesses and Associated Communication Impairment 19

Amyotrophic Lateral Sclerosis (ALS) 19

Parkinson's Disease (PD) 19

Stroke (Brain Attack) 20

Alzheimer's Disease (AD) and Other Dementias 20

Similarities and Differences: What Dimensions Matter 21

Onset and Course of Disorder 21

Communication Aspect Most Affected and Its Impact 23

Communication Effects on Self Presentation 24

Issues of Self as Externally Perceived 26

Illness Narrative 29

Moving Forward 29

Introduction to Section II 31

Chapter 3 The Self 33

The Dimensions of the Self 34

The Self and Culture 34

The Self and Roles 36

The Self and Situational Interactions 37

The Self and Biography 38

An Example 38

Agency 39

Power 40

Cultural Power 40

Power from Roles 40

Power in Interactions 41

Power from Biography 41

Agency, Power, and the Self 41

The Social Construction of the Self 42

An Illustrative Clinical Scenario 43

Conclusion 45

Chapter 4 Narrative Processes Exploring Narrative 47

Narrative and the Self 47

Narrative as a Backdrop to Illness 51

The Illness Narrative 52

Community Narrative 53

Health Narrative 55

The Role of Life Stage in Illness Narrative 57

Communication Impairment and Illness Narratives 58

Caregiver Perspectives 59

In Search of Biographical Accommodation 60

Tools Supporting Narrative Communication 61

Narrative in the Clinical Context 61

Chapter 5 Life Stories across the Life Span: Considering Time 63

Aging as Temporality 63

Life Span Considerations 64

Life Storying in Aging 66

Self, Stereotype, and the Narrative of Decline 68

Social Grounding of Self in Aging 72

The Boundaries of Normal Aging 72

A Lesson Learned Through Reggie's Story 73

Introduction to Section III 75

Chapter 6 Life Stories in ALS 79

Communication in ALS 82

Self and Life Stories 84

Self and Culture 84

Self and Roles 88

Self and Interaction 90

Self and Biography 95

Illness Narratives 96

The Illness Narrative: Diagnosis and Change 96

The Illness Narrative: Time 97

Views of Time 98

Life Span Issues 100

Time for Reframing the Life Story 101

The Illness Narrative: What Do Persons with ALS Seek? 102

The Illness Narrative: Social Situatedness and Social Others 104

Family and Friends 104

Caregivers 106

Support Groups and Communities 109

Communication Tools and Technology 111

In Closing 116

Postscript 117

Chapter 7 Life Stories in Parkinson's Disease 119

Parkinson's Disease and the Self 121

Self and Culture 122

Self and Roles 123

Self and Interactions 124

Self and Biography 126

Parkinson's Disease and the New Life Narrative 126

The New Narrative: Culture and the Self 129

The New Narrative: Roles and the Self 129

The New Narrative: Social Interactions 129

The New Narrative: Biography 130

Elements of the Narrative 130

Temporality 130

Social Situatedness and Social Others 131

Agency and Control 132

Dignity, Respect, Acceptance, and Understanding 133

Tools and Technology 134

Conclusion 135

Chapter 8 Life Stories in Aphasia 137

Aphasia and Life Impact 140

Language Loss 140

Quality of Life 144

Self and Life Stories 145

Self and Culture 147

Self and Roles 149

Self and Interactions 150

Self and Biography 151

Constructing a New Narrative Self: The Story of Mike 151

Cultural Tools and Resources 152

Roles 152

Interactions 153

Biographical Tools 153

Life Story and the Illness Narrative 154

Temporality: Past, Present, and Future 158

Life Span 160

Themes in Illness Narratives 161

Control, Agency, and Related Constructs 161

Spirituality and Religion 162

Recognition and Respect 163

Acceptance and Understanding 164

The Importance of Others in the Illness Narrative 165

Perspectives from Caregivers and Significant Others 166

Groups and Communities 167

Communication Treatment and Tools 168

Moving Forward 172

Chapter 9 life Stories in Dementia 175

The Present Clinical Context for the Dementias 175

Communication Impairment Associated with Dementia 176

Self for Self and for Others in Progressive Dementia 178

The Story of Flo Watkins 179

Prior to Alzheimer's Disease 179

Flo's Children 179

Flo's Life 180

First Years of the Slow Descent 181

The Middle Years 182

Ending 184

Dementia and Self Construction 185

Cultural Tools and the Person with Dementia 185

Roles and the Person with Dementia 186

Interactions and the Person with Dementia 187

Biography and the Self 188

Storying and the Illness Narrative in Dementia 188

Dimensions of the Self 189

Narratives of Age and Illness 189

Social Living 189

Life's Pleasures-Keeping the Mind Alive 192

Self-Care 194

Narrative Self in Progressive Dementia: Who Writes the Story? 195

Introduction to Section IV 199

Chapter 10 Postmodernism and the Story of the Self: A Call to Action 201

When an Illness Narrative Becomes a Life Story 202

Modernism and Postmodernism: The Creation of the Self 203

Modernism and Postmodernism: The Self and Illness Narratives 204

Chapter 11 A Sociocultural Approach to Clinical Action 207

A Sociocultural Approach 207

Theory about Self, Identities, and Personhood 208

From Theory to Therapy 209

Cultural Tool Kit 209

Cultural Tools 209

Socially Shared Cultural Tools 209

Tools for the Person 209

Storying: Cultural Tools and Agentive Action 210

Putting Tools to Use 211

Self Construction and Sense of Self as Part of Clinical Action 211

Clinical Action in the Moment 212

Synthesis 212

The Sense of Self 212

Clinical Action 213

People and Communities of People as Tools 213

Clinical Action for Narrative Self Work 214

To Be a Clinician 214

Writing Goals and Objectives for Narrative Self 215

Person-Centered Goals and Objectives 216

Final Thoughts 217

Chapter 12 Supporting the Narrative Self 219

Key Themes Revisited 221

Life as Storied 221

Self as Socially Constructed 222

Communication at the Core of Life Storying 222

Discrediting the Narrator 223

Loss of Mechanism for Filtering Life Experiences 223

Narrative Self and Clinical Practice: Clinicians as Facilitators of Narrative Self Reconstruction 224

Targeting Dimensions of Self 225

Biographical Self 225

Interactions and Relationships 226

Roles and Situations 227

Self in Culture 228

Using Intervention Tools and Processes More Effectively 228

Goal Setting 228

Working Directly with Life Stories and Illness Narrative 229

Optimal Treatment Contexts 230

Time Lines for Intervention 231

Tools for Supporting Narrative Self 232

Narrative Self and Clinical Practice: Clinician as Coconstructor and Character in Restorying of Self 233

In Closing 235

References 237

Index 253

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