The case: a story found and lost

This first case in our series presents an elderly patient's encounters with the medical system as chronicled in her medical records.     

Memories of suffering: Exploring the life story narratives of twice-widowed elderly women

Narratives of suffering often reflect remembered accounts of past traumas and other significant events in individuals' lives that they deem worthy of public presentation and feel comfortable enough to share. This paper examines the life stories of three elderly women who were widowed early in life (“off-time”), eventually remarried, and were later re-widowed “on time.” Their narratives illustrate the complexities of the transitions from wife to widow and from widowhood to remarriage and back again. Commonalities and differences in the narrative are explored, including how suffering was revealed, with an emphasis on understanding the utility of what the women chose to remember, tried to forget, and opted to reveal about their lives. Also considered is their outright rejection of the identity “widow.” Within the broader discussion of remembering and suffering, how individual histories contextualize reactions to subsequent events is also explored.     

Mental illness, supported education, employment and recovery: Ben's story

Supported education programs aim to facilitate the successful return to higher education for people living with mental illness who may have experienced educational interruptions due to their illness. This article shares the story of Ben who lives with mental illness and his experience of participating in an Australian supported education course. The two authors draw on a qualitative life history approach as they reflected on Ben's experiences of mental illness, educational disruption and returning to education and employment. The losses associated with educational disruption and the positive and empowering experience of becoming a student again are described as positively impacting recovery. Ben's story is shared in anticipation that other people living with mental illness, their family and carers, or workers supporting those people, may draw from his determination and success, in their own journeys of recovery.     

Telling a modest story: accounts of men's upward mobility from the National Child Development Study

While the pattern of social mobility in postwar Britain has been extensively studied, revealing considerable upward mobility, much less is known about the subjective dimension to mobility. In this article, we employ a new sample of in-depth interviews with 50-year old men from the National Child Development Study to examine in detail the link between objective mobility patterns and the way the upwardly mobile narrate their life trajectories. In contrast to the mobility ideology suggested by the Oxford mobility survey of the early 1970s, in which the upwardly mobile recognized and internalized their success as a project of the self, we report how members of this later generation of men with highly successful careers prefer instead to articulate 'modest' life stories. By treating the career as a narrative device, we are able to show how the disavowal of the dominant, linear hierarchical career model by these men allows them to tell particular and distinctive stories which establish their individuality and personhood, while, paradoxically, recognizing the cultural power of the dominant model. In particular, we highlight the use of 'linear contingent' narratives by these men, in which specific events, especially those connected with occupational and geographical transitions, are deployed as contingent thresholds to mark out key shifts and passages in their lives. We then compare their accounts with those of immobile and downwardly men, who instead deploy 'ghostly' stories, preoccupied by the past, or defensive accounts, displaying unease with their failure to live up to the expectations of the linear career model. Having shown that men's accounts of mobility are suffused with an awareness of their need to establish their own individuality through repudiating the social trope of the instrumental careerist, we conclude that the links between career identities and objective mobility patterns are not straightforward and need careful unravelling.     

Dying patients' thoughts of ending their lives: a pilot study of rural New Mexico

Forty-nine hospice patients in rural New Mexico were directly interviewed concerning their thoughts about ending their lives. Thirty-one patients (63%) did not have thoughts of ending their lives, whereas 18 patients (37%) reported having suicidal thoughts. There were no differences between patients with and without thoughts of suicide related to gender; ethnicity; age; education; disease; religion; importance of religion; location of hospice agency; remaining financial, family, or spiritual issues; satisfaction with hospice care; sum of hospice personnel seen; or sum of medical equipment used. There were significant differences between patients with and without thoughts of suicide related to the number of household members (p = .02); the symptoms of trouble sleeping (p = .04) and nervousness (p =.03); and Medicare insurance coverage for hospice care (p =.01). No other symptom, including pain and hopelessness, was significant. Seven (39%) of the 18 patients who thought of ending their lives told someone about these thoughts. There were no variable differences between patients who did and did not tell someone about these thoughts.     

The power of the individual's story.

A full-time chaplain to transplant patients and their families cautions that the natural sympathy inspired by the plight of individual transplant candidates may lead the public to neglect the less dramatic medical needs of the masses of poor and uninsured.     

“I Am Tired But If I Don't Try to Have Sex,My Wife Will Think I've Been Fooling around in the City”: Work,Migration, and Sex Among Vietnamese Migrant Laborers

Mostly operating from a risk and risk-reduction paradigm, existing research on migrants in Vietnam tends to conceptualize sex and risky sexual behaviors as isolated life domains. This study begins to develop a contextually rich understanding of migrants’ sex lives by examining the relationships among sex, work, and the constant pendulum-like migrating movements of 23 Vietnamese married migrants in Hanoi and Ho Chi Minh City. Using data from in-depth interviews, it was found that most participants had no sex in the city; this was followed by visits to the home village, where they had sex with their spouses as often as possible to make up for the “long drought” in the city. Within this sexual schema, sex came secondary, and even peripherally, to migrants’ working lives; thus, exhaustion from work was cited by migrants as the overwhelming factor leading to their sexual problems. This study suggests that migrants’ intimate lives are more strongly linked to their working lives than has previously been recognized, and that their sexual behaviors should be viewed in tandem with the hardships of their working lives.     

Imperfect Love,Imperfect Lives: Making Love,Making Sex,Making Moral Judgments

Psychoanalysis' judgments about patients' decentered sexual lives are often influenced by analytic ideals that are based on long-cherished cultural values and/or theoretical constructs. These analytic value judgments sometimes assume that all or most individuals are optimally fulfilled in the context of deeply intimate and sexually monogamous long-term relationships, where attachment love and sexual passion coexist in equal intensity. Such analytic aims may not at all correspond to the wishes of any given patient, nor do such aims consider the literature that suggests that what may be called attachment love is often difficult to integrate with intense erotic desire. As well, there is risk that analysts' aims for patients may be hypocritically more idealistic than the values that analysts themselves adhere to in their own personal lives. Analysts' acknowledgment and acceptance of their own imperfect sex lives and love lives may leave more room to respect the idiosyncratic compromises and adaptations of each uniquely individual patient.     

Isolated, invisible, and in the closet: the life story of a Scottish Muslim lesbian

In the last three decades, there has been a significant growth in the literature on lesbian identity and relationships, but the study of lesbians from a Muslim background is conspicuously absent. This article was prompted partly by the relative absence of research into the lives of Muslim lesbians in Britain, and partly by the fact that much of the literature on Islam and homosexuality has tended to focus on homosexual men, ignoring the position of lesbian sexuality in Islam. It also charts the difficulties faced by a heterosexual researcher in conducting an interview with a lesbian and calls attention to the invisibility of self-identified Muslim lesbians in Glasgow. The life story interview is used to explore the very hidden and untold story of a Muslim lesbian; as such the article draws heavily on the subject's narrative.     

Telling their story of homelessness: voices of Victoria’s Tent City

In a climate of reduced access to affordable and appropriate housing, tent cities have emerged as a unique solution to homelessness. Conducted with a semi-structured interview schedule, this qualitative study presents the findings of research conducted at Tent City, Victoria in 2016. Using snowball sampling, 12 residents of Tent City participated in research that revealed four themes for analysis: (1) push and pull motivations to join the encampment; (2) the role of services in resident’s lives; (3) residents’ experiences with the outside community; and (4) Tent City as a home community. Push factors included substance abuse, mental health problems, unemployment, family problems while pull factors included lack of affordable and appropriate housing, loss of housing, and personal issues. Residents’ experiences with services were generally negative with social/health services being considered inadequate, housing options overly restrictive and controlling. The outside community was considered hostile and uninformed as the workings of Tent City and the benefits it provided. Importantly, Tent City provided both a psychological and functional sense of community for residents. While the directions for future research are many, further examination of the broader sociopolitical context in which tent cities emerge could be examined. As well, the themes identified here could be explored further in terms of how existing services could be restructured to better respond to the needs of homeless persons.     

In life and in death: the story of people living with metastatic cancer

ABSTRACT

Advances in the treatment of metastatic cancers such as melanoma enable patients to live for many years. However, melanoma patients are under constant threat of a recurrence or a new growth, are under intensive follow-up, and must avoid exposure to the sun. These factors engender anxiety, a constant fear of recurrence, and a reduction in routine activity, thus requiring patients to develop mechanisms for coping simultaneously with the illness and the threat of death. This study uses content analysis of the documentation of a support group for metastatic melanoma patients to examine how they cope with both. The findings suggest that they are able to cope with both simultaneously. However, perhaps because they recognise their total lack of control over the illness, they exercise control in how they cope with death. The findings suggest that support groups like the one documented in this article could serve as sheltered and effective therapeutic spaces for coping with the threat of death.     

Dismantling Public Housing,Reconstructing the Lives of Children

Just as the lives of adults may be turned upside down when a move is made from public housing, so too may be the lives of children. Over the course of 5 years, mothers relocated out of a housing development in the southwest U.S. participated in surveys and focus groups, discussing among many topics the lives of their children after the move. Mothers talked about their children's behaviour, the lack of play spaces, their children experiences in their schools, and the schools' responses. The mothers offered insights into ways to ease the relocation process and make the new space home.     

The past is always present: Creative methods for capturing the life story

Since human behavior is so complex, efforts to change it require that therapists and patients draw upon as many sources of information as possible. Effective treatment necessarily involves taking a comprehensive account of patients' histories and their continually evolving life story so that dynamic connections between the past and present can be understood and thereby be reinforced or unlinked. This article discusses the salience of personal history and demonstrates its impact and benefit in therapy. It offers three creative methods with illustrative examples for unfolding and examining the life story.     

‘I see myself as a different person who [has] acquired a lot …’: Somali female students’ journeys to belonging 1

How do refugee students construct their lives in school in their host country? What are some difficulties that they face and how do they respond to those? Findings of a qualitative study conducted with female refugee students from Somalia indicate that students are to varying degrees active agents in the construction of their lives in a US urban school. Although they do experience religious discrimination, they find creative ways to respond to it and, despite the fact that learning English is an initial obstacle in their lives in their host country, they tend to be successful in acquiring the new language. These findings problematize the perception of students as passive victims of the structural forces that inform their lives. At the same time, they challenge educators to seek ways that could make schools positive contexts of reception of refugee and immigrant students. Although the study focuses on the experiences of refugee students with distinct cultural characteristics in the US, the issues raised may provide a window to understanding the experiences of newcomer students in other parts of the world.     

A habitus of instability: youth homelessness and instability

This research introduces the concept of a habitus of insecurity to account for the lives of homeless young people. It outlines how conditions of existence are internalised and how homeless young people come to expect and in turn recreate instability in their lives. This research addresses the internalisation and naturalisation of experiences of instability, insecurity and marginalisation and how people can come to subjectively aspire to what they are socialised to see as objectively probable or ‘for the likes of them'. The research draws on ethnographic research and participant observation to examine the complex lives of homeless young people and how they are shaped by instability and insecurity inculcated before, during and after experiences of homelessness. This research highlights that people should not be defined merely by their experiences of homelessness of housing status, but by the complex array of conditions that shape their lives.     

Parkinson's disease: current scientific understanding,and John's story

1. Parkinson's disease is a progressive, neurological disease that has no cure, although medications may delay or relieve symptoms. Surgical treatments are appropriate for some patients. 2. Monitoring symptoms of Parkinson's disease is important because all medications deemed helpful for patients can also have serious side effects, including delusions and hallucinations. 3. Clients who have difficulty expressing themselves need a family member or friend to inform caregivers of their interests and sources of enjoyment. 4. Efforts can be made to forestall isolation in the client's home or long-term residence. Suggestions and answers to commonly asked questions can be found on the Internet.     

Wherefore the Oedipus Complex in Adolescence? Its Relevance,Evolution, and Appearance in Treatment

This article is a critique of the frequent and reflexive use of the Oedipus complex in clinical discussions as a constellation that refers specifically to experiences of young children. A more fluid concept of the Oedipus complex is described in which it is seen as a constellation of issues that derives from early childhood and recurs throughout development. The adolescent Oedipus complex is described in detail and is seen as the more probable form that occurs in treatment when adult patients are describing their sexual and gender-based lives.     

Cancer in the Family: Review of the Psychosocial Perspectives of Patients and Family Members

As advances in cancer care have led to more treatment options and longer survival for cancer patients, a focus on quality of life for patients and their families has gained importance. This review provides a discussion of stress and coping theory, documents the relevance of this topic area for social work practice, and illuminates the results of a literature review by emphasizing the perspective from which research was collected within the family system. Recognizing the impact of cancer on the lives of patients, their partners, children, and the family as a whole is an essential factor in providing appropriate and adequate psychosocial services to families facing cancer.