The Functions of ‘Always’ in Women’s Narratives of Living with Multiple Sclerosis: An Exploratory Analysis of Identity Maintenance and Change

Abstract

Multiple sclerosis (MS) is a chronic neurological disease that commonly impairs mobility, continence, and levels of energy. The progressive loss of functioning and the unpredictable trajectory of the illness are recognised to threaten identity and create biographical disruption. This paper is based on indepth qualitative research interviews with six women about their strategies for living with MS. Previous research into identity change (by Mishler, 1999) has noted the regular appearance of ‘always’ in the narratives of people describing major life transitions. Influenced by these observations, the author examined the functions and meanings of this word within the women’s narratives. The analysis revealed that ‘always’ was often used when the women were emphasising the long-lasting beliefs, attitudes, interests and personality characteristics that sustained them in coping with MS (eg. ‘always positive’, ‘always interested in art’). These durable characteristics appeared to provide stability of identity in the midst of change and loss. Some references to ‘always’ marked the presence of strong, reliable supportive relationships (eg. that people were ‘always encouraging’). ‘Always’ was also used in contexts which revealed certain ongoing difficulties and the complexities of coping with illness. They provided insights into the women’s ‘uncomfortable truce’ with MS. These sections tended to have the form ‘always … but …’. Whilst not replacing a conventional thematic analysis, this focus upon the use of words and linguistic patterns in the narratives provided rich insights into identity maintenance and identity threat during chronic illness