While the word narrative now appears with notable regularity in the titles of anthropological studies of illness or disease, there are relatively few studies that explore the philosophical or ontological basis of narrative, or that avail themselves of the large body of writing on narrative in literary criticism, philosophy, or linguistics. Indeed, like the social science "interview" analyzed by Briggs in Learning How to Ask (1986), "narrative" is often conceived of as a more or less transparent medium for obtaining or revealing information about disease X from the perspective of ethnic group Y or interest group Z. In other words, what linguistic anthropologists like Briggs describe as the referential function of language (e.g., the world of objects) is privileged over the pragmatic or metacommunicative functions of language. Nevertheless, as Good notes in Medicine Rationality and Experience (1994), anthropologists, and social scientists more generally, are becoming increasingly concerned with questions like: "To what extent do the stories report or depict events or experiences as they occurred? ... Does a good history mirror events and experience, or does it select events and organize them culturally? To what extent is social life itself organized in narrative terms?" (p. 139).
Using the work of William Labov as a baseline, it is also possible to detect a shift in the way these questions are answered, although there is clearly no consensus, and, undoubtedly, never will be, about what a narrative is.
As several authors have noted (Langellier, 1989; Mishler, 1995; Reissman, 1993), the prototype for examining orally produced texts is found in an article by Labov and Waletsky, "Narrative Analysis: Oral Versions and Personal Experience," published in 1967. In this early work, which focused on stories African-American teenagers tell to members of their peer group (and, of course, Labov & Waletsky), narrative is a very restricted speech category. Minimally, to be considered a narrative, a speech act must describe an actual event that occurred sometime in the past, and is remarkable or extraordinary in some way. A fully formed narrative, in turn, contained six additional attributes: (1) an abstract or summary of the story that followed, (2) an orientation which set the story in time and place, (3) a complicating action or plot (e.g., a sequence), (4) an evaluation or interpretation of the events by the narrator, (5) a resolution, an account of how things turned out, and, finally, (6) a coda, a summation which brings the audience back to the present.
Moreover, according to Labov and Waletsky, narrative was representational rather than constitutive of reality. The storyline is not only chronological, it reflects the order of events in the narrated world. As the two authors note, events move in a linear way through time and the "order can not be changed without changing the inferred sequence of events in the original semantic interpretation" (p. 21).
If the early work of Labov and Waletsky provides a convenient starting point for discussing narrative analysis in the social sciences, it is clear that anthropologists have not been constrained by the definitions proposed in this piece. Indeed, "Narrative Analysis" serves more as a monument to change than a guide for analysis, since virtually all the assumptions about narrative in the article have been challenged.
For one thing, the separation between narrative description and the narrated world is considered highly problematic in the post-modernist context. In Healing Dramas and Clinical Plots, for example, Mattingly (1998) argues that narratives are so compelling because life itself is structured narratively; "patients have a need for narrative" and experience contains "the seeds of narrative." By positing a homology between experience and narrative description, or better, by suggesting that the experience we are concerned with is the "experience and action created by telling the story" (p. 43), not the experience described in the story, narratologists, like Mattingly, avoid some of the methodological conundrums that surfaced in correspondence theories or mimetic theories like Labov's. After all, since we learn about events through stories, how could we ever determine whether the story matches the actual event, except through another narrative? And, then, how does one adjudicate between different narratives? Since illness narratives are by many accounts "polyphonic" this is, indeed, a difficult nut to crack.
By intentionally focusing on ordinary therapy sessions (p. 86) and routine activities (e.g., checkers games), Mattingly also raises the question: What is it, or who is it, that makes narratives extraordinary? While nothing, it seems, is inherently interesting, or eventful; any event— a walk down a corridor, combing one's hair—can become so, if the therapist figures out "what story [she's] in" (p. 72), and how a sequence of activities connects to the patient's new life story. Indeed, Mattingly departs from other contemporary writers, such as Becker, Gay (1994), by arguing that narrative has more to do with locating desire or overcoming a gap than with attempting to maintain or restore a semblance of unity to a badly disordered body (p. 107). In short, what makes narrative extraordinary is not a unique sequence of events, but the many small acts of interpretation through which the therapist/narrator uniquely connects an activity or event with an individual patient.
The idea that narrative is singularly concerned with past events is also viewed as overly restrictive (Langellier, 1989). For example, in describing illness narratives in Turkey, Good (1994) notes that stories not only tell of past events, but project them forward in time, "organizing our desires and strategies teleologically, directing them toward imagined ends or forms of experience which our lives ... are intended to fulfill" (p. 139). And in Doctor Talk and Diabetes (1998), Loewe, Freeman, Schwartzman, Quinn, and Zukerman argue that physician narratives are even more future-oriented. While patients are often uncertain about what the future will bring, or are simply caught up in the act of daily life, physician time, rooted in epidemiological models, can be thought of as "organic time in the sense that it is marked by the progressive and relatively predictable breakdown of specific organ systems" (p. 1271).
In recent years, narratologists have also moved away from the assumption that narratives of any type are the product of an individual author (Jefferson, 1978; Langellier, 1989; Mishler, 1995; or that stories are passively consumed by a listening audience. Whether narratives emerge out of a medical consultation (Mishler, 1995), an occupational therapy session (Mattingly, 1998), a family squabble (Stein, 1985), or an interview, they are increasingly seen as joint productions. Similarly, Good, following Ricoeur, Iser, and the reader response theorists, asserts that the plot of the story is not simply there for the taking, but is composed moment by moment by the reader/listener as he or she proceeds through the text.
Finally, as Good (1994) suggests, illness stories may not provide very much resolution (Labov's fifth criteria), since the narrators are "still engaged in the striving, in the quest for a cure" (p. 146), and may be considering several alternative outcomes at a given time. Indeed, as Price (1987) notes in her study of illness narratives in Ecuador (p. 328)—or for that matter as Garcia-Marquez and Rabasa (1996) suggest in Chronicles of a Death Foretold—there can be six different ways to account for an illness and there are many ways to interpret a death.
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