Running head: CHRONIC ILLNESS, IDENTITY AND MEDICATION 1
The Relationship Between Medication, Identity and Illness:
Symbolic Interactionism Account of Self and Identity
Chanal Carlisle
Northwestern University
CHRONIC ILLNESS, IDENTITY AND MEDICATION
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The Relationship Between Medication, Identity and Illness:
Symbolic Interactionism Account of Self and Identity
Introduction
Human suffering stems from more than physical pain. Suffering occurs through a dynamic
view of the human self. In regards to chronic illness, all facets of the patient need to be given equal
attention. In order to view chronic illness through the symbolic interactionism perspective one must
give value to more than simply the physical manifestation of illness. This paper will examine the
relationship between medication, illness and identity. The impact these issues have on medication
adherence and other identity threatening healthcare procedures of chronically ill individuals will be
presented. Additionally, this paper will include an alternative idea to healthcare practice. Continuing
on, the implications of current medical and pharmaceutical care practices will be assessed and
highlighted changes that need to occur in provider-patient interactions will be expressed. The impact
of family, peers, and media along with future research ideas will also be explored.
Relationship between Medication, Identity & Illness
When an individual is diagnosed with a chronic illness their world is immediately changed.
Kathy Charmaz states, “Experiencing serious illness challenges prior meanings and ways of living
that have been taken for granted and ways of knowing self” (2000, p. 277). The newly diagnosed are
now at the mercy and word of their practitioner and may lose the option of choice. For example, a
once proud and established businessman is now diagnosed with cancer and left without choice in
regard to treatment options. His whole identity of strength and vitality has been diminished with his
new title of “cancer patient.” A world that was once filled with planning vacations is now spent
scheduling radiation appointments. The savings he had for his children’s college fund are now spent
paying medical bills and insurance deductibles. The world he once cherished is shattered.
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Illness brings the loss of identity and sense of self in addition to the loss of control (Charmaz,
2000; Lambert et al., 2009). The chronically ill are forced to assess the life they had (prior to
diagnosis) and prepare for a new one that is unknown and unplanned. The body that carried them
through life is now forever ill. The way our body is viewed and the response that individuals receive
from others, in addition to the way in which the body performs, aids in the creation of an
individual’s role identity (McCall & Simmons, 1978). The body is our means of communication
with the world around us and is the medium through which our conceptions of self are formed
(Corbin & Strauss, 1988). When a person experiences body failure or lacks the ability to execute
essential role identity performances it can be devastating to one’s conception of self and self–esteem.
It is important to know the impact body failure has on an individual’s identity because it affects all
aspects of human self.
The trajectory model looks to explain the various means necessary to work through the
phases of illness. This model stems from a health policy model that focuses on the social scientific
view of chronic illness as opposed to the traditional mechanistic or medical view (Strauss & Corbin,
1988). This model focuses on the phases of illness and the work that is required of the patient and
the people in the patients’ life (Strauss & Corbin, 1988).
The trajectory model of illness uses the term BBC chain (biographical time, body and
conceptions of self) to describe the three major dimensions of an individual’s biography (Corbin &
Strauss, 1987). The conceptions of self affect social and role identities of the individual and play a
key role in the psychological outcome of the chronically ill, however, all three dimensions of the
chain must be given attention and focus. When a chronically ill person’s body starts to fail them their
conceptions of self will be challenged and this may create severe psychological suffering (Lambert
et al., 2009). This person is forced to deal with not only the physical pain but the loss of self in
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addition to the role and social identity attached to the person they used to be. These biographical
losses must be addressed in order for the chronically ill to find meaning and gain contextualization
skills in order to cope with their illness.
Identity Threatening Healthcare Procedures
In the case of chronic illness, a person may be stigmatized, or fall victim to a role altering
handicap later in life, thereby threatening an established role identity. This stigmatization can happen
in various ways such as medication usage or social encounters. In these situations an individual
struggles to find the new version of self due to their once “normal” self–ideal that has now been
changed (Goffman, 1963). Individuals who find themselves diagnosed with chronic illness later in
life may experience identity conflicts, stigmatization and loss of their prior social network (Goffman,
1963).
