Transformations of self in surviving cancer: an ethnographic account of bodily appearance and selfhood

This study focuses on the transformations of self in some breast cancer survivors, particularly as related to changes in bodily appearance (due to radiation, chemotherapy or surgery.) Analyzing various discourses of cancer survivors (such as excerpts of talk from interviews, journal entries, photographs and public presentations), I study the ways in which selves are reconstituted in relation to a change in physical form due to medical treatment (such as, hair loss or having one or both breasts removed.) The lived experiences of individuals create the basis for understanding appearance as a bodily experience rather than mere image or representation. Using ethnographic methods, I explore the viewpoints of the women who suffered through cancer treatment and the meanings of appearances they constructed in social interaction with others. By integrating symbolic interactionist and phenomenological approaches to the study of physical body and self, this study locates the self in the body as a reflective process emerging through social interaction. I emphasize appearance as bodily experience in terms of its visual and tactile aspects and examine its implications on women’s selves, self-presentations and social interactions. Using Goffman’s (1959, 1963) concepts of self-presentation, stigma and interaction order I show the ways in which my participants experienced “stigmatization” due to temporary or permanent bodily changes. Furthermore, I demonstrate that stigma management not only pertains to public life but also intimate contexts. Observing the inseparability of appearance and self as a common theme in the discourse of survivors, I argue that appearance is more than just an expression of self but it constitutes the self, or a part of self. It is in some way through our looks, along with the responses of others to it that we grow up with, that we come to recognize ourselves as who we are. Breast cancer survivors interviewed in this study reported a “loss of self” as a result of a change in physical appearance which they attributed to their inability to integrate their altered physical appearance as a part of themselves. While some survivors accepted the way they look and made it a part of their selves, others resisted the change and managed their image to restore their selves. This shows us that the role of the individual in shaping the definition of the self is evident, “through the little ways in which we resist the pull” (Goffman, 1961), as opposed to the notion of self as a fluid product of others imputations. Despite their different choices, survivors showed an effort to maintain the coherence of the self in moments of change and uncertainty. This active and autonomous view of self challenges the characterization of appearance and beauty practices as oppressive and thereby challenges the understanding of women as passive and manipulated by cultural ideologies.