ABOUT THE BOOK
While there is currently considerable focus on psychosocial issues for persons with aphasia and their significant others, there has been little unifying work that attempts to bring diverse interdisciplinary perspectives together to understand the impact of aphasia on the social construction and mediation of self or identity. In this book, the authors explore the ideas of social construction of self and/or identity as they apply to treatments for aphasia, interventions for significant others, and other neurological disorders that affect adults -- their premise being that different disorders have a profoundly different impact on one’s perception of self and one’s ability to negotiate the social reconstruction of self in the context of a neurological disorder.
They present theoretical grounding for using the concepts of self and the idea of a social and cultural tool kit that enables clients to interact with others and to define themselves in the context of those around them.
CONTENTS
Preface
Acknowledgments
INTRODUCTION TO SECTION I
Chapter 1: Clinical Practices and the Narrative Self
What Is Narrative Self?
Theoretical Foundations
Perspectives on Self and Narrative
Evolving Clinical Perspectives on Person and Function
Establishing Our Framework for Narrative Self
The Concept of Self
Human Narrative and Narrative Self
Communicative Processes and Narrative Self
Narrative Self and Neurogenic Communication Disorders
Summary and Caveats
Chapter 2: Neurogenic Communication Disorders
The Illnesses and Associated Communication Impairment
Amyotrophic Lateral Sclerosis (ALS)
Parkinson’s Disease (PD)
Stroke (Brain Attack)
Alzheimer’s Disease (AD) and Other Dementias
Similarities and Differences: What Dimensions Matter
Onset and Course of Disorder
Communication Aspect Most Affected and Its Impact
Communication Effects and Self Presentation
Issues of Self as Externally Perceived
Illness Narrative
Moving Forward
INTRODUCTION TO SECTION II
Chapter 3: The Self
The Dimensions of the Self
The Self and Culture
The Self and Roles
The Self and Situational Interactions
The Self and Biography
An Example
Agency
Power
Cultural Power
Power from Roles
Power in Interactions
Power from Biography
Agency, Power, and the Self
The Social Construction of the Self
An Illustrative Clinical Scenario
Conclusion
Chapter 4: Narrative Processes
Exploring Narrative
Narrative and the Self
Narrative as a Backdrop to Illness
The Illness Narrative
Community Narrative
Health Narrative
The Role of Life Stage in Illness Narrative
Communication Impairment and Illness Narratives
Caregiver Perspectives
In Search of Biographical Accommodation
Tools Supporting Narrative Communication
Narrative in the Clinical Context
Chapter 5: Life Stories across the Life Span: Considering Time
Aging as Temporality
Life Span Considerations
Life Storying in Aging
Self, Stereotype, and the Narrative of Decline
Social Grounding of Self in Aging
The Boundaries of Normal Aging
A Lesson Learned Through Reggie’s Story
INTRODUCTION TO SECTION III
Chapter 6: Life Stories in ALS
Communication in ALS
Self and Life Stories
Self and Culture
Self and Roles
Self and Interaction
Self and Biography
Illness Narratives
The Illness Narrative: Diagnosis and Change
The Illness Narrative: Time
Views of Time
Life Span Issues
Time for Reframing the Life Story
The Illness Narrative: What Do Persons with ALS Seek?
The Illness Narrative: Social Situatedness and Social Others
Family and Friends
Caregivers
Support Groups and Communities
Communication Tools and Technology
Chapter 7: Life Stories in Parkinson’s Disease
Parkinson’s Disease and the Self
Self and Culture
Self and Roles
Self and Interactions
Self and Biography
Parkinson’s Disease and the New Life Narrative
The New Narrative: Culture and the Self
The New Narrative: Roles and the Self
The New Narrative: Social Interactions
The New Narrative: Biography
Elements of the Narrative
Temporality
Social Situatedness and Social Others
Agency and Control
Dignity, Respect, Acceptance, and Understanding
Tools and Technology
Conclusion
Chapter 8: Life Stories in Aphasia
Aphasia and Life Impact
Language Loss
Quality of Life
Self and Life Stories
Self and Culture
Self and Roles
Self and Interactions
Self and Biography
Constructing a New Narrative Self: The Story of Mike
Cultural Tools and Resources
Roles
Interactions
Biographical Tools
Life Story and the Illness Narrative
Temporality: Past, Present, and Future
Life Span
Themes in Illness Narratives
Control, Agency, and Related Constructs
Spirituality and Religion
Recognition and Respect
Acceptance and Understanding
The Importance of Others in the Illness Narrative
Perspectives from Caregivers and Significant Others
Groups and Communities
Communication Treatment and Tools
Moving Forward
Chapter 9: Life Stories in Dementia
The Present Clinical Context for the Dementias
Communication Impairment Associated with Dementia
Self for Self and for Others in Progressive Dementia
The Story of Flo Watkins
Prior to Alzheimer’s Disease
Flo’s Children.
Flo’s Life
First Years of the Slow Descent
The Middle Years
Ending
Dementia and Self Construction
Cultural Tools and the Person with Dementia
Roles and the Person with Dementia
Interactions and the Person with Dementia
Biography and the Self
Storying and the Illness Narrative in Dementia
Dimensions of the Self
Narratives of Age and Illness
Social Living
Life’s Pleasures—Keeping the Mind Alive
Self-Care
Narrative Self in Progressive Dementia: Who Writes the Story?
INTRODUCTION TO SECTION IV
Chapter 10: Postmodernism and the Story of the Self: A Call to Action
When an Illness Narrative Becomes a Life Story
Modernism and Postmodernism: The Creation of the Self
Modernism and Postmodernism: The Self and Illness Narratives
Chapter 11: A Sociocultural Approach to Clinical Action
A Sociocultural Approach
Theory about Self, Identities, and Personhood
From Theory to Therapy
Cultural Tool Kit
Cultural Tools
Socially Shared Cultural Tools
Tools for the Person
Storying: Cultural Tools and Agentive Action
Putting Tools to Use
Self Construction and Sense of Self as Part of Clinical Action
Clinical Action in the Moment
Synthesis
The Sense of Self
Clinical Action
People and Communities of People as Tools
Clinical Action for Narrative Self Work
To Be a Clinician
Writing Goals and Objectives for Narrative Self
Person-Centered Goals and Objectives
Final Thoughts
Chapter 12: Supporting the Narrative Self
Key Themes Revisited
Life as Storied
Self as Socially Constructed
Communication at the Core of Life Storying
Discrediting the Narrator
Loss of Mechanism for Filtering Life Experiences
Narrative Self and Clinical Practice: Clinicians as Facilitators of Narrative Self Reconstruction
Targeting Dimensions of Self
Biographical Self
Interactions and Relationships
Roles and Situations
Self in Culture
Using Intervention Tools and Processes More Effectively
Goal Setting
Working Directly with Life Stories and Illness Narrative
Optimal Treatment Contexts
Time Lines for Intervention
Tools for Supporting Narrative Self
Narrative Self and Clinical Practice: Clinician as Coconstructor and Character in Restorying of Self
In Closing
References
Index
ABOUT THE AUTHORS
Barbara B. Shadden, Ph.D.
Barbara B. Shadden is Professor/Director of the Program in Communication Disorders and Co-Director of the Office for Studies on Aging at the University of Arkansas. She has published three textbooks and presented on topics in aging, aphasia, and other neurogenic disorders, discourse, and augmentative communication. She has also served on the editorial board of two journals and as reviewer for seven journals and three funding agencies. Dr. Shadden worked previously as co-coordinator of Neuropathology Services, University of Tennessee, and speech-language consultant to two hospitals. She has recently served as a Board Member for the Academy of Neurological Communication Sciences and Disorders, and is an ASHA Fellow and honoree of the Council of Academic Programs in Communication Sciences and Disorders.
Fran Hagstrom, Ph.D.
Fran Hagstrom is an Assistant Professor in the Program in Communication Disorders at the University of Arkansas. She has published and presented widely on topics associated with socio-cultural approaches to cognition and communication across the life-span and on identity issues for those with a variety of communication differences. She has also served on the editorial board of two international journals and as a reviewer for two journals in the field of communication disorders. Her extensive clinical work includes adult and pediatric rehabilitation at Fresno Community Hospital in Fresno, California, and home-based service delivery through the California-Hawaii Elks Major Project and the Massachusetts Society for the Prevention of Cruelty to Children.
Patricia R. Koski, Ph.D.
Patricia R. Koski is the Associate Dean of the Graduate School and Associate Professor in the Department of Sociology and Criminal Justice at the University of Arkansas, where she also previously served as the Chair of the Department of Sociology, Social Work, and Criminal Justice. She has published and presented primarily on topics related to family violence, sociology of culture, and the creation of the self. She received her Ph.D. in sociology from Washington State University. In recent years, her professional affiliations have been in the area of graduate education, where she has served on various committees with the Conference of Southern Graduate Schools.
AUDIENCE
Primary:
Speech-Language Pathology
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