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

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.