In the United States, women with breast cancer often find their identity confined by a sociocultural context that encourages them to adopt an overly optimistic outlook while hiding signs of their physical illness. Online social support groups offer a promising venue for breast cancer patients to take control of their self-definition and connect with individuals going through similar experiences. During the analysis of discussion board posts for an online breast cancer support group, ice cream unexpectedly emerged as a central component of group discussions. This included frequent sexual jokes about the deliverymen that brought the women ice cream. A grounded theory analysis revealed that ice cream symbolized the pursuit of everyday, physical desires, which allowed group members to construct a joyful, but forthright, shared identity. This paper demonstrates how online support groups can enable individuals facing a health crisis to use seemingly trivial symbols to take control over their self-definition.
TopIntroduction
For many women, a breast cancer diagnosis changes everything. Breast cancer and the side effects of treatment create daunting physical and emotional challenges (National Cancer Institute, 2012) and pose unique threats to body image and femininity (Ehlers & Krupar, 2012; Oster, Astrom, Linda & Magnusson, 2009). Loss of hair, changes in body shape and functioning, and acute awareness of illness-related stigma might dramatically alter how a breast cancer patient perceives and feels about her body (Mathieson & Stam, 1995; Pelusi, 2006). Perhaps most jarring, women with breast cancer often have to deal with existential concerns about their mortality (Kenne Sarenmalm, Toren-Jonsson, Gaston-Johnsson, & Ohlen, 2009). Because a cancer diagnosis can profoundly alter the way women view themselves and the world around them, patients often have little choice but to renegotiate their identity in relation to their cancer (Carpenter et al., 1999; Henriksen & Hansen, 2009). For many women in the United States, this identity negotiation is confined by a sociocultural context that encourages them to adopt an overly optimistic outlook while hiding signs of their physical illness (e.g., through the use of wigs and prosthetic breasts) (Broom, 2001; Wilkinson, 2001). This context can have a profound impact on how breast cancer patients view their illness, their relationships to it, and their identities as women with breast cancer.
Online support groups have received much attention for their potential to help cancer patients achieve positive health outcomes (e.g. Gufstason et al., 2005, 2008; Hawkins et al., 2010; Sandaunet, 2008). In particular, they offer women with breast cancer a promising venue wherein they can confront their negative emotions and take control of their self-definition. By connecting women who share similar experiences, online support groups have the capacity to build social networks outside of a particular sociocultural context (Pitts, 2004; Sandaunet, 2008; Van Uden-Kraan et al., 2008).
This study initially began with the intention of examining the degree to which members of an online breast cancer support group, enabled by the Center for Health Enhancement Systems Studies (CHESS), exchanged informational and emotional support messages and the effects these messages had on psychosocial outcomes. During the analysis of discussion board posts, ice cream unexpectedly emerged as a significant and central component of group discussions. This included frequent sexual jokes about the deliverymen that brought ice cream to the women. In the context of breast cancer, the topic of ice cream appeared rather trivial, yet group members appeared to be coalescing around this seemingly lighthearted topic in a meaningful way.