Words act. Acceptance is a frequently used concept in clinical practices around chronic illness. The idea of facing one’s conditions and taking responsibility has a number of historical antecedents (in this particular context, existential thinking is an important one), yet there seems to be a new interest in the idea of acceptance in practices of chronic illness interventions. Sometimes referred to as the third wave in cognitive therapy¸ practices of mindfulness and ACT  (Acceptance Commitment Therapy) have experienced a veritable boom in chronic illness intervention (cf Hayes et al., 2006; McCracken, 2010; McCracken & Gutirrez-Martinez, 2011). But the status of “acceptance” goes well beyond buzz word. In my presentation I will reflect on the concept of acceptance. The primary focus is on how it forms patients’ self narratives and enables/restricts agency.  These reflections are based on a broad framework of narrative and discursive theory (Potter, 2009; Garro & Mattingly, 2000; Mattingly, 2010; White, 2007). I will also point to further discussion of political implications of acceptance practices.

Based on empirical work from my PhD on pain, narrative and sociality (Johannesen, 2011), I will argue that the concept and practice of acceptance takes part in shaping the metanarrative of The Good Chronic (Pain) Patient. This metanarrative presents a normative idea of the selfgoverning, responsible, active, courageous patient, who insists on The Good Life In Spite of Illness.

A short empirical excerpt will be used to illustrate how “acceptance” is active both as concept and practice in patients’ narrative work. How the concept is resisted and creatively negotiated, thus potentially expanding our theoretical understanding of acceptance.

Reference List

Garro, L. & Mattingly, C. (2000). Narrative as Construct and Construction. In L.Garro & C. Mattingly (Eds.), Narrative and the Cultural Construction of Illness and Healing ( Berkeley: University of California Press.

Hayes, S. C., Luoma, J. B., Bond, F. W., Masuda, A., & Lillis, J. (2006). Acceptance and Commitment Therapy: Model, processes and outcomes. Behaviour Research and Therapy, 44, 1-25.

Johannesen, N. (2011). Smertens socialitet - Bidrag til nye forståelser af det lidelsesfulde i liv med kroniske smerter. Institut for Psykologi, Københavns Universitet.

Mattingly, C. (2010). The Paradox of Hope - Journeys through a clinical borderland. University of California Press.

McCracken, L. M. (2010). Toward understanding acceptance and psychological flexibility in chronic pain. Pain, 149, 420-421.

McCracken, L. M. & Gutirrez-Martinez, O. (2011). Processes of change in psychological flexibility in an interdisciplinary group-based treatment for chronic pain based on Acceptance and Commitment Therapy. Behaviour Research and Therapy, 49, 267-274.

Potter, J. (2009). Discourse analysis and discursive psychology. In P.M.Camic, J. E. Rhodes, & L. Yardley (Eds.), Qualitative research in psychology: Expanding perspectives in methodology and design (pp. 73-94). Washington: American Psycholoical Association.

White, M. (2007). Maps of Narrative Practice. W.W. Norton & Co.