Narrative Functions to support the meaning-making process during cancer traumatic experience in pediatric oncology

The onset of an illness such as acute lympho¬blastic leukemia in pediatric oncology is considered a traumatic event, not only for the child, but also for parents accompanying their child’s difficult thera¬peutic process; a child’s cancer is seen as a “family illness” with consequences that affect all its members. The psychological trauma, within a socio-constructivist and semiotics perspective of the mind, is related to the sudden and unexpected alteration of the basic elements that regulate the relationship between the subjects and the external world and to a crisis of the meaning processes that support the personal life story. This crisis of meaning destabilizes the subjective time perspective which is characterized by divisions, fractures, fragmentation, uncertainty towards the future, feeling of interruption and suspension of life, inability to reformulate past experiences that may persist over time. The narrative becomes the most important device to support meaning-making processes and for the reconfiguration of time perspectives aimed at supporting the traumatic experience, healing and development. Within the narrative paradigm, researchers highlight the existence of different types of narratives: narratives that fulfill a transformative function and integration of experiences and the construction of new meanings and narratives that do not pertain to that function. The narrative and the quality of the narrative output, in its form and in its content, convey different narrative functions that become indicators of a good, or not, process of construction of the meaning of experiences and integration of traumatic experiences. In our opinion we believe that the narrative output does not always it is transformative and healthy for the subject and therefore we consider necessary that the narrative, as a process, can be configured, within clinical settings, such as drivers of the transformation of meanings and regulation of the experiences. More frequently it is observed as the traumatic experience, especially in its beginning stage, be involved in and be put into words, we could say physiologically, to a disorganized and chaotic narrative. We believe that this represents a physiological passage where the narrative is disorganized or chaotic, however, a way of meaning and a way to manage the phases of shock and annihilation related to the beginning stages of such conditions. Our aim is to reflect on the construction of a diachronic model capable to highlight the narrative functions of support to the process of meaning-making for parents that accompany the traumatic experience of a ill child. Integrating the contributions proposed by the narrative therapy and our research findings we present a narrative model, a set of compasses that guide the process of meaning-making of the traumatic experience, where the narration, in being a clinical device, fulfills and carries out various supportive functions to the meaning-making processes: Putting the Shattering and Annihilating Experience Into Words; Reordering the Events; Connecting Emotions and Events; Reevaluating the Event; Reconstructing the Time Process. In the first time, the narrative device contains and gives legitimacy to the pain without being able to scare and then fulfills a reconstructive and transformative function. Identify the different functions do not represent an ideal model of narrative into which lead parents but bushes and trajectories that can guide the clinical action towards subjective development areas. The operation of the fragmentation of narrative functions responds to a logic aimed at breaking up functions to re-construct the process. We believe that the promotion of the elaboration of the traumatic experience is the sum and the synergy of all aforementioned narrative functions designed to make past the experience and be able to build new meanings, on the basis of experience, and new synthesis between continuity and discontinuity of life. We believe that this diachronic support should not develop within a predetermined time or at least that this can not be defined a priori in a generalized way, but we can say that it develops in relation to the time of the illness and to the transiency of the meanings in the flow of time.