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This paper offers an alternative to the conventional social/psychological definition of "coping." Using a theoretical framework of "illness trajectory," the authors examine the uncertainty of temporality, body, and identity inherent in coping with cancer. Analysis then turns to the interaction among these uncertain conditions and the complex work processes described by people with cancer, as they tolerate, i.e., "cope with," the disease. Although presented separately for purposes of clarity, these processes and their related activities are experienced in varying combinations and with varying and fluctuating importance by each individual. Viewed comprehensively, however, they constitute the larger process of coping with cancer, with implications for other diseases as well.
INTRODUCTION
As defined by Benner and Wrubel ( 1 989, p. 62; see also Pearlin, 1 989), "Stress is the experience of the disruption of meanings, understanding and smooth function. Coping is what one does about that disruption. Since the goal of coping is the restoration of meaning, coping is nota series of strategies that people choose from a list of unlimited options. Coping is always bounded by the meanings and issues inherent in what counts as stressful" (Benner & Wrubel, 1989, p. 408). An alternative perspective is that "coping, adjustment, and stress are terms that seem to us as either obscuring very complex biographical processes and work processes or as missing many of the interactional and sociological aspects of what is happening during downward trajectory phases" (Corbin & Strauss, 1988, p. 170). In this paper, we offer a "trajectory perspective", with its emphasis on work processes and their intertwining with interactional and sociological processes, as a way to view coping with a chronic illness. ("Process" is used here not to imply stages but in the sense of change over time.)
Tolerating the uncertainty of living with a chronic illness has long been of interest to social scientists (Comaroff & Maguire, 1981; Davis, F., 1963; Davis,M., 1973; Fox, 1959; Schneider & Conrad, 1983; Wiener, 1975; Weitz, 1989). Studies of the uncertainty surrounding chronic illness cannot avoid the self-evident proposition that all life is uncertain - that living requires coming to terms with uncertainty in much the same manner as described by people who are chronically ill: by developing strategies, balancing options and making choices. Chronically ill people,...