‘There is nothing beautiful or life-affirming in it’: experiences of harm in a narrative course combining rehabilitative and palliative care approaches for people who have or have had cancer

Abstract

Narrative methods have been shown to help people with cancer to create meaning, find hope and restore a sense of coherence in life. Likewise, the combination of rehabilitation and palliative care for people with life-threatening illness is receiving increasing interest and is generally perceived as beneficial for patients. Four narrative courses combining rehabilitation and palliative care approaches for people who have or have had cancer were carried out in Denmark between 2021 and 2022. An ethnographic field study revealed that some of the course participants experienced harm during the courses and therefore chose to withdraw. Findings show that a rehabilitation approach dominated in the courses and that the participants’ experiences of harm occurred in a complex interplay between the participants, the professionals and the specific narrative exercises. While some participants’ stories were recognised as legitimate and meaningful and were continuously supported and encouraged, other participants’ stories of suffering were suppressed.