Making sense of suffering: Illness meaning among somatizing Swedish women in contact with local health care services

Abstract

This qualitative study was performed with the aim of exploring structures of illness meaning among somatizing Swedish-born women. Patients in contact with local health care services were interviewed about illness experiences and beliefs. An analysis was made using a grounded theory approach, and results are presented in terms of the patient's versus health care's agenda of understanding. Health care emphasized a psychological agenda of understanding. For most participants illness beliefs and attribution changed from explaining bodily symptoms in terms of somatic origin to considering additional emotional and psychological explanations. Psychological conceptualizations came to be regarded as tools for understanding and as giving access to the use of new healing strategies. This process of change is a transformation of the cognitive system used to make sense of illness. Healing is a transaction across systems of meaning, and structures for meaning make the world comprehensible and predictable. For most participants construction of illness meaning was an active process of internalization and re-evaluation in which the extra-medical environment had a supportive role. These findings among native-born patients are discussed in relation to the migrants' situation of being uprooted, dislocated, relocated and having to encounter a new health care system.