Verbal and nonverbal communication of agency in illness narratives of patients suffering from medically unexplained symptoms (MUS)

Abstract

The objective of the study is to explore how patients presenting medically unexplained symptoms (MUS) - that is, symptoms that do not have an obvious underlying diagnosis - communicate agency. It is assumed that agency can be exercised verbally through narrative structure and content as well as nonverbally through patients' behaviours, in particular their gestures. This, in turn, points to the ways patients conceptualize their identities and selves. Pauses and disfluencies in the patients' accounts as well as an imprecise use of gestures can indicate a cognitive or conceptual conflict and uncertainty related to MUS. This paper reports on preliminary findings obtained from the analysis of 20 video-filmed interviews with Polish patients with MUS, and presents two case studies of patients who, despite fairly similar medical test results, deliver different illness narratives: (1) a narrative indicative of low agency and characterized by fragmentation, vagueness, repetitiveness and redundancy of content, dispreference markers and the imprecise use of gestures; and (2) a narrative reflecting high agency, characterized by specificity, coherence and the precise use of gestures.