Creative adventures and flow in art-making: A qualitative study of women living with cancer

Abstract

(Introduction) A diagnosis of cancer is recognised as highly fear-arousing. People not only face the discomforts of potentially disfiguring medical treatment but also confront issues of mortality. Even those who have completed treatment tend to ‘live with’ cancer for many years, because they remain subject to intrusive thoughts about cancer and concerned about possible recurrence and metastasis (Saegrov and Halding 2003, Laubmeier and Zakowski 2004). As well as creating worry and vigilance, cancer imposes what has been described as a biographical disruption (Bury 1982). After such a diagnosis, the person may feel that valued life goals are unattainable. The assumptions that guided life before cancer may be shattered and the person may feel disconnected from the familiar self, observing – from the avoidance or the pity of others – that only a stigmatised cancer identity remains (Frank 1991, Mathieson and Stam 1995). Facing such a combination of physical, emotional, cognitive and social stressors, it would seem difficult for people with cancer to construct a life of positive quality. Yet research studies suggest that many people devise resourceful coping strategies. Some people cope by reprioritising their goals to enjoy more authentic relationships and activities. Some even come to re-evaluate their illness as having catalysed certain positive changes (for example, Mathieson and Stam 1995, Carpenter et al 1999, Urcuyo et al 2005). However, previous research has tended to neglect the potential contribution of meaningful occupations to maintaining or regaining subjective wellbeing in cancer. Flow has been conceptualised as a particular type of optimal experience associated with ‘vital engagement’, a deep involvement in activities that are significant to the self and that promote feelings of aliveness or vitality (Nakamura and Csikszentmihalyi 2002, p83). To what extent vital engagement offers people living with cancer a source of subjective wellbeing has received little previous examination in the occupational therapy literature. This issue is addressed here.