Malignant Fictions: Workshop Report

The second workshop of the Illness as Fiction project, led by Dr Maria Vaccarella, took place at the University of Bristol on Thursday 20/9/18, and focused on fictional and autobiographical cancer stories. As my research considers representations of women’s bodies as divine, and the ‘pathologizing’ of female sexuality, I am a loyal attendee of Maria’s workshops. I am particularly interested in the idea that fake illness narratives often employ a narrative of salvation, or ‘saintly’ cures; a trope we often encountered in the first workshop. We started the day’s session with an ice-breaker which was, quite aptly, somewhat religiously-themed: with the help of Post-it notes, we anonymously ‘confessed’ whether we had faked an illness to get out of social commitments. The ‘confession board’ looked like this:

The fake illness ‘confession board’

After rejoicing that I wasn’t the only one who had lied about period pains, I wondered what separates such utterances from ‘malignant’ fabrications of illness narratives.


Maria, then, started by briefly introducing the project and the previous workshop, and by updating us on the progress of the project so far. She opened the day’s discussion with the provocative notion that fake illness narratives may be the purest form of illness narratives, as they present an illness which has no reality outside the text. Quoting the foundational essay by Susan Sontag, ‘Illness as Metaphor’, Maria reflected on the use of ‘prominent’ illnesses (such as cancer) as metaphors in cultural conversation, an ultimately damaging phenomenon for the people actually suffering from the illness, which alerts us to the difficulties involved in narrativizing illness.


During the morning session we had three presentations on different iterations of fake illness narratives. The first speaker was Louise Benson James, doctoral student in the Department of English at Bristol and Research Assistant for Illness as Fiction, who told us about her work to build a database of fake illness narratives. Ranging from literary to internet-based examples, her database is an effective way to find patterns in the illness narrative genre. Her database is divided into four categories: print texts, scholarship, Munchausen by Internet and online deceptions. Rather than trying to perform her own ‘hoax-hunting’, when it comes to internet sources, she decided to list only internet hoaxes that had already been disproved. Online hoaxes pose specific challenges, as the pages are often taken down once the creator is found to be lying. Louise’s project is ongoing, so more categories might emerge as the research progresses, and more texts will be added to the list!


Second on the lineup was Dr Sophie Stammers, Research Fellow at the University of Birmingham where she works as part of the PERFECT Project. This project, whose name is an acronym for Pragmatic and Epistemic Role of Factually Erroneous Cognitions and Thoughts, wants to establish the potential benefit to people’s social and/or mental wellbeing of beliefs that are false or irrational. Sophie spoke to us specifically about her work on confabulations, i.e. a story or explanation which is false but has no malicious intent, as it is based on a false memory or belief. Sophie interestingly connects confabulations with Fisher’s concept of ‘resonance’: the ‘confabulated’ explanation is such because it ‘strikes a chord’ with the speaker or their audience. Sophie raised interesting questions on the extent to which these kinds of confabulation have a positive effect on someone’s wellbeing and their social life, and what role they have in someone’s recovery narrative.


Last but not least, Dr Jurek Kirakowski (Cork) presented his work with Dr Aideen Lawlor on Munchausen by Internet (MBIs, feigning illness online) as displayed in Online Support Groups (OSGs). While OSGs are constructed to provide people suffering from a disease with empowerment, connection and support, they are also fragile, as they do not provide ‘tangible’ connections, and they are also fertile ground for MBIs. Jurek explained that MBIs display some of the psychological characteristics of the con artist, such as misinforming and causing hopelessness, in order to feed an emotional need. These practices have negative effects on real sufferers: some will edit their real accounts to conform more closely with the fake MBI’s account, and all users feel manipulated. One particular difficulty in detecting MBIs is that, once they are suspected of lying, they usually get expunged from online forums. Despite the many difficulties, one key characteristic Jurek identified is that they tend to define themselves by their illness, whereas genuine users usually want to move ‘beyond’ their condition.


The presentations sparked a lively discussion between the audience and the speakers, ranging from distinctions between a pathology of delusion and everyday instances of lying as social functioning, to the different paths of recovery in cases of confabulation and MBIs. These discussions in turn moved us smoothly to the more hands-on activities of the afternoon session. First, we tested the boundaries between fact and fiction by trying to guess whether a text was a novel or a memoir from reading selected passages. As someone who scored an embarrassing 3/10, I can testify that the boundary is more slippery than it might seem!


After this exercise, we considered ‘the clichés that cause the trouble’, in the words of Jeanette Winterson in Written on the Body, here with reference to the frequent use of clichés and specific metaphors in cancer narratives. Starting from a chart of cliché language and illness compiled by Jack Coulehan (‘paternal metaphors, ‘war metaphors’ and ‘engineering metaphors’), we moved to our next and final activity. Splitting into two groups, we joined forces for a collaborative textual analysis of two different excerpts from cancer narratives, The Fault in Our Stars by John Green, and ‘The Poetry Fox (and Other Tales from the Cancer Center’ by Nina Riggs – the former a novel, and the latter a memoir in blog form. We were tasked specifically with looking for the use of cliché language related to cancer, and whether there were attempts to overcome such language. These extracts led us to discussions about the nature of ‘telling’ illness, the possibility of subverting those clichés, and whether patients can really choose how to express their illness or feel like they have to conform to a specific vocabulary for their symptoms to be recognized and believed. A conclusion which leaves many interesting questions open for discussion at the next workshop!