Blogs as Dialogical Reparatory Work: A Theoretically Informed Analysis of Online Cancer Narratives

Abstract

Globally, the World Health Organization (WHO) estimates that there are 20.6 million new cancer cases each year, and its incidence is expected to rise as the global population ages. At the same time, new technologies and advanced treatments are increasing survival rates, particularly in high-income countries. The need to understand cancer’s impact on psychosocial well-being and patients’ existential lifeworld is reflected in research, literature, pathographies, and other art forms. This article examines blogs as a distinctive arena for meaning-making, healing, and the articulation of cancer experiences. Through a close reading of three cancer blogs written by individuals with pelvic and colorectal cancers living in Norway, we examine illness narratives that often receive limited attention in private and public discourse. Drawing on Paul Ricoeur’s theory of narrative identity and configuration, we analyse how bloggers organise events, create meaning, and narrate their lives during potentially terminal illness. We also engage with Mikhail Bakhtin’s reflections on genre to explore blogs’ communicative character, heterogeneity of voices, and orientation towards anticipated responses. The findings suggest that cancer blogs function as intentional narrative and social resources during profound existential transformation. They also demonstrate that philosophical and literary concepts are valuable tools for analysing blogs as health humanities texts capable of capturing chaotic and disrupted illness stories.

1. Introduction

Cancer affects populations across all demographic groups and countries, and its incidence is expected to increase as the global population ages. At the same time, new technologies and advanced, personalised treatments are contributing to a growing proportion of cancer survivors, particularly in high-income countries. Cancer survivorship entails living with severe physical, mental, and existential challenges that can alter a person’s identity, and it is often impossible to return to the way things were (Harris 2019). The disruption of cancer often creates a need to process and voice experiences (Frank 1995; Gubar 2016; Jurecic 2012). Research on illness narratives has demonstrated that writing and sharing can be therapeutic by exploring existential aspects of living with and beyond cancer (Synnes 2016; Synnes and Bondevik 2024; Frank 1995; Hvidt 2015; Laranjeira 2012; McElearney 2019). While cancer was once considered taboo (Jain 2013; Sontag 1978), personal stories of cancer are now shared in autobiographies, novels, films, television series, and online media.

One significant and increasing genre for articulating experiences of cancer is personal blogs. In Norway alone, which is the context of this study, we found more than 200 personal blogs on Norwegian cancer organisations’ websites and blog platforms. As cancer blogs delve into essential questions regarding illness experiences, they are valuable texts for understanding cultural and personal attempts at meaning-making in the 21st century (Lamprell and Braithwaite 2019; Lian and Grue 2017; Lenemark 2019; Sadler 2022). Previous research on illness blogs has characterized blogging as providing agency (Nesby and Salamonsen 2016), a venue for performing “affective labour” (McCosker and Darcy 2013, p. 1267 referring to Hardt and Negri 2004), “shared ineffability” (Andersson 2019, p. 395), and “entrepreneurial,” generating added value beyond themselves (Stage 2017, p. 46). Research has also shown a tendency for cancer blogs to mirror positive ideals inspired by cultural representations of cancer, such as the “Pink Ribbon” breast cancer narratives (King 2006; Kvaale et al. 2022).

The growing influence of narrative approaches in health contexts has been criticised for privileging coherence and plot, thereby leaving less space for linguistic forms that are fragmented, affective, or resistant to conventional narrative organisation (Bleakley and Neilson 2024; Hyvärinen et al. 2010; Woods 2011). In this article, we extend this critique, together with previous research on blogs, by asking what these instantaneous and fragmented narratives—which differ from traditional narrative formats—do for writers and readers.

To understand the potential meaning-making and purpose that blogs facilitate, we turn to theoretical perspectives from Paul Ricoeur and Mikhail Bakhtin that will guide our analysis. Ricoeur’s (1992) perspectives on narrative identity and Bakhtin’s (1984, 1986) work on genre will help illuminate characteristics of the blog genre, in contrast to traditional pathographies and other more solitary art forms. Thus, theoretically informed by Ricoeur and Bakhtin, we address the following two research questions:

• How do blogs facilitate diverse narrative identity constructions among cancer patients and survivors?
• How does the blog genre allow for various voices, styles, and dialogues among cancer patients and survivors?

As such, a purpose of the article is to explore the ways in which perspectives and analytical concepts from Ricoeur and Bakhtin can be applied to blogs, and what results can be gained from such an analysis.

1.1. Theoretical Perspectives

1.1.1. Ricoeur on Narrative Identity

Ricoeur (1992) states that language and narration are fundamental to human meaning-making. Both metaphors and narratives are part of poetic language, a creative and expressive language that helps humans understand themselves in terms of potentiality. Subjects are constantly developing through engagement with stories and the linguistic resources of a specific culture. Ricoeur (1991) expands on the constitutive aspect of narrative in what he termed “narrative identity,” which is “the sort of identity to which a human being has access, thanks to the mediation of the narrative function” (Ricoeur 1991, p. 73). For Ricoeur (1984, p. xi), narrative identity is linked to time, specifically how we can make sense of (or humanize) time by organizing it via narrative structures: “I see in the plots we invent the privileged means by which we re-configure our confused, unformed, at the limit mute temporal experience”.

The creation of plots, or emplotment, is the process of configuring various events into an overarching structure that creates coherence and meaning (Ricoeur 1984). A central characteristic of emplotment is how it enables the reconfiguration of stories considering unexpected events or ruptures in one’s life. While these disruptions might challenge a person’s expected life trajectory or life story, through emplotment, they can be integrated into the story and provide a new direction. What was once a rupture becomes central to the story’s logic (Ricoeur 1992). Viewing the plot as a concordant discordance helps us to better understand identity, since the plot can be considered to involve two aspects of identity: idem (sameness) and ipse (selfhood) (Ricoeur 1992). The stability of the character defines identity as idem, someone recognizable as oneself, in permanence through time. Identity as ipse implies change in time, exemplified by being true to one’s word and fulfilling one’s promises, even if one has changed. For Ricoeur, the plot gives the story’s protagonist her narrative identity as an interplay between sameness and change over time.

Narrative identity underlines how the configuration of the plot might make crucial losses and ruptures throughout life meaningful or bearable (Ricoeur 1992). For instance, when a person experiences a severe illness, such as cancer, the disruptive nature of the diagnosis might involve reorganizing previous events to establish a new version of the self. This configuration allows for narrative meaning-making to be potentially therapeutic and cathartic (Ricoeur 1988). However, Ricoeur acknowledges that a narrative identity is vulnerable and might be threatened or even lost. It might be too difficult to make some events into a story. When a loss of configuration is experienced, it may feel as though random things happen with no narrative connection: “To the loss of personal identity corresponds a loss of narrative configuration and, in particular, a crisis of its closure” (Ricoeur 1991, p. 196). Ricoeur explains the loss of narrative configuration as ipse (selfhood), losing the support of the stable identity of idem (sameness). In our analysis, we examined how the blogs can allow for various narrative configurations of identity.

1.1.2. Bakhtin on Genre and Voice

According to Bakhtin (1986), genres are “certain relatively stable thematic, compositional, and stylistic types of utterances” (Bakhtin 1986, p. 61). Genres allow us to differentiate various literary forms. However, they also play a pivotal role in the social aspect of human life. By understanding language as dialogic, Bakhtin offers a way to look at the intentions and meanings of a text and its context. Bakhtin (1981) states that all utterances inherently possess a responsive character. This suggests that individuals who share narratives that draw on personal experiences must consider or be aware of the expectations of their potential audience. All language use constantly competes with others in dialogue, and it changes due to the highly social character of language. Bakhtin (1986) argues that all utterances are directed at someone, either an “immediate participant” or “an indefinite, concretized other”—a trait he calls “addressivity” (Bakhtin 1986, p. 95). This someone is a more or less physical other, the listeners or readers who simultaneously understand and shape the utterances. These reflections and concepts align particularly well with the characteristics of blogs, which accommodate both specific readers who might comment and engage with the blogger, and imagined readers who might potentially influence the ongoing blogging.

Another relevant concept from Bakhtin concerns “polyphony,” or understanding individual voices as a dialogue between multiple voices (Bakhtin 1984). In his work on narrative analysis, Frank (2012, p. 35) sees “polyphony as emphasizing how one speaker’s voice is always resonant with the voices of specific others—people whom the speaker listens to and whose response she or he anticipates. This concept helps us explore the innate attributes of the blog genre, which showcases a multitude of self-expressions shaped by both internal and external influences. Bakhtin (1984) initially described polyphony as “a plurality of independent and unmerged voices and consciousnesses” (Bakhtin 1984, p. 6), suggesting that an author may present not just one perspective but several simultaneously. Bakhtin’s argument on polyphony is grounded in his readings of Dostoevsky’s novels. We do not claim that his arguments are directly translatable to blogs; rather, they help us to see certain aspects of the blogs that might otherwise go unnoticed.

Cultural discourse profoundly influences our personal expressions through language, it is “half-ours and half-someone else’s” (Bakhtin 1981, p. 345). With this interpretation of language as heterogeneous in mind, we examined the internal dialogues and multiple voices emerging from the individual bloggers.

1.2. Context, Methods, and Analysis

1.2.1. The Blog as a Genre

The word “blog” originates from “weblogs” (coined in the late 1990s by Barger), which initially referred to texts published online that contained brief comments and links to news, media, and culture (Rettberg 2016). Soon after, the first personal blogs appeared, with longer texts and many similarities to online diaries: fragmented narratives that jump from topic to topic, recording the writer’s daily life in detail. In the following decades, blogs grew rapidly in terms of number and readership, as they were incorporated into daily newspapers and magazines. The genre’s emergence was partly connected to technological innovations but also to cultural momentum, and the milieu of the time, which was described as being coloured by a “mediated voyeurism” and the authors’ motivation to disclose themselves to a broad audience, to enlighten others and provide therapeutic benefits for themselves (Calvert 2000, cited in Miller and Shepherd 2004, p. 4).

A common characteristic of blogs is that each specific entry, or post, typically follows the convention of starting in medias res, with the most recent post displayed first when the webpage is accessed. Their frequency can vary from several daily posts to one every few months. The writer, or “blogger,” decides whether to use their full name, first name, or a pseudonym. They typically choose all the content, including photographs and links.

Another characteristic of personal blogs is that they are regarded as truthful descriptions of their authors’ experiences, akin to biographies. Bloggers have an implicit contract with their readers regarding the authenticity of their blog, which is broken if their writing becomes evidently fictitious (McNeill and Zuern 2015). This authenticity does not mean that blogs are not shaped: As Miller and Shepherd (2004) claim, “[t]he self that is disclosed is a construction” (Miller and Shepherd 2004, p. 9). Bloggers’ self-expression is influenced by what they choose to share and how they share it. However, actual or anticipated feedback from their readers encourages bloggers to address specific themes and emotions more frequently than others.

Unlike personal diaries and novels, blogs promote greater intimacy between their author and their audience by addressing their readers, and they usually allow their readers to communicate with their authors through the comment field, creating a more direct dialogue. Serfaty (2004), positioning blogs in the digital humanities field, describes this social element as a “co-production,” “the deliberate construction of the text for an audience that can respond to or to collaborate in the diarist’s project of self-presentation or self-construction” (Serfaty 2004, p. 465). The distance of the blogger from physical others may create a safer space—even more so if they use a pseudonym. Without anyone judging them, some bloggers share more than they otherwise would in the physical world, and they choose whether to disclose or keep secrets in a dialectic relationship with an unknown but ideal other (Serfaty 2004). Sharing personal experiences about severe illnesses, such as cancer, via blog provides bloggers—and, through comment fields, their readers—with powerful, rich insights (de Boer and Slatman 2014; Andersson 2019).

1.2.2. The Context of the Study

This study examines blogs written by women living in Norway with pelvic or colorectal cancer, conditions that remain comparatively taboo, less visible, and rarely discussed in public discourse. Although Norway is often understood as a gender-equal society with a developed welfare state and broadly accessible healthcare services, less visible forms of stigma and taboo remain attached to these conditions. Norwegian cancer discourse is also shaped by literature, film, music, and illness vocabularies from English-speaking contexts, including the cultural influence of Pink Ribbon campaigns (Pink Ribbon in Norway 2026).

The gendered corpus analysed in this article reflects a notable difference between men’s and women’s narratives, as women’s are more prevalent, while men’s are less visible in social media and on personal web pages. According to Album and Westin (2008), the silence around these cancers may be related to where these types of cancer are embedded in the body, areas culturally associated with purity and lust (Douglas 1966). Thus, cancers connected to the bowel, rectal, or reproductive organs are considered “culturally silenced” because they are attached to areas of the body associated with taboos, shame, and stigma. In contrast to breast cancer, we have yet to see a Norwegian celebrity come forwards and share their gynaecological cancer diagnosis on national television. Research in Norway confirms that individuals with gynaecological cancer feel “second-class” compared with breast cancer patients (Solbrække and Bondevik 2015). For instance, women’s experiences with hysterectomy—the most common procedure in the treatment of gynaecological cancers—remain understudied (Solbrække and Bondevik 2015).

1.3. Materials and Methods

The study comprises 31 Norwegian cancer blogs concerning pelvic and colorectal cancers. The blogs were accessed between November 2019 and February 2020. We chose these blogs because these forms of cancer have low visibility in both private and public spheres (Reynolds et al. 2018). As there are no blog registries in Norway, the blogs were identified through purposive sampling: the first author searched for texts via cancer associations, newspaper articles, social media, and targeted web searches, such as entering ‘uterine cancer blog’ into a search engine. Owing to the lack of male bloggers with these cancers, all blogs analysed for this article were written by women, a finding that is significant in itself as it portrays how forms of expression is gendered, but also that women may dominate in creating, adhering to, or changing the cultural narratives circulating in our society today (Kvaale et al. 2024). All material relevant to the research questions in the study was collected, organised, and stored in NVivo (Lumivero, Denver, US). All original texts were written in Norwegian and were translated by the research team.

Our analysis of all 31 texts has been presented elsewhere (Kvaale et al. 2022). Across the full corpus, a recurring theme was the bloggers’ reflection on how the defining moment of diagnosis altered their way of being in the world. The most frequently recurring themes concerned the existential uncertainty of living with and beyond cancer. The bloggers described the immediate chaos and trauma of diagnosis and how uncertainty subsequently became connected to all aspects of life, including everyday tasks, bodily interpretation, social relations, identity, and the ‘new’ meaning of life. Gratitude was also a recurring theme in relation to diagnosis, treatment, and care. It was often associated with having a potentially curable form of cancer, receiving an early diagnosis, or experiencing timely and competent support from individual healthcare professionals, hospitals, and the Norwegian health and welfare system. The relative absence of economic concern, reflecting Norway’s strong welfare state, is an important finding that differs from accounts by cancer bloggers outside Scandinavia. Gratitude was also connected to supportive relationships and networks (Kvaale et al. 2022). Another prevalent cultural aspect of the blogs was their frequent invocation of nature as a resource for hope and comfort; a pattern also identified in other research in a Norwegian context (Synnes 2014).

In this article we focus on three of the blogs as cases. They were chosen because they provide rich answers to the research questions in this article. Although the bloggers shared their work intentionally and openly with the public, we still secured their informed consent to use their blogs for this study, and we changed their names to pseudonyms to comply with privacy regulations which was required by the National Research Ethics committee. Norwegian privacy regulations prohibit citing specific texts where the author has not given informed consent. The quotations included in this article are therefore drawn only from individuals whom we were able to contact and from whom we obtained consent to use their words in publications. This restriction in the potential to refer directly to the blogs is a limitation of the analysis.

Case 1 is the blog of QueenDina, a woman in her 40s who began blogging after she was diagnosed with an aggressive form of uterine cancer. She lives alone, works as a journalist, and enjoys hobbies such as singing and acting. She blogged infrequently for one year, with more postings during her treatment. Her most recent blog posts do not indicate that she will discontinue the blog; however, as her health improves, she wonders what she should write about when she is “no longer half-dead” (6 November 2018). The way in which the blog is written is typical of the genre: diary-like, in the moment, seemingly unedited, and spontaneous. The blog includes a vast number of pictures, mostly selfies with her own comments. Sometimes, the comments on the photos are longer than the text in the post itself and contain short stories or jokes—almost like cartoon strips—about the author’s life at the hospital. Her content ranges from small details about food to what is read as more sincere and open posts about her treatment, pain, and loneliness. Communication in the comment field appears limited, suggesting that her blog is primarily read by colleagues and close friends.

Case 2 is the blog of PonderingTrine, a woman in her 50s who began blogging before being diagnosed with abdominal cancer. Her treatment necessitated the removal of all her abdominal organs, during which she nearly died. Since then, she has developed a substantial section of her blog dedicated to her illness and cancer experiences. She writes retrospectively, covering the period from a month after her cancer diagnosis to five years later, culminating in a post titled “Life Afterwards” on 23 January 2020. By writing new posts years after her experiences, she diverges from one key characteristic of blogs, potentially altering both the content and form as details may be forgotten, deliberately omitted, or edited. Still, most of her posts are written shortly after follow-up appointments, which serve as reminders and evoke fears of recurrence. PonderingTrine has a husband and adult children, whom she frequently mentions in her blog as her “support system” and “the loves of her life.” Her blog is still active, and several posts have been edited and published in magazines and newspapers with links to the blog. She and her family were even featured in a television documentary that followed her cancer treatment. After being laid off from her long-term job, mainly due to her illness, she now works as a freelance writer for newspapers and magazines and as a freelance photographer. Compared to the other bloggers in the material, PonderingTrine is more of a professional author than a typical blogger. After losing her job, her blog may be even more of a necessity than purely therapeutic. By writing retrospectively and editing with previous events rewritten into complete narratives, she distinguishes it from the diaristic writing that generally characterizes the genre. In addition, while bloggers are expected to share real-life stories and insights as they happen or come to mind, PonderingTrine has admitted that she sometimes bends the truth to improve a story.

Case 3 is the blog of GoHelene, who began writing the blog two weeks after she was diagnosed with bowel cancer in February 2015, which suggests that she began blogging in response to her cancer and treatment. In the first post, titled “The C-Word,” she clearly and descriptively tells her story, from when she started to feel unusually tired, to her reaction after she received “the message I feared most” (22 February 2015). She explains the diagnostic procedure to non-experts: for example, why a good, computed tomography result is essential. Her language is clean, unpretentious, and impersonal, providing what may be called a “technical account.” She discloses why she refrains from writing highly emotional posts. “I have always tried to have a long-term perspective on what I write. It should be ok to read both for my family and me, also in the future” (13 June 2015). She frequently creates lists, such as “The Ten Best Things About” (11 March 2015), and offers tips on avoiding boredom in the hospital, underlining her desire to share her knowledge with others. Her blog reflects many of the characteristics of the blog genre, as she describes her treatments, test results, and side effects in detail. She invites readers to follow her on Facebook and shares links to many newspapers, radio shows, television shows, and conferences where she has been featured. Thus, GoHelene started with her blogging, which turned her into a well-known figure in cancer survivorship. When she published a book based on her blog, she posted about it several times on her blog, stating in each post where it could be purchased. Even though it was just one book, she describes it as a dream fulfilled and as evidence that something good can come from her dreadful experience.

All three bloggers demonstrate at least semi-professional writing skills, which significantly influence the reader experience. Although they appear to target different (intended) audiences, their writing leaves a lasting impression, offering readers a sense of having gained valuable insights.

Analysis

In our study of the three blogs, we focused on what the bloggers expressed, with particular interest in how they expressed it and why they may have done so and how they entered into dialogue with their real or imagined readers. We aimed to explore various texts within the same genre to gain insights into how personal experiences with cancer are conveyed and to examine how online writing helps individuals to navigate the uncertainties of cancer while preserving their sense of self.

In analysing the material, we considered how plots (or the lack thereof) in the blog posts, along with their structure and the linguistic images and metaphors used, can be as central to constructing meaning in the stories as the content (Riessman 2008).

To understand what the blog posts attempt to convey, we regarded the texts as attempts to express existential transformation triggered by illness. We closely and analytically read the cases initially with a “hermeneutics of faith,” understanding and trusting in the texts as representing subjective experiences, as opposed to a “hermeneutics of suspicion” (i.e., a focus on texts as bearers of repressed hidden meanings and ideologies) (Ricoeur 1970). Thus, we investigated what the texts tell us about human life and what happens “in front of the text” instead of decoding or problematizing the texts’ possible hidden intentions (Felski 2010). However, we acknowledge the importance of cultural influences on the individual narratives and of our own horizons (Josselson 2004; Gadamer 1979). Therefore, beyond analysing the individual meanings in the three blogs, as well as their similarities and differences, we were also interested in how the blogs engage with and are shaped by cultural discourses, normative scripts, and actual and imagined readers.

2. Results

Our close reading of the three blogs with Ricoeur and Bakhtin as theoretical lenses revealed four themes that illuminate how blogs can be resources for people living with cancer: (a) negotiating narrative identity, (b) verbalizing loss of configuration and meaning, (c) providing a dialogue with the reader, and (d) opening a dialogue with oneself. The first and second themes show that narrative identity is essential but also vulnerable during an illness experience, while the third and fourth themes concern how blogs function as spaces for external and internal dialogues.

2.1. Negotiating Narrative Identity

Our three cases differ in form and content; however, they share the therapeutic aspect of reconfiguring a sense of self after a disrupting experience of illness, calling attention to how the blogs articulate changes and developments over time. Each case processes the writer’s grief over the loss of their past life and the potential loss of their future. Thus, each blogger uses their blog to integrate their past self into their present self and to construct a future self. Interestingly, descriptions of the physical and intimate side effects of their diagnoses and treatments are largely avoided in the blogs. This avoidance might suggest either a confirmation of taboos related to the areas affected by these cancers or that other parts of their experience, such as the existential, are more highly prioritised by the bloggers (Kvaale et al. 2024). Another interpretation is that the cancer per se is more impactful than the cancer type on their lives onwards. There are a few blog posts concerning infertility, especially by QueenDina, since she was childless before her cancer diagnosis. GoHelene shares a picture of her scarred belly and stoma bag, which was published in national newspapers, but she does not disclose details about living with a stoma.

QueenDina openly describes her reasons for writing a blog as therapeutic: to sort out her thoughts and to use the writing as a “survival strategy” (13 June 2018). She also reflects on how writing offers a way of “working through” a crisis that differs from how she acts in her everyday social life:

I have never been good at talking about such things. At least, not with tears flowing. [Instead, I become] completely silent and closed. I’m better at writing the shit out. But maybe, one day, I will be able to say what I really feel when I really feel it (…). However, by writing about this here [and] now, I have probably come a long way.

(11 August 2018)

She explicitly describes how writing her blog allows her to process her pain and frustration as a catharsis, making the writing itself a gateway for the outpouring of her emotions, which she usually struggles to express in physical encounters.

PonderingTrine uses her blog as a creative space, as seen in her narratives’ more literary form, as they read more like short stories. She consciously chooses to “express herself creatively”; after experiencing illness, she wants to live meaningfully and “tell stories about life” through words (25 April 2017). At the same time, her need to establish a new source of income makes the combination of these two aspects potentially rewarding. Her writing appears rough and direct, often employing short sentences. A typical example is the following passage, where she describes her return to the hospital for a check-up: “On the way in. But first, I look up at my window. The room where one after another moved out. I stayed behind. New samples. New drains. New complications” (22 September 2015). Her experience and ability as a writer make us wonder why she has chosen to write in the blog format in the first place. A possible reason may be precisely the therapeutic aspect of the format: It is a safe space where she can be vulnerable and still dwell on her cancer experiences years later without feeling compelled by those around her “to move on,” as she writes five years after her surgery:

Am I the only one who thinks everyone moves on? That yes, I continue, but a little slower, a little more scared, a little lonelier. They say I should get over it now and move on. That’s what the voices I listen to say. I think they are right that I must move on and forget the cancer.

(23 January 2020)

We acknowledge that PonderingTrine expresses her desire to move on, but at the same time, she needs those around her to recognize that she is still experiencing fear and pain. It may be easier to convey such a message in a blog or book. QueenDina has already explained how she struggles to engage in dialogue about her suffering, and many others may feel similarly, finding it difficult to open up and be vulnerable face-to-face. In a blog, they can even choose not to share their name and face, which can facilitate sharing without fear.

PonderingTrine’s memories sometimes appear suddenly, triggered by a smell or an image, causing her to relive painful sensations. The blog format allows her to immediately react to these sentiments by writing about them. She documents her bodily reactions to her surroundings in her blog, employing contrasts, as seen in the following passage describing her return to the hospital: “I know where I’m going. Enter the door and [go] to the right. Register at the X-ray counter. Then, blood tests. Past Narvesen [a kiosk]. The sweet smell of pastries. I think it smells like cancer. Blood. Death” (22 September 2018). In the quote, she combines the brutality of death with the recognizable and mundane pleasure of smelling pastries fresh out of the oven, turning the latter into something disgusting. The sensory impressions are conveyed almost simultaneously and bring a sense of immediacy to the reader, as they are placed in a single paragraph in a post written with an exact date and time. Furthermore, PonderingTrine’s short sentences and specific images resemble associations or a mosaic rather than the telling of a coherent story. The experiences and emotions are noted, rewritten, and reflected upon as she develops her narrative identity, moving from patient to survivor. She also exemplifies how Ricoeur sees narrative identity as vulnerable. Part of PonderingTrine’s pre-cancer identity frequently challenges the new self she has become (Ricoeur 1992).

GoHelene’s blog also reflects the genre’s immediacy, as she talks about her “need” to write down her experiences to process them and as a means of “getting kind of done with it” (14 March 2016). Moreover, by writing instead of talking to friends and family about her experiences, she feels spared the stress of having to repeatedly announce her condition and prognosis. As cancer takes centre stage in her life, she worries that without the blog, “all we’d talk about for the next year would be cancer” (8 February 2016).

GoHelene seldom writes about the existential aspects of her disease. When she does, she mentions them only briefly, such as “I have some heavy days … but then, there are all the good days” (24 March 2015) and “In September, I am scheduled to be healthy again, and we are already talking about everything we should do when this disease is just a parenthesis in [my] life” (22 February 2015). Here, she seems to believe that cancer will have a minor impact on her life and that she can return to “normal” after completing her treatments. Later, she revisits this approach of simply getting through it and instead lists the five most important ways she has changed. She further writes, “Life only moves forward. (…) I have worked hard to get in shape and get back to work, but not to get exactly where I was. It is impossible, and pursuing ‘becoming as before’ is doomed to fail” (29 May 2019).

2.2. Verbalizing Loss of Configuration and Meaning

An interesting finding is that the blog format may enable the verbalizing of a loss of meaning or narrative coherence. QueenDina, in particular, shares moments of despair, which she has previously described as challenging to put into writing. One striking example is when she expresses her frustration and anger at her situation by using capital letters and repeating the following exclamation 100 times:

• FUCKING HELL SHIT CANCER!
• FUCKING HELL SHIT CANCER!
• FUCKING HELL SHIT CANCER!
• (…).
(11 March 2018)

Indeed, QueenDina writes that she feels it is unfair that she contracted cancer at this point in her life, and she is furious but does not know how to alleviate her anger besides writing the blog, which provides an outlet. The swearing works as a release of frustration, resulting in QueenDina’s writing of a poem-like text containing her anger and bitterness but with no narrative configuration. We see here how blogs also provide a space for expressing and sharing strong emotions that might be difficult to fit into a story. In many ways, the example above illustrates the collapse of narrative time, where the blog post reflects only a desperate now.

PonderingTrine often writes to find meaning in the experiences she cannot control or indicates that part of her writing on the blog is in itself a way to take control of her uncertain situation (Kvaale et al. 2022). As she processes her memories and reflections, her writing skills develop from shorter descriptions of frustration and sadness to more existential reflections on what is essential in life and socially. During and immediately after her treatments, she shared that she was shocked by the way the world around her appeared as if nothing had happened. Bitterly, she saw that everyone continued their everyday tasks and laughed as before. For her, as she repeated in two of her posts, “I look the same. Everything is changed” (15 April 2015; 29 April 2015). The paradox of time is here expressed in an evocative way, where the reader is left with two separate statements and asked to fill in the missing parts, leaving an opening for an imagined story or a lost story.

Conversely, GoHelene involves her readers in her treatments at the hospital bedside but only minimally verbalizes her most challenging moments as they occur. One reason might be her fear of worrying or alarming those closest to her, or perhaps she wishes to maintain some distance, keeping her readers from coming too close.

2.3. A Dialogue with the Reader

Of the three bloggers, GoHelene most explicitly writes directly for her readers. She uses the second-person pronoun “you” in many of her posts to address her readers. She communicates her experiences by explaining them to others and offering advice to those with similar experiences. She also asks for and receives advice and support from her readers, such as series to watch while in hospital or motivation to stay positive when waiting for results. Generally, she writes with an overwhelmingly positive tone, as in the following:

[F]or me, in the weeks that have been and all the weeks to come, I really appreciate all good thoughts and words. [I] get a lot of [those]. I can’t answer everyone, but it means a lot, so thank you very much!

(22 February 2015)

Indeed, GoHelene generally does not use emotive language, preferring to keep her tone easy-going and optimistic. In several posts in her blog, she explicitly says she wants to show her readers that it is possible to live quite a good life even with cancer. She feels lucky to handle things as she does and tries to keep her spirits high for herself, those around her, and her readers: “Your body can handle more than you think; it is strong” (22 July 2015). She publishes posts with titles such as “Everyday Pleasures” (25 April 2015) and “Doing Things You Don’t Know You Can Do” (28 August 2015), in which she recounts climbing mountains and even running a marathon. GoHelene believes that she could overcome her disappointment about not being able to have the third child she wanted, due to her cancer, by looking at the bright side:

The cancer treatment meant that we could not have more children, even though we really wanted to. It has not been easy to accept, but it is how it is, and we are so insanely lucky to have the children we have [that I] think we [just] have to make the best of it.

(16 June 2016)

In a later post, GoHelene states that she has received feedback on her attempts at looking at the bright side from readers who perceive her blog to be so happy.

GoHelene responds by writing more about her diagnosis and the disruption and uncertainty that followed it. Even so, GoHelene stays true to the optimistic basic tone of her blog and underlines that although she would not have chosen to get cancer, it had given her new experiences, encounters, and opportunities: “It’s fascinating how good things can actually come out of really dreadful, bad things” (16 August 2015).

QueenDina conveys a similar message in some of her posts, though in fewer words and often by underlining her new outlook on life as something not to take for granted: “Life is so incredibly fragile. That is why it is so important to allow oneself to be present. Dare to do what you dream of. Complete what you believe in. Alternatively, turn around if something feels wrong” (3 August 2018). Moreover, she says her blog helps her to verbalize emergent issues and manage the loneliness she feels: “I also choose to be open about this because I need all the support and encouragement I can get. No one should go through this alone. At least I know I need you! So, thank you for being here” (27 November 2017). The positivity in this quote somewhat contrasts with the vulnerable, painful, and angry posts she has previously shared. This dialogic expression could imply that she simultaneously holds both perspectives, experiences them at different moments in time, or is consciously choosing not to scare her readers away or feel sorry for herself.

The three bloggers do not refer to each other’s blogs or any of their readers directly in their posts. Still, sometimes they mention that they have received feedback, though we do not know how or from whom as they are not visible in the comment fields.

PonderingTrine communicates directly with her readers regarding one subject: when promoting her magazine articles or the documentary. Thus, this could be seen as a promotion more than a dialogue. Her language is generally more professional, literary, and written less in medias res, and her posts are often structured more like a traditional narrative, with a beginning and an end. Similar to someone who authors books, she seems more interested in writing a good piece and expressing her feelings in a truthful yet poetic manner than in interacting with her readers. We could interpret this as her way of establishing her new writing career and an indication that the blog is more of a means to that end.

2.4. A Dialogue with Oneself

In our analysis, we saw how the bloggers not only engage in dialogues with real and/or intended readers, but also with their own previous posts, as well as memories of past experiences and emotions. This allows them to express their identity as a plurality of selves (Renedo 2010). Sometimes, the differences in self-representation between posts are so large as to make them appear to be different “voices,” such as when the anger expressed in one post can be entirely dissipated in the next. QueenDina’s blog contains the most contrasting voices. Her posts are filled with ups and downs. In one of her more easy-going and mundane posts, she ends with the following passage in parentheses that directly turns into an analysis or metacommentary of her reaction to cancer, meant both for herself and the reader:

(Yes, I know it might sound like I’m in relatively good shape right now. It’s just a “survival mechanism.” The truth is that I feel very small, scared, weak, and alone right now. The pain and side effects of this chemo round have been much stronger and more severe than before. Yesterday, for example, I literally had to crawl when I was going up the attic stairs)

(21 June 2018)

In another example of QueenDina’s contrasting voices, she says that although she feels weak and sad, she firmly believes in staying strong: “Life has turned really brutally upside down, but I refuse to let this break me” (27 November 2017). She actively and consciously uses humour to keep her greatest fears and loneliness at a distance, claiming that “humour and self-irony are underrated medicine” (12 June 2018). The contrasts may certainly be descriptions of the chaotic moments she is experiencing. It may also be that she is unsure about which coping strategy—unloading screaming, crying, or joking—will provide the most relief. Any of these strategies may be pertinent in that particular moment, and all these reasons are equally interesting when describing life with cancer. Additionally, as genre is of particular interest in this article, it could also be an integrated response to more cultural ways of expressing illness, suggesting that QueenDina wishes to be perceived as strong and positive in facing her cancer.

PonderingTrine was initially angry and frustrated that those around her did not understand her situation. However, this changed as time passed: “It’s been half a year. It’s been a lifetime. It has been painful and lonely. At times bitter. But life going forward has taken on a new meaning. The bitterness is gone. The pain and loneliness too” (15 April 2015). Later, years after the onset of her disease, her worldview shifted even further, from the previous bitterness to an awakening:

And maybe it’s so that cancer has given me a greater sense of freedom that I no longer care so much about what others think. Maybe it has also made me happier about the small things, those that do not mean anything to others but make me warm and fuzzy, deep, deep inside of me.

(31 July 2018)

The diverse voices PonderingTrine expresses may describe valuable illness narratives from the onset of the illness, through treatment, and into the many years afterwards. Thus, her changes in voice convey a journey through time, from being acutely ill to navigating the aftermath with mental and physical scars.

We can observe the attitude of staying strong and positive in the bloggers’ dialogue with themselves as they seek to motivate themselves or regulate their darker thoughts. For instance, QueenDina frequently interrupts her writing about pain and suffering with positive remarks, such as when she is struggling with chemotherapy and the doctors are considering trying another type of therapy:

[I]t has been so bad that I have been really anxious about a new round, especially if it should lead to me becoming as ill [as] or worse than I have been now. It has been so bad that I have considered refusing [further treatment] (…) Otherwise, the weather has been good the last few days, and I have managed to enjoy it with terrace life, barbecues, gardening, and good company. So, everything is not just grief, after all.

(4 July 2018)

As mentioned, GoHelene seldom shares her most intimate thoughts and emotions in her blog. She is actively involved in providing information and advice to other cancer patients and their loved ones. She shows a brave face most of the time and lets us into her hospital bed and treatment rooms without sadness or anger (besides “giving the finger” to cancer). She is more reserved on her blog and thus appears to have a different “need” for the blog than QueenDina, perhaps because GoHelene has a husband and family around her with whom she communicates more openly.

3. Discussion

Our analysis shows how the three bloggers utilize the blog genre to negotiate and perform vital identity constructions in close dialogue with their readers and themselves. In the following, we highlight how these ongoing negotiations can be seen through the lenses of narrative identity, moral identity (Ricoeur), and genre theory (Bakhtin).

3.1. Narrative Identity Constructions in the Blogs

In his discussion on narrative identity, Ricoeur turns to literature to exemplify various identity positions. He argues that the loss of configuration is something we rarely find in everyday experiences and narrations, thus requiring insights from fiction to shed light on this phenomenon. One notable finding in this study is how the blogs can address a loss of configuration or a loss of narrative: for example, when QueenDina writes, “FUCKING HELL SHIT CANCER!” 100 times. The blog exemplifies how what cannot be expressed elsewhere can be put in writing and given a space. Here, we also find a clear parallel to Frank’s (1995) “chaos narratives”: some experiences are too stressful to be expressed in language or take such a form that others are not capable or willing to receive the message. For Frank, chaos narratives are “anti-narratives,” because the chaos makes storytelling impossible. This is also connected to temporality, where narrative progression is replaced by an “incessant present with no memorable past and no future worth anticipating” (Frank 1995, p. 99). Considering this, we see how the blogs can show and contain this lack of narrative configuration as it occurs and give form to the meaninglessness. In her study of Swedish cancer blogs, Andersson (2019) refers to a similar aspect as the blogs’ “shared ineffability”:

through the digital, network technology, an affective communication is performed, where not only language but also the deficiencies of language—and the shared ineffability—is valuable and meaningful as part of a late modern approach to death.

(Andersson 2019, p. 408)

Our analysis of QueenDina’s blog reveals how the blog format might enable the sharing of the ineffable.

One final aspect of narrative identity in the blogs is how they can “humanize time,” by portraying temporal experience (Ricoeur 1988, 1992). One striking example is how PonderingTrine repeats the phrase “I look the same; everything is changed” (15 April 2015; 29 April 2015) in two blog posts. This phrase contains complex experiences of the time that has passed after intensive treatment, which can be read as a highly condensed narrative in which two disparate events are juxtaposed to address a long and complicated cancer experience. How the bloggers comprehend and describe time is essential to developing new perspectives on their situation and identity. For some bloggers, this entails consolidating a survivor identity in time through their blogs, providing what Hawkins (1999) calls a “longitudinal view of illness” ( Hawkins 1999, p. 129).

Another way that the blogs expand or thematize time is mostly in the here and now, which not only makes the blogs non-linear but also gives the bloggers and readers insight into what is experienced in a moment when they do not know what will happen. Besides the anomaly of PonderingTrine, this aspect differentiates blogs from pathographies, written after the fact—when the outcome is known. As such, blogs give their writers agency and help them shape their narratives as they write. The blogs can thus offer a space for existential meaning-making by thematizing time passed and time lost that otherwise would be left unspoken.

3.2. A Genre That Opens for Dialogue—With Others and Oneself

Blogs differ from other narrative genres with regards to their inherent social dimension and how they involve a dialogue between blogger and reader (Serfaty 2004). This dialogue can be immediate, as readers can respond to a post seconds after it is published on the blog. This feedback influences the blogger, helping to shape their posts going forwards and, thus, the landscape of the blog. Moreover, as Bakhtin (1981) emphasizes, context is crucial for meaning making on multiple levels. Thus, blogs should be evaluated regarding their impact on writers and readers. These interactions are deeply intertwined, and shaped by, prevailing cultural norms and values, and together they form part of the relational and cultural conditions through which illness experience is articulated. The direct and social qualities of blogs are therefore especially valuable for examining how illness narratives are shaped by prevailing norms of communication, metaphors, values, and taboos within cultural contexts.

All three bloggers are conscious about sharing their texts but differ in how they consider their imagined readers. PonderingTrine and GoHelene write their posts in a way that could engage anyone, even though they seem to appeal to write towards different audiences. PonderingTrine writes skilfully, applying literary techniques, while GoHelene uses more straightforward language and seems to aim for a broad general audience. QueenDina appears to use her blog more as a trusted online friend. These bloggers’ different perceptions of their imagined readers influence their narrations in how they filter their texts: whether to hold back or share their emotions. The real readers are only visible to us in the direct responses in the comment field, although certain posts indicate that the bloggers also receive feedback from readers via other social media platforms, phone, or mail. Our impression of the readers, based on the comment field, is that they mainly offer support and motivation, posting comments such as “stay strong,” “get well soon,” and “you can do it,” as well as many heart emojis. The fact that there are actual readers may influence the bloggers with regards to what and how they write, but it may also keep bloggers from feeling depressed or lonely (Kvaale et al. 2022).

At the same time, our cases reveal that although showing vulnerability is acceptable in illness blogs, soliciting pity is not. The bloggers’ reluctance to discuss matters affiliated with taboos and their intention to stay strong or positive are examples of cultural narrative influences. The Pink Ribbon movement from the United States has likely influenced cancer narratives in Norway and the Nordic countries; indeed, Norway has similar campaigns, for example targeting prostate cancer and the associated Movember campaign. Metaphors of battle and narratives promoting optimism and heroism in the face of illness are deeply ingrained in Norwegian cancer blogs (Kvaale et al. 2024). However, personification also appears alongside these conventional expressions, giving cancer human characteristics, providing the bloggers with an outlet for fear and frustration, including sadness and anger, and thereby departing from narratives centred solely on heroism and positive thinking.

As reflected in our material, however, all three bloggers emphasize the importance of avoiding excessive pessimism. While the authors share some of their darker sentiments, they do so to varying degrees and often interrupt these reflections with positive remarks. This may reflect the cultural trend of positive thinking, which recognizes optimism as a critical element of healing (Ehrenreich 2010; Youll and Meekosha 2013). The reluctance to express negativity may also reflect an effort to avoid alienating potential readers. Consequently, the drive to remain positive and express gratitude emerges not merely as a personal inclination but as a broader social norm to avoid the gruesome and less optimistic sides of cancer (Ngai 2005). Blogging may thus be considered a balancing act between the bloggers’ existential uncertainty and despair on the one hand and their optimism and hope on the other. Further, the development of breast cancer norms in other cancer types, called breast-cancer-ization (Bell 2014), is visible in our corpus. Thus, the particular cancer types are seldom the main focus; instead, more existential subjects are prioritised.

Following Bakhtin, we understand identity, communication, and language as fundamentally dialogical. Blogs are particularly well suited to make such dialogical processes visible, because the genre allows, to a particular degree, for reader interaction, intercalated narration, and self-reflective writing. Rather than treating polyphony only as a feature of genre or voice, we use Bakhtin, as interpreted by Renedo, to understand how a plurality of selves and perspectives may be articulated within the same illness narrative. Renedo (2010) explains how social representations and knowledge are constructed through multiple, often contradictory, voices and perspectives: “Bakhtinian positioning enables the person to move along many locations and relationships in the social fabric simultaneously existing in multiple inner and outer dialogues through which a sense of self and knowledge about the world are mutually co-constructed. The polyphony of the person leads to a multiplicity of co-authorships in the co-construction of self and knowledge, and explains the plurality of the ontological, as well as the epistemological” (Renedo 2010, p. 15). In QueenDina’s blog, for example, this polyphony emerges through a self-reflective and dialogical style of writing, enhanced by the possibilities of the blog genre. She writes in ways that show internal conflict and present multiple sides of an illness experience without resolving them into a single authoritative perspective. As such, the blog becomes a space in which cancer experiences can be expressed as complex, ambivalent and shifting, including hope, gratitude, fear and despair—often in the same post.

3.3. Repairing Through Sharing—From Narrative Identity to Moral Identity

One reparatory aspect of the blog genre lies in the opportunity it gives bloggers to be vulnerable and constantly reflect on their identities, even when they feel like these identities are dissolving. In Ricoeurian terms, writing may thus function as a defense against annihilation, sustaining a fragile narrative identity at precisely those moments when coherence, continuity, and self-recognition are most profoundly threatened. Similar to diaries, blogs act as spaces in which authors can process situations in their changing surroundings that are physically and mentally challenging. The blog format allows for distinct configurations, including expressions of despair and a multitude of voices as they engage in dialogue with themselves and imagined and existing readers (Bakhtin 1984).

An essential aspect of the bloggers’ motivations is to leave something behind that can change something for someone else. As GoHelene explained in her first blog post, she started the blog to share her experiences to educate and inspire people by showing them that it is possible to live a joyful life despite having cancer. The fact that the texts live on, regardless of what happens to their author, is part of what Ricoeur (1984) calls “refiguration”—that is, the story reaches its conclusion in the reader.

Another aspect of the blogs is how they can enable an ethical commitment towards others amid despair. According to Ricoeur (1992), a person who experiences a loss of story and narrative configuration will struggle to find an answer to the existential question “Who am I?” Instead, Ricoeur suggests that this question be replaced with the declaration “Here I am!” which transcends the subject and expresses responsibility and care for others. Ricoeur views this as a fruitful tension between narrative identity (Who am I?) and moral identity (Here I am!). Our analysis suggests that being useful or helping others allows these bloggers to do something and gives them a sense of purpose in situations where uncertainty dominates their lives. When they are in despair, they can hold on to the hope that something valuable may come from their “dreadful” (to quote GoHelene) experiences. Thus, we argue that the bloggers’ motivations to aid others by sharing their experiences can be viewed in relation to Ricoeur’s description of the ethical aspect of identity—and that doing so can provide important insights for themselves and for others. Thus, as long as they are writing their blog, they may have a sense of purpose.

4. Closing Reflections

Blogs have emerged as a powerful medium for individuals to articulate their experiences, particularly regarding illnesses like cancer. They offer a unique platform that enables several critical functions in meaning-making and the negotiation of narrative identity. Through the lenses of Ricoeur and Bakhtin’s theories and analytical concepts, we have explored how blogs allow for important identity and existential meaning-making when living with cancer.

Firstly, blogs facilitate the articulation of temporal experiences over time. This allows individuals to document and reflect upon their trajectory through illness, capturing the progression of their experiences and emotions. By doing so, bloggers can continuously shape and reshape their sense of self in response to the evolving nature of their illness. These blogs allow us to explore how time is perceived and captured in the present as changes occur, as “time becomes fragmented and is no longer linear and coherent” (Bondevik et al. 2016, p. 6). This temporal aspect is crucial, providing a structured yet flexible way for individuals to make sense of their experiences over extended periods.

Secondly, blogs provide a space for articulating complex emotions such as frustration, anger, and fear. The blog format accommodates texts that may lack a traditional narrative configuration, allowing for a more raw and unfiltered expression of feelings. This flexibility can illustrate where the narrative breaks down or halts, mirroring the chaotic and non-linear nature of living with a severe illness. We argue that the episodic nature of blogs may correspond more closely to writers lived experience than traditional narrative forms. By allowing experiences to be articulated in fragmented and non-linear ways, blogs invite readers to attend to expressions of desperation and fear that might otherwise remain unvoiced.

Such honest portrayals may be meaningful for the writer and may resonate deeply with readers who recognize similar emotions. Moreover, blogs enable a dialogue with the self, in which the individual voice becomes visible precisely through fragmentation, while the act of writing gradually gathers dispersed experiences into the contours of a possible new coherence.

This self-dialogue is a form of introspection that can lead to greater self-awareness and understanding. By articulating their thoughts and feelings in a public forum, bloggers can confront and process their experiences in a way that private reflection may not allow. This visibility of one’s narrative can be empowering, providing a sense of control, both over their experience and the cancer itself, in the face of illness.

Finally, blogs facilitate a dialogue with others, offering support and meaning both for the blogger and their readers. This interaction can transform a personal narrative into a moral identity, where shared experiences contribute to a collective understanding of illness and coping. Readers can provide feedback, encouragement, and empathy, creating a supportive community. This communal aspect not only aids in the emotional well-being of the blogger but also helps to destigmatize illness and foster a broader cultural conversation about health and disease. Blogs thus serve as a multifaceted tool for individuals navigating the complexities of cancer. They allow for articulating temporal experiences, expressing difficult emotions, self-dialogue, and meaningful interactions with others. These functions highlight the significant role that blogs can play in the personal and collective processes of meaning-making and identity formation in the context of illness. These narratives of experiences from cancer diagnosis to cancer survival offer valuable insights for healthcare personnel, other cancer survivors, and their loved ones.

For the medical and health humanities, the exploration of narratives in digital media broadens our understanding of the genre of illness narratives to capture diverse illness experiences. By recognizing dominant scripts and ideals of cancer survivorship, we can compare and broaden their influence in a local context. As depicted in this article, many norms from Anglo-American cancer survivorship are visible, e.g., norms of positive thinking and staying strong. However, the bloggers also sometimes refuse (either by themselves or when reminded by readers) to be defined solely by dominant scripts. They are often aware of, and critical towards, the taboo connected to certain words and subjects concerning their illness and strive to find nuanced ways to express cancer survivorship. Explorations like these might be particularly relevant in the developing field of medical humanities in the Nordic countries.