Family illness narratives of inherited cancer risk: continuity and transformation.

Family narratives of genetic disease address multigenerational legacies of illness, guide expectations about future diagnoses and anticipated losses, and promote continuity and coherence. Yet contemporary families with histories of genetic disease face the challenge of integrating long-standing family illness narratives with technological advances in the detection and treatment of the identified disease. The authors recommend the use of narrative methods to (a) integrate multiple or competing perspectives into a comprehensive story of the illness experience, (b) accommodate historically based illness narratives to modern technological advances that enable novel trajectories, and (c) identify pathways to sustained physical and mental health through enhanced medical decision making. A case example illustrates the use of a medical genogram to track patterns of illness expression and narrative construction over multiple generations, and implications for family therapy and research are discussed.