Speaking Shame and Laughing It Off: Using Humorous Narrative to Conquer the Shame of Anorectal Illness

Patients with anorectal illness (AI) must deal with shame from social stigma and difficulties in the medical context. Recovering from shame is a challenge. Applying shame resilience theory (SRT) to the Chinese health care setting, this study explores how patients with AI develop resilience to shame using humor to facilitate the narrative's five functions. The method is a thematic narrative analysis of 60 stories from a Chinese online community. Four main themes were identified: understanding shame events, normalizing them, shifting priorities, and transforming shame into pride. Storytellers can use humor to externalize shame, reflect on their concealment and avoidance, eliminate the shame associated with making health decisions, re-establish shameless identities, achieve positive agency, and build illness communities through "aligning moments" with their audiences and subverting hierarchies of normality and abnormality.