KARNILOWICZ a social phenomenon (Spry 2001). It is a narrative of per- sonal experience and is also used in this instance to con- front dominant forms of representation and power in an attempt to make room for marginalised spaces (Tierny 1998). For example, Foucault (1980) proposed that profes- sionals and specialists in possession of expert knowledge have the power to control over those with less power and are able to regulate society by prescribing actions and discipline. This power differential is especially evident in the health industry (Tang & Anderson 1999) and enacted within the associated hospital consulting rooms, local doctors surgeries and health clinics. Within this model it is important to consider that professionals and patients often interpret the reality of illness or disease differently. Therefore, the analysis of illness or disease from the per- spective of the less powerful through an examination of a patients’ lived experience of their illness (Sweeney et al. 2001) is as necessary as it is valuable. Autoethnography enables one to examine meaning through their lived expe- rience and this is an investigation of the personal experi- ence of psychological ownership and how it is constructed when confronted by a life-threatening disease. Included is an account of the nature of the practitioner–patient relationship, which is importantly considered within ownership. While autoethnography promotes this search for meaning, it does not prescribe method. Instead, autoeth- nography falls on a continuum between art and science (Ellis 1999). The approach is subjective and personal although one’s self-revelations necessarily involve revela- tions of others (Ellis 2007). Consequently, there is the need for considered self-censorship (Philaretou & Allen 2006) within an ethic of care (Ellis 2007).The task is to know and understand what psychological ownership and identity means. In short, it is an examination of the con- struction of identity and ownership. This study examines a socially constructed reality interpreted from the perspec- tive of one who has experienced a life-threatening disease. It is not meant to be self-indulgent or selﬁsh but serves to present a unique albeit shared view of that ‘reality’. In short, self as an autoethnography is the autobiographical narrative individuals use to explain and account for their personal life world (Clarke & James 2003) within a cul- tural framework. The validity of this narrative is deter- mined by the degree to which the reader as participant accepts it as truthful and meaningful. D I S C U S S I O N Notions of identity and psychological ownership are inex- tricably linked. Identity is socially prescribed and con- 278 structed within a system of symbols, values and beliefs represented and enacted through an individual’s behav- iour and associated cognitive processes. These symbols, values and beliefs in turn are mediated through the active experience of psychological ownership (Pierce et al. 2003). This process constitutes a ‘single’ reality constructed as a singular ‘whole’ with the cultural, the social and the self considered as one. With a life-threatening disease or chronic illness, the process of psychological ownership is often instigated by an epiphany as a sudden revelation, turning point, signiﬁ- cant life event, experience, critical juncture or realisation within a signiﬁcant life event (King et al. 2003). In this instance the epiphanic moment was a response to the initial diagnosis, the latter represented and expressed through the words and actions of the GP in the ﬁrst instance and then followed by the urologist. As was the case in this instance, epiphany moments are rarely planned, often unpredictable and uncontrollable and may result in a fundamental shift in the meaning, direction or purpose of one’s life (Rasmussen et al. 2007). In short, the experience alters an individual’s concept of self and view of life and leads to new levels of insight (Goud 1995). Culture and the associated social context are the bases for psychological ownership related to illness and disease state. In this sense, the essence of health care is a cultural construction borne out of a physical and physiological reality developed from beliefs about the nature of disease and the human body. However, different cultures with varying concepts, aetiologies and deﬁnitions of health have different systems and methods for deﬁning good health and understanding treatment (Farrell et al. 2004). Therefore, the management of illness is multidimensional and involves a complex interplay of personal, cultural and social circumstances (Townsend et al. 2006). More to the point is that culture is embedded within an individual’s perceptions and processes in interpreting information (Matsumoto & Juang 2004) and in the way meanings are formulated (Ratner 1997). In particular, cultural beliefs inﬂuence an individual’s sense of control and self-efﬁcacy related to the illness or disease state. Nonetheless, the biomedical paradigm involves experts who take control, problematise, label and treat according to a prescribed symptom(s). The cause of the problem and a patient’s identity are rarely considered or addressed. Chronic ill- nesses are therefore objectiﬁed and often hidden behind the doors and within the walls of the clinician’s ofﬁce. The systemic aspects of healthcare professional and patient relationships are positioned within interpersonal communication and the power of discourse. Different cat- egories of relationship exist (e.g. patient-driven, collabora- © 2010 Blackwell Publishing Ltd