“I changed, I had to realize that I was wrong”: Identity gap management amidst evolving illness uncertainty

Doubt that a family member’s health issues are real, severe, or even possible entwines some of the most challenging aspects of medical, personal, and social uncertainty. Although several studies have examined doubt, this investigation focuses on how doubt evolves and foregrounds the identity implications of uncertainty. Guided by Communication Theory of Identity (CTI), the purpose of this study was to explore the identity gaps people experience as they navigate evolving doubt about a family member’s health and how they manage those identity gaps. We interviewed 33 individuals in the U.S. about a family member’s health issues that they doubted but began to believe. Our analysis uncovered three identity gaps among personal, relational, and enacted layers of identity: personal-enacted, relational-enacted, and personal-relational-enacted identity gaps. Participants managed identity gaps in two primary ways: (a) closing gaps by altering personal, relational, or enacted layers of their own identity; and (b) maintaining identity gaps by putting the locus of responsibility for identity change within their family member’s relational identities. This study offers theoretical implications for CTI as well as practical implications for individuals navigating doubt and evolving illness uncertainty in their family relationships.