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Phenomenology for Therapists

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Phenomenology for Therapists

Researching the Lived World

By Linda Finlay

A John Wiley & Sons, Ltd., Publication

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144 Phenomenology for Therapists

potential threat to the self to do likewise’. (Smith et al., 2009, p. 142).
This suggests that HIV risk behaviour is actively used to accomplish re-
lational ends. Contrary to ‘common sense’ perception, individuals may
be acting in a rational manner: being rational about their life choices
rather than the health risks their behaviour may involve.

Example 9.2 One woman’s account of personal meanings of
dialysis treatment

Jonathan Smith examines one patient’s experience of the psychological
impact of haemodialysis treatment for kidney failure (Smith et al., 2009).
The extended case study of Carole draws on metaphors and dream
interpretation to evoke how both the disease and the dialysis appear to
undermine Carole’s identity. Single case studies like this one make it
possible to capture lived experience in detail. Smith et al. (2009) argue
that such cases can then enter into dialogue with other findings and
wider theoretical constructs in the literature.

Carole, aged 44 years, had been dialysing in hospital for 6 months
before the start of this research. The semi-structured interview took
place before one session. Carole was asked such questions as ‘What do
you do when you are dialysing?’ and ‘How does dialysis affect your
everyday life?’

In the following extract, Smith et al. (2009) suggest a theme entitled,
‘It’s waiting to hurt me’.

Carole appears to project her current trepidation about dialysis onto the
machine itself:

Interviewer: How do you think of the machine?
Carole: I think I find it quite harsh [ ] It’s stuck up there or down

there I think it’s sort of waiting for me (laughs) waiting to hurt
maybe and keeping me prisoner to it.

A presentation of the machine as malevolent seems to symbolize the
entrapment Carole feels. Her sense of passivity and helplessness is turned,
in the account, to her being a victim of the machine. Further, while
recognizing the good the dialysis machine is doing her, Carole is acutely
aware of its invasive nature:

It’s sort of intrusive cos it’s got these sharp needles of the thing that
attaches you to it [ ] with the needling [ ] It can be quite painful
and it’s yeah that intrusion of metal into a very soft part of yourself.
(Reproduced from Smith, J.A., Flowers, P. and Larkin, M. (2009).
Interpretative Phenomenological Analysis: Theory, Method and Re-
search. Los Angeles, CA: Sage (p. 126), with the kind permission
of Sage Publication.)

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Interpretative Phenomenological Analysis 145

Interestingly, during the interview Carole recounted a dream, or rather
a nightmare, in which a devil spirit had rushed into and through her,
causing great pain. The symbolic parallels with her dialysis are almost
irresistible as the authors suggest below:

Carole: . . . When it rushed through it was alike a nervous um an
electric shock. And it was very painful this sort of rushing through.
And then it would call my name again sort of very quietly I thought
I was safe and it would call – I knew it was going to happen again.
(p. 128)

. . . Dialysis treatment has, for Carole, come to mean restriction, entrap-
ment, a lack of control, passivity, invasion, and fear. These are not de-
scriptions of the treatment itself, but rather of how Carole construes the
meaning of the treatment for her at this stage in time. And it is these
particular constructions that play into the undermining of her sense of
identity that Carole experiences . . .

The dream sequence is powerful in its own right but its meaning is
strengthened when one recognizes it as contributing to the whole – the
understanding of the personally debilitating impact of dialysis for Carole.
And of course the horror of the dream becomes even more vivid when one
realizes that much of what it seems to be about is the dialysis treatment.
(Smith et al., 2009, pp. 130–131)

Example 9.3 The contribution of visual art-making to the
subjective well-being of women living with cancer

Frances Reynolds and Kee Hean Lim (2007) explored women’s views
about the contribution of art-making to their sense of well-being in the
context of living with cancer. Participants were recruited through invita-
tions placed in national UK art magazines. Twelve women participated
in semi-structured interviews, each lasting between 1 and 2 hours, and
their accounts were then analysed thematically.

Art-making was found to support subjective well-being in four main
ways:

1) Creative activities helped the women to focus outwards on positive
experiences rather than inwards on the destructive nature of cancer.
As one participant said, ‘While you’re doing something, you’re not
dying. Literally.’ (2007, p. 6).

2) Art-making enhanced a sense of self-worth by providing opportu-
nities for achievement and challenge.

3) Art-making offered interest and helped the women to maintain a
social identity beyond being a cancer sufferer.

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298 Index

openness, 77–9, 166, 208
outcomes, research. see evidence-based

practice

parallel process, 176, 196, 240–41
participant observation, 201–205
participant validation, 96, 222–3
participants

recommended number of, 96, 127,
136, 141, 196

recruitment. See also relationships,
with participants, 191–2

phenomena, 16, 96
phenomenological attitude, 4, 23–4,

73–84, 99, 127, 138, 183, 208–10,
214, 218, 233

phenomenology
comparison of approaches, 88–91
defined, x, 3, 4, 15, 16, 26, 150
descriptive empirical, 88, 93–107,

147, 176, 261
first-person approaches, 90, 149–58
hermeneutic, 88, 109–23
interpretative phenomenological

analysis (IPA), 79, 83, 90, 121,
139–48, 196, 261, 263

lifeworld approaches, 88, 109–23
reflexive-relational approaches, 91,

159–76
value of, 12, 26, 258–9

philosophy, 4, 36–7, 43–71, 66, 67, 156
planning research, 181–96
poetry, 19, 52, 66, 121, 171, 242–3,

248–9, 255
Polkinghorn, D, 13, 287, 219–20, 248,

287
positivism, 67
postmodernism, 64, 71, 104–105
power, researcher, 167, 189, 219–20,

225, 226
practiced based evidence, 12, 13,
pregnancy, experience of, 154–5, 247
protocols, 97, 106, 187, 206

qualitative/quantitative research
contrasted, 8–9

realism. See also critical realism, 67, 96,
106

recording, 141, 219
reductions. See also bracketing;

phenomenological attitude, 46–9,
68, 73–4, 82, 83, 95, 97

reflections
personal, 6, 17, 20, 79, 140,147, 149,

151, 239
philosopher/researcher, 6, 22, 74–5,

79, 83, 240
reflective lifeworld research, 126–8,

135, 261
reflexivity, 23, 74, 149, 167

bodily, 37–40, 79, 80, 81, 84, 172–3,
204, 209, 211–3

defined, 23–4, 74, 83–4, 113–4, 149,
156, 167, 244–5, 266

examples, 24, 39, 81, 171–3,
203–204, 240–41, 268–9

hermeneutic. See also
phenomenology,
reflexive-relational approaches, 79

relational-centred research. See also
phenomenology,
reflexive-relational approaches,
165–7, 171–3, 176

relationships
with others, 20, 61, 117–8
with participants, 167, 175, 176, 214,

215
relativism, 54, 165, 174
relevance, of research, 265
research

aims/goals, 8, 182
planning, 181–96
politics, 6, 13
question, 8, 14, 182–3
therapeutic potential, 12, 254
topic, choosing, 182, 184, 195

researcher
assumptions, values, 53, 59, 68, 122,

184
emotions, 193, 205

resonance, of research, 9, 17, 120, 265,
267–8, 271

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Index 299

Ricoeur, P., 63–4, 123, 287–8
rigour, of research, 19, 48, 95,105, 142,

263, 264–5

sample. See also participants, 136, 192,
196

Sartre, J-P., 25, 30, 36, 46, 55, 60, 63, 69,
80, 125, 288

Schutz, A., 128, 137, 288
second person perspective, 40, 84, 215
science, 18–9, 106
Seamon, D., 33, 41, 68, 117–8, 122,

129–30, 133–4, 136, 137, 207, 215,
289

shame, 10, 20, 31–2, 60, 116, 151–2,
240–41, 248–9

Simms, E., 29–30, 247, 252, 290
Smith J.A., 79, 121–2, 141, 142, 196,

244, 261, 266–7, 278, 290
Smith, S., 56, 290
sociality, 45, 131–2
Sorge, 50, 121
spatiality, 19, 20, 27, 33, 41, 45, 103,

118–9, 122, 129–30, 132, 133–4,
252, 286

spiritual dimensions, 57
structure, 17, 18–9, 94, 101, 104, 263
subjectivity, 10, 23, 45, 71, 94, 154
supervision, 193–4
support systems, for researcher, 192–4

technology, 51
temporality, 20, 45, 52, 103, 131, 132
texture, 18–9, 104, 255, 263

themes, 25, 233–7
therapy-research, bridging, 3, 5–7, 12–3
thrownness, 50
Todres, L., 27, 53–4, 65, 104, 107,

116–7, 121, 122, 210, 242, 255,
256, 263–4, 271, 281, 291

Toombs, S.K., 56, 151–2, 236, 291
totalizing, 51, 61
transcendental, 48, 67
transcription, 215, 229
transformation, 10, 24–5, 254
triangulation, 187, 195

unheimlich, 27, 35, 41, 51, 68, 119, 235

validity, 223
van den Berg, J.H., x, 3, 33, 41, 122, 291
van Manen, M., 20, 25, 31, 67, 83, 114,

120, 149, 150, 183, 184, 206, 231,
247, 291–2

vicarious traumatisation. See also
researcher, emotions, 193, 205,
240

voice, participant’s, 10, 226

Wertz, F., 75, 77, 94, 95, 98–100, 104,
107, 110, 120, 184, 244, 271, 292

Willis, P., 122, 156, 210, 292
wonder, 66, 215, 228, 230–31, 247
writing

expressive, 17, 53–4, 111, 114–5, 122,
249

writing up research, 142, 224–5,
244–5, 255–7, 257–8

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