Å komme til seg selv – i bevegelse, sansning og forståelse

I dette essayet fortolkes Trygve Braatøys tanker om nervøse og psykosomatiske lidelser i lys av Løgstrups sansefilosofi. Braatøy beskrev muskulære belastninger som vevd sammen med følelsesmessige belastninger, og bevissthet som kroppslig forankret. I hans tenkning er muskulære konflikter et særtrekk ved slike lidelser, og forbundet med regulering av overveldende inntrykk som binder personen i møte med verden. Løgstrup la ut menneskers universelt gitte grunnvilkår, og mente at den menneskelige tilværelse er sammenvevd med eller felt inn i omgivelsene i pust og ernæring, men også i sansningen. Og sansningen er mer enn nevrofysiologiske prosesser, den er vår klangbunn, stemt av inntrykk. Som fenomen rommer sansningen både den som sanser og det som sanses. Med Løgstrups sansefilosofi som tolkningsperspektiv i møte med Braatøys tenkning drøftes bevissthet som kroppslig forankret, med distinksjon mellom bevissthet i sansning og bevissthet i forståelse. I denne fortolkningen fremheves kroppslig forankret bevissthet både som klangbunn stemt av livets erfaringer, og samtidig som tilstedeværelse her og nå, i varierende grad av åpenhet

Living the dream – but not without hardship: stories about self-directed weight transformation from severe obesity

The objective of this narrative study was to explore experiences and assigned meanings in stories about self-directed weight loss (WL) maintenance after severe obesity (SO). Design In-depth interviews were conducted with eight women and two men, aged 27 to 59 years, who had carried out self-directed WL from SO for 5 years or more. Two themes ran across the stories: Fear of weight-regain, and food and emotion. We performed a case-based narrative analysis of especially rich interviews that illustrate these. Results pointed to persistently cultivating new competencies, establishing new eating habits, re-establishing old physical-training habits, and forming new relational bonds. Participants reinvented themselves and their lives. However, the stories are not all about transformation, but also about new and old health problems. Conclusion The study directs attention to ‘different obesities’, not only to initial weight from which WL takes place, but also linked to the experiential horizons that the persons embody from childhood on. Furthermore, there was no way back in the present stories, always haunted in the wake of the lost weight. A double burden imposed on the person with obesity related to meta-stories in society deepens the understanding of this imperative: being vulnerable health-wise and exposed to stigmatization.publishedVersio

“My quality of life is worse compared to my earlier life”: Living with chronic problems after weight loss surgery

Weight loss surgery is commonly regarded as improving individuals' health and social life, and resulting in a happier and more active life for those defined as “morbidly obese.” However, some researchers have started to doubt whether these positive outcomes apply to everyone and this article explores this doubt further. More specifically, we focus on the experiences of women whose life situation became worse after weight loss surgery. The material draws on qualitative interviews of five Norwegian women undergoing the irreversible gastric bypass procedure. Our findings illustrate that the women lived seemingly “normal” lives prior to the surgery with few signs of illness. Worries about future illness as well as social stigma because of their body shape motivated them to undergo weight loss surgery. After the surgery, however, their situation was profoundly changed and their lives were dramatically restricted. Chronic pain, loss of energy, as well as feelings of shame and failure for having these problems not only limited their social lives but it also made them less physically active. In addition, they had difficulties taking care of their children, and functioning satisfactorily at work. Accordingly, the women gradually felt more “disabled,” regarding themselves as “outsiders” whose problems needed to be kept private. The results highlight some “subtle” consequences of weight loss surgery, particularly the shame and stigma experienced by those whose lives became dramatically worse. Living in a society where negative impacts of weight loss surgery are more or less neglected in research as well as in the public debate the women seemed to suffer in silence. Their problems were clearly present and felt in the body but not talked about and shared with others

Practising physical activity following weight-loss surgery: The significance of joy, satisfaction, and well-being

While health care professionals advise those who have undergone weight loss  surgery (WLS) to increase their levels of physical activity, research suggests that  often this is not achieved. This paper explores the experiences of ten Norwegian women as they engaged in physical activity several years after weight loss surgery (WLS). In contrast to the existing literature, which explores physical activity post-WLS largely in terms of quantitative data and measurable outcomes, the present study sought to explore women’s lived experiences of physical activity, including the meanings they ascribed to different forms of activity and how such meanings changed over time. The research participants, all of whom had undergone WLS more than five years earlier, described (during individual interviews) the meanings they attached to becoming physically active, as well as the different  activities and movement practices they engaged in, from interval training to  mountain hiking and yoga. For all the women, maintaining and increasing their level of physical activity was challenging. On the one hand, engaging in exercise after weight loss improved their sense of joy and well-being and expanded their  opportunities to move and act. On the other hand, during physical activity they needed to be constantly alert to symptoms of post-surgical side-effects, including variable energy levels, digestive problems and acute illness episodes. As the women explored their new capacities, it seemed to be important for them to explore various forms of physical activity in order to find the form of exercise which best suited them or which they most enjoyed. In some cases, they constructed new meanings around activities which, prior to surgery, had seemed onerous and bereft of pleasure. We argue that such insights will benefit health professionals who provide advice on physical activity at different post-surgical stages, sometimes to persons seriously concerned about regaining weight

Patients’ experiences from basic body awareness therapy in the treatment of binge eating disorder -movement toward health: a phenomenological study

Background Binge Eating Disorder (BED) is the most common eating disorder. Patients with BED are often not diagnosed, nor offered adequate specific treatment. A great number of those who receive recommended treatment do not recover over time. More knowledge about central aspects of BED, and treatments that specifically target such aspects is needed. Previous research has linked body experience to the development and maintenance of eating disorders, as well as influencing treatment results and the risk of relapse. The aim of this study was to explore how patients with BED experience Basic Body Awareness Therapy (BBAT), which is a psychomotor physiotherapy treatment addressing body experience. Method In this phenomenological study, we interviewed two patients with BED in depth during and after treatment. Video observations of treatment sessions and logs written by the patients were used as supporting data. The analysis was guided by Van Manen’s hermeneutic phenomenology. Results A meaning structure was identified: “On the way from the body as a problem to the body as a possibility.” The two participants that besides BED also had a history of childhood trauma, perceived BBAT as a process of getting to know their own bodies in new ways, and described that the way they related to their own body changed as did aspects of their way of being. These changes were prominent when the participants described emotions, movement, pain, calmness, and self-experience, and interwoven with relational aspects as well as practices in everyday life. Conclusion The present results indicate that BBAT stimulated body experience in a way that opened new possibilities for two participants with BED, and hence that BBAT can improve the health status of BED patients also suffering from childhood trauma.publishedVersio

Moglegheiter og fallgruver: ei utforsking av sosionomar og vernepleiarar sine refleksjonar kring deltaking i ein multimetodisk studie basert på Interpersonal Process Recall og fokusgruppeintervju

Interpersonal process recall (IPR) is a qualitative research method employing video-assisted interviews, originating from training in psychotherapy skills. This method strongly emphasises recall and reflexivity, aiming to explore the interaction experience, primarily between clients and caregivers. It is used to study professions emphasising reflexive practice, such as psychotherapy and counselling but has been absent from research on social work professions. This article explores the experiences and reflections of five social workers and five social educators who participated in research applying a combination of IPR and focus group methods. Overall, the findings suggest that the participants, possessing critical and reflective practice skills, found their involvement advantageous. Their capacity for reflection and reflexivity not only benefited the participants themselves but also facilitated the researchers in gaining new insights into professional experiences in professional and service user interaction.publishedVersio

Balancing responsibility, boundaries and time: social workers’ experiences in service user meetings – a multi-method study based on Interpersonal Process Recall

The article focuses on social workers’ reflections on their own professional practice in conversations with vulnerable service users in the Norwegian Labour and Welfare Administration (Nav). Drawing on Interpersonal Process Recall (IPR), a video-based method, together with a focus group interview, the study explores the experiences and reflections of five social workers of in-situ encounters with service users. A key finding is that the social workers, who worked in two different offices within the work and activation field, perceived their professional practice as highly complex, negotiated, and ambiguous. The social workers nevertheless displayed a multitude of knowledge and competences, expressed through practical synthesis in the conversations. The article argues that more attention should be paid to ethical aspects of professional knowledge, such as when balancing contradictory considerations towards national workfare policies and vulnerable service users, and how to set the limits for their own professional responsibility in the work towards the service users. Furthermore, the article also directs the attention to another area of professional knowledge, as it explores time as an embedded and ubiquitous aspect of, and condition for, professional knowledge to unfold.publishedVersio

Persevering professionals: dilemmas of relationships and self-determination in work with people with intellectual disability – a multi-method study based on interpersonal process recall

The article focuses on social educators’ reflections on their own professional practice in encounters with people with intellectual disability receiving services. Drawing on Interpersonal Process Recall, a video-assisted method, together with a focus group interview, the study explores the experiences from in-situ encounters of five social educators employed in a Norwegian municipality. The key findings are that they view relationship-building as integral to their work, they grant primacy to the ideal of autonomy and they strive towards realizing this in their daily work. The study however displays how these emphases might lead to dilemmas, especially between the wish to support the service users’ self-determination and the urge to protect them from harm. Of special note was how the service users’ increasing use of social media was perceived as a particular challenge for social educators, who were left with an experience of being unable to protect.publishedVersio

Facilitating new movement strategies: Equine assisted physiotherapy for children with cerebral palsy

Background: Equine Assisted Physiotherapy (EAPT) offers children with cerebral palsy (CP) opportunities for new movement experiences, and may influence movement qualities. Descriptions of how, and to what extent EAPT affects trunk control is missing. The aim of this study was to explore if, and how changes in trunk control and changes in other movement aspects were observable in children with CP during EAPT, and if potential changes in trunk control could be measured.Method: A multiple case study with a mixed methods design was completed. Two children with CP, GMFCS grade 1, were observed using video during a period of six months, and tested with Trunk Impairment Scale modified Norwegian Version. Skilled physiotherapists analyzed the videos qualitatively, and triangulated recurring changes in movement with the results from the test.Results: Riding bareback, improvements in trunk control were observed and measured. However, riding in a saddle led to reduced trunk control. Other observable movement changes were: from asymmetry to symmetry, adaptation to rhythm, mastery of riding skills, and reduced loss of postural control. Increased instances of adapting own movements in spontaneous dialogue with the horse, were observed. Instructions and feedback from the therapist influenced the dialogue with the horse both positively and negatively.Conclusion: This study describes in detail how balance and symmetry can be stimulated during EAPT in a body characterized by imbalance and asymmetry. During EAPT, the children gained the possibility to explore new movement qualities. Equipment and feedback influenced movement qualities. (C) 2020 The Authors. Published by Elsevier Ltd