Ontological and Epistemological Reflexivity: A Core Skill for Therapists

This paper develops the argument that a core skill needed to be an effective therapist is to have acquired an awareness of one’s own ontological and epistemological position in relation to one’s work as a therapist. In the same way that researchers need to develop reflexive awareness of their assumptions about what there is to know (ontology) and how they can come to know about it (epistemology), therapists need to be aware of their fundamental assumptions about human beings and the world they live in (ontology) as well as their beliefs about how best to develop an understanding of their clients and the meaning(s) of their experiences (epistemology). Regardless of which particular therapeutic model is adopted, the language used to talk about (and in) therapy, the kinds of questions asked of clients and the comments/interpretations offered, all presuppose and reinforce particular versions of human being and experiencing which are themselves not usually questioned or challenged during the course of therapy. In this paper it will be argued that it is essential that therapists are aware of their own fundamental assumptions about what it means to be human, and that they recognise their ontological and epistemological positions as positions that they are taking (rather than perceiving them to be self-evident truths). This is important for two reasons: i) if clients do not share the therapist’s assumptions (ie. their ‘model of the person’), the therapeutic work cannot proceed and be effective; ii) without such an awareness, therapists are at risk of unwittingly imposing their own model of the person upon the client which raises ethical issues

Surrender to Win: Constructions of 12-Step Recovery from Alcoholism and Drug Addiction.

This article focuses on the ways in which members of Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) construct themselves as being in recovery from addiction. In this original study, data were taken from nineteen participants. They were analysed using Willig’s (2013) six-stage Foucauldian discourse analytic method. This method is suited to enabling the analyst to locate discourse resources used by participants within broader, dominant, discourses, and for exploration of the implications of these constructions for subjectivity and practice. This article presents a discussion of analytic findings. Mainstream academia has often constructed 12-Step recovery as a largely totalising discourse. This is likely to have negatively prejudiced health professionals and may help explain relatively low referral rates into 12-Step resources for addicted clients. However, our analysis suggested that participants constructed themselves not as subjected by AA and NA discourse, but as drawing on it in ways aligned with agency, in order to practice care of the self in pursuit of various ethical goals. This implies 12-Step recovery to be less antithetical to, and indeed more aligned with, humanistic practitioner values than is perhaps often assumed to be the case. This finding suggests that practitioners may need to consider reappraising their view of 12-Step recovery. The discussion will therefore focus on the agency-structure dialectic that seemed to be at the heart of participant constructions of addiction and recovery. It is also is a finding which points to an urgent need for more qualitative studies in the currently under-researched, and hence perhaps poorly understood, area of 12-Step recovery from addiction

What can qualitative research contribute to psychological knowledge?

This paper reflects on what qualitative research in psychology can contribute to the accumulation of psychological knowledge. It provides an overview of qualitative research in psychology and discusses its potential value to quantitative researchers. It reviews the differences and similarities between qualitative and quantitative research and explains how qualitative research can be differentiated from other forms of knowing that are concerned with human experience. This paper explains what makes qualitative research ‘research’, and how to determine if something is qualitative research or another kind of meaning-making activity. The paper starts by defining and characterising qualitative psychology and by identifying qualitative psychology’s aims and objectives. The paper goes on to examine qualitative psychology’s relationship with the pursuit of knowledge and to position it within the wider field of psychological inquiry. The paper identifies ways in which qualitative research contributes to psychological knowledge (including thick description, critique, theory development) and concludes by affirming its place in a psychological research community that seeks to improve our understanding of ourselves and the world we live in

Reflections on the Use of Object Elicitation

Objective This paper reflects on the use of object elicitation in a phenomenological study of the experience of living with advanced cancer. Method Object elicitation was used to assist data collection by facilitating participants’ reflections on the quality and texture of their lived experience. Participants were invited to select objects that held special meaning for them during the current phase of their lives, and to reflect on their relationship with these objects during a research interview. Findings This paper reflects upon the opportunities and challenges inherent in the use of object elicitation. These include the method’s ability to prompt unrehearsed, in-the-moment reflections about what it means to be ‘living with dying’ as well as to shed light on participants’ sense of who they can be during this final phase of their lives. At the same time, the focus on objects can result in the imposition of an object-led structure on the interviews and a consequent failure to follow up on aspects of participants’ accounts which transcend their relationship with the objects they brought. A further challenge resides in the temptation to look for meaning in the objects themselves rather than in the participants’ use of, and relationship with, the objects. Conclusion The paper formulates guidance on the use of object-elicitation

"My Bus Is Here": A Phenomenological Exploration of "Living-With-Dying"

OBJECTIVES: This article has 2 aims. The first is to demonstrate how the application of an innovative qualitative methodology generated novel insights into the experience of living with advanced cancer. The article’s second aim is to challenge the idea that the identification of shared themes provides the researcher with access to the meaning and significance of the experience of “living-with-dying.” METHOD: The research used object elicitation together with existentially informed hermeneutic phenomenological analysis. The analysis is based on 10 semistructured interviews with people who are living with advanced cancer. RESULTS: Three brief case studies demonstrate the variability in accounts that characterizes the data set as a whole. This is followed by reflections on the way in which, despite striking individual differences, all participants seemed to experience living-with-dying as an existential challenge that demands that the individual concerned finds a way of coming to terms with the very parameters of human existence. CONCLUSION: A thoroughly idiographic approach that advocates staying with the diversity that characterizes the experience of living with advanced cancer. It is argued that to make sense of the remarkable differences between the research participants’ accounts of their experiences of living with a diagnosis of advanced cancer, a focus on process (i.e., What happens when people encounter their mortality?) and meaning (i.e., What does it mean to them?) helps us to understand these as different responses to the challenge of death awareness

'Unlike a Rock, a Tree, a Horse or an Angel ...' Reflections on the Struggle for Meaning through Writing during the Process of Cancer Diagnosis

In this article I present some reflections on my experience of the process of wresting meaning from meaninglessness. My reflections are both personal and scholarly in that I trace my own experience of struggling with meaning-making and attempt to illuminate them with reference to published work, drawing on concepts from existentialist philosophy in particular. Much of what is contained in this article is based upon reflections recorded in my personal diary written during the process of being diagnosed with cancer. As such, the article itself constitutes an example of the kind of writing that this special section is concerned with. I quote verbatim from my diary throughout this article in order to demonstrate the process of meaning-making through writing

A metasynthesis of studies of patients’ experience of living with terminal cancer

Objective: The aim of this research was to produce a synthesis of phenomenological studies of the experience of living with the awareness of having terminal cancer in order to gain a more complete understanding of the parameters of this experience. Methods: This research used metasynthesis as a method for integrating the results of 23 phenomenological studies of the experience of living with the awareness of having terminal cancer published between 2011 and 2016. Results: The metasynthesis generated 19 theme clusters which informed the construction of four master themes: trauma, liminality, holding on to life and life as a cancer patient. Each master theme captures a distinct experiential dimension of living with the awareness of having terminal cancer. Each dimension brings with it significant and distinctive psychological challenges. Conclusion: The results from the present metasynthesis suggest that the experience of living with the awareness of having terminal cancer is a multi-dimensional experience which patients actively negotiate as they search for ways in which they can rise to the psychological challenges associated with it. A better understanding of the parameters of this experience can help health care professionals provide appropriate support for this client group

Older women and everyday talk about the ageing body

This discourse analytic study shows how 10 older women, who exercise regularly or attend the University of the Third Age, adjust to the ageing body in their `everyday talk' through taking a dualist position. The part of the body which is discursively constructed as ageing becomes objectified through appealing to a wider cultural discourse of ageing as biological decline. This dualist position is embedded within a wider cultural discourse of personal agency. The individual's control of the ageing body is emphasized, the ability to monitor and manage `ageing body parts' through exerting the `active mind' and the `busy body' in activities, or simply focusing on `looking good'

Making sense of self-injury: A pluralistic case-study

Aims: Self-injury is widely seen as a complex behaviour imbued with highly individual meanings. The objective of this paper was to show how research using a pluralistic qualitative approach could inform clinical practice, by outlining how intricate and at times divergent meanings could be attached to the behaviour in the areas of control, guilt and relatedness. Method: A set of three interviews conducted with a woman with a long history of self-injury were analysed using three different interpretative lenses: interpretative phenomenological analysis (IPA), narrative analysis, and a psychosocial approach. Findings: Combining different interpretations of the text brought out the participant’s multifaceted understanding of control, guilt and social connection in relation to her selfinjuring. The behaviour could be seen as a means of control and a sign that one was out of control; as inducing guilt but not responsibility; as a mode of communication steeped in disconnection. Conclusion: While adhering to a recognised therapeutic model of the behaviour might be of considerable value to the practitioner, there is much to be gained from a careful exploration of the multiple and at times contradictory meanings attached to self-injury by each individual client