La incorporación de estudiantes con discapacidad en instituciones de

The ultimate justification of the need to engage with subjectivity and meaning is our theory of knowledge or epistemological stance. Do we understand the social world by making objective observations shorn of context or individual interiority and deducing their fit with existing theory? Or do we pay attention to the context, subjectivity and behaviour and develop theory through induction and inference of our data? Whilst objectivity may be necessary to explain the impact of one celestial body upon another, subjectivity is essential to understand the effect upon a patient of being observed by their doctor. My search would have to acknowledge the existence of several truths and subjectivities because in privileging objectivity, I fall foul of complementarity theory and constructionist critiques (Bohr 1977; Gergen 2007). Dilthey, an early proponent of qualitative approaches, is supposed to have asserted that different methodologies were required in natural and human sciences as “we explain nature but can only describe human relations, with meaning crucial to our understanding” (Ratner 2008, p. 515). Understanding conflict in psychosis treatment cannot be done without looking at subjective meanings of psychosis and treatment.

Whilst deduction used to be the only valid method of inference in positivist science, induction, abduction and deduction are crucial in modern scientific endeavour (Fox 2008). Sole use of deduction or hypothetico-deductivism fragments the social world by abstracting too much and leaving out the context. Qualitative methods help restore balance by retaining rich links with the data and context. Some insist that we have only recently begun to understand the complexities of our relational and intersubjective nature because of the development of qualitative epistemology (Gergen 2007; Sampson 1993). Others assert that the previously dominant methods of positivist objectivism and deduction led to the use of disembodied or decontextualised facts (Ratner 2008). That disembodied perspective led science into developing objective theories, now being questioned in light of the emphasis upon subjectivity

in modern science (Bohm 1980). If subjectivity is critically involved in physics and biology, it is surely worth paying attention to in emotional and physical health matters.

Intersubjectivity shapes us, with our self-coming into existence through interactions with others; it is therefore an ontological rather than a developmental achievement (Stolorow, Atwood and Orange 2001; Hobson 2004). If our personhood forms through our interactions, understanding patients and psychiatrists needs a deep engagement with physical, psychological and spiritual aspects in the other as well as the self. This necessary engagement and understanding was crucial in choosing my method, ruling out quantitative measures because of the need for a ‘subjectively guided process’ (Kirschenbaum & Henderson 1990, p. 268). In asking questions about experiences and interpreting the answers, my own subjectivity and those of my participants becomes essential to the study. The chosen methodology had to be in line with such ontological and epistemological needs, with only qualitative methods able to allow the requisite flexibility of inference and context.

3.2

Choosing approaches and monitoring processes

Approaches to qualitative data analysis can be divided into three categories, according to Smith & Firth (2011):

• Socio-linguistic methods that explore construction of identity through use and meaning of language such as discourse and conversation analysis

• Methods that explore social processes and use that understanding to develop theory, typified by grounded theory

• Methods that describe and interpret participants’ views and experience of the world through content and thematic analysis.

My primary objective of understanding experience inevitably meant an exploration of social and individual processes within psychiatry, the Movement and the mutual conflicts. The method also needed to pay attention to experiences and their meaning for individuals, with a view to understanding the conflicts and any measures needed to bridge them. Although generating new theory was not the aim, it may be a by-product of the understanding gained. With my focus upon inner experience rather than identity, it was a relatively simple decision to discount the use

of socio-linguistic methods. The language used can indicate power dynamics in any setting and inform how one sets themselves apart or above another group. If my primary interest had been to investigate power dynamics between psychiatrists and patients, I may well have used discourse analysis.

As Firth & Smith (2011) illustrate, qualitative research methods usually divide so that a phenomenological exploration is incompatible with investigating social processes. Although I was interested in generating rich data on my participants’ lived experience of psychosis treatment, I did not want to stop there. Interpretative Phenomenological Analysis or other such methods would have focussed the study exclusively upon participants’ descriptions and attribution of meaning, without developing an understanding of the social processes. As well as ‘a thematic description of pre-given essences and structures of lived experience’ (Starks and Trinidad 2007, p.1373), I wanted to understand the social phenomena framing those experiences. My wish to investigate and understand psychosis treatment, the social conflicts and construct a bridge needed a methodology able to let theory emerge. Grounded theory may have been appropriate and allowed me to posit ‘plausible relationships’ among sets of concepts arising from collected data (Strauss & Corbin 1998). I would have understood their social worlds through induction or testing propositions against the mutual experiencing of my participants rather than producing ‘absolute truths’ (ibid.). Specific interest in an aspect of the field such as the conflict goes against the spirit of Grounded Theory, however, as do my a priori interests in bridging the conflict, my choice of patients from the Movement and wish to make policy recommendations (Starks and Trinidad 2007). I was therefore led to reject Grounded theory as a methodology and choose a qualitative mixed methodology.