Presentación

Interpretative Phenomenological Analysis (IPA) was developed by Jonathan Smith in the 1990’s promoting greater interpretation of the data than in descriptive phenomenology, (Langdridge, 2007). Interpretative phenomenological analysis is ‘concerned with understanding personal lived experience and thus with exploring person’s relatedness to, or involvement in, a particular event or process (phenomenon)’, (Smith et al., 2009, p40). There is ‘less emphasis on description and greater interpretation than in descriptive phenomenology’, (Langdridge, 2007, p55). Hence the researcher attempts to interpret the interpretations of the individual but ‘the researcher can never, entirely, know this personal world but can only approach somewhere towards accessing it’, (Howitt and Cramer, 2008, p373)

Interpretative Phenomenological Analysis was chosen as the approach for this study for a number of reasons that I drew from my career as a clinician, academic and researcher. Given the timeframe in which to meet individuals, whether they be patients, clients, or research participants I believe that it is impossible to fully understand them as people; how their life’s experiences have shaped and affected them, their beliefs and their actions. My interaction with them is a snap-shot in time and my understanding of them is, on the whole, an interpretation of what they want me to see and, potentially, what I want to see. This is not a weakness but a strength. In formal settings patients or research participants, alike, can chose their words and demeanour carefully to reflect themselves as they wished to be viewed. Regardless of how we might wish to facilitate a relaxing environment the clinical setting and research setting can have a formal air to it. That is not to say that the trained eye cannot see through an individual’s ‘superficial front’ but a clinician or a researcher must accept the possibility that they are being presented with one version of the person’s life. Willig (2001, p53) recognised this ‘impossibility of gaining direct access to research participant’s life worlds’. The rationale for IPA, therefore, reflects my own beliefs and experiences. As a clinician I must accept and believe the stories within the case history that each patient, or client, presents to me as their absolute truth at that time. Some clinical presentations can

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appear obscure to the layman but clarity of thought is important to consider possible causes of the patient’s signs and symptoms and so form clinical diagnosis. Equally, my role is not to judge my patients, or clients, and so my clinical approach must be non-judgemental. Geoffrey Maitland was world-renowned within the physiotherapy profession for his teaching and contribution to clinical practice. Maitland recognised that patients are all inherently different in physical structure and emotional state and thus believed that a single diagnosis can have many different physical presentations. As such his approach differed from the anatomical and medical model of health-care arguing that ‘many diagnostic titles are sometimes inadequate, incorrect, or may be merely linked with patterns of symptomatology; they may even be based on suppositions’ and as such ‘it is sometimes difficult to relate a patient’s history and examination findings to a precise and meaningful diagnosis’, (Maitland et al., 2005, p6). His clinical approach related more to function than anatomy. Maitland insisted upon the need for continuous analytical assessment before, during and after each of the application of each treatment session, (Maitland et al., 2005). There is consideration, reflection and then decision making for the next course of action. This is second nature for me as a clinician and lecturer over twenty years. Hence, as a researcher, I accept Smith and Osborn’s (2003) proposition that the IPA researcher has ‘a theoretical commitment to the person as a cognitive, linguistic, affective and physical being’, (Smith and Osborn, 2003, p52), as I recognise us all as complex, changing beings.

As importantly, I recognise that many individuals, regardless of walk of life and status, wish to be careful in what they say and/or need to ‘think on our feet’ when ‘put on the spot’. There can be:

a chain of connection between people’s talk and their thinking and emotional state…. people struggle to express what they are thinking and feeling, there may be reasons why they do not wish to self-disclose, and the researcher has to interpret people’s mental and emotional state from what they say, (Smith and Osborn, 2003, p52).

I believe that, as a researcher, I cannot exclude aspects of my life from my research. The concept of Husserl’s epoché (or bracketing) meaning to renounce our presuppositions and preconceived ideas from that we are investigating, (Langdridge, 2007), is problematic. I believe that my insider knowledge is a strength to this exploration but concede that careful

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reflexion is required. Coolican (2004, p229) recognised that ‘any attempt to report on another individual’s experience will necessarily be distorted by the phenomenology of the reporter’. I see and interpret my close world because of my experiences within it - as a physiotherapist, a lecturer, a patient, a researcher and as a family man- and how these relate to me. These give meaning and richness to my life and therefore I cannot, nor want to, detach myself from it, (Maggs-Rapport, 2001). Willig (2001) argued that this separation of the researcher from the study is unlikely and unnecessary as there is a natural interaction between researcher and participant. As a result, Willig informs us the ‘analysis by the researcher is always an

interpretation of the participant’s experience’, (Willig, 2001, p53).