The experience of feeling fat for women with anorexia nervosa: An interpretative phenomenological analysis

Feeling fat has been implicated as a maintenance factor in anorexia nervosa (AN), despite limited research into the experience. This study expanded the literature by exploring the lived experience of feeling fat for women with a diagnosis of AN. Seven women participated in this study and data was collected through semi-structured interviews. Interpretive Phenomenological Analysis (IPA) was employed to explore the participants’ experience of ‘feeling fat’ and its relevance for clinical treatment. Four main themes emerged from the data: ‘negative sense of self’, ‘feeling out of control’, ‘coping with feeling fat’, and ‘making sense of feeling fat is complex’. These results highlight feeling fat as a significant experience and maintenance factor for women with a diagnosis of AN. Implications for addressing feeling fat within psychological therapy are explored.     

How talking therapists experience working with adult clients who have autism

This research aims to gain new insight by exploring the thoughts, feelings and experiences of therapists working with clients who have autism. Three professional talking therapists participated in the study. Unstructured interviews were conducted and analysed using interpretive phenomenological analysis. Six main themes and 13 sub-themes were found which include therapists’ validation of autism, how therapists integrated autism when addressing mental health problems, how their personal experiences of autism impacted on their work and how they experienced the situation in which autism emerges during the therapy. Helpful suggestions are made for clinicians, namely, to zoom-in and zoom-out of autism, hold the knowledge that people with autism process information differently, incorporate working with trauma, consider disclosing a personal connection to autism and consider carefully whether, or not, to tell a client that they may have autism.     

Stigma and the delegitimation experience: An interpretative phenomenological analysis of people living with chronic fatigue syndrome

Individual in-depth interviews with 14 people with chronic fatigue syndrome (CFS) were conducted, focusing on the experience of living with CFS. The interviews were transcribed verbatim and were analysed for recurrent themes using interpretative phenomenological analysis (IPA). Here we present two inter-related themes: “Negotiating a diagnosis” and “Negotiating CFS with loved ones”. Participants reported delay, negotiation and debate over diagnosis: further, they perceived their GPs to be sceptical, disrespectful and to be lacking in knowledge and interpersonal skills. However, participants found delegitimising encounters with their partners more difficult to deal with. Participants viewed such delegitimation as a form of personal rejection; they were hurt by their loved ones’ reactions and subsequently pondered the price of love, respect and friendship. The findings are discussed in relation to extant literature, and recommendations for future research are suggested.     

Women's experience of brain injury: An interpretative phenomenological analysis

Acquired traumatic brain injury (TBI) can leave the survivor with a complex range of psychological sequalae. This study aims to investigate the experience from the perspective of women with acquired TBI. Using a qualitative research method, six women with a TBI were interviewed about their experience, and the interviews were transcribed verbatim and analysed according to Interpretative Phenomenological Analysis (IPA). The major themes that emerged were: awareness of change; the emotional reaction; struggling to make sense; adaptation and acceptance. This article describes the process of adaptation, and the implications for rehabilitation are discussed. It is suggested that an intervention based on these themes might be an effective tool in rehabilitation.     

Multiperspectival designs and processes in interpretative phenomenological analysis research

ABSTRACT

Researchers using interpretative phenomenological analysis (IPA) within applied research typically use homogenous samples exploring shared perspectives on a single phenomenon of interest. This article explores the challenges and opportunities involved with developing rigorous and epistemologically coherent research designs for capturing more complex and systemic experiential phenomena, through the use of multiple perspectives to explore the same phenomenon. We outline a series of multiple perspective designs and analytic procedures that can be adapted and used across many diverse settings and populations. Whilst building upon existing approaches within qualitative methods and IPA, these designs and procedures are intended to scaffold clear routes to practical application, psychological intervention, the design of behaviour change interventions, and other recommendations for policy and practice. We discuss a variety of conceptual antecedents which situate these designs within phenomenology, pluralistic idiography, qualitative psychology, and wider debates within psychology and other social and behavioural sciences.     

Understanding the impact of HIV diagnosis amongst gay men in Scotland: An interpretative phenomenological analysis

Objectives: Although a wide literature details the psychological impact of human immunodeficiency virus (HIV) diagnosis, it predates the introduction of effective treatment for HIV (i.e. anti-retroviral therapies, ARTs). This article explores the psychological impact of HIV diagnosis in post-ART accounts. This is important, given the recent policy developments which focus upon increasing HIV testing and thus diagnoses.

Design: This study presents a qualitative exploration of the experiential accounts of HIV-positive gay men living in Scotland. A total of 14 HIV-positive gay men took part in open-ended interviews.

Methods: Interpretative phenomenological analysis was employed to identify recurrent themes across the interviews.

Results: Our analysis focuses upon the participants’ struggles in adjusting to their HIV status. Diagnosis was a deeply shocking and unexpected experience. Stigma and fear of prejudice dominated their accounts. HIV was understood, variously, as a shameful, fatal and life-changing condition. Overall, within these accounts there was little sense of HIV normalisation.

Conclusions: In Scotland, where HIV prevalence is low, and where no accessible HIV-positive sub-culture exists, there is on-going psychological distress and morbidity amongst gay men testing HIV positive. As HIV-related policy increasingly focuses on increasing rates of antibody testing, there is a need to reduce the psychosocial costs associated with HIV-positive diagnoses.     

The impact of assuming the primary caregiver role following traumatic spinal cord injury: An interpretative phenomenological analysis of the spouse's experience

This study aimed to explore the lived experience of assuming the primary caregiver role in a group of spouses of individuals living with a traumatic spinal cord injury (SCI) (injuries ranged from paraplegia to quadriplegia). Individual in-depth interviews were conducted with 11 participants who were both the spouse and primary caregiver of an individual with a SCI; of these, 10 were female and 1 was male. All interviews were transcribed verbatim and were subjected to interpretative phenomenological analysis (IPA). Here we present three inter-related master themes: ‘The emotional impact of SCI’; ‘Post-injury shift in relationship dynamics’ and ‘Impact of caregiving on identity’. Regarding the emotional impact of spinal injury, participants reported an almost instantaneous sense of loss, emptiness and grief during the injured person's rehabilitative period and feelings of anxiety were reported in anticipation of their return to the family home. A distinct change in role from spouse and lover to care provider was reported and this ultimately contributed to relationship change and a loss of former identity. The findings are discussed in relation to extant caregiver literature and recommendations for future caregiver support are highlighted.     

Participants and researchers searching for meaning: Conceptual developments for interpretative phenomenological analysis

ABSTRACT

In this article I offer a theoretical account of interpretative phenomenological analysis’s (IPA’s) position in relation to meaning-making by participant and researcher. In doing this, I draw on a range of theoretical writing on meaning. I then apply these ideas to a series of empirical studies on pain which I have been involved in. The intention, therefore, is for the article to contribute a theoretically informed and empirically grounded extension to the literature on IPA.     

Discourse analysis: Rich pickings for counsellors and therapists

Aim: It is only relatively recently that discourse analysis has begun to rise to prominence in the fields of counselling and psychotherapy. This paper briefly explains ways of understanding discourse analysis, discussing what the approach can offer counselling research and practice. Approach: An initial categorisation of recent discourse analysis studies is offered, to demonstrate diverse ways in which this type of research can address issues relevant to counselling practice. The five categories proposed range from the examination of language use in therapy to analyses that focus on the social structures, meanings and power relations related to therapy. Implications: The paper demonstrates that through the critical analysis of counselling sessions, research interviews, written texts and other materials, discourse analysis can provide insight into ways in which counselling operates as a social practice, and so help counsellors to contextualise their work within broader social structures and processes.     

Being a non-drinking student: An interpretative phenomenological analysis

Recent research suggests that safer student alcohol consumption might be assisted by understanding how social occasions are managed by non-drinkers. In-depth, semi-structured interviews with five 19 – 22 year old non-drinking English undergraduates were subjected to interpretative phenomenological analysis. We present five inter-linked themes: ‘living with challenges to non-drinking’; ‘seeing what goes on in drinking environments’; ‘dealing with conversations about non-drinking (making excuses vs. coming out)’; ‘knowing which friends care about you’; and ‘the importance of minimising “legroom” for peer pressure’. Participants felt under persistent peer scrutiny (as a form of peer pressure) and could feel alienated in drinking environments. Talking about non-drinking was characterised by whether to ‘come out’ (as a non-drinker) or ‘fake it’ (e.g. ‘I’m on antibiotics’). Loyal friendships were reported as particularly important in this context. The decision not to drink was experienced as providing a successful buffer to peer pressure for former drinkers. Our findings unsettle traditional health promotion campaigns which advocate moderate drinking among students without always suggesting how it might be most successfully accomplished and offer tentative guidance on how non-drinking during specific social occasions might be managed more successfully. Findings are discussed in relation to extant literature and future research directions are suggested.     

Doctors as patients: How psychological therapists experience the opposing ideologies

Research suggests that doctors experience higher levels of stress and mental health problems than the general population. Doctors frequently experience difficulty seeking help, and also challenges during psychological treatment, due to role reversal and competing ideologies.

Focusing specifically on the under-researched area of doctors as patients in a psychological context, this paper explores the processes underlying role transition as well as the therapeutic relationship that follows.

Furthermore, therapeutic reactions and adaptions of practice to this dynamic is also explored. A qualitative approach was employed and seven psychological therapists who had worked extensively with doctors as their patients were interviewed.

Subsequent interview data were thematically analyzed.

Six themes were generated: fear and pressure; status and control; variation of ideologies; change in practice; temporal changes; and help seeking and support.

The main barrier to recovery for doctors is difficulty in accessing services owing to the high-levels of stigma and shame that may be experienced. This research identifies some of the adaptions made by psychological therapists within their practice when working with doctors as patients.     

Worlds within worlds: a strategy for using interpretative phenomenological analysis with focus groups

There is increasing interest in applying interpretative phenomenological analysis (IPA) to focus group data and in developing appropriate strategies for doing so. These strategies should exploit the unique features of focus groups, which provide a rich canvas of experiences not seen in individual interviews, while remaining true to the personal, phenomenological perspective of IPA. We present a four-stage approach with specific group focused analytical strategies: looking for “groupness,” clustering reoccurring group interactions, identifying interactional relationships, and incorporating group elements into an analysis. These stages are illustrated with worked examples developed while working with data from focus groups of women with gynaecological cancer discussing a yoga intervention, and explain how these can enrich our understanding of participants’ lived experiences. This approach demonstrates a suggested framework for developing IPA themes from focus group data by analysing and interpreting the group setting. We discuss links to psychological concepts, potential applications and limitations. This empirically based methodology is presented as a practical guide for other researchers grappling with this type of data.     

Women's experiential journey toward voluntary childlessness: An interpretative phenomenological analysis

Voluntary childlessness is a relatively novel yet growing phenomenon. This idiographic study explored three women's experiential journeys toward voluntary childlessness. Semi‐structured interviews were carried out and analysed using Interpretative Phenomenological Analysis. Themes identified were: Owning the choice to be childless, social expectations, and models of mothering. Despite defining ‘voluntary childlessness’ as an unequivocal decision, the women's experiential accounts revealed an intrinsic fluidity in their journeys toward childlessness. Factors including beliefs in equality, independence and career aspirations competed with constructs of mothering/motherhood, partnership and choice to create a complex tapestry of contributory factors in these women's childlessness. The findings question the notion of choice and particularly women's ownership of that choice. The journeys toward childlessness these women shared reveal a synthesis of agentic decision‐making, personal histories and challenging lifestyle choices bound up within an existential need to be a woman. More research is needed to determine the place of voluntary childlessness within society. Copyright © 2010 John Wiley & Sons, Ltd.     

Leadership experiences of bicultural business leaders: An interpretative phenomenological analysis

Using the lens of interpretative phenomenological analysis, this study explored the leadership experiences of bicultural business leaders in the Philippines. Semistructured interviews were conducted among 16 leaders in family-owned, small and medium-sized enterprises in the Philippines who are ethnically Chinese and have Filipino nationality. Findings focused on salient expressions of biculturalism in leadership, bicultural leadership challenges, and advantages. Most of the participants experienced fluidity in their expressions of Filipino and Chinese identities and how these manifest in the workplace. Challenges shared pertain to generational factors as participants assumed leadership roles through kinship, as well as relational challenges reflective of cultural nuances. The leaders view their being bicultural as having the “best of both worlds” as they have greater access to cultural information and a more holistic view of which values and norms to use in their leadership roles and in various social interactions. Fluency in communicating in Chinese and Filipino was perceived to enable effective interactions and facilitate trust building with their customers, employees, and suppliers. Implications focused on the need to consider biculturalism in leadership development programmes in educational institutions and organizations, especially with increasing bi/multiculturalism in workplaces.     

Picturing ourselves in the world: Drawings,interpretative phenomenological analysis and the relational mapping interview

ABSTRACT

Some aspects of experience can be challenging for research participants to verbalise. Interpretative phenomenological analysis (IPA) researchers need to get experience-near to meet their phenomenological commitments, capturing the “texture” and quality of existence, and placing participants in relation to events, objects, others, and the world. Incorporating drawing into IPA designs provides a vehicle through which participants can better explore and communicate their lifeworlds. IPA researchers also require rich accounts to fulfil their interpretative commitments. Drawing taps into multiple sensory registers simultaneously, providing polysemous data, which in turn lends itself to hermeneutic analysis. This article outlines a multimodal method, the relational mapping interview, which was developed to understand the relational context of various forms of distress and disruption. We illustrate how the approach results in richly nuanced visual and verbal accounts of relational experience. Drawing on an “expanded hermeneutic phenomenology,” we suggest how visual data can be analysed within an IPA framework to offer significant experiential insights.     

The transition to motherhood in an organizational context: An interpretative phenomenological analysis

Most of the extant literature on maternity issues is survey based, primarily concerned with identifying the predictors of return to work. The current study aims instead to understand experiences of maternity leave per se. Of the 10 women interviewed during pregnancy, 8 women were followed through to their return to work. Their interviews were analysed using interpretative phenomenological analysis to identify transitional themes. Findings are discussed in terms of two master themes: changes of identity (involving feelings of gradual invisibility as a valued employee, acquisition of a ‘mother’ identity creating return dilemmas and efforts to revalidate oneself upon re‐entry as both a valued employee and a mother); and changed psychological contracts (pertaining to the fulfilment of mutual expectations). Overall, women appeared to struggle subjectively with prevailing their rights, needs and concerns as mothers while simultaneously also maintaining their identity as valued and functional members of the organization. The findings can be conceptualized within existing theoretical frameworks (e.g. Psychological Contract Theory) and to this extent it is possible to draw out implications for a more effective management of the transition process from pregnancy to return to work.