Interpretative Phenomenological Analysis

Adjustment and Coping in Spousal Caregivers Following a Traumatic Spinal Cord Injury: An Interpretative Phenomenological Analysis

by Paul Flowers

Adele Dickson, Grainne O’Brien, Richard Ward,
Paul Flowers, David Allan and Ronan O’Carroll

Semi-structured interviews were conducted with 11 spousal caregivers to people with a traumatic spinal cord injury and... more Semi-structured interviews were conducted with 11 spousal caregivers to people with a traumatic spinal cord injury and were subjected to interpretative phenomenological analysis (IPA). Here, we present two inter-related master themes: (1) coping with the spousal caregiver role; and (2) putting the pieces back
together again. Within these, the analysis describes how regular venting of emotion, social support and focusing on the positive aspects of the situation all promoted coping. Adjustment was reportedly hindered by the introduction of paid caregivers as this represented a loss of privacy and power for the participants.
The findings are discussed in relation to the wider literature and recommendations for future caregiver support are highlighted.

Re-defining ‘Me’: Exploring career transition and the experience of loss in the context of redundancy for professional opera choristers

by Paul Flowers

Jane Oakland, Raymond A. MacDonald and
Paul Flowers

This paper presents an in-depth, qualitative investigation into the impact of job loss for seven opera choristers. The... more This paper presents an in-depth, qualitative investigation into the impact of job loss for seven opera choristers. The paper focuses on their perception of this loss and how this perception influences the experience of career transition and subsequent redefinition of the self. Interpretative Phenomenological Analysis is used to highlight the individual nature of dealing with loss and transition. Discussion centres on three themes which best capture the psychological process involved in the renegotiation of self for
the participants. Analysis shows that a key issue in adapting to career transition is re-defining what it means to be a singer without the validation of full-time employment. The Organismic Valuing Theory of growth after adversity (Joseph & Linley, 2005) is used as a framework within which to discuss individual
fluctuations between searching to develop new areas of the self and restoring the established self. The study concludes that singers are unique in the employment market because of their relationship to their embodied voice. For the seven participants, the experience of career disruption is determined by their
ability to re-evaluate the role of singing as a primary agent of self-formation.

Health and romance: Understanding unprotected sex in relationships between gay men

by Paul Flowers

Objectives. To explore the theoretical utility of current health psychology in understanding the occurrence of... more Objectives. To explore the theoretical utility of current health psychology in understanding the occurrence of unprotected anal sex amongst gay men in relationships.

Design. Interpretative Phenomenological Analysis was employed to highlight the utility of incorporating the perspective of gay men in addressing a theoretical understanding of sexual decision making.

Methods. Twenty in-depth interviews were conducted with working-class gay men from a small South Yorkshire town. These were transcribed and analysed for recurrent themes which reflect the way gay men thought about sex and relationships.

Results. There were many differences between the way gay men thought about sexual activity and the way health psychology assumes men think about it. Within the context of romantic relationships men often privileged the expression of commitment, trust and love as more important than their own health.

Conclusions. Psychological theory relating to sexual health would benefit from a consideration of the way gay men report thinking about sexual behaviour in the context of romantic relationships. Such an informed theory would direct sexual health promotion beyond the simple provision of condoms

Community, responsibility and culpability: HIV risk‐management amongst Scottish gay men

by Paul Flowers

This paper draws upon a qualitative study of Scottish gay men's understandings of HIV testing to explore the... more This paper draws upon a qualitative study of Scottish gay men's understandings of HIV testing to explore the importance and changing understandings of ‘community’ within gay men's HIV risk-management. Nineteen men took part in one-to-one interviews, and 18 men took part in focus group discussions concerning HIV testing, HIV status and HIV risk-management. These discussions were subsequently analysed for recurrent themes using Interpretive Phenomenlogical Analysis. We focus on the ways in which new health technologies have afforded a process of ‘othering’: creating the social exclusion of known or assumed HIV positive men, and thus contributing to the fragmenting of the gay community. Further, we argue that, through shifting HIV avoidance mechanisms from their originally collective level to that of the individual, such technologies have had the unintended consequence of facilitating inadequate lay constructions of risk-management, potentially putting gay men at risk of HIV infection

The Bars, the Bogs, and the Bushes': the Impact of Locale on Sexual Cultures

by Paul Flowers

This paper explores the role of locale and location in understanding gay men's sexual behaviour. Twenty gay men from... more This paper explores the role of locale and location in understanding gay men's sexual behaviour. Twenty gay men from Glasgow, Scotland took part in semi-structured, in-depth interviews. Interpretative Phenomenological Analysis (IPA) was employed to analyse transcripts for recurrent themes. Shared understanding relating to the relationship between locale and sexual activity emerged as important. Findings suggest the existence of distinct sexual cultures associated with locales such as the commercial gay scene (the bars), public toilets (the bogs) and public parks (the bushes). Furthermore, sexual activity was directly affected by its specific location. Sexual behaviour is understood and patterned by the locale (i.e. sexual space) in which it occurs; it is also constrained by location (i.e. specific site). In the light of these findings the appropriateness of traditional psychological approaches to understanding sexual activity and the relevance of other perspectives which map the links between social context and sexual behaviour are discussed

Re‐appraising HIV testing: An exploration of the psychosocial costs and benefits associated with learning one's HIV status in a purposive sample of Scottish gay men

by Paul Flowers

OBJECTIVE:
This study explored contemporary understandings of the psychosocial costs and benefits associated with... more OBJECTIVE:
This study explored contemporary understandings of the psychosocial costs and benefits associated with learning one's HIV status within a purposive sample of Scottish gay men. It seeks to provide insight into the psychosocial factors associated with decision-making processes relating to the HIV antibody test.
METHOD:
Transcripts of one-to-one interviews (N = 19) and four focus groups (N = 18) were analysed using Interpretative Phenomenological Analysis. Participants had varied HIV testing histories, and the sample included men who identified their HIV status as positive, men who identified it as negative, and men who did not know.
RESULTS:
The HIV test could resolve doubt and anxiety for some men, but only when 'not knowing' was experienced as less tolerable than an imagined positive result. Many participants were deterred from seeking an HIV test because of their fears of the implications of a positive result. The decision to take an HIV test could be understood as a choice between living with uncertainty and the perceived impact of ascertaining HIV status.
CONCLUSION:
For the participants in this study, the decision to test or not involved many complex medical, psychological and social factors. It is argued that the development of HIV testing policy must start with a perspective grounded in an understanding and appreciation of these complexities.

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

by Paul Flowers

OBJECTIVES:
Although a wide literature details the psychological impact of human immunodeficiency virus (HIV)... more 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.

Diagnosis and Stigma and Identity Amongst HIV Positive Black Africans Living In the UK

by Paul Flowers

Individual in-depth, semi-structured interviews with 30 HIV positive Black Africans were conducted in London, UK. The... more Individual in-depth, semi-structured interviews with 30 HIV positive Black Africans were conducted in London, UK. The interviews focused upon experiential accounts of living with HIV. The interviews were transcribed and analysed for recurrent themes using interpretative phenomenological analysis. The social context of being a Black African living in the UK emerged as an important framework within which the experience of being HIV positive was positioned. In terms of people's accounts of their own experiences of living with HIV, diagnosis figured as an important moment in people's lives. The majority of participants were surprised and upset upon receiving their positive antibody test results. Many reported a period of depression and social isolation. Stigma and prejudice associated with HIV also emerged as a major force shaping the daily lives of the participants. We discuss the role of identity and social context in disrupting the medical meaning of diagnostic tests.

Interpretative Phenomenological Analysis: Theory, Method and Research

by Paul Flowers

Exploring lived experience

by Paul Flowers

UNDERSTANDING experience is the very bread and butter of psychology, and interpretative phenomenological analysis... more UNDERSTANDING experience is the very bread and butter of psychology, and interpretative phenomenological analysis (IPA: Smith, 1996) offers psychologists the opportunity to learn from the insights of the experts – research participants themselves. What is it like to experience auditory hallucinations, or chronic pain, for example? How can we better understand the decisions that people make, about issues as diverse as safe-sex practices, genetic testing, drug use or participation in dangerous sports? In this article we describe the recent development of IPA and show how it can help answer such questions.

A STUDY OF HITCHCOCK'S FILM THE REAR WINDOW ON HOW WE INTERPRET SOCIAL ACTIONS

by Oriol Iglesias

Co-authored with Catalina Pons and Eduard Bonet - Work in progress

The papers explores the ideas of Alfred Schultz on how we interpret social actions using the film "The Rear... more The papers explores the ideas of Alfred Schultz on how we interpret social actions using the film "The Rear Window" by Alfred Hitchcok as an example.

Decision-making in planned lesbian parenting: An interpretative phenomenological analysis

by Adrian Coyle

Co-authored with Elena Touroni. Published in 2002 in the Journal of Community & Applied Social Psychology, 12, 194-209. Please contact me if you would like a complete copy of the paper but are unable to locate it.

What does it mean to be a donor offspring? The identity experiences of adults conceived by donor insemination and the implications for counselling and therapy

by Adrian Coyle

Co-authored with Amanda J. Turner. Published in 2000 in Human Reproduction, 15(9), 2041-2051. Please contact me if you would like a copy of this paper but experience difficulties in locating it.

Spiritual beliefs and the search for meaning among older adults following partner loss

by Adrian Coyle

Co-authored with Richard Golsworthy. Published in 1999 in Mortality, 4(1), 21-40. Please contact me if you would like a copy of the complete paper but experience difficulties in locating it.

Jewish gay men's accounts of negotiating cultural, religious, and sexual identity: A qualitative study

by Adrian Coyle

Co-authored with Deborah Rafalin. Published in 2000 in the Journal of Psychology & Human Sexuality, 12(4), 21-48. A manuscript version of this article can be downloaded from http://epubs.surrey.ac.uk/1704/1/fulltext.pdf

Research on the construction of lesbian and gay identity has represented this process as carrying considerable... more Research on the construction of lesbian and gay identity has represented this process as carrying considerable potential for intrapsychic and interpersonal stress and conflict. This process may be rendered even more psychologically challenging for those whose identities feature salient components that are not easily reconciled with a lesbian or gay identity. An example of this is the simultaneous holding of Jewish and gay identities. This paper reports findings from a qualitative study of 21 Jewish gay men in Britain. Participants were interviewed about the development of their gay identity, the relationship between their gay identity and their Jewish identity, the psychological and social implications of holding these identities, and strategies for managing any difficulties associated with this. Data were subjected to interpretative phenomenological analysis. All but one of the men reported experiences of identity conflict, arising mainly from the perceived incompatibility of Jewish and gay identities. This was said to have impacted negatively upon their psychological well-being. Those who had received negative reactions to the disclosure of sexual identity within Jewish contexts often attributed this to an anti-gay stance within Judaism and a concern with ensuring the continuation of the Jewish people. Various strategies were said to have been used to manage identity threat, including compartmentalizing Jewish and gay identity and revising the content or salience of Jewish identity. Recommendations are offered for psychological interventions which could help Jewish gay men manage identity conflict.

Can parental responses to adult children with schizophrenia be conceptualised in terms of loss and grief? A case study analysis

by Adrian Coyle

Co-authored with James Osborne. Published in 2002 in Counselling Psychology Quarterly, 15(4), 307-323. A manuscript version of this paper can be downloaded from http://epubs.surrey.ac.uk/1716/1/fulltext.pdf

It has been suggested that parental responses to adult children with schizophrenia may involve feelings of loss and... more It has been suggested that parental responses to adult children with schizophrenia may involve feelings of loss and grief, centred around loss of the pre-morbid version of their child. In this exploratory study, an in-depth case study analysis of four parental accounts of their responses was undertaken in order to obtain insights into whether these responses can be conceptualised in terms of loss and grief, with the aim of informing therapeutic practice with parents in this position. Information was also obtained on how parents coped with the
reactions that their child’s condition elicited in them. Data were analysed using Interpretative Phenomenological Analysis. In relation to the central research question, it was found that the perception of loss was not uniform amongst participants. Three acknowledged a sense of loss at least to some extent but one parent resisted such an interpretation because she perceived a continuity over time in her son’s behaviour and she also challenged her son’s diagnosis. One parent acknowledged a loss of his daughter’s premorbid self but qualified this by pointing to her continued physical presence. The usefulness of existing models of grief are examined in light of the findings. The implications for the practice of counselling psychology are discussed.

Young people’s accounts of homelessness: A case study analysis of psychological well-being and identity

by Adrian Coyle

Co-authored with Esther Riggs. Published in 2002 in Counselling Psychology Review, 17(3), 5-15. A manuscript version of this paper can be downloaded from http://epubs.surrey.ac.uk/1714/1/fulltext.pdf

With the aim of informing counselling psychology practice with young homeless people, this paper reports a qualitative... more With the aim of informing counselling psychology practice with young homeless people, this paper reports a qualitative study of psychological well-being and identity among four young people, recruited in the English Midlands, who had experienced homelessness between the ages of 16 and 25. All participants were interviewed; interview transcripts were subjected to interpretative phenomenological analysis, with analyses presented on a case-by-case basis. In physical terms, participants associated homelessness with a lack of permanent housing or a secure place for physical possessions. In psychological terms, homelessness was associated with feeling isolated, rejected or alienated, lacking an emotional attachment to or identification with a place and lacking a safe space for psychological ‘belongings’. Participants also referred to a loss of identity and person-hood whilst homeless. Identity threat had been dealt with through intrapsychic and intergroup coping strategies. Suggestions are offered for counselling psychology practice with this population.

The experience of hearing voices: An interpretative phenomenological analysis

by Adrian Coyle

Co-authored with Ben Knudson. Published in 2002 in Existential Analysis, 13(1), 117-134. A manuscript version of this paper can be downloaded from http://epubs.surrey.ac.uk/1713/1/fulltext.pdf

This article presents an analysis of two case studies of people who hear voices. In accordance with a phenomenological... more This article presents an analysis of two case studies of people who hear voices. In accordance with a phenomenological approach, the meanings which the participants attribute to their voices are highlighted in the analysis (specifically in relation to the nature and origin of the voices) and the influence which these interpretations have on their efforts at managing and reducing their disruptive effects is explored. It is concluded that if this analysis has accessed general processes in voice hearers’ experiences, therapeutic practitioners may need to work with voice hearers in promoting psychologically satisfying meaning-making around their experiences, from which contextualised responses to managing the voices can be developed.

The ethical challenge of working with spiritual difference: An interpretative phenomenological analysis of practitioners’ accounts

by Adrian Coyle

Co-authored with Joanna Jackson. Published in 2009 in Counselling Psychology Review, 24(3 & 4), 86-99. A manuscript version of this paper can be downloaded from http://epubs.surrey.ac.uk/2038/1/Jackson_and_Coyle_2009_Counselling_Psychology_Review_paper.pdf

Addressing spirituality in therapy is not only important for a substantial number of clients but many therapists also... more Addressing spirituality in therapy is not only important for a substantial number of clients but many therapists also regard it as potentially valuable. However, practitioners report difficulties and confusion regarding how to work with spiritual difference, especially when clients’ spiritual beliefs are perceived as undermining their psychological well-being. The current study aimed to explore this challenge through the use of a qualitative design. Semistructured interviews were conducted with 11 practitioners and the transcripts were analysed using interpretative phenomenological analysis. Three superordinate themes were discerned in the data: ‘therapists’ perception of clients’ spiritual beliefs: psychological understanding and impact’, ‘therapists’ aims and responsibilities: (in)compatibility with clients’ spiritual beliefs’ and ‘therapists’ practice responses to psychologically unhelpful spiritual beliefs: explicit and implicit approaches’. When clients’ spiritual beliefs were perceived as psychologically unhelpful, therapists experienced a conflict between their ethical stance to respect clients’ beliefs and their aim to enhance psychological well-being. This conflict presented the greatest challenge for therapists working with different spiritual beliefs. Implications and recommendations for practice are considered and avenues for future research are highlighted. In particular, it is recommended for therapists to recognize this challenge as an ethical dilemma, to develop an ethical analytic framework and to reflect on their own beliefs within this framework.

'Arabic is the language of the Muslims - that's how it was supposed to be': Exploring language and religious identity through reflective accounts from young British-born South Asians

by Adrian Coyle

Co-authored with Rusi Jaspal. Published in 2010 in Mental Health, Religion & Culture, 13, 17-36. Please contact me if you would like a copy of this paper but experience difficulties in locating it.