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Interpretative Phenomenological Analysis, Exams of Psychology

The aim of interpretative phenomenological analysis (IPA) is to explore in detail how participants are making sense of their personal and social world,.

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The aim of interpretative phenomenological analysis (IPA) is to explore in
detail how participants are making sense of their personal and social world,
and the main currency for an IPA study is the meanings particular experiences,
events, states hold for participants. The approach is phenomenological (see
Chapter 3) in that it involves detailed examination of the participant’s life-
world; it attempts to explore personal experience and is concerned with an
individual’s personal perception or account of an object or event, as opposed
to an attempt to produce an objective statement of the object or event itself.
At the same time, IPA also emphasizes that the research exercise is a dynamic
process with an active role for the researcher in that process. One is trying to
get close to the participant’s personal world, to take, in Conrad’s (1987)
words, an ‘insider’s perspective’, but one cannot do this directly or completely.
Access depends on, and is complicated by, the researcher’s own conceptions;
indeed, these are required in order to make sense of that other personal world
through a process of interpretative activity. Thus, a two-stage interpretation
process, or a double hermeneutic, is involved. The participants are trying to
make sense of their world; the researcher is trying to make sense of the partic-
ipants trying to make sense of their world. IPA is therefore intellectually con-
nected to hermeneutics and theories of interpretation (Packer and Addison,
1989; Palmer,1969; Smith, in press;see also Chapter 2 this volume).Different
interpretative stances are possible, and IPA combines an empathic hermeneu-
tics with a questioning hermeneutics.Thus, consistent with its phenomenolog-
ical origins, IPA is concerned with trying to understand what it is like,from the
point of view of the participants, to take their side.At the same time, a detailed
IPA analysis can also involve asking critical questions of the texts from partic-
ipants, such as the following: What is the person trying to achieve here? Is
something leaking out here that wasn’t intended? Do I have a sense of some-
thing going on here that maybe the participants themselves are less aware of?
Four
Interpretative Phenomenological Analysis
Jonathan A. Smith and Mike Osborn
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The aim of interpretative phenomenological analysis (IPA) is to explore in detail how participants are making sense of their personal and social world, and the main currency for an IPA study is the meanings particular experiences, events, states hold for participants. The approach is phenomenological (see Chapter 3) in that it involves detailed examination of the participant’s life- world; it attempts to explore personal experience and is concerned with an individual’s personal perception or account of an object or event, as opposed to an attempt to produce an objective statement of the object or event itself. At the same time, IPA also emphasizes that the research exercise is a dynamic process with an active role for the researcher in that process. One is trying to get close to the participant’s personal world, to take, in Conrad’s (1987) words, an ‘insider’s perspective’, but one cannot do this directly or completely. Access depends on, and is complicated by, the researcher’s own conceptions; indeed, these are required in order to make sense of that other personal world through a process of interpretative activity. Thus, a two-stage interpretation process, or a double hermeneutic, is involved. The participants are trying to make sense of their world; the researcher is trying to make sense of the partic- ipants trying to make sense of their world. IPA is therefore intellectually con- nected to hermeneutics and theories of interpretation (Packer and Addison, 1989; Palmer, 1969; Smith, in press; see also Chapter 2 this volume). Different interpretative stances are possible, and IPA combines an empathic hermeneu- tics with a questioning hermeneutics. Thus, consistent with its phenomenolog- ical origins, IPA is concerned with trying to understand what it is like, from the point of view of the participants, to take their side. At the same time, a detailed IPA analysis can also involve asking critical questions of the texts from partic- ipants, such as the following: What is the person trying to achieve here? Is something leaking out here that wasn’t intended? Do I have a sense of some- thing going on here that maybe the participants themselves are less aware of?

Four

Interpretative Phenomenological Analysis

Jonathan A. Smith and Mike Osborn

We would say that both styles of interpretation are part of sustained qualitative inquiry but that the degree of emphasis will depend on the particularities of the IPA study concerned. The ordinary word ‘understanding’ usefully captures these two aspects of interpretation-understanding in the sense of identifying or empathizing with and understanding as trying to make sense of. Allowing for both aspects in the inquiry is likely to lead to a richer analysis and to do greater justice to the totality of the person, ‘warts and all’. IPA also acknowl- edges a debt to symbolic interactionism (Denzin, 1995) with its concern for how meanings are constructed by individuals within both a social and a personal world. IPA has a theoretical commitment to the person as a cognitive, linguistic, affective and physical being and assumes a chain of connection between people’s talk and their thinking and emotional state. At the same time, IPA researchers realize this chain of connection is complicated – 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. IPA’s emphasis on sense-making by both participant and researcher means that it can be described as having cognition as a central analytic concern, and this suggests an interesting theoretical alliance with the cognitive paradigm that is dominant in contemporary psychology. IPA shares with the cognitive psychol- ogy and social cognition approaches in social and clinical psychology (Fiske and Taylor, 1991) a concern with mental processes. However, IPA strongly diverges from mainstream psychology when it comes to deciding the appropriate methodology for such questions. While mainstream psychology is still strongly committed to quantitative and experimental methodology, IPA employs in- depth qualitative analysis. Thus, IPA and mainstream psychology converge in being interested in examining how people think about what is happening to them but diverge in deciding how this thinking can best be studied. Indeed, we would argue that IPA’s commitment to the exploration of mean- ing and sense-making links it quite closely to the original concerns of cogni- tive psychology in its rejection of the behavourist paradigm that had thus far dominated the discipline. It is interesting to see how Bruner (1990), one of the founders of the cognitive approach, regrets how it swiftly moved from a cen- tral concern with meaning and meaning making into the science of informa- tion processing. For more on the theoretical foundations of IPA, see Smith (1996a) and Eatough and Smith (in press). The aim of this chapter is to provide for the reader new to this way of working a detailed presentation of the stages involved in doing interpretative phenomenological analysis. It gives details of each stage and illustrates them with material taken from a study conducted by the authors. At the same time, it should be recognized that, as is generally the case with qualitative research, there is no single, definitive way to do IPA. We are offering suggestions, ways we have found that have worked for us. We hope these will be useful in

54 Qualitative Psychology

not to say that IPA is opposed to more general claims for larger populations; it is just that it is committed to the painstaking analysis of cases rather than jump- ing to generalizations. This is described as an idiographic mode of inquiry as opposed to the nomothetic approach which predominates in psychology (Smith et al., 1995). In a nomothetic study, analysis is at the level of groups and popula- tions, and one can make only probabilistic claims about individuals; for example, there is a 70 per cent chance that person x will respond in this way. In an idio- graphic study, because it has been derived from the examination of individual case studies, it is also possible to make specific statements about those individuals. IPA researchers usually try to find a fairly homogeneous sample. The basic logic is that if one is interviewing, for example, six participants, it is not very helpful to think in terms of random or representative sampling. IPA therefore goes in the opposite direction and, through purposive sampling, finds a more closely defined group for whom the research question will be significant. How the specificity of a sample is defined will depend on the study; in some cases, the topic under inves- tigation may itself be rare and define the boundaries of the relevant sample. In other cases where a less specific issue is under investigation, the sample may be drawn from a population with similar demographic/socio-economic status pro- files. The logic is similar to that employed by the social anthropologist conduct- ing ethnographic research in one particular community. The anthropologist then reports in detail about that particular culture but does not claim to be able to say something about all cultures. In time, of course, it will be possible for subsequent studies to be conducted with other groups, and so, gradually, more general claims can be made, but each founded on the detailed examination of a set of case studies. It is also possible to think in terms of theoretical rather than empirical generalizability. In this case, the readers make links between the findings of an IPA study, their own personal and professional experience, and the claims in the extant literature. The power of the IPA study is judged by the light it sheds within this broader context. A final note on sampling: it should be remembered that one always has to be pragmatic when doing research; one’s sample will in part be defined by who is prepared to be included in it! There is no right answer to the question of the sample size. It partly depends on several factors: the degree of commitment to the case study level of analy- sis and reporting, the richness of the individual cases, and the constraints one is operating under. For example, IPA studies have been published with samples of one, four, nine, fifteen and more. Recently there has been a trend for some IPA studies to be conducted with a very small number of participants. A dis- tinctive feature of IPA is its commitment to a detailed interpretative account of the cases included and many researchers are recognizing that this can only realistically be done on a very small sample – thus in simple terms one is sacrificing breadth for depth. Recently the first author has been arguing the case for the single case study (Smith, 2004) and for recent examples of IPA case studies, see Eatough and Smith (2006a, 2006b). In the recent past, five or six has sometimes been recommended as a reasonable sample size for a student

56 Qualitative Psychology

project using IPA. Our current thinking is that for students doing IPA for the first time, three is an extremely useful number for the sample. This allows sufficient in-depth engagement with each individual case but also allows a detailed exami- nation of similarity and difference, convergence and divergence. The danger for the newcomer is that if the sample size is too large they become overwhelmed by the vast amount of data generated by a qualitative study and are not able to produce a sufficiently penetrating analysis. We express an intellectual debt to George Kelly here (see Bannister and Fransella, 1971; Smith, 1990 and Chapter 2 in this volume). To facilitate accessing an individual’s personal constructs, Kelly suggested considering three elements at a time, allowing the individual to focus closely on the relationship between the elements in considering a way in which two were similar to and different from the third. IPA doesn’t prescribe a tech- nique in the same way but our thinking is clearly related.

Collecting Data: Semi-structured Interviews as the

Exemplary Method for IPA

IPA researchers wish to analyse in detail how participants perceive and make sense of things which are happening to them. It therefore requires a flexible data collection instrument. While it is possible to obtain data suitable for IPA analysis in a number of ways – such as personal accounts, and diaries – probably the best way to collect data for an IPA study and the way most IPA studies have been con- ducted is through the semi-structured interview. This form of interviewing allows the researcher and participant to engage in a dialogue whereby initial questions are modified in the light of the participants’ responses and the investigator is able to probe interesting and important areas which arise. Therefore, we will discuss semi-structured interviewing in detail in this chapter. For discussion of other data collection methods either used in or consonant with IPA, see Smith (1990) and Plummer (2000). It is useful first to contrast the primary features of a semi- structured interview with those of a structured interview.

TThhee SSttrruuccttuurreedd IInntteerrvviieeww

The structured interview shares much of the rationale of the psychological exper- iment. Generally, the investigator decides in advance exactly what constitutes the required data and constructs the questions in such a way as to elicit answers cor- responding to, and easily contained within, predetermined categories, which can then be numerically analysed. In order to enhance reliability, the interviewer should stick very closely to the interview schedule and behave with as little vari- ation as possible between interviews. The interviewer will aim to:

  • use short specific questions
  • read the question exactly as on the schedule

Interpretative Phenomenological Analysis^57

pursue. At the same time, there is a wish to try to enter, as far as possible, the psychological and social world of the respondent. Therefore, the respondent shares more closely in the direction the interview takes, and the respondent can introduce an issue the investigator had not thought of. In this relationship, the respondents can be perceived as the experiential expert on the subject and should therefore be allowed maximum opportunity to tell their own story. Thus, we could summarize the advantages of the semi-structured interview. It facilitates rapport/empathy, allows a greater flexibility of coverage and allows the interview to go into novel areas, and it tends to produce richer data. On the debit side, this form of interviewing reduces the control the investiga- tor has over the situation, takes longer to carry out, and is harder to analyse.

Constructing the Interview Schedule

Although an investigator conducting a semi-structured interview is likely to see it as a co-determined interaction in its own right, it is still important when working in this way to produce an interview schedule in advance. Why? Producing a schedule beforehand forces us to think explicitly about what we think/hope the interview might cover. More specifically, it enables us to think of difficulties that might be encountered, for example, in terms of question wording or sensitive areas, and to give some thought to how these difficulties might be handled. Having thought in advance about the different ways the interview may proceed allows us, when it comes to the interview itself, to concentrate more thoroughly and more confidently on what the respondent is actually saying. For example, Box 4.2 presents a schedule from a project one of us conducted on kidney disease patients’ response to their illness. The participants are undergoing dialysis treat- ment for their kidney disease – an extremely demanding treatment regimen which involves going to hospital three or four times a week and being attached to a dialysis machine for about three hours.

Box 4.2 Interview schedule: patient’s experience of renal dialysis

A. Dialysis

  1. Could you give me a brief history of your kidney problem from when it started to your beginning dialysis?
  2. Could you describe what happens in dialysis, in your own words?
  3. What do you do when you are having dialysis?
  4. How do you feel when you are dialysing? prompt: physically, emotionally, mentally. (Continued)

Interpretative Phenomenological Analysis^59

(Continued)

  1. What do you think about?
  2. How do you feel about having dialysis? prompt: some people/relief from previous illness/a bind.
  3. How does dialysis/kidney disease affect your everyday life? prompt: work, interests, relationships.
  4. If you had to describe what the dialysis machine means to you, what would you say? prompt: What words come to mind, what images? Do you have a nickname for it?

B. Identity

  1. How would you describe yourself as a person? prompt: What sort of person are you? Most important characteristics: happy, moody, nervy.
  2. Has having kidney disease and starting dialysis made a difference to how you see yourself? prompt: If so, how do you see yourself now as different from before you started dialysis? How would you say you have changed?
  3. What about compared to before you had kidney disease?
  4. What about the way other people see you? prompt: members of your family, friends? changed?

C. Coping

  1. What does the term ‘illness’ mean to you? How do you define it?
  2. How much do you think about your own physical health?
  3. Do you see yourself as being ill? prompt: always, sometimes? Would you say you were an ill person?
  4. On a day-to-day basis, how do you deal with having kidney disease (the illness)? prompt: do you have particular strategies for helping you? ways of cop- ing, practical, mental.
  5. Do you think about the future much?

The following list suggests a sequence for producing an interview schedule. This is intended to be only suggestive, not prescriptive. Note also that doing this sort of work is often iterative rather than linear, and you may find your ideas of what the interview should cover changing or developing as you work on the schedule.

60 Qualitative Psychology

Thus, the interviewer starts with the most general possible question and hopes that this will be sufficient to enable the respondent to talk about the subject. If respondents have difficulty, say they do not understand, or give a short or tangential reply, the interviewer can move to the prompt, which is more specific. Hopefully, this will be enough to get the participant talking. The more specific level questions are there to deal with more difficult cases where the respondent is more hesitant. It is likely that a successful interview will include questions and answers at both general and more specific levels and will move between the two fairly seamlessly. If an interview is taken up with material entirely derived from very specific follow-up questions, you may need to ask yourself how engaged the respondent is. Are you really entering the personal/social life world of the participants, or are you forcing them, per- haps reluctantly and unsuccessfully, to enter yours? Funnelling is a related technique. For certain issues, it may well be that you are interested in eliciting both the respondents’ general views and their response to more specific concerns. Constructing this part of the schedule as a funnel allows you to do this. Thus, in Box 4.3, the first question attempts to elicit the respondent’s general view on government policy. Having established that, the interviewer probes for more specific issues. The general point is that by asking questions in this sequence, you have allowed the respondents to give their own views before funnelling them into more specific questions of partic- ular concern to you. Conducted in the reverse sequence, the interview is more likely to produce data biased in the direction of the investigator’s prior and specific concerns. Of course, it is possible that when answering the first ques- tion, the respondent may also address the targeted issue and so make it redun- dant for you to ask the more specific questions.

Box 4.3 Funnelling

  1. What do you think of current government policies?
  2. What do you think of the current government policies towards health and welfare issues?
  3. Do you think the government record in this area is okay, or should it be doing anything different?
  4. If so, what?
  5. It has been suggested that government policy is moving towards one of self- reliance, the welfare system being there only as a safety net for people unable to finance their own provision. What do you think of this as a policy?

Below we provide some more tips on good practice for constructing the inter- view schedule:

62 Qualitative Psychology

  • Questions should be neutral rather than value-laden or leading. Bad: Do you think that the prime minister is doing a good job? Better: What do you think of the prime minister’s record in office so far?
  • Avoid jargon or assumptions of technical proficiency. Try to think of the perspective and language of the participants in your study and frame your questions in a way they will feel familiar and comfortable with. Bad: What do you think of the human genome project? Better: What do you know about recent developments in genetics? Obviously, the first question would be fine if one were talking to biologists!
  • Use open, not closed, questions. Closed questions encourage Yes/No answers rather than getting the respondent to open up about their thoughts and feelings. Bad: Should the manager resign? Better: What do you think the manager should do now? It all depends on intent and context, however. It is possible to ask what seems like a closed question in such a way and at such a point in the interview that it is actually unlikely to close down the response.

Having constructed your schedule, you should try and learn it by heart before beginning to interview so that, when it comes to the interview, the schedule can act merely as a mental prompt, if you need it, rather than you having con- stantly to refer to it.

Interviewing

Semi-structured interviews generally last for a considerable amount of time (usually an hour or more) and can become intense and involved, depending on the particular topic. It is therefore sensible to try to make sure that the inter- view can proceed without interruption as far as possible, and usually it is bet- ter to conduct the interview with the respondent alone. At the same time, one can think of exceptions where this would be neither practical nor sensible. For example, it may not be advisable with young children. The location of the interview can also make a difference. People usually feel most comfortable in a setting they are familiar with, as in their own home, but there may be times when this is not practicable and a different venue will need to be chosen. It is sensible to concentrate at the beginning of the interview on putting respondents at ease, to enable them to feel comfortable talking to you before any of the substantive areas of the schedule are introduced. Hopefully, then, this positive and responsive ‘set’ will continue through the interview. The interviewer’s role in a semi-structured interview is to facilitate and guide, rather than dictate exactly what will happen during the encounter. If the interviewer has learnt the schedule in advance, he or she can concentrate during the interview on what the respondent is saying, and occasionally mon- itor the coverage of the scheduled topics. Thus, the interviewer uses the sched- ule to indicate the general area of interest and to provide cues when the

Interpretative Phenomenological Analysis^63

Of course, the respondent may not like being taped and may even not agree to the interview if it is recorded. It is also important not to reify the tape recording. While the record it produces is fuller, it is not a complete ‘objective’ record. Non-verbal behaviour is excluded, and the recording still requires a process of interpretation by the transcriber or any other listener. If you do decide to tape and transcribe the interview, the normal convention is to transcribe the whole interview, including the interviewer’s questions (see Box 4.4 for a sample). Leave a margin wide enough on both sides to make your analytic comments. For IPA, the level of transcription is generally at the semantic level: one needs to see all the words spoken including false starts; sig- nificant pauses, laughs and other features are also worth recording. However, for IPA, one does not need the more detailed transcription of prosodic features of the talk which are required in conversation analysis (see Chapter 7). Transcription of tapes takes a long time, depending on the clarity of the record- ing and one’s typing proficiency. As a rough guide, one needs to allow between five and eight hours of transcription time per hour of interview.

Box 4.4 Sample of transcription from dialysis project

Q Right, okay, em, so I would like to start with some questions about dialysis, okay? And a very basic one just to start with, can you tell me what you do, physically do, when you’re dialysing? R What I actually do with myself while I’m sat there? Q Yeah. R Well, what I tend to do is, I always have a paper, or I watch TV, you mean actually just sat there? Q Yeah. R I read the papers, I always take two papers from work or a magazine and read those. Q Do you mean work papers or? R No, just normal everyday papers cos the problem I’ve got is because I’m right-handed and the fistula (?) is on the right-hand side, which is the one annoyance but I can’t write. Q Because you can’t write, yeah. R Or else I would be able to, so I read the papers or take as many magazines as I can and I always keep myself busy or watch TV. If I’m getting a good enough sound from the television point I watch the news, I always do it the same way, get in, get on, read the news daily papers, any magazines I’ve got, then if I’ve got a good enough sound on the TV I watch the news from half 6 to half 7, that’s during the week when I’m in there, on the Sunday now I do it on a morning, I just buy a Sunday paper and I always read the paper or read a magazine. Always the same, just so I can keep my mind occupied. I always need to do that. (Continued)

Interpretative Phenomenological Analysis^65

(Continued) Q So you are able to concentrate enough to be able to do? R Yeah. And sometimes if I’m tired I can go to sleep for an hour. Q Right. R Or if I’ve run out of papers and sometimes I just shut me eyes for an hour, and I can fall asleep but normally if I can I always make sure I get a maga- zine or a paper and read that and do something. Q And that sounds as though you’re, that’s quite a determined routine. R Yeah. Q Do you, what’s behind that, what what why do you feel the necessity to be so methodical? R I think what I try and do is, yeah, so that I treat it as part of normal routine, I think that’s what I do it for, I’m sometimes, I always get a paper from work, the same papers, always try and borrow a magazine and read and keep myself, a way not thinking about it while I’m on, that is why I do it and watch TV, so I don’t think about the machine or I get bored if I’m just sat there doing nothing, but mainly not so I don’t think about it, so I can just think about reading the paper, and I read the paper from top to bottom even if I’ve, I just read everything, it’s the same things in the same papers in the daily paper, but I always read the same things, even if it’s just reading the same things again I read the papers from top to bottom all the way through, and any magazines I always read them and read it from the beginning to the end or watch the TV, always keep myself busy thinking about something rather than that, that’s what I feel I do it for.

Analysis

The assumption in IPA is that the analyst is interested in learning something about the respondent’s psychological world. This may be in the form of beliefs and constructs that are made manifest or suggested by the respondent’s talk, or it may be that the analyst holds that the respondent’s story can itself be said to represent a piece of the respondent’s identity (Smith, 2003). Either way, meaning is central, and the aim is to try to understand the content and com- plexity of those meanings rather than measure their frequency. This involves the investigator engaging in an interpretative relationship with the transcript. While one is attempting to capture and do justice to the meanings of the respondents to learn about their mental and social world, those meanings are not transparently available – they must be obtained through a sustained engagement with the text and a process of interpretation. The following section describes a step-by-step approach to the analysis in IPA, illustrated with a worked example from a study on the impact of chronic

66 Qualitative Psychology

Int. How long has it been like that? Aggression Not who I am – identity Being mean Can’t help it – no control Me doing it but not me Conflict, tension Me vs nice Shame, if you knew – disgust Fear of being known M. Since it started getting bad, I was always snappy with it but not like this, it’s not who I am it’s just who I am if you know what I mean, it’s not really me, I get like that and I know like, you’re being mean now but I can’t help it. It’s the pain, it’s me, but it is me, me doing it but not me do you understand what I’m say- ing, if I was to describe myself like you said, I’m a nice person, but then I’m not am I, and there’s other stuff, stuff I haven’t told you, if you knew you’d be disgusted I just get so hateful. Int. When you talk about you and then sometimes not you, what do you mean? Not always me, part of

himself that is rejected

  • hateful, the ‘not me’ Not me = pain, defending against implications that it is ‘me’ Helpless Mean/sour – worse than the pain M. I’m not me these days, I am sometimes, I am all right, but then I get this mean bit, the hateful bit, that’s not me. Int. What’s that bit? M. I dunno, that’s the pain bit, I know you’re gonna say it’s all me, but I can’t help it even though I don’t like it. It’s the mean me, my mean head all sour and horrible, I can’t cope with that bit, I cope with the pain better. Int. How do you cope with it? Tearful/distressed, avoidant/resistant Unbearable, shocked at self M. Get out the way, [tearful] sit in my room, just get away, look do you mind if we stop now, I didn’t think it would be like this, I don’t want to talk any more.

68 Qualitative Psychology

This process is continued for the whole of the first transcript. Then one returns to the beginning of the transcript, and the other margin is used to document emerging theme titles. Here the initial notes are transformed into concise phrases which aim to capture the essential quality of what was found in the text. The themes move the response to a slightly higher level of abstraction and may invoke more psychological terminology. At the same time, the thread back to what the participant actually said and one’s initial response should be apparent. So the skill at this stage is finding expressions which are high level enough to allow theoretical connections within and across cases but which are still grounded in the particularity of the specific thing said. From Martha’s account, related above, the following themes emerged and were noted:

Int. How long has it been like that? Anger and pain Struggle to accept self and identity – unwanted self Lack of control over self Responsibility, self vs pain

Shameful self – struggle with unwanted self Fear of judgement M. Since it started getting bad, I was always snappy with it but not like this, it’s not who I am it’s just who I am if you know what I

mean, it’s not really me, I get like that and I know like, you’re being mean now but I can’t help it. It’s the pain, it’s me, but it is me, me doing it but not me do you understand what I’m saying, if I was to describe myself like you said, I’m a nice person, but then I’m not am I, and there’s other stuff, stuff I haven’t told you, if you knew you’d be dis- gusted I just get so hateful. Int. When you talk about you and then some- times not you, what do you mean? M. I’m not me these days, I am sometimes, I am all right, but then I get this mean bit, the hateful bit, that’s not me. Unwanted self rejected as true self

Int. What’s that bit? M. I dunno, that’s the pain bit, I know you’re gonna say it’s all me, but I can’t help it even though I don’t like it. It’s the mean me, my mean head all sour and horrible, I can’t cope with that bit, I cope with the pain better. Attribution of unwanted self to the pain Defence of original self Ranking duress, self vs pain Int. How do you cope with it? Shame of disclosure M. Get out the way, [tearful] sit in my room, just get away, look do you mind if we stop now, I didn’t think it would be like this, I don’t want to talk any more.

Interpretative Phenomenological Analysis^69

This transformation of initial notes into themes is continued through the whole transcript. It may well be that similar themes emerge as you go through the tran- script and where that happens the same theme title is therefore repeated. We have presented the two stages for a small extract above to show the way in which the transformation into themes works. To illustrate this process further, here is another section of the transcript, showing first the initial notes and then the emergent themes:

Resistance to change Avoidance Struggle against being ‘bad person’, depression Fear of exposure/public knowledge Mean, unsociable, undesirable Schadenfreude Loss of care, bitter against will Rejected as true self Confusion, lack of control M. No, not really, well, you don’t want to think you’ve changed at all, and I don’t think about it, you’ve asked me and I’m trying to think and yeah, I don’t want to, but I think I’m not a bad person, perhaps, yeah, it

brings you down, and then you end up spoil- ing things. Int. How do you mean? M. No one is going to hear this tape, right? Int. Like we agreed, anonymous and confi- dential, you get the tape after I’m done. M. Right, [pause] the pain makes me mean. I don’t want to be, but I get like, mean, I don’t care about other people, nothing’s funny, and I get mad if they try to be nice, like pity. It’s not really me, but it is me if know what I mean, I don’t like it but I do it, do you understand, and I end up saying sorry, if I’ve snapped like, it’s the pain it’s killing, it does that sometimes.

The emergent themes for this extract were noted in the right-hand margin:

(Continued)

Responsibility, self vs pain Shameful self – struggle with unwanted self Fear of judgement Unwanted self rejected as true self Attribution of unwanted self to the pain Defence of original self Ranking duress, self vs pain Shame of disclosure Rejection of change Avoidance of implications Struggle to accept new self Undesirable, destructive self Shame Undesirable behaviour ascribed to pain Lack of compassion Conflict of selves, me vs not me Living with a new ‘me’

Box 4.6 Clustering of themes

Undesirable behaviour ascribed to pain Struggle to accept self and identity – unwanted self Shameful self – struggle with unwanted self, fear of judgement Shame of disclosure Struggle to accept new self Undesirable, destructive self Conflict of selves, me vs not me Living with a new ‘me’ Unwanted self rejected as true self Attribution of unwanted self to the pain Defence of original self Lack of control over self Rejection of change Avoidance of implications Responsibility, self vs pain Shame Lack of compassion Anger and pain Ranking duress, self vs pain Shame of disclosure

Interpretative Phenomenological Analysis^71

As the clustering of themes emerges, it is checked in the transcript to make sure the connections work for the primary source material – the actual words of the participant. This form of analysis is iterative and involves a close inter- action between reader and text. As a researcher one is drawing on one’s inter- pretative resources to make sense of what the person is saying, but at the same time one is constantly checking one’s own sense-making against what the per- son actually said. As an adjunct to the process of clustering, it may help to compile directories of the participant’s phrases that support related themes. This can easily be done with the cut and paste functions on a standard word- processing package. The material can be printed to help with the clustering, and as the clustering develops, so the extract material can be moved, con- densed and edited. The next stage is to produce a table of the themes, ordered coherently. Thus, the above process will have identified some clusters of themes which capture most strongly the respondent’s concerns on this particular topic. The clusters are themselves given a name and represent the superordinate themes. The table lists the themes which go with each superordinate theme, and an iden- tifier is added to each instance to aid the organization of the analysis and facil- itate finding the original source subsequently. The identifier indicates where in the transcript instances of each theme can be found by giving key words from the particular extract plus the page number of the transcript. During this process, certain themes may be dropped: those which neither fit well in the emerging structure nor are very rich in evidence within the transcript. The final table of themes for Martha is presented in Box 4.7. Because most of the themes recur in this transcript, the identifier in this case points to a particularly good example of the relevant theme.

Box 4.7 Table of themes from first participant

1.Living with an unwanted self

  • Undesirable behaviour ascribed to pain 1.16 ‘it’s the pain’
  • Struggle to accept self and identity – unwanted self 24.11 ‘who I am’
  • Unwanted self rejected as true self 24.24 ‘hateful bit’
  • Struggle to accept new self 1.8 ‘hard to believe’
  • Undesirable, destructive self 5.14 ‘mean’
  • Conflict of selves, me vs not me 7.11 ‘me not me’
  • Living with a new self 9.6 ‘new me’ 2.A self that cannot be understood or controlled
  • Lack of control over self 24.13 ‘can’t help’
  • Rejection of change 1.7 ‘still same’

72 Qualitative Psychology