This paper discusses our use of a hermeneutic phenomenological methodology to explore the lived e... more This paper discusses our use of a hermeneutic phenomenological methodology to explore the lived experience of feeling joyful. Semi-structured interviews were used to discuss two contrasting experiences of joy for each participant. Analysis was informed by van Manen's human science method, facilitated by King's template analysis. Our findings suggest that joy was a profoundly meaningful sense of positivity. Sometimes this feeling was fleeting, at other times it was described as a longer lasting experience. Regardless of duration, joy involved a desire to relinquish control which could be expressed as a freedom of movement, and could be enabled by the security that significant others provided. We discuss our findings in relation to distinctions previously drawn in the literature between happiness and joy and argue that, despite differences in experiences, the participants' accounts support an understanding of joy as a meaningful and social phenomenon which, though often unexpected, requires intentional engagement.
International Journal of Mental Health and Addiction, 2014
Public perception of alcohol addiction is frequently negative, whilst an important part of recove... more Public perception of alcohol addiction is frequently negative, whilst an important part of recovery is the construction of a positive sense of self. In order to explore how this might be achieved, we investigated how those who self-identify as in recovery from alcohol problems view themselves and their difficulties with alcohol and how they make sense of others' responses to their addiction. Semi-structured interviews with six individuals who had been in recovery between 5 and 35 years and in contact with Alcoholics Anonymous were analysed using Interpretative Phenomenological Analysis. The participants were acutely aware of stigmatising images of 'alcoholics' and described having struggled with a considerable dilemma in accepting this identity themselves. However, to some extent they were able to resist stigma by conceiving of an 'aware alcoholic self' which was divorced from their previously unaware self and formed the basis for a new more knowing and valued identity.
Purpose: Audio-diary methods are under-utilised in contemporary qualitative research. In this pap... more Purpose: Audio-diary methods are under-utilised in contemporary qualitative research. In this paper we discuss participants and researchers' experiences of using audio-diaries alongside semi-structured interviews to explore breastfeeding experiences in a short-term longitudinal study with 22 first-time mothers. Methodology: We provide a qualitative content analysis of the participants' feedback about their experiences of the audio-diary method and supplement this with the perspectives of the research team based on fieldwork notes, memos and team discussions. We pay particular attention to the ways in which the data attained from diaries compared with those from the interviews. Findings: The diaries produced were highly heterogeneous in terms of data length and quality. Participants' experiences with the method were varied. Some found the process therapeutic and useful for reflecting upon the development of breastfeeding skills whilst negative aspects related to lack of mobility, self-consciousness and concerns about confidentiality. Researchers were positive about the audio-diary method but raised certain ethical, epistemological and methodological concerns. These include debates around the use of prompts, appropriate support for participants and the potential of the method to influence the behaviour under scrutiny. Interview and diary accounts contrasted and complemented in ways which typically enriched data analysis.
Recent feminist analyses, particularly from those working within a poststructuralist framework, h... more Recent feminist analyses, particularly from those working within a poststructuralist framework, have highlighted a number of historically located and contradictory socio-cultural constructions and practices which women are faced with when negotiating infant feeding, especially breastfeeding, within contemporary western contexts. However, there has been little explicit analysis of the practice of expressing breast milk. The aim of this article is to explore the embodied practice of expressing breast milk. This is done by analysing, from a feminist poststructuralist perspective, discourse surrounding expressing breast milk in sixteen first time mothers' accounts of early infant feeding. Participants were recruited from a hospital in the South Midlands of England. The data are drawn from the first phase of a larger longitudinal study, during which mothers kept an audio diary about their breastfeeding experiences for seven days following discharge from hospital, and then took part i...
Psychology and Psychotherapy: Theory, Research and Practice, 2004
An increased clinical interest in shame has been reflected in the growing number of research stud... more An increased clinical interest in shame has been reflected in the growing number of research studies in this area. However, clinically-orientated empirical investigation has mostly been restricted to the investigation of individual differences in dispositional shame. This paper reviews recent work on dispositional shame but then argues that the primacy of this construct has been problematic in a number of ways. Most importantly, the notion of shame as a context-free intrapsychic variable has distracted clinical researchers from investigating the management and repair of experiences of shame and shameful identities, and has made the social constitution of shame less visible. Several suggestions are made for alternative ways in which susceptibility to shame could be conceptualised, which consider how shame might arise in certain contexts and as a product of particular social encounters. For example, persistent difficulties with shame may relate to the salience of stigmatising discourses within a particular social context, the roles or subject positions available to an individual, the establishment of a repertoire of context-relevant shame avoidance strategies and the personal meaning of shamefulness. 3 Dispositional shame The concepts of internalised shame and shame-proneness Andrews (1998) suggests that 'high-shame' people have been conceptualised in three different ways i) shame-prone or more likely than other people to feel shame in commonly shame-eliciting situations, ii) frequently or continuously experiencing generalised or global shame, sometimes described as internalised shame or iii) particularly ashamed of some aspect of their behaviour or personal characteristics. Most studies have focused on the first two of these, conceptualising shame as a trait or disposition. Therefore less attention has been paid to specific shame about something, for example related to some kind of stigma. Instead, chronic shame is approached as if it is a property of the individual, existing independently of the contexts in which it might be manifest. Kaufman (1989) has been instrumental in developing the idea of internalised shame. Drawing on Tomkins' (1963) affect theory, Kaufman describes internalised shame as a 'shamebound' personality or 'shame-based identity'. He argues that internal representations of the expression of affects, interpersonal needs, drives and competencies become linked with representations of shame, through repeated experiences of shaming, particularly in childhood. When this happens it becomes impossible to experience these affects, needs, drives and competencies without experiencing shame and the child develops a generalised sense of being unworthy and inferior which persists into adulthood. Therefore, according to Kaufman, someone who experiences a significant degree of internalised shame not only experiences shame frequently in relation to specific situations, but tends to engage in generalised negative self evaluations and carries a sense of personal inadequacy. Shame-proneness appears to be a concept which is less clearly defined than internalised shame. The former term is often employed more loosely and has been used to mean both the readiness with which someone might experience shame and hence the frequency of the emotion, and also the intensity with which the emotion is usually experienced (Gilbert, 1998b). It has also
Many women report difficulties with breastfeeding and do not maintain the practice for as long as... more Many women report difficulties with breastfeeding and do not maintain the practice for as long as intended. Although psychologists and other researchers have explored some of the difficulties they experience, fuller exploration of the relational contexts in which breastfeeding takes place is warranted to enable more in-depth analysis of the challenges these pose for breastfeeding women. The present paper is based on qualitative data collected from 22 first-time breastfeeding mothers through two phases of interviews and audio-diaries which explored how the participants experienced their relationships with significant others and the wider social context of breastfeeding in the first five weeks postpartum. Using a thematic analysis informed by symbolic interactionism, we develop the overarching theme of 'Practising socially sensitive lactation' which captures how participants felt the need to manage tensions between breastfeeding and their perceptions of the needs, expectations and comfort of others. We argue that breastfeeding remains a problematic social act, despite its agreed importance for child health. Whilst acknowledging the limitations of our sample and analytic approach, we suggest ways in which perinatal and public health interventions can take more effective account of the social challenges of breastfeeding in order to facilitate the health and psychological well-being of mothers and their infants.
Breastfeeding is a practice which is promoted and scrutinised in the UK and internationally. In t... more Breastfeeding is a practice which is promoted and scrutinised in the UK and internationally. In this paper we use interpretative phenomenological analysis to explore the experiences of eight, British, first-time mothers who struggled with breastfeeding in the early postpartum period. Participants kept audio diary accounts of their infant feeding experiences across a seven day period immediately following the birth of their infant and took part in related semistructured interviews a few days after completion of the diary. The overarching theme identified was of a tension between the participants' lived, embodied experience of struggling to breastfeed and the cultural construction of breastfeeding as 'natural' and trouble-free. Participants reported particular difficulties interpreting the pain they experienced during feeds, and their emerging maternal identities were threatened, often fluctuating considerably from feed to feed. We discuss some of the implications for breastfeeding promotion and argue for greater awareness and understanding of breastfeeding difficulties, so that breastfeeding women are less likely to interpret these as a personal shortcoming in a manner which disempowers them. We also advocate the need to address proximal and distal influences around the breastfeeding dyad and in particular to consider the broader cultural context in the United Kingdom where breastfeeding is routinely 2 promoted yet often constructed as a shameful act if performed in the public arena.
There is now a body of research evaluating breastfeeding interventions and exploring mothers' and... more There is now a body of research evaluating breastfeeding interventions and exploring mothers' and health professionals' views on effective and ineffective breastfeeding support. However, this literature leaves relatively unexplored a number of questions about how breastfeeding women experience and make sense of their relationships with those trained to provide breastfeeding support. The present study collected qualitative data from 22 breastfeeding first-time mothers in the UK on their experiences of, and orientation towards, relationships with maternity care professionals and other breastfeeding advisors. The data were obtained from interviews and audio-diaries at two time points during the first five weeks postpartum. We discuss a key theme within the data of 'Making use of expertise' and three subthemes which capture the way in which the women's orientation towards those assumed to have breastfeeding expertise varied according to whether the women (i) adopted a position of consulting experts versus one of deferring to feeding authorities (ii) experienced difficulty interpreting their own and their baby's bodies and (iii) experienced the expertise of health workers as empowering or disempowering. Although sometimes mothers felt empowered by aligning themselves with the scientific approach and 'normalising gaze' of healthcare professionals, at other times this gaze could be experienced as objectifying and diminishing. The merits and limitations of a person-centred approach to breastfeeding support are discussed in relation to using breastfeeding expertise in an empowering rather than disempowering way.
Aim. This paper is a report of a descriptive study of early infant feeding experiences focusing o... more Aim. This paper is a report of a descriptive study of early infant feeding experiences focusing on accounts of women who expressed milk extensively in the first few weeks postpartum. Background. Relatively little is known about the reasons for expressing milk following healthy term births. Evidence indicates it is an increasingly common practice during early infant feeding in Westernised countries. A more comprehensive understanding of this practice will help midwives and nurses assist mothers negotiate early feeding challenges. Method. Audio-diary and semi-structured interview data from seven British women who extensively expressed milk in the first month postpartum were analysed. These data were drawn from a larger qualitative longitudinal study which took place in 2006-2007. Themes, discursive constructions and discourses are identified through the use of a feminist informed analysis. Findings. The practice of expressing was employed as a solution to managing the competing demands and dilemmas of early breastfeeding and ensuring the continued provision of breast milk thereby deflecting potential 2 accusations of poor mothering. In addition, the practice may afford a degree of freedom to new mothers. Conclusions. The need to maintain the 'good maternal body' can account for the motivation to express milk, although there may be reasons to be cautious about promoting expression as a solution to breastfeeding difficulties. Education for health professionals which emphasises the complexities and contradictions of mothering and which challenges prescriptive notions of 'good mothering' could better support new mothers in their feeding 'choices'.
To meet their aim of reducing the acceptability of psychoactive substances to young people, the d... more To meet their aim of reducing the acceptability of psychoactive substances to young people, the designers of drug prevention programmes need to have a thorough understanding of the personal views already held by their audience with respect to the object of attitude and behavioural change. However, few studies involving younger adolescents have collated participant-generated impressions of a range of legal and illegal substances. The present study used a word association methodology to explore adolescents' impressions of cigarette smoking, drinking alcohol and taking a range of illegal drugs. In total, 3571 images were generated which were placed into 24 categories on the basis of content analysis. The predominance of negative imagery was of note, particularly for cigarette smoking and drug taking and there was little evidence of a simplistic generic attitude to substance use. Images of alcohol, especially alcopops, were markedly more positive and were much less likely to contain reference to specific health problems than the images of cigarette smoking. However, there was less differentiation between `hard' and `soft' illegal drugs than has been found with older adolescents in other studies and many of the images relating to illegal drugs were poorly defined, revealing vague notions of danger and risk. The present methodology is proposed as a useful tool for assessing attitudes both prior to and following prevention programmes and it is suggested, based on the wide variation in images elicited, that successful prevention dialogues with young people may need to vary their message according to the particular substance targeted.
... disability or decline. The diagnostic categories therefore had many of the same Page 11. 10 a... more ... disability or decline. The diagnostic categories therefore had many of the same Page 11. 10 associations for the participants that they have for the general public (eg Crisp et al., 2000; Read & Harré, 2001). Chloe, who was quite ambivalent about the value of diagnosis, said: ...
This paper discusses our use of a hermeneutic phenomenological methodology to explore the lived e... more This paper discusses our use of a hermeneutic phenomenological methodology to explore the lived experience of feeling joyful. Semi-structured interviews were used to discuss two contrasting experiences of joy for each participant. Analysis was informed by van Manen's human science method, facilitated by King's template analysis. Our findings suggest that joy was a profoundly meaningful sense of positivity. Sometimes this feeling was fleeting, at other times it was described as a longer lasting experience. Regardless of duration, joy involved a desire to relinquish control which could be expressed as a freedom of movement, and could be enabled by the security that significant others provided. We discuss our findings in relation to distinctions previously drawn in the literature between happiness and joy and argue that, despite differences in experiences, the participants' accounts support an understanding of joy as a meaningful and social phenomenon which, though often unexpected, requires intentional engagement.
International Journal of Mental Health and Addiction, 2014
Public perception of alcohol addiction is frequently negative, whilst an important part of recove... more Public perception of alcohol addiction is frequently negative, whilst an important part of recovery is the construction of a positive sense of self. In order to explore how this might be achieved, we investigated how those who self-identify as in recovery from alcohol problems view themselves and their difficulties with alcohol and how they make sense of others' responses to their addiction. Semi-structured interviews with six individuals who had been in recovery between 5 and 35 years and in contact with Alcoholics Anonymous were analysed using Interpretative Phenomenological Analysis. The participants were acutely aware of stigmatising images of 'alcoholics' and described having struggled with a considerable dilemma in accepting this identity themselves. However, to some extent they were able to resist stigma by conceiving of an 'aware alcoholic self' which was divorced from their previously unaware self and formed the basis for a new more knowing and valued identity.
Purpose: Audio-diary methods are under-utilised in contemporary qualitative research. In this pap... more Purpose: Audio-diary methods are under-utilised in contemporary qualitative research. In this paper we discuss participants and researchers' experiences of using audio-diaries alongside semi-structured interviews to explore breastfeeding experiences in a short-term longitudinal study with 22 first-time mothers. Methodology: We provide a qualitative content analysis of the participants' feedback about their experiences of the audio-diary method and supplement this with the perspectives of the research team based on fieldwork notes, memos and team discussions. We pay particular attention to the ways in which the data attained from diaries compared with those from the interviews. Findings: The diaries produced were highly heterogeneous in terms of data length and quality. Participants' experiences with the method were varied. Some found the process therapeutic and useful for reflecting upon the development of breastfeeding skills whilst negative aspects related to lack of mobility, self-consciousness and concerns about confidentiality. Researchers were positive about the audio-diary method but raised certain ethical, epistemological and methodological concerns. These include debates around the use of prompts, appropriate support for participants and the potential of the method to influence the behaviour under scrutiny. Interview and diary accounts contrasted and complemented in ways which typically enriched data analysis.
Recent feminist analyses, particularly from those working within a poststructuralist framework, h... more Recent feminist analyses, particularly from those working within a poststructuralist framework, have highlighted a number of historically located and contradictory socio-cultural constructions and practices which women are faced with when negotiating infant feeding, especially breastfeeding, within contemporary western contexts. However, there has been little explicit analysis of the practice of expressing breast milk. The aim of this article is to explore the embodied practice of expressing breast milk. This is done by analysing, from a feminist poststructuralist perspective, discourse surrounding expressing breast milk in sixteen first time mothers' accounts of early infant feeding. Participants were recruited from a hospital in the South Midlands of England. The data are drawn from the first phase of a larger longitudinal study, during which mothers kept an audio diary about their breastfeeding experiences for seven days following discharge from hospital, and then took part i...
Psychology and Psychotherapy: Theory, Research and Practice, 2004
An increased clinical interest in shame has been reflected in the growing number of research stud... more An increased clinical interest in shame has been reflected in the growing number of research studies in this area. However, clinically-orientated empirical investigation has mostly been restricted to the investigation of individual differences in dispositional shame. This paper reviews recent work on dispositional shame but then argues that the primacy of this construct has been problematic in a number of ways. Most importantly, the notion of shame as a context-free intrapsychic variable has distracted clinical researchers from investigating the management and repair of experiences of shame and shameful identities, and has made the social constitution of shame less visible. Several suggestions are made for alternative ways in which susceptibility to shame could be conceptualised, which consider how shame might arise in certain contexts and as a product of particular social encounters. For example, persistent difficulties with shame may relate to the salience of stigmatising discourses within a particular social context, the roles or subject positions available to an individual, the establishment of a repertoire of context-relevant shame avoidance strategies and the personal meaning of shamefulness. 3 Dispositional shame The concepts of internalised shame and shame-proneness Andrews (1998) suggests that 'high-shame' people have been conceptualised in three different ways i) shame-prone or more likely than other people to feel shame in commonly shame-eliciting situations, ii) frequently or continuously experiencing generalised or global shame, sometimes described as internalised shame or iii) particularly ashamed of some aspect of their behaviour or personal characteristics. Most studies have focused on the first two of these, conceptualising shame as a trait or disposition. Therefore less attention has been paid to specific shame about something, for example related to some kind of stigma. Instead, chronic shame is approached as if it is a property of the individual, existing independently of the contexts in which it might be manifest. Kaufman (1989) has been instrumental in developing the idea of internalised shame. Drawing on Tomkins' (1963) affect theory, Kaufman describes internalised shame as a 'shamebound' personality or 'shame-based identity'. He argues that internal representations of the expression of affects, interpersonal needs, drives and competencies become linked with representations of shame, through repeated experiences of shaming, particularly in childhood. When this happens it becomes impossible to experience these affects, needs, drives and competencies without experiencing shame and the child develops a generalised sense of being unworthy and inferior which persists into adulthood. Therefore, according to Kaufman, someone who experiences a significant degree of internalised shame not only experiences shame frequently in relation to specific situations, but tends to engage in generalised negative self evaluations and carries a sense of personal inadequacy. Shame-proneness appears to be a concept which is less clearly defined than internalised shame. The former term is often employed more loosely and has been used to mean both the readiness with which someone might experience shame and hence the frequency of the emotion, and also the intensity with which the emotion is usually experienced (Gilbert, 1998b). It has also
Many women report difficulties with breastfeeding and do not maintain the practice for as long as... more Many women report difficulties with breastfeeding and do not maintain the practice for as long as intended. Although psychologists and other researchers have explored some of the difficulties they experience, fuller exploration of the relational contexts in which breastfeeding takes place is warranted to enable more in-depth analysis of the challenges these pose for breastfeeding women. The present paper is based on qualitative data collected from 22 first-time breastfeeding mothers through two phases of interviews and audio-diaries which explored how the participants experienced their relationships with significant others and the wider social context of breastfeeding in the first five weeks postpartum. Using a thematic analysis informed by symbolic interactionism, we develop the overarching theme of 'Practising socially sensitive lactation' which captures how participants felt the need to manage tensions between breastfeeding and their perceptions of the needs, expectations and comfort of others. We argue that breastfeeding remains a problematic social act, despite its agreed importance for child health. Whilst acknowledging the limitations of our sample and analytic approach, we suggest ways in which perinatal and public health interventions can take more effective account of the social challenges of breastfeeding in order to facilitate the health and psychological well-being of mothers and their infants.
Breastfeeding is a practice which is promoted and scrutinised in the UK and internationally. In t... more Breastfeeding is a practice which is promoted and scrutinised in the UK and internationally. In this paper we use interpretative phenomenological analysis to explore the experiences of eight, British, first-time mothers who struggled with breastfeeding in the early postpartum period. Participants kept audio diary accounts of their infant feeding experiences across a seven day period immediately following the birth of their infant and took part in related semistructured interviews a few days after completion of the diary. The overarching theme identified was of a tension between the participants' lived, embodied experience of struggling to breastfeed and the cultural construction of breastfeeding as 'natural' and trouble-free. Participants reported particular difficulties interpreting the pain they experienced during feeds, and their emerging maternal identities were threatened, often fluctuating considerably from feed to feed. We discuss some of the implications for breastfeeding promotion and argue for greater awareness and understanding of breastfeeding difficulties, so that breastfeeding women are less likely to interpret these as a personal shortcoming in a manner which disempowers them. We also advocate the need to address proximal and distal influences around the breastfeeding dyad and in particular to consider the broader cultural context in the United Kingdom where breastfeeding is routinely 2 promoted yet often constructed as a shameful act if performed in the public arena.
There is now a body of research evaluating breastfeeding interventions and exploring mothers' and... more There is now a body of research evaluating breastfeeding interventions and exploring mothers' and health professionals' views on effective and ineffective breastfeeding support. However, this literature leaves relatively unexplored a number of questions about how breastfeeding women experience and make sense of their relationships with those trained to provide breastfeeding support. The present study collected qualitative data from 22 breastfeeding first-time mothers in the UK on their experiences of, and orientation towards, relationships with maternity care professionals and other breastfeeding advisors. The data were obtained from interviews and audio-diaries at two time points during the first five weeks postpartum. We discuss a key theme within the data of 'Making use of expertise' and three subthemes which capture the way in which the women's orientation towards those assumed to have breastfeeding expertise varied according to whether the women (i) adopted a position of consulting experts versus one of deferring to feeding authorities (ii) experienced difficulty interpreting their own and their baby's bodies and (iii) experienced the expertise of health workers as empowering or disempowering. Although sometimes mothers felt empowered by aligning themselves with the scientific approach and 'normalising gaze' of healthcare professionals, at other times this gaze could be experienced as objectifying and diminishing. The merits and limitations of a person-centred approach to breastfeeding support are discussed in relation to using breastfeeding expertise in an empowering rather than disempowering way.
Aim. This paper is a report of a descriptive study of early infant feeding experiences focusing o... more Aim. This paper is a report of a descriptive study of early infant feeding experiences focusing on accounts of women who expressed milk extensively in the first few weeks postpartum. Background. Relatively little is known about the reasons for expressing milk following healthy term births. Evidence indicates it is an increasingly common practice during early infant feeding in Westernised countries. A more comprehensive understanding of this practice will help midwives and nurses assist mothers negotiate early feeding challenges. Method. Audio-diary and semi-structured interview data from seven British women who extensively expressed milk in the first month postpartum were analysed. These data were drawn from a larger qualitative longitudinal study which took place in 2006-2007. Themes, discursive constructions and discourses are identified through the use of a feminist informed analysis. Findings. The practice of expressing was employed as a solution to managing the competing demands and dilemmas of early breastfeeding and ensuring the continued provision of breast milk thereby deflecting potential 2 accusations of poor mothering. In addition, the practice may afford a degree of freedom to new mothers. Conclusions. The need to maintain the 'good maternal body' can account for the motivation to express milk, although there may be reasons to be cautious about promoting expression as a solution to breastfeeding difficulties. Education for health professionals which emphasises the complexities and contradictions of mothering and which challenges prescriptive notions of 'good mothering' could better support new mothers in their feeding 'choices'.
To meet their aim of reducing the acceptability of psychoactive substances to young people, the d... more To meet their aim of reducing the acceptability of psychoactive substances to young people, the designers of drug prevention programmes need to have a thorough understanding of the personal views already held by their audience with respect to the object of attitude and behavioural change. However, few studies involving younger adolescents have collated participant-generated impressions of a range of legal and illegal substances. The present study used a word association methodology to explore adolescents' impressions of cigarette smoking, drinking alcohol and taking a range of illegal drugs. In total, 3571 images were generated which were placed into 24 categories on the basis of content analysis. The predominance of negative imagery was of note, particularly for cigarette smoking and drug taking and there was little evidence of a simplistic generic attitude to substance use. Images of alcohol, especially alcopops, were markedly more positive and were much less likely to contain reference to specific health problems than the images of cigarette smoking. However, there was less differentiation between `hard' and `soft' illegal drugs than has been found with older adolescents in other studies and many of the images relating to illegal drugs were poorly defined, revealing vague notions of danger and risk. The present methodology is proposed as a useful tool for assessing attitudes both prior to and following prevention programmes and it is suggested, based on the wide variation in images elicited, that successful prevention dialogues with young people may need to vary their message according to the particular substance targeted.
... disability or decline. The diagnostic categories therefore had many of the same Page 11. 10 a... more ... disability or decline. The diagnostic categories therefore had many of the same Page 11. 10 associations for the participants that they have for the general public (eg Crisp et al., 2000; Read & Harré, 2001). Chloe, who was quite ambivalent about the value of diagnosis, said: ...
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Papers by Dawn Leeming