A space for complexity

Opening this qualitative methods conference, keynote speaker Brendan Gough (Leeds Beckett University) promised to be 'provocative, playful, pushing boundaries', already moving on to a 'post-qualitative world' that 'is very strange… it takes place somewhere else, mostly in education. Psychologists are starting to take notice, actually as it's about to die.'

Consciously or otherwise, post-qualitative ideas were to the fore throughout: in particular, how the researcher is 'de-centred', with Gough saying that the post-qualitative turn is 'a timely and sobering injunction for qualitative researchers to rein in any pretensions concerning researcher "expertise", to take care in offering knowledge claims, and to incorporate into their analyses corporeal (material) dimensions as far as possible.'

Gough's lockdown puppy, Leo, becomes 'an apposite materialisation of post-qualitative endeavour, full of contradictory impulses, tendencies, affects'. 'Is that a load of rubbish?' Gough pondered. 'I don't know.' [For more on this, see our interview with Gough.] Writing theoretically and experimentally, Gough showed how it's possible to 'move from the simple mining of meanings from the minds of human participants towards co-producing and mapping significant relations with creative and often less human-centric means, aiming to uncover how human interests, desires and intentions are – in the words of Pauliina Rautio – 'but a part of agency that locates in multiple and messy relations between humans and all that surrounds them'.

In lockdown, Gough's relationship with his Dad, pictured above, came into his head, and he thought he'd 'write something a bit different'. Traditional research options were limited – Gough's Dad lives in Belfast, spends most days in the pub, doesn't have a mobile phone. 'Imagine going to my Da with consent forms!' With post qualitative options, 'you could just really riff… conceptual flights of fancy, creative writing with my father as a focus, references to fictional fathers/sons… it's carte blanche, you can go to town on this'.

The researcher-self becomes a conduit, 'drawn into research at a deep, unconscious level'. Theory remains central, Gough says, but there's affect and emotion in there too. Exploring 'absent presence', and continuities and differences in masculinities, has real implications for recruiting marginalised and minority men into therapy, and how to engage meaningfully with these men if successful in getting them in the room. Animals tend to feature prominently in the post qualitative world, reinstating the importance of embodiment and materiality, with Gough musing 'My Da's called Bear, not Brendan, and we don't know why that is.'

'You could just really riff… conceptual flights of fancy, creative writing with my father as a focus, references to fictional fathers/sons… it's carte blanche, you can go to town on this'

Voice and volume

For me, Gough set the tone for the rest of the conference with his emphasis on participants as co-researchers, and psychologists working in teams, with communities. 'People are enmeshed in webs or connections they don't fully understand or have control over,' he said. 'We work together to understand complexity and fluidity.'

Candice Whitaker (Leeds Trinity University) continued that theme of where the researcher positions themselves in the process, and finding voice and volume. That takes speaking to other people, and exploring alternative means of dissemination (such as the use of comics). Whitaker felt it was important to have her own experiences in her thesis, on eating and body image. Initially writing in the third person, 'she was me' was put in later, with Whitaker saying 'I felt quite uncomfortable writing it. It literally was a purging activity. I think it's important to have self-reflection and reflexivity through the PhD journey.'

Authors in much published research can opt to take that voice and throw it, creating the illusion that voices are coming from participants. So said Sergio Silverio (King's College London, with Catherine Wilkinson and Samantha Wilkinson), talking on 'ventriloquism' in academic writing. The idea of anonymity in qualitative research is in constant flux, Silverio said, and it can serve as a smokescreen, a misdirection from the data. 'Participants themselves can find anonymity an injustice: they may even doubt whether selected quotations came from them.'

'I think it's important to have self-reflection and reflexivity through the PhD journey.'

Silverio cautioned against 'ad-libbed reinterpretations of the data' where the 'discussion doesn't quite match the results'. Instead, we should work with people on genuine Patient and Public Involvement and Engagement (PPIE) to shape research (including proper remuneration for time and travel).  

Others ensured people with mental health issues voices and stories were central to their research. 'Listening to them provides real learning', said Lindsay Badger (Plymouth). Brian Charlesworth, Army Veteran and Psychotherapist (Leeds Beckett University), found that his participants couldn't wait to talk to someone 'in the know'. 'They didn't see me as a researcher… which was a bit weird, because I wanted to be one.'

Charlesworth's positioning, and 'depth of empathy rather than being an "expert"', allowed him to vividly portray the transition from 'the army way' to 'civvy life'. The military are 'trained to cause and endure trauma', and then have to build a new identity in which they redefine their masculinity. 'The day I left the army was like falling off a cruise ship,' one said: 'I'm at sea, I'm going to die'. The importance of finding alternative ways to feel valued, and part of something bigger, was clear to see.

That overwhelming feeling 'that no one really cares' also cropped up in Kristina Newman's (Nottingham Trent University) study of the psychological wellbeing of frontline health staff, at the rather critical time of April to May 2020. They felt overwhelmed trying to protect everyone, distressed by mixed messages from management. 'We're lambs to the slaughter'… 'I didn't sign up to a death sentence.'

People often suffered in silence though, a theme picked up by Nikki Moore and Gabby Keating (University of Bradford) in looking at the impact of pandemic on research activity. They highlighted the need to build a wider sense of community outside of research.

Mattering the world

In her video keynote, Michelle Fine (The Graduate Center, CUNY, University of South Africa) was 'bumping into debates, dissenting moments', seeing them as 'theory ruptures: not an undermining of our science, but an expansion of it toward justice'. Fine positions herself as a 'narrative doula in revolting times… bringing narratives into a world that is ready to cannibalise, criminalise and commodify them.

The approach – 'not a methodology, it's an epistemology' – is Critical Participatory Action Research. It's about contesting dominant lies, excavating buried / silenced / marginalised knowledges that are born in struggle. What is the role of those most impacted, and to what extent is analysis genuinely participatory? Fine gave the example of her work on the impact of college in prison on women, their children and their post-release outcomes.

It's a 'delicate curating', a 'complex story of humanity, mistakes, structural violence, remorse and radical transformations'. The women insisted that Fine took off her blinders to tell the full story of choices made in difficult circumstances. 'Michelle, please don't romanticize us,' Donna said. 'Add in the preface that some of us killed our children and think about it every day.' 'That was a theoretical rupture: it opens up our narrative responsibilities,' said Fine.

Similarly, 'What's your issue?', a national participatory survey designed by / for queer youth, was another example of Fine trying to clean up a complicated story. 'We had set up this space for complexity, and now we were reproducing these categories [around sexuality] that had choked them all their lives.' Fine raised the question of whose knowledge matters. There are limits of participation – in the prison research, for example, the superintendent or guards weren't invited onto the research team.

Fine also linked back to an earlier talk from Kate Sheese (Sigmund Freud University, Berlin) on volunteers at refugee camps in Greece finding themselves 'complicit in structures they had come there to resist'. Participants spoke of 'mattering the world' – creatively bringing themselves into being in the world by acting on it. Reflecting on her own role, Sheese had admitted 'I'm scared of my own data. I don't know what I am doing.' How do we connect to the anger and rage, Fine asked, in order to speak from there? How should we communicate the real uncertainty, the dark spaces? How do we protect storytellers?

'We had set up this space for complexity, and now we were reproducing these categories [around sexuality] that had choked them all their lives.'

Also exploring the dark spaces was Simon Goodman (De Montfort University) with an analysis of the use of the 'All Lives Matter' and 'White Lives Matter' hashtags on social media in the wake of the Black Lives Matter movement. ALM was used to undermine BLM, 'a way to deny the specific and prominent violence against Blacks by appealing to a larger universal'.

Those opposing ALM then get challenged for denying everyone is equal: the cultural norm against prejudice is being used as a tool against an anti-prejudice campaign, in service of maintaining the status quo. ALM tended to crop up in support of the more extreme WLM, both downgrading the importance of race and being used as a proxy for arguments about the extent to which anti-Black racism exists.

Kristina Newman was also navigating that 'chaotic world of information sharing' in a talk on fake news and misinformation, with participants' actions influenced by their own positionings on staying social: 'I'm not a confrontational or very argumentative person'. People may often just share without reading or fact checking. Max Lasse Schaefer (Edinburgh) also put himself in the echo chamber, investigating how men who identify as Incels maintain ingroup harmful ideologies.

Creative methods

Several presenters pushed innovative methods to the fore, such as photo elicitation – with Ben Lond from De Montfort University around mesothelioma, a terminal cancer generally caused by exposure to asbestos; and his colleague Kerry Quincey on 'sleep as a natural process that doesn't necessarily come naturally', with people putting themselves into a category of 'good' or 'bad' sleeper. Lond highlighted the emotional salience and challenge in inviting participants to share intimate and emotive scenes.

Jonathan Moss (Leeds Beckett) used Descriptive Experience Sampling, sending festival goers regular prompts that produced a picture of the experience that was 'nuanced, reflective, nebulous, dynamic, oscillating and conflicting'. Phil Hutchinson and Doug Hardman covered the use of 'imagined or found' examples, and Katherine Slade (Aston) mined papers for 'data poetry', pulling together snippets in a way that told a new story around carers of those with profound and multiple learning disabilities.

Elizabeth Peel (Loughborough University) got creative in recruitment, advertising for dog owners on social media, in the park, at dog groomers and more. Our furry friends provided much needed thinking and reflecting time during the pandemic, Peel said, a period which 'has made us as humans unhealthily self-obsessed… we do ourselves a great disservice if we ignore human-animal links' (back to the post qualitative there).

Again, putting the person back at the centre and finding new ways to tell their stories was a recurring theme. Peter Blundell (Liverpool John Moores) and Lisa Oakley (Chester University) advocated Single Pen Portrait Analysis as a secondary form of qualitative data analysis, aiming to 'develop an illustrative picture of the participants' holistic lived experience missing from the initial data analysis'. And those illustrative pictures were everywhere to be seen: Dennis Nigbur (Canterbury Christ) concluding his presentation on the subjectivity of 'home' for EU migrants in the UK with the evocative quote: 'Even the sun was a different colour'.

Intentional and persistent

All in all, the three days were a call to question whether the way we do research is fit for purpose, which is how Dawn Edge (University of Manchester) framed her closing keynote. Edge's career, tackling race-based inequalities in psychosis care, is a template for how services should be culturally-adapted, drawing on community stakeholders as true research partners, with equal decision-making power.

Edge's parents were part of the Windrush generation, and when she followed them from Jamaica to Manchester – on her own and at the age of 11 – she was suddenly granted 'this new identity, of being a Black person'. It was 'sheer culture ', shaping her thinking about inclusion and what it means to be 'othered'.

Sold the dream of 'rebuilding the mother country', successive generations 'couldn't tell people back home just how bad it was… they had too much invested.' Looking into perinatal depression in Black Carribean women, Edge found a similar story: mothers weren't talking within their communities, and wouldn't talk to health professionals either.

There was fear that babies would be taken, and of the label of schizophrenia, as a Black person: 'diagnosis was a one-way ticket to oblivion', involving negative care pathways, more coercive care, lack of psychological therapies, and worse clinical outcomes for African and Carribean people. 'If this is your experience, why would you want to engage with services?' A consequence was coming into services quite late, when symptoms were more severe. This could increase the burden on families, and set up fear and mistrust.

'Sold the dream of 'rebuilding the mother country', successive generations 'couldn't tell people back home just how bad it was… they had too much invested.'

For decades now, organisations (e.g. the Sainsburys Centre) have been talking about breaking the 'circles of fear', and the NICE guidelines for psychosis/schizophrenia in 2009 talked about ensuring culturally appropriate psychological and psychosocial treatment. Edge talked about Community Engagement Conferences, held in churches – 'not just places of worship, places of activism and community, assets we haven't really tapped into in a meaningful way'.

These conferences sparked open and honest conversations, where it was clear people wanted alternatives to medication, and more information. This in turn inspired Culturally-adapted Family Intervention. If people don't have access to their family, they are often automatically excluded from talking therapies, so CaFI recruits 'family support members'. People rated the intervention highly.

Edge also recruited 404 family units from Sub-Saharan African and Carribean people diagnosed with psychosis in the UK into the CaSPER study: Culturally-appropriate Schizophrenia Psychological Education Resource. Again co-production is central, with Edge saying: 'I get really frustrated with seeing things written up as co-production when they aren't'.

She's also clearly frustrated by slow progress around race equality in general: 'I'm still receiving grants to review where exclusion criteria include inability to read and write English. That's scandalous in 2022.' Edge reminded us that some of the hardest to reach people are going to have the greatest health need, concluding: 'We have to be intentional, and persistent.'