Autoethnography and Severe Perineal Trauma

An Unexpected Journey From Disembodiment to Embodiment

Holly S. Priddis

Disclosures

BMC Womens Health. 2015;15(88) 

In This Article

Methods

The growth of autoethnography as a method conflicts with traditionalist perspectives which value objectivity, validity and reliability in the design and analysis of research. As a result there are multiple definitions and presentations of this methodological approach.[22,25] Evolving from the work of ethnography, whereby the researcher explores meaning behind behaviour and interactions in a specific cultural group within a natural context, autoethnographers identify their position within the cultural group being researched and weave their personal experience into the analysis and interpretation of the collected data.[16,26,27] There are two key autoethnographic approaches in research design, analysis and presentation—evocative or emotive, and analytic.

Two Autoethnographic Approaches

The origins of autoethnography draw upon emotion, an autobiographical presentation of the journey of the researcher, and are therefore described as evocative.[25,28] Evocative, also described as emotive autoethnography values the story of the autoethnographer, however it "transcends mere narration of self to engage in cultural analysis and interpretation".[29] Through a reflective writing process, autoethnographers make themselves vulnerable as they share their own story to benefit the group they are researching. As stated by Denzin (,[30] p. 228), autoethnographers "…bypass the representational problem by invoking the epistemology of emotion, moving the reader to feel the feelings of the other.".

When undertaking analytic autoethnography, Anderson[21] suggests that there are five key features: complete member research status, analytic reflexivity, narrative visibility of the researcher's self, dialogue with informants beyond the self, and commitment to theoretical analysis. Analytic reflexivity requires the researcher to have an awareness of their place within the research and the potential impact this has upon the interaction with study participants and interpretation of data.[31] The use of analytic reflexivity attempts to ensure objectivity and authenticity throughout the research process.[21,32] However this does not sit well with those who value evocative autoethnography, with Ellis and Bochner stating (,[22] p. 440): "If you turn a story told into a story analysed…you sacrifice the story at the altar of traditional sociological rigor. You transform the story into another language, the language of generalization and analysis, and thus you lose the very qualities that make a story a story".

In response to the division between the emotive and analytic approaches of autoethnography, Tedlock[33] presents examples of autoethnographic literature where authors have chosen to interweave both emotive and analytic approaches in writing. In the work presented by Giorgio, she demonstrates this interweaving of both approaches through her reflection: "When I sit down to write, I find the story behind the memories; I then begin to make sense of those memories, their meaning for me and for others" (,[34] p. 406). As a novice autoethnographer I valued both the emotive and analytic perspectives, and felt it necessary to combine both approaches not only to truly embrace and travel the bumpy road that is the autoethnographic journey, but to fulfil doctoral research requirements.

Positioning Myself Amongst the Participants

In this study, while I am considered a member of this marginalised population, I acknowledged that the experiences of the women who have sustained SPT are also individual; therefore my position as complete member researcher provides only one perspective on exploring the experience of the marginalised group.[31] In depth interviews were conducted with 12 women who had sustained SPT, with the purpose of the interviews to explore the way women understand and have experienced SPT. This included their experiences of, and interactions with, health services. The recruitment, participation process, demographics of participants, and findings have been previously published.[35] To ensure informed consent, participants were provided with an information sheet prior to the interview being conducted. Participants were then asked to read and sign the consent form if they agreed to participate. During the interview process, I provided full disclosure of my experience of a fourth degree perineal tear and associated morbidities. However, when a woman became distressed during the interview, it felt inappropriate to tell my story as I was concerned that this would shift the focus from the woman to myself as the researcher. In this situation, I made the woman aware of my story at a more appropriate time following the interview. Ethics approval was obtained by Western Sydney University Human Research Ethics Committee.

This disclosure immediately allowed for identification as an "insider" and facilitated a more open discussion. The role of insider occurs when the researcher has dual identities as both researcher, and as a member of the marginalised group being researched.[36,37] During a few of the interviews an interesting shift occurred following disclosure of my experience. The women—as a result of identification with my experience—revised roles and became the interviewer. The women were curious as to my daily management strategies, recovery following treatments and surgeries, with a particular focus on sexuality and the practical aspects of intercourse with my partner. I let this transference of ownership of the interview evolve and followed the path set by the woman, to see where the journey would end.

The autoethnographer, as a result of critical self-reflection, may experience a change in perspective as a result of the research itself.[17,38] This is further explored by Schwalbe (,[39] p.58) who describes the impact of autoethnography on the researcher: "Every insight was both a doorway and a mirror—a way to see into their experience and a way to look back at mine.". In reflecting on the roots of autoethnography, Bochner described how autoethnography found strength as an alternative to the limitations found in the social sciences, and "feeds a hunger for details, meaning and peace of mind".[40] The growth of this qualitative genre has allowed for personalised interpretations and explorations of experience, "peace of mind" is not however, something that is always experienced by the autoethnographer, and this certainly rings true for my own experience which is explored in this paper.[41,42]

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