Free Association Narrative Interview Research Articles

Consultant nurse–consultant physician: a new partnership for patient‐centred care?

The aim was to describe the process of role transition by an individual who has assumed the position of a consultant nurse in cardiovascular health care. The objective was to explain the 'gestalt' of being a consultant nurse and how the 'gestalt' has evolved. The development of the consultant nurse role is new, research has described the value and potential contribution of the role. The literature suggests that the role still requires further evaluation and description to be understood better. DESIGN. A free-association narrative interview method was chosen as the research design. An in depth interview, tape-recorded and analysed along with field note analysis was the method for eliciting the narrative. The analysis of the narrative reveals an emerging 'gestalt' for being a consultant nurse. Various concepts and phenomena attributable to the role are identified from the experience described. The gestalt explains the journey of the individual through an 'apprenticeship' to role attainment, whereby a new sense of professional self or 'Me' is realized. The significance of the paper lies in the analysis of the narrative and the insights it gives to help other aspirant consultant nurses. It is through the understanding of these insights that individuals could plan their own learning and development to be achieved in the role of consultant nurse. To be effective and provide effective patient care, one can argue that appropriate learning needs to take place. Those that have been appointed to the role have battled to find achievement and acceptance. These battles may be made easier to win if the role is better understood and appropriate preparation provided. Only then will the real potential of the role be realized in improved patient care outcomes.

Queer Individualization: The Transformation of Personal Life in the Early 21st Century

This article explores what happens to understandings of social change in the realm of personal life when an empirical investigation is carried out that begins from rather different ontological and epistemological premises from those that have underpinned recent debates. It draws on UK‐based research that was framed by an engagement with sociological theories of individualization, psychoanalytically informed psycho‐social studies and queer theory, and that was designed to explore the psychic and affective dimensions, and the unconventional, counter‐heteronormative practices, of contemporary personal life. The study used the free association narrative interview method to examine the practices and ethics of personal life of people living outside conventional couples. It found considerable levels of psychic conflict and emotional distress, and some mental illness, amongst the people interviewed. Many interviewees told stories of experiencing a fracturing of self as they faced lives in which they felt alone and in which they were expected to be self‐responsible. These experiences, it is suggested, can be understood as tied up with losses contingent upon processes of individualization. However, the research also found evidence of a set of interrelated, counter‐heteronormative relationship practices that served reparatively to suture the selves undone by these processes of individualization: the prioritizing of friendship, the decentring of sexual/love relationships, and the forming of non‐conventional partnerships. The article proposes the notion of queer individualization to capture this set of transformations in the organization and experience of personal life, and suggests the necessity of understanding contemporary personal life as involving both the pain of loss, and new, reparative non‐conventional connections.

The psycho-social subject in 'evidence-based practice'

In this paper I provide a theoretical outline, followed by two case examples, of a qualitative method, called the free association narrative interview, which produces evidence that is congruent with the kinds and contexts of knowledge that human service professionals use in their work. Following a critique of assumptions about what constitutes evidence in evidence-based practice and an argument for the use of experiential and theoretical, as well as empirical, ways of knowing, I focus on qualitative methods and the shortcomings of semi-structured interviewing as an alternative method for evidence-based practice. In particular I argue that the theory of the research subject and the research relationship that is assumed in most qualitative methods is misguided and affects the character of the evidence that can be produced. I outline an alternative theory of the (research) subject, a psycho-social subject, drawing on psychoanalytic concepts that emphasise unconscious conflict, defences against anxiety and the centrality of unconscious intersubjective dynamics in the research, as in other, relationships. Two examples follow. The first illustrates the transference and counter-transference dynamics in one of my research interviews, showing their importance for what information was produced. The second example demonstrates the use of experiential, empirical and theoretical knowledge in the analysis of data from an interviewee with agoraphobia. It illustrates how the paradigm of a psycho-social subject can produce a more complex account of people's behaviour. I conclude by arguing that the kind of evidence illustrated here, being congruent with the vicissitudes of most human service professionals' work with clients, could provide a model for evidence-based practice that is not only more appropriate but also helpful for professional development.