Private Experience Research Articles

Exploring homeplace as a nexus of learning and socially reproductive labour: A feminist perspective on internationalisation at a distance

This paper explores the concept of homeplace, examining how it serves as a nexus for learning, reproductive labour, and internationalisation while problematising the gendered and depoliticised nature of international distance education. Drawing on 60 interviews with international distance students at a South African university, the research employs Black and critical feminist perspectives to critique how the blurred boundaries between private and public spheres shape learning experiences. It addresses a gap in the international distance education literature by highlighting the insufficient consideration of the social reproduction responsibilities played out in homeplaces. Our findings reveal that homeplace is neither a gender‐neutral nor an idealised study environment. Instead, it leads to unequal participation in learning spaces and internationalisation efforts. Digital platforms, crucial for connectivity and collaboration in international education at a distance, also perpetuate gendered power dynamics that marginalise women's voices and contributions, but women, however, reach out and support each other in these online spaces. The research teases out the tensions between homeplace as a site for learning, living, and social reproduction, emphasising the need for international distance education institutions to address the gendered dynamics in their design and delivery that disproportionately burden those with responsibilities for social reproduction. Practitioner notesWhat is already known about this topic International distance education focuses on distance education provided internationally. Internationalisation at a Distance (IaD) activities aim to reach a broader audience beyond local students, leveraging online and blended learning models. IaD activities depend on the home as one of the main spaces of study while seeing online platforms as the main point of internationalisation. Thus far, the literature on IaD has not undertaken a critical feminist analysis or deployed Black feminist theories to explore power relations in such spaces. What this paper adds Examines how the politics of the “homeplace” can be used to understand the educational experiences of international distance education students. Argues that current debates often overlook how the homeplace as a gendered site influences students' international distance education journeys. Highlights the gendered nature of the homeplace and complexities of studying from home and online, particularly for women Provides a critical feminist analysis of IaD, situating and problematising the homeplace as the main site for IaD. Implications for practice and/or policy Emphasises the need for institutional policies that consider the homeplace as a significant site for internationalisation at a distance. Recommends the development of support systems and resources to help students manage conflicting demands of home and study. Advocates for a more nuanced approach to distance education that addresses the diverse needs of students, including those balancing significant responsibilities like employment and family obligations.

A World of Pain

When we undertake the project of a phenomenology of pain, and even a deconstruction of the experience of pain, we discover that pain is not merely something that is felt by a subject, but rather pain—and chronic pain, especially—causes the subject to live in a new world. This essay is an investigation of that world. Moving from questions of mind/body dualism to whether or not pains are subjective representations of some material-physical state of the body, a philosophical and physiological analysis of pain is undertaken in an attempt to show how a world of pain emerges and then functions once established. Along the way, issues concerning the measurement of pain, the value of pain, the mystery of the phantom limb in pain, the use of placebos to treat pain, and the question of whether or not pain is necessarily a private experience are taken up, ultimately leading to the conclusion that an established world of pain can usher in a collapse of the distinction between subjects and their pain such that chronic pain sufferers might meaningfully be said to become their pain.

“Burn through the parochial states of mind”: Dorothy Molloy’s Illness Poetry as a Catalyst for Change

This article examines how Dorothy Molloy’s poetry inscribes the subjective experience of illness, pain, and female sexuality within ostensibly traditional lyric forms to challenge conventional representations of illness and shed light on the inequities of Celtic Tiger Ireland. The poetic medium is ideally suited to express the painful caesura of infirmity, but Molloy’s poetry also fulfils perlocutive functions that position her cancer poetry as an agent for social change. The aesthetic of the poems collected in the posthumous The Poems of Dorothy Molloy is driven by a socio-political imperative, for the multitude of images depicting debilitated bodies in these verses serves to denounce the problematic perception of terminal diseases and critique the repercussions of entrenched conservative perspectives on the treatment meted out to Molloy and other women in the oncology wards of Irish hospitals during the late 1990s and early 2000s. By adopting an eclectic approach that combines historically-informed close reading with insights from Narrative Medicine, the article shows that Molloy actively seeks an accessible literary form that turns the private experience of illness into public comment and finds it in poetry, which, despite its inherent suitability, demands recalibration. Her verses indicate that prevailing discourses on care in Ireland and much canonical poetic representation of illness necessitate an equivalent degree of adjustment as the medical treatments themselves.

Providing professional and family care-Scoping review on the experiences of double duty caregivers

Professional nurses who also care for relatives are called double duty caregivers and provide double care work. It is not obvious whether this means they have to cope with other challenges than caring relatives without aprofessional background. This article aims to gain abetter understanding and an overview of how double duty caregivers experience their dual role and the challenges they face. The systematic literature search was conducted in 11 specialized databases as well as via a snowball system. Included in the study were 32 articles published in German and English between January 1995 and October 2023. A total of 6 topic complexes were identified that deal with the experience and challenges of double duty caregivers: emotional and personal aspects, demands and expectations, personal needs, role identification, nursing expertise and interaction with professionals in the healthcare system. The challenges for double duty caregivers are complex. The results show that finding their own role in the nursing arrangement is particularly challenging as the professional and private nursing roles are closely intertwined. The preference for one of these roles varies depending on the personality, type of relationship or care situation. This problem is often not recognized or respected by the environment, which can reinforce existing feelings of stress. On the other hand, double duty caregivers use their professional and private experience to provide good nursing and care in the respective other context.

A distributed brain response predicting the facial expression of acute nociceptive pain.

Pain is a private experience observable through various verbal and non-verbal behavioural manifestations, each of which may relate to different pain-related functions. Despite the importance of understanding the cerebral mechanisms underlying those manifestations, there is currently limited knowledge of the neural correlates of the facial expression of pain. In this functional magnetic resonance imaging (fMRI) study, noxious heat stimulation was applied in healthy volunteers and we tested if previously published brain signatures of pain were sensitive to pain expression. We then applied a multivariate pattern analysis to the fMRI data to predict the facial expression of pain. Results revealed the inability of previously developed pain neurosignatures to predict the facial expression of pain. We thus propose a facial expression of pain signature (FEPS) conveying distinctive information about the brain response to nociceptive stimulations with minimal or no overlap with other pain-relevant brain signatures associated with nociception, pain ratings, thermal pain aversiveness, or pain valuation. The FEPS may provide a distinctive functional characterization of the distributed cerebral response to nociceptive pain associated with the socio-communicative role of non-verbal pain expression. This underscores the complexity of pain phenomenology by reinforcing the view that neurosignatures conceived as biomarkers must be interpreted in relation to the specific pain manifestation(s) predicted and their underlying function(s). Future studies should explore other pain-relevant manifestations and assess the specificity of the FEPS against simulated pain expressions and other types of aversive or emotional states.

A distributed brain response predicting the facial expression of acute nociceptive pain

Pain is a private experience observable through various verbal and non-verbal behavioural manifestations, each of which may relate to different pain-related functions. Despite the importance of understanding the cerebral mechanisms underlying those manifestations, there is currently limited knowledge of the neural correlates of the facial expression of pain. In this functional magnetic resonance imaging (fMRI) study, noxious heat stimulation was applied in healthy volunteers and we tested if previously published brain signatures of pain were sensitive to pain expression. We then applied a multivariate pattern analysis to the fMRI data to predict the facial expression of pain. Results revealed the inability of previously developed pain neurosignatures to predict the facial expression of pain. We thus propose a facial expression of pain signature (FEPS) conveying distinctive information about the brain response to nociceptive stimulations with minimal or no overlap with other pain-relevant brain signatures associated with nociception, pain ratings, thermal pain aversiveness, or pain valuation. The FEPS may provide a distinctive functional characterization of the distributed cerebral response to nociceptive pain associated with the socio-communicative role of non-verbal pain expression. This underscores the complexity of pain phenomenology by reinforcing the view that neurosignatures conceived as biomarkers must be interpreted in relation to the specific pain manifestation(s) predicted and their underlying function(s). Future studies should explore other pain-relevant manifestations and assess the specificity of the FEPS against simulated pain expressions and other types of aversive or emotional states.

Discussions of a Private Language: Wittgenstein and Rhees

Already one year after the publication of Philosophical Investigations, the discussion about a private language had gathered pace. Since then, the debate has moved in various directions: Discussions about Wittgenstein’s method of doing philosophy; about how to read him; about variations of ‘private’ language users; about private experiences, (private) ostensive definitions, behaviourism, the ‘inner’ and ‘outer’ etc. I have tried to cover those points, which I think crucial for the understanding of a ‘private’ language: the rule-fixing problem, the confusion of giving and using a sample, private charts, knowledge, memory, and justification. I have thereby made extensive use of remarks by Wittgenstein and Rush Rhees, particularly Wittgenstein’s manuscripts, the Whewell Court lectures 1938-41, and unpublished material by Rhees. The reason for this is that I could not have put it in any better words, and that for me these remarks speak for themselves. I wish that others will make a ‘similar’ experience.

Dreams, Visions, and Worldmaking: Envisioning Anthropology Through Dreamscapes

What does it mean to envision or dream a world into existence? Dreams and visions are often deeply personal and private experiences, but they also open up social spaces for worldmaking. From Australian Aboriginal “Dreamtime” to the ethnographic dreams of anthropologists and their research partners, many dreams and visions are entangled with the historical and analytical trajectories of anthropology. I set out in this article to stretch further the anthropological imagination about the kinds of dreams and visions that may emerge from any dreamscape. To this end, I show that the anthropology of dreams and visions is built on more than the interpenetration of dreaming and waking life, metaphysical questions, problems of communication and interpretation, active or passive dreaming, the powerful idioms that dreams afford for collective visions, or nightmares and metaphorical dreaming. Myriad dreams and visions also unfold as what I call cosmological visions that shape anthropology and vice versa.

Beyond pain privacy and pain meters: a new vision for pain biomarkers.

To an individual, pain is unambiguously real. To a caregiver, assessing pain in others is a challenging process shrouded in doubt. To explain this challenge, many assume that pain "belongs" exclusively to the bearer of that experience and accept the dogma that pain is private. However, privacy also entails that it is not possible to identify, share, or communicate that experience with others. Obviously, this is not true and the consequences of pain privacy would be devastating for healthcare. Pain is indeed unique and subjective, but not necessarily private. Pain is in fact readily communicable, though perhaps not as effectively and reliably as caregivers would like. On the other hand, healthcare systems mandate objective metrics in pain diagnosis. Smiley face caricatures are a staple of clinical practice and a universal standard for reporting pain levels. These conditions create a double paradox: Assess a private experience that is inaccessible, and use numerical scales to measure subjective attributes. Navigating this stressful environment, medical professionals experience intellectual dissonance, patients are frustrated, and value-based care is undermined. Offering a way out, first, we refute the privacy and objectification of pain citing philosophical, behavioral, and neuroscientific arguments. We discuss Wittgensteinian views against privacy, explore the clear evolutionary advantage of communicating pain to others, and identify neural circuits in the mammalian brain that contribute to empathy. Second, we highlight the subjectivity of pain, embracing the complexity and uniqueness of an individual's pain. We also provide compelling evidence for brain mechanisms that actively shape the pain experience according to predictive coding principles. Third, we offer a vision for the development of biomarker technologies that assess pain fairly without engendering bias against the patient's narrative. Our recommendations are based on the overwhelming appreciation that "medicine by emoji" is inadequate for capturing the multidimensional nature of pain. Our view is that the most promising candidates for pain biomarkers consist of self-reports as ground truth augmented by physiological signatures of biological relevance to pain. Integration of subjective and objective multimodal features will be key for the development of comprehensive pain assessment models.

Revolution and feelings: an introduction

ABSTRACT The recent fragmentation of the political landscape and the increasing uncertainty of its boundaries have made historians more acutely aware that politics does not exist only ‘high up’ and on the macro level but reaches deep into the private lives of people, shapes their identities and perceptions, influences their thoughts and emotions, regulates and modifies their behaviour. This makes the public/private divide a starting point from which to explore the multiple layers of politics. This is the perspective adopted in this Special Issue, that is dedicated to forms of revolutionary militancy in nineteenth and twentieth century Italy. Indeed, few other historiographical events are better suited than revolution and its concrete manifestation in history to be investigated from the perspective of private experiences, feelings, and emotions. The aim of these papers is, therefore, to describe the different Italian revolutionary cultures from the nineteenth century until the 1970s, analysing on the one hand the intersection between history and individual stories and on the other the emotional substratum of politics.

Josiah Royce, William James, and the Social Renewal of the “Sick Soul”: Exploring the Communal Dimension of Religious Experience

In The Sources of Religious Insight, Josiah Royce assesses William James’ pragmatic evaluation of exalted, private religious experience, advanced in The Varieties of Religious Experience as inadequate to encompass the full range of religious experience. Among other contributions, Royce adds social and communal experience to James’ individualistic appraisal. Rather than tacking on to the familiar contemporary critical conversation about the Jamesian restriction to private experience, I argue that James and Royce are helpfully brought together through an understanding of religious conversion: James’ foundational predicament of the “sick soul” returned to health through religious conversion gains depth and coherence through the attention Royce gives to overcoming alienation through communal participation. In our time of dislocation and self-preoccupation, drawing together these two seminal models of religious experience provides an instructive account of the individual’s transformation by way of communal renewal.

Cooperation and social organization depend on weighing private and public reputations

To avoid exploitation by defectors, people can use past experiences with others when deciding to cooperate or not (‘private information’). Alternatively, people can derive others’ reputation from ‘public’ information provided by individuals within the social network. However, public information may be aligned or misaligned with one’s own private experiences and different individuals, such as ‘friends’ and ‘enemies’, may have different opinions about the reputation of others. Using evolutionary agent-based simulations, we examine how cooperation and social organization is shaped when agents (1) prioritize private or public information about others’ reputation, and (2) integrate others’ opinions using a friend-focused or a friend-and-enemy focused heuristic (relying on reputation information from only friends or also enemies, respectively). When agents prioritize public information and rely on friend-and-enemy heuristics, we observe polarization cycles marked by high cooperation, invasion by defectors, and subsequent population fragmentation. Prioritizing private information diminishes polarization and defector invasions, but also results in limited cooperation. Only when using friend-focused heuristics and following past experiences or the recommendation of friends create prosperous and stable populations based on cooperation. These results show how combining one’s own experiences and the opinions of friends can lead to stable and large-scale cooperation and highlight the important role of following the advice of friends in the evolution of group cooperation.

A distributed brain response predicting the facial expression of acute nociceptive pain.

Pain is a private experience observable through various verbal and non-verbal behavioural manifestations, each of which may relate to different pain-related functions. Despite the importance of understanding the cerebral mechanisms underlying those manifestations, there is currently limited knowledge on the neural correlates of the facial expression of pain. In this functional magnetic resonance imaging (fMRI) study, noxious heat stimulation was applied in healthy volunteers and we tested if previously published brain signatures of pain were sensitive to pain expression. We then applied a multivariate pattern analysis to the fMRI data to predict the facial expression of pain. Results revealed the inability of previously developed pain neurosignatures to predict the facial expression of pain. We thus propose a Facial Expression of Pain Signature (FEPS) conveying distinctive information about the brain response to nociceptive stimulations with minimal or no overlap with other pain-relevant brain signatures associated with nociception, pain ratings, thermal pain aversiveness, or pain valuation. The FEPS may provide a distinctive functional characterization of the distributed cerebral response to nociceptive pain associated with the socio-communicative role of non-verbal pain expression. This underscores the complexity of pain phenomenology by reinforcing the view that neurosignatures conceived as biomarkers must be interpreted in relation to the specific pain manifestation(s) predicted and their underlying function(s). Future studies should explore other pain-relevant manifestations and assess the specificity of the FEPS against simulated pain expressions and other types of aversive or emotional states.

Cluster analysis of medical students’ attitudes regarding people who use drugs: a first step to design a tailored education program

IntroductionPeople with substance use disorder (SUD) deal with stigmatization in various areas of life, including healthcare system. In this study, we investigated the attitudes of final-year medical students towards SUD people and attempted to understand their influence.MethodsWe conducted a two-stage cluster analysis (hierarchical ascending classification followed by K-means clustering) based on the “beSAAS”. We administrated this 23-item questionnaire to 923 final-year medical students in Belgium (response rate = 71,1%). Sociodemographic characteristics were compared between the clusters.ResultsFour clusters of students with specific characteristics were identified in this study. The first, “The Inclusives” (including 27,9% of respondents) had the least negative attitudes; they wanted to specialize mainly in psychiatry and gynecology. The second, “The Centrists" (23,6%) consisted mainly of male students. They had many private and professional experiences with substance use and considered themselves less healthy than others did. Most wanted to specialize in pediatrics and general practice. Their attitudes were slightly negative towards people with SUD. The third, “The Moralists” (27,6%), were mainly older, from non-European countries, had the least experience with substance use (or contact mainly in hospitals), had the less high mother’s level of education and reported excellent health. They were heading toward other specialties. They had the most stereotypes and moralism, and less treatment optimism. The fourth, “The Specialist care-oriented” (20,8%), were the most in favor of specialized treatment. This group had a higher proportion of Belgian, females, and students who had specific contact with this population. They especially intended to specialize in internal medicine.ConclusionThis study revealed 4 profiles of medical students with different attitudes towards SUD people. “The Moralists”, including more than a quarter of the respondents, were characterized by strong stereotypes and moralism and little treatment optimism. These clusters could contribute to the design of a learner-centered program aimed at addressing stigma within the main curriculum.

The freedom to love, move and organize

The late Tom Lodge’s magisterial Red Road to Freedom will surely become the standard text on communism in South Africa, definitively re-assessing the sociological development and historiographically-contested political arc of the Communist Party of South Africa (CPSA). The book, nevertheless, is squarely focused on the South African public realm, eliding the important private experiences of individual CPSA members and significant transnational interchanges with the broader Southern and Central African region. Early CPSA leaders were often strikingly restrictive about the kinds of relationships available to members; had a complicated, often hostile, relationship with immigrant workers; and were opposed to organising across colonial borders. For marginalised groups, these examples prompt difficult questions about what ‘freedom’ meant to communists and where the early CPSA’s Red Road was ultimately headed to.

Fear of Cancer and State Anxiety Among Women Undergoing Hysterectomy

Background Fear of cancer may develop after surgery in women who underwent surgery for suspected malignancy in preoperative examinations. It is important from a psychosocial point of view that the fear of cancer and the factors affecting anxiety are determined and necessary interventions are made. Objectives The aim of this study was to determine the level of state anxiety, fear of cancer, and influencing factors in women who had hysterectomies with a risk of cancer in the waiting period for the pathology result. Methods The research data were collected from 109 women who underwent hysterectomy while waiting for the pathology result on the third or fourth postoperative day. Patients completed the Personal Information Form, State-Trait Anxiety Inventory-I, and Cancer Worry Scale. Results Women who underwent hysterectomy with the risk of gynecological cancer had high levels of state anxiety and cancer fear after hysterectomy; type of hysterectomy significantly affected cancer fear (P = .022), and social support (P = .015), type of hysterectomy (P = .024), and family history of cancer (P = .022) significantly affected state anxiety. Conclusion The management of these women’s concerns can be improved if healthcare professionals know more about the factors affecting their state anxiety and fear. Implications for Practice Health professionals witness patients’ most private experiences and play a key role in providing care and support. This study may be foundational in the planning and implementation of nursing interventions to manage causes of anxiety and fear during this waiting period.

Teaching clinical phenomenology in a post-graduate medical training program

IntroductionPatient care suffers when practitioners do not understand the patient’s experience of the illness. This is especially true in psychiatry relative to patients having learned the jargon and studying the diagnostic criteria for various mental disorders using internet search engines, especially Google. Patients more commonly present with a list of symptoms that match the checklist for their self-diagnosis. Their experience may be quite different from the words they use to present their symptoms to medical personnel. More than ever, psychiatric providers need to unpack the words their patients use to discover the actual experience. K. Toombs has written exquisitely about clinical phenomenology in the context of her diagnosis of multiple sclerosis and her negotiation of a medical system that largely ignored her lived experience. This algorithmic, checklist approach to human suffering derives from an understanding of clinical practice in which the practitioner applies scientific knowledge of the bodily processes of diseases, recognizing those diseases by inquiring about the presence of symptoms characterizing those diseases and then rendering treatments based upon statistical studies (preferably randomized, controlled trials) of large groups of individuals. Within this approach, little need exists to encounter the person with the disease as an actual human being, an Other in the sense of Levinas. This approach suffers because even history-taking requires an encounter with an Other in which the internal, private experience of this Other must be heard and made part of the clinical process. This approach can ignore the role of the doctor-patient relationship and the clinical encounter in symptom relief.ObjectivesTo describe an educational program in clinical phenomenology that was well received by trainees who rated that it improved their practice.MethodsIn this presentation, we will describe our efforts at teaching clinical phenomenology and psychiatry within a residency training program, in which we encourage trainees to develop deeper listening skills through conducting life story interviews, motivational interviewing techniques, and narrative approaches in which they search for the metaphors underlying the patients’ illness. We will describe factors influencing trainees’ acceptance or rejection of these approaches and the change in the culture of our training program and clinic that have arisen from their implementation.ResultsOne hundred and twenty residents have taken this course. Eighty-eight percent reported improved clinical skills and ability to relate to patients.ConclusionsThe practice of medicine does not exist independently from the relationships in which medicine is practiced and a thorough understanding of the lived experience and experience of the patient is necessary for accurate diagnosis, psychiatric or medical, and for discovery of a treatment approach with the patient.Disclosure of InterestNone Declared

Investigating University Students Social Media Stalking Situations

Investigating University Students Social Media Stalking Situations

The Sense of Certainty and the Access to Inner Experience: A Qualitative Investigation

Questions about private experiences such as future-related thinking or anger rumination are standard repertoire in many types of psychological research. Evaluating the quality and reliability of participant reports in response to such questions is, however, a complex endeavor—especially for third-person research where observer and observed are distributed across two different individuals and disparate scales of reference may hence challenge the interpretation of findings. Reliable tools to assess an individual’s actual experience are thus needed. In the present article, we conceptually specified and empirically explored the sense of certainty as a vehicle to assess participant’s access to their experience. We conducted semi-structured interviews with 20 participants performing mathematical calculation, imagination, and memory tasks and cross-validated the qualitative reports with their certainty ratings. The results of the Thematic Analysis revealed affective, cognitive, somatic, and rudimentary behavioral dimensions of the sense of certainty. The qualitative data provide the basis for a sense of certainty scale that we argue can assess the sense of certainty as an internal criterion for access to inner experience in a more differentiated manner than standard rating tasks.

Theorising a spectrum of reasons for failure in knowledge brokering: a developmental evaluation

Background: Despite the growing interest in knowledge brokering as an approach to mobilising knowledge for societal benefit, research has only recently begun investigating the consequences of knowledge brokers’ actions. In particular, while it is known that failure can provide a valuable learning experience for individuals and organisations alike, very few studies have explored failure in knowledge brokering. Aims and objectives: With the aim of informing how knowledge brokers can navigate common professional challenges, this article discusses a spectrum of reasons for failure in the professional practice of knowledge brokering. Methods: Data for this article comes from a developmental evaluation of a network of knowledge brokers, focusing specifically on a set of semi-structured interviews (N = 20). Findings: The overarching themes identified in this study are organised according to the three constructs that knowledge brokers act upon in the i-PARIHS framework: innovation, recipients, and context. Knowledge brokers experienced different types of failure across these constructs, ranging from violations of prescribed practices and processes to exploratory testing. Discussion and conclusions: Failure is not a monolithic outcome, and future research could seek to identify levers for change regarding the failure experiences available to knowledge brokers. Additionally, it will not be enough to learn to fail; research and practice in knowledge brokering must learn to fail intelligently. Finally, failure cannot remain a private experience. Advancing the field of knowledge brokering will require researchers and practitioners to share when and how their efforts have failed.