Narrative as a Research Tool: Application Research in Stuttering
About the presenter: Harsha Kathard is a senior lecturer in Speech-Language Pathology and Audiology in the Department of Speech Hearing Therapy at the University of Durban-Westville, South Africa. She runs the clinical training programme at the University and also a school-based programme. She has also worked with people who stutter in her part-time private practice. Her research intereste is in narratives as a methodological tool in stuttering research.
NARRATIVE AS A RESEARCH TOOL : APPLICATION RESEARCH IN STUTTERING
by Harsha Kathard
from South Africa
In this introductory paper I advance a rationale for engaging life history research as a methodological approach for theorising the subjective experiences of People Who Stutter (PWS). I sketch my concerns about the fitness of the current knowledge base in informing my practice in a context characterised by diversity and locate the dissenting voices of researchers who challenge the dominant research cannon. A critical analysis of the science used in stuttering research is presented to motivate my departure from the dominant paradigm. I proceed to position life history methodology within the broader genre of narrative research and illuminate its potential in serving as an authentic research lens. In claiming life history research as a legitimate science, I briefly explain its epistemological underpinnings , aspects of the methodology, and discuss the nature of generative grounded theorising by way of example. This paper is presented as an invitation to the academic and practitioner and PWS to dialogue the potentiality of life history research.
Introduction
My interest in life history research emerged from my concerns as a practitioner with PWS, and from my critical engagement with stuttering research. My concern as a practitioner is that I am faced with the whole lives of PWS of diverse backgrounds. Pillay (2001) captures this reality " In a hopelessly practical world, social power relationships intersect in the practice playground where class gender, socio-economic status difference and a host of societal factors bounce against the hard walls of our narrow professional realities" Implicit in Pillay's claim is that the current stuttering theory does not offer the practitioner relief. My claim is that stuttering by its very nature can only receive meaning if understood in a whole life context. As a researcher I have remained dormant and perhaps apathetic because the nature of science promoted within our discipline did not allow me to engage with these issues in a critical way. My stumbling upon life history research came therefore, not unsurprisingly, from outside of the disciplinary field. My colleagues in the Faculty of Education offered an understanding of science and methodologies that had instinctive appeal for researchers like myself who had grown weary of controlling variables.
Signalling departure from the dominant research tradition ..
The experience of questioning of the discipline’s research canon is not mine alone . We have reached a point in stuttering research history where the voices of dissent have challenged the status quo of the research enterprise. Mowrer (1998) has strongly argued why experimental designs have limited applicability in generating knowledge about stuttering, a complex social problem and argues for alternative research strategies. Furthermore, he emphasises that despite the potential that the stories of PWS have to add to our formal professional theory, they gain entry into scientific journals as a result of professional gatekeeping in the name of science. Perkins (1997) mounted a multipronged attack on the disciplines narrow view of science in understanding stuttering. Among the points he raises are that science was never meant to provide sanitised facts about stuttering but is intended to reveal messy realities fraught with inconsistencies and contradictions. He critiques the influence of behavioural theory in conceptualising stuttering and the extent to which it has contributed to the loss of the discovery dimension of science. He asserts that experimental research on physiological differences tantamounts to an exercise in reductionism and challenges the uncritical application of the scientific method. He suggests that s that the most insidious consequence of this paradigm is that it is self-perpetuating and without self-correction. Siegel (1998) provides a reflective analysis of issues pertaining to the stuttering theory, research and therapy in arguing for a new paradigm. In particular, he suggests that the clinic ( rather than experimental laboratory) is one source of other sources which has potential to set the research future research agenda given that the profession has a fundamental interest in providing services to PWS.
Why do we find ourselves in a paradigmatic quandary?
In order to understand the nature of the dominant science paradigm, it is perhaps necessary to interrogate its epistemological, ontological and methodological tenets. In other words we need to challenge our beliefs about reality, our views of what truth is, and the methods we use to pursue constructing knowledge. My analysis of the professions dominant science is that it bears the hallmarks of a positivist/postpostivist tradition intended for use in the natural sciences. In this paradigm reality is conceived of as apprehendable and driven by immutable natural laws and mechanisms. Research seeks to generate imprints of reality. The investigator and investigated are assumed to be independent of each other. The researcher generates hypotheses and tests these in pursuit of objectivity wherein there is an assumed one-way mirror through which the inquiry takes place. The methodological routines favour experimental design wherein the control of variables and quantification are critical for the generation of facts, certainties and universal context-free knowledge about stuttering. The problematic application of a research paradigm intended for the natural sciences and inappropriately recruited into the social sciences domain has received critique by many including those in the natural sciences ( Pillay, 2001; Denzin & Lincoln, 1998; Alvesson& Skoldberg, (2000); Mowrer, 1998).
The critique of the dominant science has been that it is reductionistic in all aspects of the research enterprise. Its interest is in generating technical, discrete knowledge and causal hypotheses about the core, pathological dimensions of stuttering. Despite the numerous methodological problems detailed by Mowrer (1998) and lack of critical purchase in theory building (Perkins 2000) we continue to pursue such research in the name of science However, I argue that the dominant paradigm is but one notion of science which has wielded hegemonic influence over the research enterprise. Perhaps it is not what it does (generates technical knowledge) that is of concern, but what it doesn’t do (generate knowledge for practice) that is of concern to me.
Identifying gaps and silences…of research
- Firstly, the current research base fails to capture an understanding of stuttering as a human phenomenon. Like most research modelled along the underpinnings of the medical model, it has engaged primarily with the pathological, symptomatic dimensions of dysfluency but does not have a metric for understanding the fundamental issues of hurt, pain, grief, hope and courage- the human dimensions of stuttering experience.
- Secondly, the perspective from which it stuttering has been researched by the outsider/s looking in i.e. an objective view. This has promoted a one-sided approach to generating facts about stuttering. Perkins (2000) describes stuttering as Janus-like having two heads facing in opposite directions. Whilst they are dissimiliar and seemingly unconnected they are integral aspects of the same phenomenon. The dominant science has pursued the head that faces outward. My concern lies with the head that faces inward- the personal experience of stuttering. Queasal (1998) challenges the discipline more than a decade ago over the lack of engagement with the core psychosocial concerns of PWS in our research activity because these aspects are difficult to quantify. He pointed out that the difficulty in quantification of these human dimensions are in danger of being interpreted as a lack of reality. We are not much further in addressing these core concerns as part of our research agenda.
- Thirdly, the understanding of stuttering in the personally-tensed cultural contexts of people’s lives is not given currency in theorising.
- Fourthly, despite agreement that stuttering is a communication phenomenon and that communication is simultaneously social and political (power differentials), these constructs marginal in our research discourse. The peril is that without accounting for issues of discrimination and prejudice we fail to understand stuttering as a sociological phenomenon (Snyder in St. Louis, 2001).
- Fifthly, the current research base does not portray the temporal- historical understanding of stuttering in a life context that for most people is characterised by change and uncertainty.
It has therefore become imperative to explore the potentialities offered by the hermeneutic and critical sciences which have gained agency in social science research. The challenge is to introduce divergent research lenses to expand our inquiry beyond the core pathological dimensions of stuttering and to engage the subjective life experiences of PWS in a fundamentally complex , dynamic, political world as a basis for theorising. The grand narrative of the profession’s research has been told and I propose a shift in the direction of interpretive and critical notions of inquiry which supports the evolution of contextually- relevant experience-based theorizing. Reality is conceived of as historical and shaped by cultural, political, social, ethnic and gender values. Knowledge is co-constructed between the researcher and participant and is transactional in nature. The methodologies are dialogical in nature and seek to generate contextually relevant understanding via a grounded approach to theorising (Denzin&Lincoln, 1998)
The defining features of grounded theory methodology is that theory evolves during the research process and there is a continous interplay between the processes of data analysis and data production (Strauss& Corbin, 1998).The theorizing process requires the generation of conceptually dense understandings. "Truth" therefore is always acknowledged as tentative and admits multiple interpretations or versions of truth. Life history is theoretically resonant with the tenets of grounded theory methodology and therefore uniquely suited to researching individual experiences of stuttering. I now proceed to explore the methodological approach further.
A case for narrative knowing
In social science research the word experience is used when there is interest in humans behaviour relationships and contexts. Clandinin and Connelly (2000) construct the notion of a three-dimensional space to capture the essence of human experience. Experience encapsulates the dimensions of personal and social interaction. Interaction, in turn, is expanded in four directions to include the inward, outward, forward and backward dimensions. The inward refers to the internal conditions of feeling, hopes, aesthetics and moral dispositions. The outward refers to the existential conditions of the environment, whilst backward and forward refer to temporal dimensions.; past, present and future (continuity) ; notion of place referring to the concrete physical boundaries of the inquiry(situation). A combination of these dimensions illuminates the individual experience. Importantly when people record such experience it isn’t recorded in raw sensory form or photographic form but in a storied form. The telling of stories therefore are the "closest we can come to experience" (Clandinin and Connelly, 2000). Stories are the way in which people attach meaning to experience.
As social beings human individuals adopt narratives in making sense of a complex world. Stories generated and conveyed via language are socially grounded and embodies the individuals cultural reservoir i.e. the telling process reveals the social practices, beliefs, ideas of the individual (Sarbin, 1986). Articulating ones experience is regarded as a privileged mode because is it capable of capturing the intimate, nuanced and emotional aspects of experience located in context and time (Polkinghorne, 1995). The appeal in narrative also stems from a reality that storytelling is part of everyday experience. Children, teachers, parents, grandparents tell stories for various purposes. Important for researchers is that people tell stories to make sense of their problematic worlds (Sarbin, 1986). Hence, the case for narrative research.
One may argue that there are stories by People Who Stutter (Jezer, 1998; St.Louis, 2001). Whilst this is, so the point I make here is that stories have been used as anecdotes and have been positioned outside of the research frame. I am advocating the use of stories as a research tool to construct knowledge about the life realities of PWS. It is true that Corcoran and Stewart (1998) have entered this domain by using interview narratives to gain insights into about the subjective experiences of stuttering and revealed suffering as a primary theme. The four key elements of suffering are described as helplessness, stigma, shame, fear and avoidance. However, I recommend a widening of the research lens to refocus on dimensions that include and extend beyond the pathological experience to include life experience as a context for generating understanding about stuttering.
Life history research .. a particular kind of narrative
Life history research within the broader genre of narrative research is always concerned with the history of a single life and is designed to simultaneously explain, describe and reflect upon life (Tillman-Rogers in Hatch and Wisnieiski , 1995). Through self-referential stories the unique point of view of the individual that is situated in culture , time and place is illuminated. Life history research is distinguished from other forms of narrative research because it has an interest in the individual life and its inherent situatedness and connection to social circumstances (Schemp in Hatch and Wisniewki, 1995) and therefore, by definition, goes beyond a personal account. The focus on the individual allows for a deeper understanding of complex relationships between ideology and culture, and the self and society. Life stories have potential of focus upon central moments, critical incidents, or fateful moments that revolve around indecision, confusion, contradictions, and ironies thereby providing a richer sense of process to a life and offers a more ambiguous, complex, and chaotic view of reality (Hatch & Wisniewski, 1995). The story offers more credible, and believable characters than the "flat", seemingly irrational, linear characters common in other forms of qualitative inquiry (Sparkes in Hatch& Wisniewski, 1995).
The individual subjective account is celebrated as a singular strength because it allows each to speak his own truth (Frank, 1995) and yields a richness of understanding that is not offered larger sample studies (Dhunpath, 2000). By advancing the case for subjectivity life history methodology challenges the researcher to suspend his own views and beliefs, not necessarily to agree but to empathize with the worldview and beliefs of the participant. The subjective reality is constructed by the individual and illuminates how they view the world and how they interpret their experiences and attach meaning to such experiences (Armstrong, 1987). Furthermore, life history research allows for the telling of stories over a lifespan and this provides a critical temporal dimension to the understanding of lives. In doing this it is able to capture changes over time from the individuals perspective i.e. temporality in the context of his experience in contrast to the strict normed developmental phases popularised in psychology.
How is life history research done
Life history research is a process of co-construction of knowledge between the researcher and participant. The participant is invited to tell his story by selecting the events and issues of relevance to him. The interview is carefully crafted not just to "give voice" to the participant but importantly to "give ear" to the story so that the outcome reflects collaborative knowledge construction. While in other disciplines the telling of story is a way of uncovering the personal truths, our discipline is doubly challenged to not only to gain access to stories, but to gain access wherein the very act of telling may be compromised. This aspect must be problematised as part of the methodology. Data is produced over many indepth discussions that could take approximately 8 —10 hours and must be recorded for the purposes of data capture and analysis. Following a rigorous transcription process, the researcher must make choices about data representation and analysis procedures.
Taking stories a step further in the research process: narrative as phenomenon and process
In my research, I chose to represent the interview data as stories in contrast to arranging the data into themes for analysis. My sensemaking of this methodological choice is reflected in Figure One. The life history data is produced in narrative form during the interview process (A), and then represented storied form (B) for the purposes of theorising. Hence, the narrative strength is retained both as phenomenon and process.
In choosing to represent the data (B) in storied form I import Polkinghorne’s (1995) explanatory concepts. He differentiates between two different types of narrative inquiry. Viz., analysis of narrative (paradigmatic) and narrative analysis (narrative reasoning). In the ‘analysis of narrative’ data is analysed using paradigmatic processes wherein common themes are traced across stories, characters or settings. In ‘narrative analysis’ the raw data is configured by means of a plot into a story thereby moving from elements to stories (B). The outcome of the data analysis process is an emplotted narrative or a story. The researcher’s task is to construct a story using data elements that unites and gives meaning to the data using a narrative structure. The researcher engages in a generative discovery process by interacting with the text and data in an iterative process.
First impressions of grounded theorising
I used life history narratives as a research tool in the pilot phase of my doctoral research and generated Nhlanhla’s story (Kathard, 2001) which tells of the life of a political activist in South Africa and his experience of stuttering. It is not possible to illuminate all of the emerging issues but I will draw on two aspects that demonstrate the value of grounded theorising.
Firstly, Nhlanhla’s story as a whole has partial alignment with the quest narrative using Frank’s (1995) typology. He frames stuttering as a challenge, seeks to accept it and uses stuttering to his advantage. His sensemaking conveyed in his story tells of the challenges he faces as an individual being disenfranchised in an oppressive society. He appropriates his personal and political resources, and strategies for dealing with the socio-political challenges and imports these resources into managing stuttering, thereby turning disadvantage into advantage. Nhlanhla’s story illustrates in a literal manner how the political can become personal and amplifies that stuttering cannot receive meaning in isolation of a life world. Therefore, the issues of shame and embarrassment in relation to stuttering are not foregrounded in his story.
Secondly, the story raises issues of identity or dynamic subjective positioning. In telling his story Nhlanhla foregrounds his identity as dynamic and his story creates identities of political activist, community leader, and father. Stuttering does not feature in a robust way in his story or identity. The story signals that the archetronics of Nhlanhla’s identity can only receive meaning by unraveling how the major axes such as race, class, gender, culture, power and disability coalesce as broad social processes. In dialogue with the text one may want to raise many questions Is his identity stable? How did his identity as a political develops and sustains itself over time? How does stuttering feature in the processes of identity formation? How did his family and community influence the development of his identity? What implications does issues of identity have for a clinician?
Nhlanhla’s story is but one story and the question that must be asked is: How has the subjective telling of stories reduced our ignorance as researchers and practitioners? This only you the reader will be able to answer because of your own positioning and beliefs. However, my contention is that the profession is clinically situated and is in dire need of theory about subjective dimensions that can be appropriated into practice. Stuttering theory mimics modern medicine in that "lacks a metric for existential qualities such as inner hurt, despair, hope, grief and moral pain that frequently accompany and indeed constitute the illnesses from which people suffer" (Greenhalgh, 1999: 50). Sheehan (1984) contested the professions’ very naming of stuttering as a fluency disorder because it fails to engage with feelings, and the significance of stuttering in the individuals life. The net effect is that fluency-shaping methodologies do not engage substantially with subjective realities and have poor long-term therapeutic outcomes. The inherent danger is that unless there is engagement with subjective realities, the profession will perpetuate the fluency fallacy as a direct consequence of its "objective" science.
Conclusion
I have provided a brief overview of the potential value of life history research. In setting the research agenda that seeks to understand and question rather than generate facts and truths we have admitted humanity into the research process by affording credibility to personal truths rather that forensic truths. It is not my intention to claim dominance of one notion of science over another but rather to recognise the worth each has, and the different purposes they may serve and importantly to recognise their inherent limitations especially for a discipline that has a moral responsibility to provide services to PWS. Witherell and Noddings ( 1991, 280) provide a convincing epilogue
" Stories are powerful research tool. They provide us with a picture of real people in real situations, struggling with real problems. They banish the indifference often generated by samples, treatments and faceless subjects. They invite us to speculate on what might be changed and with what effect. And of course, they remind us of our persistent fallibility. Most important they invite us to remember that we are in the business of teaching, learning and researching to improve the human condition. Telling and listening stories can be a powerful sign of regard-of caring-for one another"
I invite PWS who have stories to share to contact me at hkathard@pixie.udw.ac.za for the purposes of producing data that may allow me to generate knowledge about lived experiences.
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September 15, 2001
