Dear All
In my limited experience of dealing with BNIM interviews, there are 3
key ethical considerations/questions that I have had to reflect on in the
process of analysis/interpretation and publication of BNIM generated data (in addition to the
ethical issues that arise when one does BNIM interviews).
a) How to do justice to the principles of anonymity and confidentiality when we
deal with very detailed and rich case-based material? can anonymisation (merely
keeping the name of the BNIM interviewee confidential) work when there is so
much detail in the actual BNIM account that could make the interviewee
identifiable even if we do not disclose the person's name? and if we are to remove
particular details from the BNIM account when we publish case studies based on
BNIM interviews, in order to adhere to the principles of confidentiality and
anonymity, then how much detail do we need to remove? and if we go too far and
remove too much of the detail, then do we not run the risk of
de-contextualising the account and even rendering the account meaningless? how
can one strike a balance between maintaining enough detail and context in
the account on the one hand, and respecting anonymity and confidentiality
on the other?
b) From my experience of participating in BNIM interpretation panels analysing
case-based material, I can see how such panels may run the risk of
over-interpretation; over-interpretation is not peculiar to the panel approach
as a lone researcher interpreting an interview on their own may over-interpret;
but I imagine the risk of over-interpretation may be augmented when a group of
people come together to interpret BNIM material in such a detailed and focused
fashion; my experience of BNIM panels has been one where the panel members were
using foremost psychoanalytically informed hypotheses and interpretations;
although I too was using psychoanalytically informed thinking in these panels
(as I was and still am very much attracted to such thinking), I can see how at
times there was a great deal of over-psychoanalysing of the
interviewee at play during those panels, which felt quite arbitrary (?)
especially when hypotheses were made about the interviewee's innermost thoughts
and wishes and unconscious processes, ie about sensitive and very private
issues; I imagine processes of interpretation may reach extreme and
unhelpful points with other conceptual frameworks as well (for example,
sociologically informed frameworks), so I would not entirely attribute the
over-interpretation that I felt was often at play to the psychoanalytically
informed frameworks the BNIM panel members were working with; but I imagine
there is something that could be perceived as particularly arbitrary and even
disrespectful towards the interviewee implicated in a group of strangers (to
the interviewee) over-psychoanalysing the interviewee and making claims about
the interviewee's innermost thoughts and wishes and unconscious processes...of
course one can argue that all interpretations are subjective and
arbitrary...but I think we are in a much more contested and ethically difficult
and unsettling territory when we are offering claims about somebody's
unconscious processes...I am not suggesting at all that we should not work with
psychoanalytically informed frameworks of interpretation in research...I am
just flagging up the contested and difficult and unsettling nature of
interpretation of sensitive and very private material when it becomes
over-interpretation, and also pointing to the ethical implications of
over-interpretation (i.e. potentially coming across as disrespectful towards
the person/interviewee who is subjected to this over-interpretation).
c) I understand that when a
research participant gives consent for participation in a BNIM interview, they
consent to the interview data being published with the principles of anonymity
and confidentiality being adhered to. But I wonder how many, if any at all,
interviewees get to see the researchers' interpretations of their case material
before this material gets published. Here i am not talking about merely sharing
the interview transcripts with the interviewees that a lot of researchers seem
to consider as adhering to a 'participatory' approach to research. I am talking
about sharing the interpretations of somebody's case material with that person,
especially when the interpretations concern the person's innermost
thoughts and wishes and unconscious processes (sensitive and very private
issues). I feel that this person has the right to know how we have interpreted
their case material and what claims we make about their innermost thoughts and
wishes and unconscious processes before this material gets published. And this
is not about obtaining the person's agreement with our interpretations
as the person may not agree with them and after all, we as researchers need to have the freedom to interpret as we see best. but it is about respecting the person's
moral right to know how we have interpreted and presented their case material.
the person may agree with our interpretations and how we are presenting their
case material. or they may not agree but they are happy for us to publish our
interpretations. or they may disagree completely with our interpretations and even object strongly to us publishing
certain aspects of the case material (I am not talking about the entire case)- objection which I feel we may need to respect; this is not a clearly formulated view but my instinctive reaction to this issue. I would particularly welcome comments and thoughts on this one. It is essential to clarify here that I am not suggesting that the research participants are made aware of all the panel-interpretative discussions on their case; I am suggesting that the research participants get to see the researcher's final write up of their case before it gets published.
Finally, I
feel what would enrich our published account would be to have the interviewee's
own interpretations alongside our interpretations in a dialogic publication
where both voices, i.e. the researcher's and the interviewee's, would be
present (with the interviewee's consent of course). My main point here is that
in my view, publication of sensitive and very private research (BNIM) case material needs to occur
in some negotiation with the research participants whose cases are used. This is not about giving excessive veto powers to the research participants but about respecting their right to know how we are going to present their case material in the public domain and what kind of interpretations of very sensitive material about them we have made; it is also about respecting their right to disagree with our interpretations and hence about giving them the opportunity to disagree and express that disagreement. I personally have been using mental health services since 2008 and that included a period of detention in an acute psychiatric ward. For nearly 2 years my life was dominated by mental health professionals who analysed and interpreted and wrote about my mental state (and my inner thoughts and feelings) using my case material in my total absence and in a process over which I had no ownership whatsoever and where I was not given any opportunities to disagree with the professionals' interpretations and express that disagreement- which I experienced as very disempowering. I can see some parallels between this disempowering treatment and publishing BNIM generated case material in the total absence of the interviewees whose cases are used and in a process over which the interviewees have no owenrship whatsoever and where they are not given any opportunities to disagree with the researcher's interpretations and express that disagreement.
Unfortunately, time constraints and the culture and pressures of publishing in
academia are most likely to render negotiation with research participants before publication of the BNIM generated case material (as discussed above) very difficult or even impossible.
Looking foward to any comments, thoughts, disagreements...
kind regards and thanks
Dina Poursanidou
Dina's Blog on Asylum, the Magazine for Democratic Psychiatry http://www.asylumonline.net/dinas-blog/