A Foucauldian, Phenomenological Analysis of Psychological Challenges Experienced Following Spinal Cord Injury

UoM administered thesis: Doctor of Counselling Psychology

  • Authors:
  • Esther Ingham

Abstract

This study explores potential therapeutic needs of people who have recently incurred a Spinal Cord Injury (SCI) and consequently live with an acquired disability. There are currently more people living with SCI than ever, yet there is still apparently little awareness or understanding of the complexity of the many potential psychological challenges caused by the injury. Despite disability being an inevitable part of existence, it is not consistently theoretically conceptualized other than to involve issues of power and vulnerability, and therapeutic literature relating to physical disability is scant. An inductive approach to the study was taken in order to focus on personal experiences of SCI, and more than one epistemological framework is mobilized in order to more comprehensively understand issues relating to disability and SCI. Using the (apparently conflicting) works of Foucault and Merleau-Ponty to inform a discourse analysis, both the cultural and historical social constructions, and the phenomenologically embodied aspects of disability are balanced to create a more holistic understanding of the experiences of acquired disability as a result of SCI. Seven participants were recruited for the study from an NHS specialist Spinal Injury Unit. Semi-structured interviews were conducted twice – once whilst participants were in-patients of the Unit, and once soon after they had been discharged. The main body of analysis is divided into three thematic sections: the Ecological – focusing on the roles of power relationships, institutions and culture through language and behavior, The Phenomenological – identifying the body as the primary site of ‘knowing-in-the-world’ and the implications to the sense of self of altered bodily experiences as a result of a new physicality, and The Existential – exploring how SCI can force a reconsideration of the possible significance or purpose(meaning) to be found in living. Trauma is acknowledged but not addressed as a primary focus, while the temporal element to the experience of SCI is identified. Focusing on the recently injured person’s perspective at two significant points post-injury, this study aims to challenge the static concept of disability, and reconceptualise it as something experienced as fluid and context-dependent. The importance and affect of reflexivity in the study is also explored, as well as issues/implications of researcher positioning. The inter-relatedness of identified dominant themes is discussed in an attempt to illustrate the complex fluid interactions between SCI/acquired disability and individual life contexts. Identified themes are developed using critical disability theory, feminist literature, disability studies and Buddhist thought in order to advance understanding and conceptualisation of disability and the psychological experience of SCI. Education and reflexive awareness particularly regarding the machinations of widespread and embedded power relations relating to disability, as well as their consequences, are indicated as ethically necessary requirements (as an issue of social justice) for counselling psychologists to be able to practice appropriately, Ultimately, it is hoped that by investigating accounts of what affected individuals feel the dominant psychological challenges and difficulties are within their first year of injury, it may be possible for therapeutic services to become more effectively tailored to their specific needs.

Details

Original languageEnglish
Awarding Institution
Supervisors/Advisors
Award date31 Dec 2018