A Waltz with Phenomenology: Discovering the Phenomenological Method within Medical Anthropology
Phenomenology, as developed within anthropology, is a methodology that has many applications yet requires an in-depth understanding in order to remain authentic to its philosophical roots. And yet I find myself stumbling over the process of even attempting to enunciate the word aloud much less applying it to research. In my mind I sound very erudite when announcing, “I am using phenomenology in my ethnography.” In reality it comes out sounding like “fenomenomomennology,” which always elicits a few giggles from anyone listening. Alas, after a few trial runs in front of the mirror I have managed to put away this novice pronunciation as I embrace this methodology within anthropology. And yet, with this stumbling block removed, phenomenology is still as mysterious as it sounds and, I have found, requires in depth investigation in order to sidestep any criticisms for its inappropriate use or application. And to add to this quagmire, it has been suggested that “… there are as many phenomenologies as there are phenomenologists” (Robert Desjarlais and C. Jason Throop, “Phenomenological Approaches in Anthropology,” Annual Review of Anthropology 40 (2011), pp. 87–102 at p. 95). So how does one begin dancing a waltz of familiarity with this methodological approach to research? Read, read, read, and yes, read some more. With each passing article or book the dancing letters on the page begin to settle into a rhythm and meaning begins to take shape. In this effort I have found that some authors use phenomenological approaches without acknowledging it, while others are very demonstrative in why and how phenomenology applies to their work. And to address your perhaps already growing concern as to whether or not I have come to a resting place in understanding phenomenology as I embark on my fieldwork; my steadfast answer is, sadly, no. While the dancing letters are beginning to settle, I continue to uncover new questions with each passing page. However, I hope that in discussing this journey of discovery I can help others as they waltz to a similar score. In this discussion I will demonstrate the phenomenological methodology and its potential application in researching therapeutic modalities, the challenges of remaining authentic in its use, the unique characteristics of research questions as they pertain to phenomenology and lastly, suggesting its application in an analysis of the senses during therapeutic healing processes.
Phenomenology has its roots in psychology as developed by Edmund Husserl and is fundamentally concerned with a scientific approach to the nature of experience and knowledge (Joseph J. Kockelmans, A First Introduction to Husserl’s Phenomenology. Pittsburgh: Duquesne University Press, 1967). It has since been adopted and adapted by others such as, but not limited to Heidegger, Hegel, Sartre, and Merleau-Ponty. It is within this methodological context that Merleau-Ponty developed embodiment as a phenomenological approach to perception whereby the body is the starting point for interactions with the world in the social and physical domains (Robert Desjarlais and C. Jason Throop, “Phenomenological Approaches in Anthropology”). Additionally, in context of studies pertaining to the body, phenomenological embodiment has provided a framework for identifying culture and self where the focus is not on the disease but rather on “broader issues of self, emotion, religion, meaning, transformation, social interaction, institutional control of experience, and the human interface with medical technology” (Thomas Csordas, “The Body’s Career in Anthropology” in Henrietta L. Moore (eds.), Anthropological Theory Today. London: Polity Press, 1999, pp. 172-205 at p. 191). Phenomenology works well within medical anthropology research as it provides a framework for reflexivity and intersubjective empathy, characterized in the work of ethical clinician Richard Zaner who reflects on the why and how of his place in conversations with patients and their experiences with illness in the hospital setting (Conversations on the Edge: Narratives of Ethics and Illness. Washington: Georgetown University Press, 2004). Reflexivity and empathy are important for providing an intuitive understanding of critical medical conditions such as chronic pain which members of society and their families are forced to navigate on a daily basis. However, reflexivity, empathy and embodiment are not limitations of phenomenology’s use in medical anthropology, as demonstrated by the works of Arthur and Joan Kleinman (“Suffering and its Professional Transformation: Toward Ethnography of Interpersonal Experience,” Culture, Medicine and Psychiatry 15 (1991), pp. 275-301), Byron Good (Medicine, Rationality, and Experience: An Anthropological Perspective. Cambridge: Cambridge University Press, 1994), and Robert Desjarlais (Body and Emotion: The Aesthetics of Illness and Healing in the Nepal Himalayas. Philadelphia: University of Pennsylvania Press, 1992). It is in these works that a phenomenological approach is taken and when it is not explicit, it can easily be overlooked if one lacks a grounded understanding of the methods and outcomes of a phenomenological approach. It is this grounded understanding of a phenomenological approach that provides authenticity in its use within research and ethnography.
As mentioned earlier there are many “phenomenologies” and as many phenomenologists. Therefore, to implement this methodology authentically, it is crucial to understanding experiences as lived as well as the essence of those experiences. It was not enough to know what my topic was and what literature there was surrounding it, although crucial in their own right. As I embark on my ethnographic research I felt it was crucial to come to an understanding of the phenomenological methodology not only as it pertains to anthropology, but also the history of its beginnings and those involved. In order to develop proper research questions and to meet any criticisms of analysis in advance, I have to understand truly the beginnings of phenomenology and its encompassing qualities. In the reading that I have done, I have encountered critiques of the improper uses of phenomenology, for example: “… many ethnographers have failed to realize this… written highly personal, emotion-laden testaments to their own experiences…” (Kenneth Hayes Lokensgard, Blackfoot Religion and the Consequences of Cultural Commoditization. Aldershot: Asgate, 2010, p. 161). Here, Lokensgard is suggesting that the researcher’s experiences and their emotions surrounding those experiences, alone do not constitute a phenomenological approach. Rather than focusing on the researcher’s experiences within research, phenomenology can be used as a tool to focus on the intersubjective experiences of the research participant in the context of the phenomenon (Linda Finlay, “Debating Phenomenological Research Methods,” Phenomenology and Practice 3 (2009), pp. 6-25). This intersubjective focus provides the empathy for the research participant and their place within the research. It is intersubjective in that first the ethnographer must participate in and record the experience regarding the phenomenon and then consider, in the context of the research participant, the complex character of those broader issues surrounding the human condition (Michael Jackson, “Introduction: Phenomenology, Radical Empiricism, and Anthropological Critique,” in Michael Jackson (ed.) Things as They Are: New Directions in Phenomenological Anthropology. Bloomington: Indiana University Press, 1996).
Vital to remaining authentic in the use of phenomenology, and to sidestep such criticisms, is to understand the unique phenomenological methods, for example: phenomenological reduction, phenomenological epoché (involving the process of “bracketing”), abstraction and intentionality. Bracketing is difficult to implement as it requires that the researcher put aside their cultural assumptions or influence in relation to the phenomena (Robert Desjarlais and C. Jason Throop, “Phenomenological Approaches in Anthropology”). However, while it is never possible to eliminate fully cultural assumptions or influences, it is possible through anthropological reflexivity to separate the researcher’s influence from the research participants’ experience while remaining authentic in the methodology. In fact, cultural diversity, or alterity can be highlighted when making use of the epoché in the analysis of data (Jack Katz and Thomas Csordas, “Phenomenological Ethnography in Sociology and Anthropology,” Ethnography 4 (2003), pp. 275-288) by engaging with the phenomenon in the way that it presents itself from the beginning and withholding any judgement or theoretical categories. The analysis of data collected with these methods provides descriptions of phenomena and a synthesis of meanings and essences (Clark Moustakas, Phenomenological Research Methods. Thousand Oaks, CA: Sage Publications, 1994) while allowing for the lived experience of worldviews from the ground up without invoking cultural bias or hierarchy (Michael Jackson, “Introduction: Phenomenology, Radical Empiricism, and Anthropological Critique”).
To experience a worldview from the ground up is indicative of a purely qualitative approach to ethnography and research. Phenomenology is not so much concerned with numbers and statistics as it is concerned with the direct experience of phenomena and how that experience shapes culture, meaning and worldviews. The outcome of this approach is generally descriptive and not quantitative. Therefore, it is vital that the research questions considered are focused on descriptive and qualitative outcomes resulting from additional ethnographic methods such as participant observation and interviews. Participant observation allows for an intuitive understanding of the topic from direct participation in the observed phenomenon. Interviews allow for dialogue surrounding the personal knowledge of individuals in how they experience the phenomenon, which can and usually is distinctly different from how others perceive it as an outsider. In the context of medical anthropology and embodiment for example, it is important to frame questions as they pertain to the experiences of the illness, the therapy, the relationships of others in the experience, as well as forms of communication and emotions surrounding the illness. For instance, a question might be phrased to consider in what way particular illnesses and/or therapies provide opportunities to regain control of the self, the self as perceived by the individual and their social network. When considering the complexity of the body as the “existential ground of culture” (Thomas Csordas, “Embodiment as a Paradigm for Anthropology,” Ethos 18 (1990), pp. 5-47 at p. 5) research questions should perhaps also consider the experiences of sensory perception, for instance how the senses are engaged in experiences of illness and how these experiences shape ones lived experiences and worldviews.
Phenomenology offers an opportunity for an analysis of bodily experience and the senses in relation to illness. Correspondingly this methodology would also provide analysis for bodily experiences relating to healing and therapeutic treatments. Maurice Merleau-Ponty set the stage for such an analysis through embodiment on the principle of perception, where the body is the subject of sensory perception (Phenomenology of Perception. New York: Routledge, 2002. Originally published in 1947). Embodiment is also considered a central concept to sensorial anthropology as a process of engagement both historically and contextually within one’s environment and social network (Mark Nichter, “Coming to Our Senses: Appreciating the Sensorial in Medical Anthropology,” Transcultural Psychiatry 45 (2008), pp. 163-198). Therefore, the sensorium can be analyzed as what “… influences (or engenders) a person’s experience and understanding of the world” (Kathryn Linn Geurts, Culture and the Senses: Bodily Ways of Knowing in an African Community. Berkeley: University of California Press, 2002, p. 234). Synthesizing these two ideas; a person’s bodily experiences as perceived and embodied through the senses within a process of engagement with one’s environment and social network and therefore influencing an understanding of their world, provides a theoretical framework for analyzing therapeutic modalities based on sensory perception such as hearing and touch.
An authentic approach to phenomenological methodology as developed within anthropology can help in understanding worldviews from the ground up while eliminating cultural privilege hierarchy (Michael Jackson, “Introduction: Phenomenology, Radical Empiricism, and Anthropological Critique”). This has proven particularly effective within medical anthropology as ethnographies have studied the embodiment of both illness and healing within a context of empathy and reflexivity. Husserl, Merleau-Ponty, Zaner and Csordas have provided explicit examples of phenomenology in various approaches useful for data analysis. As I begin a waltz into my own fieldwork on a vitalistic therapeutic modality, I have found the phenomenological methodology to have numerous steps and requiring a thorough understanding in order to develop appropriate research questions resulting in authentic analysis. This authenticity can be found in knowing and applying the unique phenomenological methods such as, but not limited to, epoché. Furthermore, in applying this methodology to therapeutic healing modalities based in the sensorium, I have suggested a synthesis of the phenomenological concept of embodiment and the embodied sensorium as a framework for analyzing therapeutic modalities steeped in the tactile and auditory senses. While I may miss a few steps within the rhythm of this waltz with phenomenology, this article is an attempt at exploring particular applications of phenomenology within medical anthropology in understanding varying worldviews of healing within therapeutic modalities based on the sensorium.
Department of Anthropology
Image: Female dancing barefoot by quinn.anya, Wikimedia Commons.
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