My personal journey from a primary school teacher to special education, education psychology and therapies to a “multidimensional”, “holistic”, “transformative” rehabilitator, i.e. ‘conductive education teacher’ was long but direct. The focus on that ‘slice’ of the society which suffers a lot and struggles to find friendly and reliable professional help, evolved from an empathetic personality and a personal interest. Once I had learnt Conductive Education (CE), my mind slowly moved from a sceptical empiric dualist position increasingly towards a holistic one, where things can be looked at “in the round”. During studying CE at the International Peto Institute, Hungary, something very simple to the eyes but constructively so complex to the mind was unfolding in front of me. One very interesting thing I realised was that ‘Butterfly-effect’ (introduced first by Edward Lorenz in Does the flap of a butterfly’s wings in Brazil set off a tornado in Texas 1972 which highlighted that small variations of the initial condition of a dynamic system may produce large variations in the long term behaviour of the system) was real in terms of the holistic links between the various parts of the World. In the World we humans participate as part of the whole whilst functioning individually as a whole. The ‘whole’ builds up from many smaller “elements”. These elements can be found in the smallest and largest parts of our body and brain. Where, de facto, numerous simultaneous inputs can cause turbulence and change output, the overall system is able to accommodate such changes. Put simply, a global approach which is able to get in touch with the physically disabled person’s complex needs is more likely to bring about change in their condition than any other method. I thought I would find this approach in CE.
As a young professional in the field of rehabilitation I shortly realised that CE was very different from any traditional services as it takes for granted the use of pedagogy and deals with the person as whole and not only their physical needs but emotional, social and often any other needs as well. The new, unknown, professional position of the rehabilitation of the central nervous system damaged patients produces a professional loneliness and a sort of ‘professional racism’ for CE providers. The feeling of the loneliness and not being accepted, forced me into thinking harder about my own position and that of my fellow professionals. I noticed much misunderstanding about CE and I also found a colossal lack of adequate research in this area. All of these factors challenged me to look critically into the characteristics of CE again as experienced conductive education teacher and try to choose an adequate methodology to explore it.
“The holistic science includes more 'participatory methodology'. It validates the inner subjective experience as well as objective physical sense data. The worldview of wholistic science does recognize the intrinsic nature and value of the human inner life. With the scientific recognition of the inner life, the wholistic worldview permits a global view of the human being as a 'totality of body, soul and spirit.' Scientific discoveries of the interrelations of body, soul and spirit are reflected in a new educational paradigm. The new pedagogical methodology recognizes that the child's learning experiences and learning difficulties are global in nature. The global view of the child and the learning process can provide a secure theoretical and practical foundation for a holistic education that directs itself to educate the whole person for the whole of life." (Gerald Karnow, "Educating the Whole Person for the Whole of Life," Holistic Education Review vol. 5 no. 1 (Fall 1992): p. 64)
I suggest taking Karnow’s approach towards a better understanding of education of the person, and transfer it to the education of adults and hence to the rehabilitation of disabled people.
Thus, this methodology should fully support the alternative view of the self, which is responsive to issues of relationship, emotions and bodily functions etc. Such a concept would highlight the less visible aspects of the studied object as a result of the research.
An holistic way of thinking comes from the philosophical position of the researcher, which has an impact on the choice of methods used to gather and analyse data for the research. Martin Heidegger, the german philosopher, believed that one makes sense of the world by being in it, and not by being detached from it (Maggs-Rapport, 2001). “Dasein”, i.e. ‘being in the world’, is one of the main concepts of his hermeneutic phenomenology. Dasein is the experience of time and space. It is the experience of the whole without separation between the person and their life-world and where relationships are counted as part of the existance. Hermeneutic Phenomenology as research method, however, needs to be expanded.
Discovery has been the aim of science since it was first practised, but how those discoveries are made has varied with the nature of the subjects being studied and the era in which they took place. Knowledge and understanding have taken many forms. In areas ranging from sociology and education to healthcare there has been a move towards qualitative paradigms since the World War II. Out of the quantitative – qualitative paradigm battles of the 1980s, qualitative researchers took their place at the table. Qualitative methods of data gathering and analysis have gained popularity. (N.K. Denzin 2009) “Qualitative research - according to A. Strauss and J. Corbin in Basic Qualitative Research (1998) – [we mean] any type of research that produces findings not arrived by statistical procedures or other means of quantification. It can refer to research about a person’s life, lived experiences, behaviour, emotions and feelings as well as about organisational functioning, social movements, cultural phenomena, and interaction between nations. Some of the data maybe quantified, as with a census, or background information about the people or objects studied.“
In addition to the measurable benefits of Conductive Education -Brittle N, Brown M, Mant J, McManus R, Riddoch J, Sackley C. at the School of Health Sciences, University of Birmingham, Edgbaston, Birmingham, UK. Short-term effects on mobility, activities of daily living and health-related quality of life of a Conductive Education programme for adults with multiple sclerosis, Parkinson's disease and stroke, Clin Rehabil.2008 Apr; 22(4):329-37) - I believe it is important to investigate research which might shed light upon the other possible benefits of the method, therefore, qualitative research methodology seemed to be a promising methodology to use. The key difference between quantitative and qualitative methods is flexibility. Qualitative methods allow greater spontaneity and adaptation to the interaction between the researcher and the study participant(s). The relationship is less formal than in quantitative research. Participants have the opportunity to respond more elaborately and in greater detail than is typically the case with quantitative methods. In turn, the researcher has a greater opportunity to study the possible variety of dimensions of lived experience of the participants without prejudging the format of the result, and can respond immediately to the answers by tailoring subsequent questions to information the participant has provided.
For more than a quarter of century narrative and dialogic methods have reshaped qualitative inquiry and can offer an alternative solution for scholars investigating the lived experience of the individual at a deeper level. Since CE is aiming to develop the physically disabled person as a whole in group setting, I consider that a combined use of narrative and dialogic methods could well facilitate the investigation the relationship between the cognitive, social, emotional and functional dimensions of the delivery.
Clandinin and Connelly in Narrative Inquiry: Experience and Story in Qualitative Research (San Francisco: Jossey-Bass Publishers, 2000), 3 define Narrative Inquiry as a method that uses the following field texts as data sources: stories, autobiography, journals, field notes, letters, conversations, interviews, family stories, photos (and other artifacts), and life experience. It implies that knowledge itself is considered valuable and noteworthy even when known by only one person. Donald Polkinghorne writes in Narrative Knowing and the Human Sciences (Albany: SUNY Press, 1988), 132. that Jerome Bruner, the american educational psychologist’s approach places the narrative in time, to “assume an experience of time” rather than just making reference to historical time. Thus narrative captures the emotion of the moment described, rendering the event active rather than passive, infused with the latent meaning being communicated by the teller.
Narrative ,therefore, could shed light onto a person’s lived experience and emotions.
John Dewey explains Narrative Inquiry in terms of the nature of experience. Dewey viewed experience as having both social and personal meaning, believing that people should be analyzed both as individuals and as part of a group or in a social context. In his view nothing and no one exists in isolation. His ideas directed me towards dialogic inquiry. In as much as the paricipants working in group setting have a similar experience of the delivery of CE, they are probably best placed give a view on the investigated dimensions and the link between them.
In David Bohm’s opinion, dialogue is a process of direct face-to-face encounter that insists on facing the corporeal lived experience. “It really means to break things up. It emphasizes the idea of analysis, where there may be many points of view, and where everybody is presenting a different one – analysing and breaking up. That obviously has its value…” in On Dialogue (London and New York, 1997) 6-7.
Richard Kearney in Strangers, Gods, and Monsters (Routledge, 2003) highlights the dialogic dimensions. It suggests that a narrative configuration of the self involves not only a relationship of self to self but also a relationship of self to other. This relationship of self to other maybe referred to as intersubjectivity – relation and response between the subjectivity of the self and subjectivity of the other. This is achieved through dialogue. Through dialogic inquiry we could gain knowledge of the participant’s lived experience in the group and the emotions involved ,giving them a chance to share their individual experiences and further discuss those subjects.
I conclude that a combined use of narrative and dialogic methods could well facilitate the investigation into the relationship between the cognitive, social, emotional and functional dimensions of the delivery of CE.
The research study raises ethical matters which need to be addressed.
At most universities, and certainly at LJMU, before beginning research we need to obtain ethical approval for our research.
“In many ways, this process of obtaining to negotiate our inquiries works against the relational negotiation that is part of narrative inquiry. However, as an institutional requirement, obtaining ethical approval is necessary. This places inquires in a catch-22 position.”
Clandinin and Connelly in Narrative Inquiry: Experience and Story in Qualitative Research (San Francisco: Jossey-Bass Publishers, 2000) 170
“For decades, oral historians have promulgated high ethical and professional standards, including their ethical requirement to obtain informed consent prior to conducting an interview and a signed legal release at the conclusion of the interview. … A humanities-based, interpretive inquiry model…would stand alongside a revised biomedical model. A radical rethinking would produce an inclusive, ethically empowering model that would be applied to all forms of inquiry.”
Norman K. Denzin in Qualitative Inquiry under Fire, Left Coast Press Inc, California, 2009) 297
“Indeed, ethical research is perhaps best understood as part of an ongoing dialogue which not only precedes the investigation but, while participants and researchers alike my contribute to the ‘conversation’ for a short time, will also continue after it. Greenop Darren, LJMU, 2008
I am at the stage of obtaining ethical approval for my proposed research and, like many other qualitative researchers, I simply try to follow the format of the given form and fill out the required sections. However, during this exercise I have come across some difficulties. To me, one of the biggest concerns is how to outline narrative and dialogic interviews. I would be more interested in what the participants will say rather than giving them suggestions as to what to talk about. The ethical form requires an outline in advance I look for guidance on the subject of obtaining ethical approval in case of narrative and dialogic inquires.
As a young professional in the field of rehabilitation I shortly realised that CE was very different from any traditional services as it takes for granted the use of pedagogy and deals with the person as whole and not only their physical needs but emotional, social and often any other needs as well. The new, unknown, professional position of the rehabilitation of the central nervous system damaged patients produces a professional loneliness and a sort of ‘professional racism’ for CE providers. The feeling of the loneliness and not being accepted, forced me into thinking harder about my own position and that of my fellow professionals. I noticed much misunderstanding about CE and I also found a colossal lack of adequate research in this area. All of these factors challenged me to look critically into the characteristics of CE again as experienced conductive education teacher and try to choose an adequate methodology to explore it.
“The holistic science includes more 'participatory methodology'. It validates the inner subjective experience as well as objective physical sense data. The worldview of wholistic science does recognize the intrinsic nature and value of the human inner life. With the scientific recognition of the inner life, the wholistic worldview permits a global view of the human being as a 'totality of body, soul and spirit.' Scientific discoveries of the interrelations of body, soul and spirit are reflected in a new educational paradigm. The new pedagogical methodology recognizes that the child's learning experiences and learning difficulties are global in nature. The global view of the child and the learning process can provide a secure theoretical and practical foundation for a holistic education that directs itself to educate the whole person for the whole of life." (Gerald Karnow, "Educating the Whole Person for the Whole of Life," Holistic Education Review vol. 5 no. 1 (Fall 1992): p. 64)
I suggest taking Karnow’s approach towards a better understanding of education of the person, and transfer it to the education of adults and hence to the rehabilitation of disabled people.
Thus, this methodology should fully support the alternative view of the self, which is responsive to issues of relationship, emotions and bodily functions etc. Such a concept would highlight the less visible aspects of the studied object as a result of the research.
An holistic way of thinking comes from the philosophical position of the researcher, which has an impact on the choice of methods used to gather and analyse data for the research. Martin Heidegger, the german philosopher, believed that one makes sense of the world by being in it, and not by being detached from it (Maggs-Rapport, 2001). “Dasein”, i.e. ‘being in the world’, is one of the main concepts of his hermeneutic phenomenology. Dasein is the experience of time and space. It is the experience of the whole without separation between the person and their life-world and where relationships are counted as part of the existance. Hermeneutic Phenomenology as research method, however, needs to be expanded.
Discovery has been the aim of science since it was first practised, but how those discoveries are made has varied with the nature of the subjects being studied and the era in which they took place. Knowledge and understanding have taken many forms. In areas ranging from sociology and education to healthcare there has been a move towards qualitative paradigms since the World War II. Out of the quantitative – qualitative paradigm battles of the 1980s, qualitative researchers took their place at the table. Qualitative methods of data gathering and analysis have gained popularity. (N.K. Denzin 2009) “Qualitative research - according to A. Strauss and J. Corbin in Basic Qualitative Research (1998) – [we mean] any type of research that produces findings not arrived by statistical procedures or other means of quantification. It can refer to research about a person’s life, lived experiences, behaviour, emotions and feelings as well as about organisational functioning, social movements, cultural phenomena, and interaction between nations. Some of the data maybe quantified, as with a census, or background information about the people or objects studied.“
In addition to the measurable benefits of Conductive Education -Brittle N, Brown M, Mant J, McManus R, Riddoch J, Sackley C. at the School of Health Sciences, University of Birmingham, Edgbaston, Birmingham, UK. Short-term effects on mobility, activities of daily living and health-related quality of life of a Conductive Education programme for adults with multiple sclerosis, Parkinson's disease and stroke, Clin Rehabil.2008 Apr; 22(4):329-37) - I believe it is important to investigate research which might shed light upon the other possible benefits of the method, therefore, qualitative research methodology seemed to be a promising methodology to use. The key difference between quantitative and qualitative methods is flexibility. Qualitative methods allow greater spontaneity and adaptation to the interaction between the researcher and the study participant(s). The relationship is less formal than in quantitative research. Participants have the opportunity to respond more elaborately and in greater detail than is typically the case with quantitative methods. In turn, the researcher has a greater opportunity to study the possible variety of dimensions of lived experience of the participants without prejudging the format of the result, and can respond immediately to the answers by tailoring subsequent questions to information the participant has provided.
For more than a quarter of century narrative and dialogic methods have reshaped qualitative inquiry and can offer an alternative solution for scholars investigating the lived experience of the individual at a deeper level. Since CE is aiming to develop the physically disabled person as a whole in group setting, I consider that a combined use of narrative and dialogic methods could well facilitate the investigation the relationship between the cognitive, social, emotional and functional dimensions of the delivery.
Clandinin and Connelly in Narrative Inquiry: Experience and Story in Qualitative Research (San Francisco: Jossey-Bass Publishers, 2000), 3 define Narrative Inquiry as a method that uses the following field texts as data sources: stories, autobiography, journals, field notes, letters, conversations, interviews, family stories, photos (and other artifacts), and life experience. It implies that knowledge itself is considered valuable and noteworthy even when known by only one person. Donald Polkinghorne writes in Narrative Knowing and the Human Sciences (Albany: SUNY Press, 1988), 132. that Jerome Bruner, the american educational psychologist’s approach places the narrative in time, to “assume an experience of time” rather than just making reference to historical time. Thus narrative captures the emotion of the moment described, rendering the event active rather than passive, infused with the latent meaning being communicated by the teller.
Narrative ,therefore, could shed light onto a person’s lived experience and emotions.
John Dewey explains Narrative Inquiry in terms of the nature of experience. Dewey viewed experience as having both social and personal meaning, believing that people should be analyzed both as individuals and as part of a group or in a social context. In his view nothing and no one exists in isolation. His ideas directed me towards dialogic inquiry. In as much as the paricipants working in group setting have a similar experience of the delivery of CE, they are probably best placed give a view on the investigated dimensions and the link between them.
In David Bohm’s opinion, dialogue is a process of direct face-to-face encounter that insists on facing the corporeal lived experience. “It really means to break things up. It emphasizes the idea of analysis, where there may be many points of view, and where everybody is presenting a different one – analysing and breaking up. That obviously has its value…” in On Dialogue (London and New York, 1997) 6-7.
Richard Kearney in Strangers, Gods, and Monsters (Routledge, 2003) highlights the dialogic dimensions. It suggests that a narrative configuration of the self involves not only a relationship of self to self but also a relationship of self to other. This relationship of self to other maybe referred to as intersubjectivity – relation and response between the subjectivity of the self and subjectivity of the other. This is achieved through dialogue. Through dialogic inquiry we could gain knowledge of the participant’s lived experience in the group and the emotions involved ,giving them a chance to share their individual experiences and further discuss those subjects.
I conclude that a combined use of narrative and dialogic methods could well facilitate the investigation into the relationship between the cognitive, social, emotional and functional dimensions of the delivery of CE.
The research study raises ethical matters which need to be addressed.
At most universities, and certainly at LJMU, before beginning research we need to obtain ethical approval for our research.
“In many ways, this process of obtaining to negotiate our inquiries works against the relational negotiation that is part of narrative inquiry. However, as an institutional requirement, obtaining ethical approval is necessary. This places inquires in a catch-22 position.”
Clandinin and Connelly in Narrative Inquiry: Experience and Story in Qualitative Research (San Francisco: Jossey-Bass Publishers, 2000) 170
“For decades, oral historians have promulgated high ethical and professional standards, including their ethical requirement to obtain informed consent prior to conducting an interview and a signed legal release at the conclusion of the interview. … A humanities-based, interpretive inquiry model…would stand alongside a revised biomedical model. A radical rethinking would produce an inclusive, ethically empowering model that would be applied to all forms of inquiry.”
Norman K. Denzin in Qualitative Inquiry under Fire, Left Coast Press Inc, California, 2009) 297
“Indeed, ethical research is perhaps best understood as part of an ongoing dialogue which not only precedes the investigation but, while participants and researchers alike my contribute to the ‘conversation’ for a short time, will also continue after it. Greenop Darren, LJMU, 2008
I am at the stage of obtaining ethical approval for my proposed research and, like many other qualitative researchers, I simply try to follow the format of the given form and fill out the required sections. However, during this exercise I have come across some difficulties. To me, one of the biggest concerns is how to outline narrative and dialogic interviews. I would be more interested in what the participants will say rather than giving them suggestions as to what to talk about. The ethical form requires an outline in advance I look for guidance on the subject of obtaining ethical approval in case of narrative and dialogic inquires.
