Phenomenologists seek to depict the “lifeworld”Footnote 1 experiences of people. Researchers applying Heidegger's (Reference Heidegger and Macquarrie1962) existential phenomenology and Gadamer's (Reference Gadamer and Weinsheimer1975) philosophical hermeneutics seek to examine and be aware of their own past experiences with “openness and sensitivity” in order to be open to the meaning of others. Heidegger's existential phenomenology focused on the meaning of human existence (lifeworld). He asked questions about experiencing and understanding: what does it mean to be a person? As a researcher interpreting Heidegger's existential phenomenology, I understand the person to be a self-interpreting being. As a researcher, I can only make explicit what is already understood. But I can interpret their story using Heidegger's aspects of existence to gain a deeper level of meaning. The present paper brings forward a reflective account of how I interpreted Heidegger's existential phenomenology and Gadamer's hermeneutics and applied them as methodology to understand the meaning of existence for others living through the illness trajectory of motor neurone disease (MND).
BRINGING PRESUPPOSITIONS TO CONSCIOUSNESS BEFORE RECRUITING AND MEETING THE PARTICIPANTS, AND DURING INTERPRETATION
As a researcher, I have the background experience of supporting my mother living with MND. Heidegger understood that presuppositions—defined as preunderstandings, prejudices, and beliefs—cannot be “bracketed” as though they do not exist. Instead, Heidegger (Reference Heidegger and Macquarrie1962) and Gadamer (Reference Gadamer and Weinsheimer1975) recommend engaging with one's own presuppositions in order to understand oneself and others. Finlay (Reference Finlay2011) terms engaging with one's presuppositions “hermeneutic reflexivity.” Hermeneutic reflexivity was completed in the first year of my study, before completing the research proposal and before recruiting and meeting with participants. Documenting the experiences gave me a greater understanding of those past experiences—it gave me closure on many events that were not worthy of further study, to bring forward what experiences remained important, and it enabled me to focus on the questions that remained important to me as a person and as a healthcare professional. This reflective account is reported elsewhere (Harris, Reference Harris2016). The participants understood that I had both a professional and personal understanding of how MND affects people in different ways. Atkinson (Reference Atkinson1998) acknowledges that shared understanding of the topic can naturally lead the participant to reveal more than he or she otherwise might.
CHOICE OF DATA COLLECTION METHOD
Heidegger holds that human beings exist in the world through time—not time determined by a 24-hour clock, but temporal time determined by our past, present, and future. First, human beings are born into a particular history, culture, and practice. They may choose to adopt their forebears' ways of being or project themselves forward into other possibilities (Inwood, Reference Inwood1997; Moran, Reference Moran2000). Projecting themselves forward into the future of other possibilities may include being a self-employed businessman, a sales manager, and other ways of being. A hermeneutic position holds that stories are interpretations of life. A story helps us to communicate the unity of our lives and therefore to create an identity (Widdershoven, 1993, cited in Atkinson, Reference Atkinson1998). With this premise, a life story interview was chosen as a method of data collection, inviting participants to tell their story from when they first became aware that something untoward was happening to them. This provided them with an opportunity to bring forward the meaning of their existence with motor neurone disease and how this impacted on their past, present, and future. As a researcher, I listened to their stories and brought them back to the themes they had raised, and invited them to elaborate on the meaning of these experiences in their lifeworld.
WHOLE STORIES TRANSCRIBED, SO THAT OTHERS CAN UNDERSTAND (INTERPRET) THEM
The first interview was complete. Whole stories were transcribed, so that others could understand (interpret) them. I listened to participant stories several times and made a decision to have them transcribed professionally, to put the important intonations into the text. I then took their story along to the second interview and asked, “Is this the story you have told so far? Is there anything you would like to add or remove?” Gadamer (Reference Gadamer and Weinsheimer1975) would refer to this as a “fusion of horizons.” All the participants chose not to change the story and to continue on to the second interview. I then asked the participants three questions related to the study. This method of data collection meant that I had four detailed accounts of the meaning of existence with MND. I had to consider how to analyze these data without losing their meaning, and to search for deeper meaning. During the five stages of interpretation, the focus has been to remain as present as possible with the existential phenomenon (via the participant story). A more detailed account of methods and findings are published elsewhere (Harris, Reference Harris2015).
USE OF A PHILOSOPHICAL FRAMEWORK TO ANALYZE THE TEXT THAT FOCUSES ON THE PARTICIPANT'S MEANING OF EXISTENCE (LIFEWORLD), AND NOT THE RESEARCHER'S
Heidegger understood the three ecstasies of time as a lived-through past, experienced present, and anticipated future. This existential phenomenon is evident through the telling of stories. All the participants started their story about the activities they were doing when they first noticed something untoward was happening to them. They all talked openly about their past ways of being-in-the-world—being a professional sportsman, being an international business man, being a retired salesman, and being a retired care assistant. In the present, they each talked about how MND was impacting on other aspects of their existence. Those aspects of existence most apparent in their stories included: thrownness, spatiality, temporality, embodiment, mood, and mortality (Cohn, Reference Cohn1997). Aspects of existence bring forward their being, identity, and difference—their individual uniqueness.
USE OF PARTICIPANT STORIES (EXCERPTS) TO BRING RESONANCE TO THE FINDINGS
Excerpts taken from each participant story bring resonance to the findings of “existential loss” of the past ways of being-in-the-world, loss of embodiment, loss of spatiality, and loss of future (Harris, Reference Harris2015). One participant does not focus on his concern for the loss of his past or for himself in the present, despite being on noninvasive ventilation and unable to move independently. His concern is for his family and their future. He states, “I look forward to see the kids back from university, to know that we are getting on all right.” In contrast, one participant story is all about his existential loss of past ways of being-in-the-world. His mood in the experienced present tells of how he has been beaten by MND, of his present situation, and how he is anticipating his future: “It's a funny old situation. You sort of— it's like being in— It's like being on death row without knowing when the executioner is going to pop in.”
STRENGTHS AND LIMITATIONS OF THE STUDY
This study brings forward a developed hermeneutic phenomenological approach to study what it means to be a person living through the illness trajectory of MND. In doing so, the concept of “existential loss” could be found in the stories told by four participants. Existential loss refers to loss of past ways of being, embodiment, spatiality, and future. Though existential loss is varied, there were comparisons that could be drawn across all the stories. This study involved a small sample size of four participants. Small sample sizes present a challenge to the generally accepted norms of transferability (Blank et al., Reference Blank., Finlay and Prior2016). However, the trustworthiness of the study was attended to in the methodological approach chosen, the methods of data collection and analysis, the process of reflection, transcription of whole stories, and peer-reviewed interpretations. Asking the participants to tell their stories resulted in large amounts of data to interpret. In addition, interpretation involved iterative reading of the stories, which was extremely time-consuming. The process of reflecting on one's own experiences in relation to the experiences of the participants was emotionally draining for me as researcher (Harris, Reference Harris2015).
FINAL THOUGHTS
As a researcher using hermeneutic phenomenology as methodology, I have become versed as a phenomenologist, that is, seeking to depict the “lifeworld” experiences of people living through the illness trajectory of MND. It is because of one's background experiences that I ask the research question (Heidegger, Reference Heidegger and Macquarrie1962). I was asked at the research proposal stage to pull the threads of hermeneutic phenomenology through the study. What followed was total immersion in the work of Heidegger and Gadamer and those who had also interpreted and applied, albeit differently, their philosophical ideas. As Finlay (Reference Finlay2011) claims, hermeneutic phenomenology does not offer methods of data collection and analysis. The reason for this is because each researcher comes to a study with their own history, culture, and practice impacting on their interpretation. What followed were developed methods of data collection and interpretation, resulting in deeper layers of meaning than anticipated. Other researchers with their own history, culture, and background may choose to develop their own methods to understand the meaning of the existential phenomenon.
