Sunday, September 30, 2012

Dissertation on shame. Chapter 11.3. Focus groups

11.3 Focus groups

The purpose of using focus groups was to create an atmosphere where the participants could speak freely with each other; my function was ideally more like that of a chairman presiding over a meeting. In addition to the role of chairman, I had an active role as interviewer in the groups. My role as an active interviewer was modelled on a study by Holstein and Gubrium (1995). In their study, the interview situation is characterized by the fact that the participants and the researcher cooperate by co-constructive story-telling and searching for meaning. This implies a social-constructivist perspective on research; it postulates that meaning itself is also a social construction. This perspective is described by Berger and Luckmann in their classical book The social construction of reality (1966/1991). Knowledge itself is a product of interaction with other people. The researcher is not a passive observer, but an active discussion partner who creates meaning through story-telling together with the participants.

The meeting in each group started with a conversation around one or more of the situations used in a test of self-conscious affect (TOSCA-3) developed by Tangney and Dearing (2002). This is a test that measures proneness to shame, guilt, detachment, externalization and two forms of pride. Using the situations described in this test was a way of “getting started”; the group needed something concrete to discuss at the beginning of each meeting. After a period of “warming up” with TOSCA-3, the conversation was directed on to the topic of shame.

All the interviews were recorded on digital video, transferred to a laptop, transcribed in a Word document, and analysed using QSR NVivo7 (NVivo), a qualitative data analysis program (Gibbs 2002). The 26 hours of conversations were transcribed into 633 pages and stored in NVivo for further analysis.

I have chosen to conduct an empirical study on the concept of shame and phenomenon within the context of sexual abuse. Having conversations about sexual abuse is a sensitive task. Not only is the topic sensitive, but those who have been abused are also vulnerable. Conversations about the topic take place on a daily basis in the Norwegian Incest Centres. I have worked closely with one of these Incest Centre’s, the Incest Centre in Vestfold (which has given their consent to have their name used in this study), since the Centre started in July 1988. The Incest Centre of Vestfold has kept track of all activity since it started up in 1988. The statistics from their annual rapport for 2005, show that they have had a total of 180 228 telephone conversations concerning sexual abuse and 23 203 face to face conversations at the Center, from July 1988 to January 2006 (Annual report for the Incest Centre of Vestfold 2005). The Incest Centre of Vestfold is just one of 19 such Centers in Norway which I have cooperated with in this exploration (appendix 18) and which gives help to the sexually abused. One of the participants in my study is Linda, a woman who has worked at the Centre since it started in 1988 and I asked her:

Kaare:                         How many conversations have you had since you started here?
Linda:                         (.) Over 6000
Kaare:                         In all of these conversations, how often are shame and guilt present?
Linda:                         In all of them. They’re in all of them. I can’t recall having a single conversation that hasn’t been characterized by guilt and shame. They are central ((scratches her head)) to the whole issue. They’re, ((Coughs)) in a way, in the background of all the problems they have. Guilt and shame are always there.

Shame seems to be present in all of the conversations she has had and she concludes that this emotion is central to the whole issue of sexual abuse. The aim of my study has been to interview men and women who have stories to tell about shame. I have not been concerned with defining the concept of shame, but with stories of shame, histories that have been experienced by themselves or others: stories that can help cast light upon the concept of shame, and contribute to a better understanding of the concept.

After videotaping twenty hours of focus group interviews and six hours of in-depth interviews, all the recordings were transcribed. The transcription was then given back to the participants for validation and approval. 633 pages of interviews were thereafter transferred to the computer program NVivo (Gibbs 2004), a program developed for qualitative data analysis. The text was then coded[1] down to 71 nodes[2] (appendix 22) and these were again linked together to form seven node trees[3]. These seven node trees represent the same seven categories which I use in my dissertation to cast light over the meaning of shame as established by my participants (appendix 4). These seven categories are shame within the context of: the family, emotions, body, food, self image, sex and therapy.

[1] Coding is the action of identifying a passage of text in a document that exemplifies some idea or concept and then connecting it to a node that represents that idea or concept (Gibbs, 2002: 240).
[2] A node in NVivo means an object that represents an idea, theory, dimension, characteristic etc. of the data. Text in documents can be coded at a node. Nodes can be linked to other nodes either directly or by position in a node tree and linked to documents (Gibbs, 2002: 243).
[3] A node tree in NVivo is the arrangement of nodes in a hierarchy, also known as a node hierarchy. At the top are one or more root” or top” nodes and arranged below them each may have one or more child nodes (all the nodes connected to and below a specified node), which in turn may have their own child nodes etc. (Gibbs 2002: 243)

Saturday, September 29, 2012

Dissertation on shame. Chapter 11.1 Test Group

11.1 Test group

Before starting the interviews, I used a test group of three university/college students (two men and one woman) who volunteered to help me. Here I will call them Sam, Arne and Inger. All of the three were in their twenties. Sam was married and had two children. Arne and Inger were both single. We spoke together in one meeting for two hours. Recording equipment was tested, seating arrangements and other practical details were evaluated. Very quickly I realized how easy it was to fall into the traditional interviewer role of the question-answer interview, instead of taking part in an open conversation. It was also obvious that the three students found it difficult to speak about shame and that guilt was somewhat easier to talk about. One of the test group participants, Sam, said:

Sam:                           When I think about myself, I don’t believe that I feel shame. I have never thought that I feel shame. I have more a feeling of guilt. I can not remember that I have ever thought that now I’m feeling shame and that now I’m shameful. For me shame is old-fashioned. But maybe I should feel shame? For me it’s more a feeling of guilt.

Sam begins the conversation be saying that shame is an old-fashion concept and he does not feel shame, instead he talks of guilt. The conversation between the participants in the group seemed to proceed in a way that enabled them to help each other find experiences of shame and examples of how shame is embodied. Inger told a story about visiting a municipal office with her mother as a child and about how she felt ashamed because her mother was applying for social assistance. She says that she was ashamed of her mother, but this can be interpreted as being ashamed of being seen there together with her mother or feeling shame over being the daughter of her mother. It might be that this situation has to do with an ideal conception she has of her mother, as one who should not have to apply for economical assistance. It might also be that her mother was also feeling embarrassment or shame over the situation (waiting in line with others, having to explain her situation to an executive officer, and so on) and that her feelings also influenced her daughter who felt a part of the situation and therefore just wanted to disappear. We did not elaborate over these possible interpretations. What was important for her to say something about was how her body experienced this situation. She explains that her shame felt like a lump in her stomach. She can still feel this lump when she tells her story.

Inger:              I feel for the most part lumps in my stomach. I feel it like a lump in my
stomach ((Laughs)) it just lies there and oh…shame. It feels heavy and then it sinks down.
Kaare:             Can you still feel that the lump is there? Or is it gone?
Inger:              No. I can still feel it.
Kaare:             When you tell the story now, can you still feel it?
Inger:              Yes.
Kaare:                         That long after?
Inger:              Yes, but just not as intense.

When she describes the lump like this, she is describing a shame that has become embodied. Her story was personal and she had not told it to many before. She cried several times as she felt the clump rise toward her throat. We had to take a small brake at that time so that she could wash her face and let the lump fall to place again. It seemed obvious that telling her story involved and awakened many emotions, requiring alertness from me (as the mediator) in order to not go further with the interview so that it became intimidating in any way. The demands on the mediator in focus group interviews being qualified to observe emotions and reactions that evolve during the interview and take necessary measures so that ethical boundaries are not crossed and group members are not subjected to unnecessary pain is described by Överlien, Aronsson and Hydén (2005) in their study of young women talking about sexuality. They conclude that “focus group probably provided us with more natural and less intrusive format than individual interviews” (2005: 342). Showing ones feelings is natural when sensitive subjects are brought to the surface in storytelling. Inger herself did make a big deal about crying, on the contrary she felt that it felt good to let out some pressure, and that she felt better afterwards. It seemed to be more difficult for Arne and Sam to see Inger cry, then it was for Inger. These lead to an opportunity to talk about showing ones emotions to others and what it means to cry.

Inger’s story and the following discussion about emotions seemed to open a door for Arne, who now feels that he wants to tell a story about shame from his childhood as well. The story he tells is about emptying his bowels on the hillside while he was out playing. This was not something shameful as such, but a pain in his side when his mother came and took up the stools from the ground. This seems to have to do with being seen, literally “with ones pants down”. Several times when he tells his story, his voice becomes so low that is inaudible, indicating that this story is still difficult to talk about.

Arne:                          Yes ((Difficult to hear because of his low voice)). I have a memory from when I was a child. I was playing on a hilltop where we lived and had to go to the bathroom. So I emptied my bowels on the hillside. My sister saw me do this, and ran home and told my mother what I had done. Then I felt embarrassed and I also think about it with shame.
Kaare:                        Was it shameful to empty your bowels on the hillside or that your sister told your mother about it?
Arne:               It was shameful when my mother came and removed the stools from the
Kaare:             Ok. It wasn’t shameful to go to the bathroom on the hillside?
Arne:                          No, I don’t remember that as being shameful. ((His voice becomes weak and vague.))
Kaare:             Did she say anything?
Arne:                           No, not that I can remember. I just remember that I had a bad feeling. ((Says something inaudible.))  When I look back, I can feel it like something piercing me in the chest.  
Kaare:             Like a wound in the chest?
Arne:               Yeah, and that’s something I don’t do anymore.
Kaare:             In the heart?
Arne:                          Here in the side. ((Points to his side under his left arm, in the heart region.))

Arne describes his shame as a wound in his side, in the heart region, as embodied shame. He does not know of any heart problems or other physiological reasons for having this pain in his chest. This is a pain he feels when he looks back. It seems plausible that Inger’s openness towards showing her emotions, opened up for Arne’s emotions, and those emotions have something to do with ones body. After listening to both Inger and Arne, Sam has reconsidered his notion about not ever feeling shame and tells a story about shame that he experienced not long ago. He talked negatively about another person without knowing that the same person was standing not far away and might have heard his opinions about him as a person. First when he realized that the other person was close nearby, did he feel stupid and that he had stooped low. He calls his reaction as shame.

Sam:                           Well, it was outside the school here. I was standing with some other students and talking about another person who was not there. I had some opinions about that person. It was almost slander. I was probably the one who was talking the loudest. When I turned around, the person we had been talking about was standing only a few feet away from me. Then I didn’t feel so very tall – I had stooped pretty low.
Kaare:             What did you feel?
Sam:                I think I felt shame. Yeah, that’s what I felt.
Kaare:             How did that feel?
Sam:                           Well, how is it possible to be so stupid and talk like that? Yeah. But I felt shame also simply about how I could be so evil-minded. How could I be so evil-minded? I think I felt shame about that. Yeah. Whether it was the situation or the atmosphere or the others around me who made me want to impress them, which made this possible, I don’t know, but I felt ashamed. How was I capable of being so evil-minded?

The conversation shows that Sam begins by saying that he has never felt shame, only guilt. When he hears the stories of the other group members, he re-evaluates his standpoint and changes his mind. He realizes that he has had an experience where he had shown a part of himself that he was ashamed of, and he describes this feeling as not “feeling very tall”; of having stooped very low.
Here, the three informants in this test group demonstrate an example of the value of talking together in a focus group. They talked together about difficult experiences, and when one of them opened up it became easier for the others to follow up. They describe three different experiences, but their descriptions of shame show that shame has to do with the whole person, and is not just about doing something wrong and asking for forgiveness afterwards. 

This test group taught me that sensitive issues may arise during the interviews, demanding that I be alert and be sure that the research method is not misused in any way. This is done by letting the informant’s use the time they need to think and re-think about how they present their stories and that I respect their right to answer as they choose and to tell the stories they seem appropriate. I also learned that emotions will most certainly be shown and that this is not necessarily something negative, but that it requires that I monitor the discussion closely and stop when emotions need to settle down or be concerned with. Since the interviews are to be used for research and not for therapy, it became evident that I have others as a back-up, qualified personnel who are able to take care of group members during or after the focus group interview, if they need to work further with memories or emotions that the story telling awaken.

Friday, September 28, 2012

Dissertation on shame. Chapter 9.5 The sources of shame

9.5 The sources of shame

In order to answer the question of what makes people feel shame, it seems necessary first to reflect upon this human capacity. It seems clear that these emotions involve feeling bad, and the capacity to feel shame and guilt therefore builds on a natural basis of feeling bad. Both shame and guilt can be understood as involving an unpleasant awakening and both are also related to anxiety (Lewis 1971).

Baumester et al. (1994) propose two sources that guilt and shame can stem from: the awakening of empathy and the anxiety associated with social exclusion. Both of these are important and vigorous sources of emotions and motivation in close communal relations. Humans are prepared to feel empathic despair in reaction to the suffering of others. Guilt and shame combines empathic despair with a sense of responsibility for the distress and suffering of others. This is discussed further by Hoffman (1982) in Development of Prosocial Behavior: Empathy and Guilt. Here he argues that when one sees the sufferings of others, one will feel badly, and this bad feeling is the basis of guilt and shame. Even if empathic despair can arise in response to any kind of suffering, it is usually acknowledged as at it strongest in close relationships. Communal concern for the well-being of others is probably strongly bound up with empathic reactions. Together with empathy, belonging and devotion are powerful foundations for emotional reactions.

Humans experience anxiety when they face the threat of separation (Scheff and Retzinger 1991). Incidents which increase the threat of social exclusion may create anxiety which presents itself in the form of guilt or shame. This is particularly true if one has done something which may cause rejection from a partner. The result of the anxiety could then be experienced as guilt or shame. Guilt and shame often focus on those who are closest to one’s self but can also reflect the increasing feeling of communion with other people. Seen this way, as Baumeister et al. (1994) argue, the emotional basis for guilt and shame has a strong interpersonal component. This view differs considerably from perspectives that are based on factors like castration anxiety, self-aggression, or the conditioned anticipation of punishment put forth by Freud (1930/2005). The emotional roots of guilt and shame seem to lie in human belonging and awareness; this involves the human capacity to feel the suffering and despair of others and the basic fear of alienating actual or potential relationship partners. In one of my interviews, Margaret talks about the importance of accepting emotions as part of our lives, and says that all of our emotions, even shame and guilt, should be looked upon as positive.

Margaret_1:    I think everything about emotions is positive…When you’ve experienced something very disturbing, then you need to get hold of the emotions in it. That’s fine in my opinion…If I don’t get hold of what I feel, then they just sit there and grind inside me. And then you can find yourself in different kinds of situations that trigger these emotions, those that are just lying there, waiting. That’s why I believe that the more you can open up,  the better and freer you’ll feel…When you talk, everything is just mental and you don’t get hold of your emotions…Emotions are in the body…Often in the stomach ((scratches her nose)) yeah very much in the stomach…Umm they lie here ((her hand strokes the upper part of her body)), emotions lie here ((places her hand on her stomach)), emotions ((strokes her stomach)). It’s like having a stomach ache when you’re nervous about something, then your stomach aches…They are the innermost parts of us, these emotions. They’re strong stuff…When you’re working to get your emotions up and out and to get free, you’re able to open up for the world outside, something which you couldn’t do when you felt that you were stuck…Those who struggle and feel the abuse physically, uhh they can feel a whole lot of pain (.), not just afterwards but also during the process of working through, trying to get rid of the emotions. That can hurt real bad…The first commandment is always to accept the emotions you have. For example it’s really complicated to feel that you love your mother and at the same time despise her. But you have to let it out, whatever it is. Don’t feel ashamed about it and about yourself because you feel the way you do. It’s ok to feel that way. I’ve got a damned right to feel like that. I say that to myself all the time…If we hold everything back, than we’re just standing still. We don’t move. But if we provide a secure environment, so that they can be exactly who they are, and feel that it’s ok that they feel the way they do, whatever it is, if it’s shame, guilt, rage, hate, anger, whatever, but they have to let go of something and leave it here.

Emotions are a part of us, of whom we are, and Margaret argues that it is essential that we accept the large variations of emotions in our fellow human being. She says that all of our emotions are important. Scheff (2003) considers shame to be one of the most important emotions in everyday life and the most important of all of our social emotions. He argues that this is because shame has more functions than other emotions. Shame is a major component of our conscience; it is a moral emotion. Shame signals a moral transgression even without thoughts and words. Shame comes into being in situations characterized by a threat against inter relational bonds. It signals that there are problems in a relationship; it conveys the feeling of having failed to live up to one’s social and moral standards. Shame also plays a part in how we express and comprehend all of our other emotions. One can be so shameful over all of one’s emotions that they can be totally suppressed. Still, shame often proves to be almost invisible because of the taboo that arises as a result of the denial and silence in our modern society[1].

[1] Many researchers have written about this during the last decades. I wish to mention here especially Helen Block Lewis (1971) who explored shame over 25 years as part of her practice as a psychoanalytic psychiatrist and the psychologist Gershen Kaufman (1989, 1991 and 1996) who has developed a powerful and multi-dimensional view of shame.