limitations of a phenomenological study

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Doing Phenomenological Research and Writing

Michael van manen.

1 University of Alberta, Edmonton, Alberta, Canada

Max van Manen

When looking through phenomenology articles in human science and philosophy journals, we may be excused to get the impression that they offer an inconsistent array of phenomenology publications. In this article, we describe three simple but helpful distinctions for determining some order: first, the great foundational publications; second, exegetical publications in the wake of the great works; and third, phenomenological studies done directly on phenomena. Our aim in this article is not to lay claim to phenomenology as a label but rather to discuss how “doing phenomenology directly on the phenomena and the things” means taking up a certain attitude and practicing an attentive awareness to the things of the world as we live and experience them. We propose that engaging in philosophical exegesis and argumentation is not very helpful for analyzing and explicating originary meanings of experiential phenomena. And we show how doing phenomenology directly on the things can be facilitated by a phenomenologically inspired interpretive attitude as well as by a sensitive talent for employing phenomenological examples.

When discussing the subject matter of phenomenology, awkward questions may arise. What kind of phenomenology is most relevant for researchers in fields such as psychology, pedagogy, nursing, and medicine? Are some phenomenological studies more helpful than others for understanding human existence? What do such phenomenological studies look like? One obvious suggestion would be to peruse journals that publish phenomenological articles and in which reputable phenomenologists publish. What kinds of texts and publications do we find with the term “phenomenology” in the title or with the obvious intent to be considered works of phenomenology? One would have to cast the net quite wide, and one would soon discover that some journals, magazines, and other media contain writings of classic authors, specialist historical subjects, treatments of technical philosophical issues, and topics of professional practice in various professional fields, such as psychology, health science, education, pedagogy, technology, and media. In addition, one should not forget that some publications appeal to the spheres of interest of the educated general reader. But no doubt, one will discover that the range of phenomenological publications is quite large and very diverse.

With the intent to provide some order in the plethora of published phenomenological materials, the Husserlian philosopher, Joseph Kockelmans (1987) , distinguished three streams of phenomenological publications. These distinctions can still be quite helpful to the reader and are worth considering:

Over the past decades many books and essays have been written on phenomenology. Some of these publications are historical in character and were designed to give the reader an idea of the origin, meaning, and function of phenomenology and its most important trends. Others are theoretical in nature and were written to give the reader an insight into the ways in which various authors conceive of phenomenology and how they attempt to justify their views in light of the philosophical assumptions underlying their conceptions. Finally, there are a great number of publications in which the authors do not talk about phenomenology, but rather try to do what was described as possible and necessary in the first two kinds of publications. (p. vii)

• The first stream of publications contains the most original works, of historical relevance, and generally foundational to the field of phenomenology. These are the writings by highly gifted and leading philosophers and human science phenomenologists who developed the original idea of phenomenology, each naming the world in a singular and yet universal nomenclature:

Phenomenology opens onto the excess beyond philosophy from which philosophy draws. Different philosophers name that excess differently: experience, Being, the concrete, the ethical, the trace, and so on. ( Bernasconi, 2020 , p. 6)

Husserl, Heidegger, Sartre, and Merleau-Ponty are probably among the best known originators, although their work is not always easy to read and comprehend. Still, their original foundational writings offer fundamental insights that appear inexhaustible in their philosophical significance for those seriously interested in phenomenology.

Husserl’s (1954/1970a , 1900–1901/1970b , 1913/1983 ) works gave us the method of the reduction that must establish the phenomenological attitude, the mode of intentionality of consciousness that allows the things of the world to give themselves as phenomena, the epoché that involves the suspension of the natural attitude in favor of the transcendental reduction , the lifeworld as the source of our lived experiences , and the means of bracketing to assist in identifying eidetic aspects of phenomena. Heidegger’s (1927/1962 , 1982 , 2001 ) works gave us the focus on the Being of being , human ontology as Dasein , the characterization of the phenomenological method as to let that which shows itself be seen from itself in the very way in which it shows itself from itself, his notions of zuhanden and vorhanden , and his writings on technology whereby technology is not to be understood instrumentally but as the explication of the general comportment by which technology may shape our existential ways of being.

Of course, there are other early and subsequent phenomenological publications that offer founding phenomenological ideas, such as in the writings of Jean-Paul Sartre (1956 , 1991 ), Maurice Merleau-Ponty (1962) , Max Scheler (1970) , Emmanuel Levinas (1979 , 1981 ), and more contemporary originary works of thinkers such as Jean-Luc Nancy (1997 , 2007 ), Jacques Derrida (1995) , Michel Henry (1990/2008 , 1988/2009 ), and Jean-Luc Marion (2002 , 2007 ; see van Manen, 2014 ). These works are indeed recognized as brilliant, original, and pathbreaking texts offering convergent and divergent paths of thought.

As for the second stream that Kockelmans distinguishes, there is the broad scholarly literature that continues to address and explore technical, historical, and theoretical issues of phenomenology. These are publications that tend to take up in an exegetical, critical, and philosophical manner the arguments and positions of other philosophers and scholars of phenomenology. This literature is enormously variegated and extensive, sometimes offering interesting comparative studies and probing thought-provoking topics, and at other times texts that are steeped in “language” and only of interest and readable by specialized exegetical philosophers. The etymology of the term “exegesis” borrows from Latin and Greek, meaning exposition, narrative, and explanation. Exegetical phenomenology tends to be meta-phenomenology. How to recognize this form of phenomenological publications? The general style of these publications is that they offer explanations of , theories about , comments on , and introductions to other published phenomenological works, topics, and concerns that tend to be technical and/or historical in a philosophical or specialized disciplinary phenomenological sense.

Kockelmans’s third stream of phenomenological publications is neither primarily presenting new phenomenological foundations nor presenting arguments or developing theories about phenomenology and technical philosophical issues and themes. Instead, the third stream of publications is composed of phenomenological texts that actually practice or “do” phenomenology on concrete topics of the lifeworld. They try to do, as Kockelmans says, what was described as possible and necessary in the foundational and theoretical writings of phenomenologists. They “do” what the works of the two streams of founding originators and subsequent commentators suggest or imply are the possible, original, and necessary task of phenomenology: to explicate the originary meaning of the phenomenality of phenomena as they give themselves in and as human consciousness and experience. Examples of this third stream of phenomenological writings are presented in the 2021 book, Classic Writings for a Phenomenology of Practice (van Manen & van Manen). This text contains phenomenological essays and studies exploring and explicating down-to-earth phenomenological research questions, such as the following: How do we encounter a conversation? What is the meaning and significance of secrets in children’s lives? How do we come to experience humor? What is the meaning of “things” in the world of the child? How do we experience obsessive compulsions? And how do we experience a baby’s first smile?

The perceived relevance of the various titles and themes of the third stream of phenomenological publications is obviously dependent on one’s personal life interests, clinical practice, or research project. But the point is that these publications are examples of “doing phenomenology” in a manner that should not be confused with philosophizing about phenomenology or doing primarily exegesis, however interesting that may be in its own right. A philosopher who primarily pursues technical, historical, or other exegetical topics may have little propensity to pursue foundational scholarly issues that are fundamental to the direction of the field or contribute to relevant phenomenological studies that are performed directly on the concrete phenomena and events of everyday and professional life.

To do phenomenology on the things, we must turn to the things. Maurice Merleau-Ponty (1962) says that this means that we must begin by reawakening the basic experience of the world and by practicing a “direct description” of this world:

[A]ll the efforts [of phenomenology] are concentrated upon re-achieving a direct and primitive contact with the world . . . it also offers an account of space, time and the world as we “live” them. It tries to give a direct description of our experience as it is, without taking into account of its psychological origin and the causal explanations which the scientist, the historian or the sociologist may be able to provide. (p. vii)

Giving a “direct description” of experience is not just narratively reporting, copying, or telling a story. Rather, to de-scribe is to write directly (unravel or uncover) what remained hidden or concealed. Doing phenomenology on the phenomena means taking up the attitude of immediate seeing and practicing an attentive awareness to the things of the world as we live them rather than as we conceptualize or theorize them. Direct description is making straight sense of the originary meanings of lived or inceptual experience (the primal phenomena and events as given in or as consciousness).

Doing Phenomenology on the Things

Developing phenomenological insights into human existence may be considered the original and primary task of phenomenology. In the contemporary phenomenological literature, these are those phenomenological publications on topics that are meant to be of interest and relevance to ordinary and extraordinary life situations.

Contemporary phenomenological philosophers have produced publications that exemplify doing phenomenology on the phenomena: The Glance by Edward Casey (2007) , Abuses by Alphonso Lingis (2001) , The Thinking Hand by Juhani Pallasma (2009) , The Fall of Sleep by Jean-Luc Nancy (2007) , The Five Senses of Veils, Boxes, Tables, Visit, Joy by Michel Serres (2008) , and other studies that offer surprising and fascinating phenomenological insights into the meaning of concrete everyday human experiences and lifeworld events. In addition, there are publications that comprise foundational and exegetical works. For example, a text such as Derrida’s (2005) On Touching—Jean-Luc Nancy , is a genre of phenomenological philosophical thinking that transposes the apparent exegetical style of interpreting Jean-Luc Nancy’s texts to a level of originality and fascination that does not only clarify but also (re)invents.

Yet this third stream of phenomenological publications “done directly on the things” is actually rarer than exegetical texts dealing with phenomenology at a level more removed from the concrete reality of human experience. Furthermore, ironically, the third kind of publications are more likely produced by clinical psychologists, psychiatrists, medical doctors, pedagogues, and other professionals who were or are also researchers and university academics.

Historically, one early development of phenomenology on the things came to be known as “the Utrecht School” or “the Dutch School” of phenomenology although some of the authors were German or wrote in French or other languages. The Utrecht studies were probably among the first to focus on actually doing phenomenology on ordinary and professional phenomena. We believe that these writings are challenging and demanding not only because of their scholarly resourcefulness, but also because of the required talents for perceptive phenomenological insights of these early leading proponents.

Some of the well-known topics that were explored as books and as manuscripts by the proponents of the so-called Utrecht School of phenomenology were “The Hotel Room” ( David van Lennep, 1953 ), “Aspects of Sexual Incarnation” ( Johannes Linschoten, 1953 ), “The Psychology of Driving a Car” ( David van Lennep, 1953 ), “The Sickbed” ( Jan van den Berg, 1966 ), “Falling Asleep” ( Johannes Linschoten, 1987 ), “The Human Touch” ( Frederik Buytendijk, 1970 ), and so on. It is not difficult to discern the difference between exegetical phenomenological publications and the studies that may be termed “phenomenology of practice” (in the sense of professional and everyday life phenomena and events).

The work of the authors of these phenomenological writings is unique in that it speaks to the practice of doing phenomenological research to better understand aspects of professional life. The first mention of “the Utrecht School” is probably on the back cover of Persoon en Wereld [ Person and World ] ( Langeveld, 1953 ), edited by van den Berg and Linschoten. They stated, “one could say that in the fifties at Utrecht University, a phenomenological school had emerged under the leadership of F. J. J. Buytendijk.” That is likely when and where the title “the Utrecht School” of phenomenology was coined. Van den Berg and Linschoten (1953) further declared programmatically that the phenomenologist resolves to stay as close as possible to the everyday life’s ordinary events. Indeed, these phenomenologists were driven by a quotidian interest in ordinary life phenomena, even as these topics often were born in the contexts of professional practices.

In Classic Writings for a Phenomenology of Practice , Michael van Manen and Max van Manen (2021) discuss the Utrecht School of phenomenology as one of the early examples of doing phenomenology directly on the concrete phenomena and events, and reflect on methodological terms in a broad yet specifying sense, such as the phenomenological attitude and example , that are crucial for phenomenological inquiry and research. “Phenomenology is a method; it could be called an attitude,” said van den Berg (1972 , p. 77). But in what sense could the method be called a phenomenological attitude? We show that this attitude consists of a certain way of seeing, thinking, and expressing aimed at eidetic (essential) and inceptual insights into the phenomena and events of our existential lifeworld.

Herbert Spiegelberg (1960) , the encyclopedic scholar who wrote the authoritative international study entitled The Phenomenological Movement, A Historical Introduction , initially scarcely mentioned the early Utrecht School initiatives in his accounts of phenomenological developments. In this two-volume work, he only included the contributions of professional academic philosophers. And none of the Utrecht proponents started out as philosophers. But in his 1972 book, Phenomenology in Psychology and Psychiatry , Spiegelberg dedicates an extensive chapter to Frederik J. J. Buytendijk. He described Buytendijk as the “central pioneer” of the Utrecht School movement (p. 281). Buytendijk was a medically trained physician with a research interest in physiology. He received university appointments in medicine, physiology, and psychology as he gained an international reputation for his academic and clinical scholarship.

Herbert Spiegelberg had become famous for his encyclopedic presentations of phenomenological developments around the world. However, by 1975, he had apparently become dissatisfied with the way that phenomenology was progressing and practiced in philosophy. Fifteen years after the first edition of his authoritative The Phenomenological Movement , Spiegelberg (1975) published Doing Phenomenology: Essays On and In Phenomenology , in which he decried “the relative sterility in phenomenological philosophy . . . especially in comparison with what happened in such countries as France and The Netherlands” (p. 25). He proposed that what was needed is “a revival of the spirit of doing phenomenology directly on the phenomena, the ‘things,’” and he spoke nostalgically of “the spirit which permeated the first generation of phenomenologists” (p. 25).

Spiegelberg asked, “What can be done to reawaken [this spirit] in a very different setting?” (p. 25). He advocated a reorientation of “doing phenomenology on the phenomena themselves” (p. xiv) and he urged “a fresh approach directly to the phenomena in opposition to mere meta-phenomenology through textual and historical studies” (pp. 24, 25). Spiegelberg notes how Husserl had longed for some kind of practice of joint-phenomenologizing. However, Husserl’s seminars were usually dominated by his philosophical monologues. So, Spiegelberg spoke perhaps somewhat mockingly of the philosophic practice of “meta-meta-phenomenology” where “phenomenology can become a flight from the phenomena” themselves, that is, cut off from the intentionality of the experiential lifeworld that was supposedly the focus of phenomenology (p. 22). But, of course, we must realize that exegetical and epistemological explorations of phenomenology can be critical and supportive of the project of doing phenomenological research and writing. Our discussion of the phenomenological attitude, the methodological notion of example, and the idea of a phenomenology of practice are obviously presented at a meta-level in relation to the down-to-earth work of doing phenomenology directly on the things.

In his book Doing Phenomenology , Spiegelberg (1975) reported on a pilot experiment of a summer workshop organized as a cooperative phenomenology seminar between 1965 and 1972. He described gradually coming to the idea of a phenomenology workshop, in which phenomenology would be “done” and not just talked about (p. 26). But Spiegelberg was frustrated by the poor results of these workshops that did not seem to yield concrete lifeworld studies. Significantly, similar efforts were meanwhile on the way in the Netherlands—witness the works of Beets, Linschoten, and Beekman, who were students of Langeveld, Buytendijk, and van den Berg. As well, there were the subsequent phenomenology workshops by Beekman at the University of Utrecht. Apparently, Spiegelberg had become aware of the Dutch phenomenology developments and mentions them in his book Doing Phenomenology . Ironically, by the time Spiegelberg pointed at these developments, most of the leading figures had retired in the Netherlands and, by the mid-1970s, these phenomenological initiatives had eroded under the pressure of behavioral and empirical analytic science influences from the United Kingdom and the United States.

It is quite remarkable that the philosopher Herbert Spiegelberg initially ignored phenomenological initiatives by scholars who were not professional philosophers themselves. But Spiegelberg later deliberately turned toward scholars in professional fields (rather than to professional philosophers) in providing examples where the “spirit” of doing phenomenology was alive. Indeed, phenomenologists like Buytendijk, van den Berg, Linschoten, Langeveld, and others were guided by a phenomenological way of seeing while doing phenomenology on the phenomena.

Someone can be occupied with writing scholarly articles and books about phenomenology at a meta-level or, as Spiegelberg wrote, at a meta-meta-level twice removed from the effort of actually doing phenomenology on the things as intended by Husserl and in his famous dictum “back to the things themselves” ( zu den Sachen selbst ). But writing about phenomenology is not the same as doing phenomenology directly on phenomena themselves . The difference is that one can “argue” philosophically about exegetical phenomenological issues and aim to develop philosophical systems while being purblind to phenomenological “seeing” and failing to demonstrate a genuine phenomenological attitude, able to explicate sensitively and insightfully originary meanings of selected lifeworld phenomena. Significantly, in the opening pages to his “Phenomenology as a Rigorous Science,” Husserl (1965 , p. 75, 1980 , p. 47) makes clear that he is not interested in building some “‘system’ for which we yearn, which is supposed to gleam as an ideal before us in the lowlands where we are doing our investigative work.” It is unfortunate that not more contemporary philosophers seek to pursue their phenomenological interests in the lower (concrete) regions of investigative work that should make our lives more thoughtfully livable.

So, in this article, we are attentive to Spiegelberg’s (1975) phrase “doing phenomenology on the phenomena themselves” to describe the third stream of phenomenological writings that Kockelmans (1987) had identified in his Phenomenological Psychology: The Dutch School in which he collected several phenomenological essays. When Spiegelberg recommends doing phenomenology directly on the phenomena, he means not just any phenomena, but “phenomena” and “things” as they give themselves while seen under the spell of a phenomenological attitude. This is what it means to do phenomenology directly on the things, on concrete lived human experiences that are now approached with a sense of wonder regarding their phenomenality. We wonder, what really is the phenomenological meaning of “having a conversation,” “feeling compelled to do something,” “encountering humour,” “experiencing a secret place”? (see van Manen & van Manen, 2021 ). To approach any such topic as a phenomenon is part of the original intent of doing phenomenology.

The uniqueness of the writings of the Utrecht phenomenologists from the early 1930s to the late 1960s is that these protagonists had a dual interest: their (clinical) professional practice and their enthusiasm for phenomenology. They found in the leading phenomenologists of their time a source for deepened understandings and epiphanic insights of the meaning dimensions of their practices. Van den Berg, Buytendijk, and Langeveld had visited and maintained correspondences with Husserl, Heidegger, Binswanger, Scheler, Sartre, Minkowski, and Merleau-Ponty, and they were very familiar with phenomenological developments.

“Things” in the World of the Child

In this section, we use some exemplary selected extracts from Langeveld’s phenomenological study “The Thing in the World of the Child.” The text is published in full and discussed in Classic Writings for a Phenomenology of Practice by Michael van Manen and Max van Manen (2021).

Nothing seems so clearly, so self-evidently, given as the “things,” the stuff or objects of our world. Children apparently need only to learn what the things are, and in this way, something that was originally strange becomes familiar. This “strange” thing, however, continues to be the same. From the start, a chair is a chair, and it emerges, through the developmental encounters of the child, as an experienced and familiar chair. (Langeveld in van Manen & van Manen, 2021 , p. 126)

Langeveld explores a seemingly simple question: How do young children begin to experience things in their lifeworlds? To explore the phenomenological meaning of things in children’s lives, Langeveld uses observations, interactions, and insights from the literature of child development. The way things give themselves in the child’s world is in part determined by the child’s situatedness, physical fitness, adult care, and the qualities of the space and time that condition the child’s world. Langeveld uses the examples of the pencil, the slipper, the gift, the cardboard box, the seesaw, the ball, stones, flowers, and housewares as concrete “things” and examines the meaning of such things through the child’s experiential world.

We appreciate the enigmatic quality of things in the child world. A thing is truly neither just any-thing nor a no-thing. But perhaps it is exactly this multiplicity of plain connotations that reveals the elusive significance of the thingness of things for children. The online Oxford English Dictionary, etymologically defines a “thing” as “some-thing not specified by name,” but it is specifically in the unnamedness where the enigma, strangeness, and otherness of the thingness of the thing resides.

Now, it is tempting to be reminded of Heidegger’s well-known phenomenology of “The Thing,” first published as “Das Ding” in 1951 as a lecture given at the Bayerischen Akademie der Schönen Kunste . However, Langeveld may not have been aware of the text. Heidegger too uses concrete examples in his phenomenological reflections on the nature of The Thing. What is a thing? Heidegger explains that one needs “nearness” to understand the “thingness of the thing.” Next, Heidegger (1971) abruptly announces as follows: “The Jug is a thing” (p. 166). In other words, Heidegger does not bother to say, let’s take the jug as an example—yet that is exactly what he does. He then continues with an extensive descriptive explication of the phenomenological features of The Jug. And, of course, he uses the example of The Jug to address the meaning of The Thing. This essay is an exceptionally fine example of Heidegger’s way of “doing phenomenology on the things” (pun intended). True, some parts of the features of “The Jug as the Thing” are so exhaustively detailed that the reader may sometimes feel like being sucked into an ontological whirlwind, as one tries to stay attentive to the subtle and profound distinctions of Heidegger’s descriptive explications of the ontic eidos of the thing:

When we fill the jug, the pouring that fills it flows into the empty jug. The emptiness, the void, is what does the vessel’s holding. The empty space, this nothing of the jug, is what the jug is as the holding vessel. . . . But if the holding is done by the jug’s void, then the potter who forms sides and bottom on his wheel does not, strictly speaking, make the jug. He only shapes the clay. No—he shapes the void. . . . The vessel’s thingness does not lie at all in the material of which it consists, but in the void that holds. ( Heidegger, 1971 , p. 169)

The point of this passage is that we cannot understand what a “thing” is, in Heidegger’s special sense of the word, employing the properties of an object, as a substance with properties, or even the mental representation as “occurrent” ( vorhanden ). Rather, by taking the jug as an example, Heidegger shows how the thing things (shows its essence). He uses the example to show that the meaning of the jug lies, in part, in the relationality that the jug establishes between the person and the earth (how it nourishes thirst in its fullness) and between people (the host and guest). In the pouring, people experience the generosity (or skimpiness) of the jug. The notion that the potter merely “shapes the void” draws attention to the peculiar “passivity” that Heidegger takes to be essential to human productivity.

Now, Langeveld too utilizes examples in “The Thing in the World of the Child.” Yet his examples orient to make explicit and clarify understandings of a child’s unique bodied, relational, and temporal existence within the world. Consider his example of the gift of the tiny feather of a sparrow:

Consider the four-year-old child who comes to her mother, who is busy with the newborn baby, and has a “treasure” in her hand. It is the tiny feather of a sparrow. “This is for little brother, because he is still so small.” Now that is a true gift! It is not le petit cadeau qui soutient l’amitie [the little present that supports friendship] but rather, here we see l’amour qui soutient les petits cadeaux [love that supports small gifts]. This feather is a sign of a union of love. The feather is small—so be it: Is not the little brother small too? But how delicate and soft the feather is! It almost makes the beholder delicate and soft as well. (Langeveld in van Manen & van Manen, 2021 , p. 129)

Here is the phenomenological insight: “Whoever gives a gift . . . gives him- or herself.” The thing in itself is more than its tangibility, for it bears the “symbol of the love of the giver.” Methodologically, the present ( cadeau ) is an eidetic for the gift (but the present gives little more than its trivial objectedness). So, the feather as a thing is more than a mere object because it is a thing that things, in Heidegger’s sense. But Langeveld does not approach the meaning of things in the manner of Heidegger, although some of Langeveld’s explications bring out similar sensibilities. For example, the seesaw is a thing that requires two young people to join each other. It is a thing of physical and human togetherness, a communion.

When Langeveld explores the meaning of the gift and the present, he does so by giving an example of a pedagogical situation. A situational analysis makes it possible for Langeveld to show how the phenomenon of a gift differs from the phenomenon of a present . But, of course, a more radical analysis of the gift and gift-giving is possible. Jacques Derrida is a master of aporias, showing how our ordinary intentions and actions involve paradoxes, insoluble contradictions, and impasses. He calls these predicaments undecidables. For example, when we are hospitable or give someone a gift, we may think we are doing so with no strings attached. We are giving this gift out of the goodness of our hearts. But Derrida (1995) shows how things are not so simple. The conditions of possibility are at the same time the conditions of impossibility. We cannot give a gift without receiving something in return, if only gratitude or the inner satisfaction we have done good. Gifts create debts. So, is it really possible to give a gift? Or is gift-giving ultimately always some kind of exchange? It seems indeed as if authentic giving or hospitality is an undecidable: neither possible nor impossible. Here, we see how phenomenology makes possible rich interpretive explications and understandings that may not only be undecidables but also incommensurables when perceived in contrasting existential contexts.

As mentioned, Langeveld offers phenomenological interpretations of other things—the filled and empty cardboard box, the ball, a special pen, plates, and cups, to name a few—to show how a child’s sensemaking transcends the physical properties of things. The child comes to know freedom from a carefree being in the world with things, and yet the thing-world also presents the experience of limitation:

One plays in the sand, the water and the snow; one builds with stones, always because they invite one to do so. The flowing water, the swirling sand, and the snow that sticks together well, they speak a totally pathic language and entice us toward play. But soon the unspecified manipulation of formless materials must stop, and organization begins. Whoever wants to build something out of sand or snow or wants to put a bridge over a stream must come to reckon with the objective qualities of sand, snow, and water. Again, the thing-world lures the organizing, the sense-making person, just as one is lured into a magic forest. (Langeveld in van Manen & van Manen, 2021 , p. 138)

The difference between Heidegger’s example of the jug and Langeveld’s example of things such as the slipper or the feather is that the jug is a thing that already has a history of meanings for Heidegger, meanings that are existentially embedded in the world in which humans are born. So, in everyday life, seeing a jug is not a matter of sensemaking, of wondering what this thing is as it presents itself, but rather the presence of the jug is a matter of reaching for it to pour some of its contents. Or one might use the jug to hold some cut flowers. In our everyday world, it is actually rather odd to consider the jug as an example of the phenomenology of a thing. Only when inspired by the phenomenological attitude would one consider the profound inceptual meanings that Heidegger is able to intuitively “see” and explicate in his pathic and vocative language and style about the nature of this thing, the jug.

In contrast, when Husserl gives the example of looking at a thing, he does not consider any particular thing but rather things in general—when he gives his foundational description of the phenomenon of adumbration. When we look at a thing, such as a book, every perception of consciousness is perspectival. We never see the whole thing (book) at once but what is visible is, first of all, a surface: “I see it now from this ‘side,’ now from that, continuously perceiving it from ever differing sides” ( Husserl, 1954/1970a , p. 157). And yet, we retain a sense-intuition of certainty about the thing. So, as we never perceive a thing from all sides at once, but only in adumbrated perspectives, we become phenomenologically aware that seeing some-thing empirically is not necessarily knowing it fully or completely.

So, if Husserl would see a thing like a jug, he would look at its surfaces from above, below, and the inside, but would he know it like Heidegger knows a jug? Husserl is interested in how the thing “appears” and “shows itself” as we look at its perceptual surfaces and dimensions. But, of course, when we see this book, we also may see its invitation to be read, or the obligation that we need to return the book to its lender, and so on. Heidegger is interested in how the jug appears as a meaningful thing in our existential world. Now, in contrast, in the world of the child, things do not have dimensions or meanings yet, but the child can climb over things, throw things, sit inside things (like in a big box), and thus, the child learns to make sense of the meaning of things in an as yet open world.

Langeveld’s exploration of the thing in the world of the child reveals a different modality of sense. If the child sees a jug on the kitchen table, he or she may curiously look inside or even put or hide something inside it. Similarly, Langeveld shows that when the child sees a slipper, it can be many different things. This imaginative or playful seeing is more a matter of the child’s existence of open sensemaking that may or may not be restrained by some of the limitations that Langeveld supposes could be part of the way that the thing in the world of the child appears. For example, the slippers are mama’s and so the slippers give themselves as the things that the mother puts on her feet. The sense the child makes is that the slippers embody “mama.” So, Langeveld gives the example of the slipper to show how in the child’s world, the slipper is not merely an object worn on the foot. The slipper becomes sensual as it finds its way into a child’s mouth, or handy as it is employed to hammer some objects, or cradle-like as it becomes a bed for a doll. The slipper as a thing invites playful sensemaking for the child.

Things do more: through the encounter with things, children develop a past with each other. The things bring them together. Ultimately, Langeveld offers originary and nuanced reflections on “The Thing in the World of the Child.” We gain insights that are immanent to the thinging of things. We catch phenomenological glimpses and sights into the lifeworld of the child that give the adult thoughtful understandings that make possible pedagogically tactful interactions of the adult with the child.

Being Guided by the Phenomenological Attitude

As attentive readers, we may have been aware of the phenomenological attitude that Langeveld adopts in his phenomenological analysis of the thing in the child’s world. This attitude functions as a method of attentiveness. Langeveld (in)famously pointed out that in Husserl’s writings, the term “phenomenology” occurs in two meaning contexts: “to signify a method and to signify a philosophy.” Langeveld chose to use the term primarily to refer to the method and remain impartial to Husserl’s development of a phenomenological philosophy ( Langeveld, 1972 ). Of course, Langeveld was correct that phenomenology is the name of a method. We suggest that the third stream of publications, that Kockelmans describes, were guided by the method of the phenomenological attitude to gain insights into the originary meanings of a phenomenon like the thing in the world of the child. In other words, the phenomenological attitude functions like a rich and internalized method. And yet, a feature of Langeveld and his colleagues’ works appears to be that they rarely engaged in arguing or articulating the philosophical technicalities of phenomenology for their inquiry. This absence of theorizing about methodological and philosophical issues was likely because these proponents were all professional practitioners, often with significant clinical responsibilities. While it is evident that most of these proponents had read the philosophical phenomenological literature, apparently, they just were not that interested in philosophizing about the conditions of doing phenomenology. However, their disinterest for theorizing was also a consequence of their view of the nature of phenomenology: “the phenomenologist is obsessed by the concrete . . . he distrusts theoretical and objective observations,” said van den Berg (1972) , in his A Different Existence (p. 76).

One might ask, “How were these individuals able to practice phenomenology in their respective fields of psychology, medicine, pedagogy, law, and psychiatry when they generally opted not to engage in exegetical studies of the philosophical discourses of Husserl and his followers that established phenomenology?” The point is that through their familiarity with the works of Husserl, Stein, Heidegger, Scheler, Sartre, and Merleau-Ponty, the Utrecht phenomenologists internalized the phenomenological attitude while largely ignoring the technical philosophical discourses that preoccupied the increasing number of academic philosophers who were engaged in exegetically arguing about abstracted phenomenological themes, issues, systems, and theories of their time.

How can the internalization of the phenomenological attitude be described? We have to begin with the “natural attitude” that we all carry most of the time. Dermot Moran (2013) pointed out that the natural or naturalistic attitude is so taken-for-granted that the bearers of this attitude do not know that they have it. In contrast, phenomenologists must understand the nature of this natural attitude, and they must understand the critical and methodological importance of transforming the natural attitude into the phenomenological attitude that enables phenomenological seeing and intuition.

The significance of the phenomenological attitude is evident already in the foundational explications of phenomenology by Heidegger (1927/1962) , Merleau-Ponty (1962) , Henry (1990/2008) , and others. Heidegger (1972/1975) stated that Husserl’s teaching took the form of practicing phenomenological “seeing” (p. 78). Merleau-Ponty (1962) described phenomenology as a “manner or style of thinking” (p. viii). In addition, Henry (1990/2008) put that the “transcendental possibility of experience is the original phenomenalizing of the phenomenality of the phenomenon” (p. 104), which is opening the path to the meaning of a phenomenon. None of these methodological characterizations refer to the application of a technical or scientific set of procedural steps. The practice of phenomenological “seeing” is an internalized, perception-based, and sensitive serendipitous act. Furthermore, the methods of the epoché and the reduction are involved, in a broad sense, as the distinguishing critical feature and essence of the phenomenological attitude.

While Husserl (1954/1970a) characterized the practice of the epoché and the reduction in many different ways (he mentions the transcendental, phenomenological, skeptical, vocational, and psychological epoché and reduction), a key feature is that it makes possible a transformation of the natural attitude. It is hard to fully realize and recognize the depth, pervasiveness, and taken-for-grantedness of the objectivism, naturalism, positivism, and shallow distractionism that shapes our way of looking at ourselves and the world around us and how this has affected the ecology of the planet and human civilizations. Even expressing our naturalistic predicament like this betrays a blindness to the fact that we always already immediately see the things around us as objects and objective forces.

Etymologically, the term “attitude” refers to the disposedness, disposition, posture, and fittedness of the comportment of a certain way of seeing, feeling, and acting, according to the online Oxford English Dictionary. An attitude regarding an object of thought can be deliberately or even unwittingly adopted. And an attitude can also be purposefully altered or disposed. This is a key idea for Husserl’s phenomenology as it is the taken-for-grantedness of the natural attitude that prevents us from seeing the so-called hidden meanings of phenomena. He defines an “attitude” ( Einstellung ) as

a habitually fixed style of willing life comprising directions of the will or interests that are prescribed by this style, comprising the ultimate ends, the cultural accomplishments whose total style is thereby determined . . . Humanity always lives under some attitude or other. ( Husserl, 1954/1970a , p. 280)

Husserl speaks about “the natural primordial attitude, of the attitude of original natural life” (p. 281) as the attitude of the culture and the historical age in which we are born, and that forms the default natural orientation to life that characterizes our being-in-the-world.

Langeveld published in 1972, Capita from the General Methodology of Pedagogical Science , in which he addressed the issue of method in his phenomenological work. He suggested that one can debate Husserl (1954/1970a) on philosophical issues and he criticized the assumptions introduced by Husserl’s elaborations of transcendental subjectivity. Husserl had proposed how the knowing self must experimentally annul the existence of the world, meaning annul the self as the concrete subject of this knowledge of the world, by experimentally pretending that there is no world and no knowing subject. In Langeveld’s view, this sense of transcendental subjectivity abrogates the empirical “I” and the lived “world” relative to objective knowing. Langeveld asked rhetorically what the point would be of a phenomenological philosophy that only yields forms of knowing and understanding that are so detached from everyday human experience that they fail to serve the existential lives of (professional) practitioners or any other human beings? What good are transcendental truths and “pure” ideas that can neither be related to the concrete world nor to the lives of those who live in this world?

Langeveld suggested that refusing to follow Husserl into this philosophy of transcendental subjectivity did not mean that one must give up on the phenomenological method of inquiry. To reiterate, he pointed out that in Husserl’s writings, the term “phenomenology” occurs in two general meaning contexts: “to signify a method and to signify a philosophy.” Langeveld (1972) chose to use the term primarily to refer to the method and remain impartial to Husserl’s development of a phenomenological philosophy. Thus, Langeveld and his colleagues mostly were interested in foundational and epistemological issues to the extent that they contributed to doing phenomenological research and writing on the phenomena. Yet they certainly shared an understanding of the philosophical method that lies at the core of phenomenology. This understanding was realized through the sensibility of what may be called the “phenomenological attitude or disposition.”

Langeveld and his colleagues adopted (wittingly or unwittingly) the phenomenological attitude as a tacit application or transformation of the epoché and the reduction in a broad sense. While many contemporary phenomenologists no longer mention the Husserlian terminology of the epoché and the reduction, they nevertheless seem to adopt through a process of mimesis, the methods of the epoché and the reduction when practicing phenomenology on concrete phenomena. In contrast, while some more theoretically inclined philosophers may understand the necessity of adopting a phenomenological way of seeing, they yet may fail to do so as they are too preoccupied arguing about technicalities. It is hard for them to let go of the exegetical attitude. In other words, a scholar may be able to expertly traverse and address numerous thematic topics and issues in texts by Husserl and other foundational phenomenologists and yet may strangely lack the talent or ability to adopt the phenomenological attitude required to write an insightful phenomenological study on a concrete phenomenon or event.

In Husserl’s texts, we seldom meet extended concrete examples of the practice of the phenomenological attitude. Dermot Moran (2000) said that, although Husserl’s project was ostensibly “ descriptive phenomenology,” ironically, Husserl’s writings are often abstract, focusing on technicalities, and notoriously “lacking in concrete examples” (p. 63). In an interview, van den Berg also remarked that Husserl remained too tied to his desk and hardly moved outside the philosophical world ( Kruger, 1985 ). It is well-known that even Husserl’s home was an extension of his university office when he invited students for philosophy seminars. Indeed, it might be interesting to speculate how Husserl’s followers might have been inspired and how the development of phenomenology might have unfolded in a richer fashion if Husserl himself had indulged some of the time to focus on concrete and down-to-earth lifeworld phenomena in his pursuit of a pure phenomenology.

Langeveld, Buytendijk, Linschoten, and van den Berg admired Husserl’s genius and his dedication and perfectionism and they recognized his need for continuously rewriting his articles. Still, despite this admiration, they did not think they needed to follow Husserl into all those explorations of the foundational technicalities that Husserl obstinately kept pursuing and that keeps present-day philosophers still obsessed and preoccupied. Thus, we also hope that more philosophically based authors may recognize the value and join the effort to do more phenomenology on the concrete phenomena of our professional and everyday existence.

Approaching Phenomenology as the Study of Examples

Buytendijk once referred to phenomenology as the “science of examples” ( van Manen, 2014 , p. 257). Whether taking the form of vignettes, anecdotes, or narratives, “examples” may be understood as rhetorical and aesthetic devices for evoking phenomenological understandings or phenomenological knowledge that cannot necessarily be expressed, explained, or explicated in a straightforward propositional or prosaic manner. The use of “phenomenological examples” is a clear feature of phenomenological texts that focus on the phenomena themselves. Examples in this methodical sense are also found in the wider phenomenological philosophical literature: the example of “boredom” while waiting for the train in the study of metaphysics in Martin Heidegger (1995 , p. 93), the example of the myth of “the Gaze of Orpheus” in the study of writing in Maurice Blanchot (1981 , pp. 99–104), the example of the voyeur looking through the keyhole of the door in “the look” in Jean-Paul Sartre (1956 , pp, 259, 260), “Homer’s Odysseus” as an example of The Homecomer in Alfred Schutz (1971 , pp. 106–119), the example of “Morpheus” in The Fall of Sleep in Jean-Luc Nancy (2007 , pp. 8, 9), and so on.

Although Husserl rarely used detailed reflections of concrete examples to analyze and explicate the meaning of a concrete phenomenon or event, a well-known use of example occurs when Husserl describes the cogito as an act. He says,

Let us start with an example. In front of me, in the dim light, lies this white paper. I see it, touch it. This perceptual seeing and touching of the paper as the full concrete experience of the paper that lies here as given in truth precisely with these qualities, precisely with this relative lack of clearness, with this imperfect definition, appearing to me from this particular angle—is a cogitatio , a conscious experience. ( Husserl, 1913/2014 , p. 65)

Husserl sets himself the task of describing the phenomenon of conscious experience ( Erlebnis ), meaning “lived experience.” According to Husserl, the cogitatio, the stream-of-consciousness lived experience, in the fullness of its unity, can be seen to give access to the essence of every lived experience.

The Eidos, the pure essence , can be exemplified intuitively in the data of experience, data of perception, memory, and so forth, but just as readily also in the mere data of fancy (Phantasie) . Hence with the aim of grasping an essence itself in its primordial form, we can set out from corresponding empirical intuitions, but we can also set out just as well from non-empirical intuitions, intuitions that do not apprehend sensory existence, intuitions rather of a merely imaginative order . ( Husserl, 1913/2014 , p. 14)

The philosopher Edward Casey (2000 , 2007 ) has written several insightful and eloquent phenomenological studies on topics such as places and landscapes, the glance, and imagining. Casey (2000) asserts that the phenomenological method as conceived by Husserl takes its beginning from carefully selected examples. Note earlier that W. R. Boyce Gibson’s translation of Husserl’s Ideas reads as follows:

The Eidos, the pure essence , can be exemplified intuitively in the data of experience. ( Husserl, 1913/2014 , p. 14)

Casey, however, translates this passage as follows:

The eidos or pure essence, can be exhibited by example. ( Casey, 2000 , p. 23)

With this slight but pronounced modification, Casey lets Husserl make his point even more clearly and emphatically than Husserl probably meant himself. But the point for us is that phenomenology may indeed be seen to proceed through examples. For Casey, the “example” is not only the method to carefully select his studies, but he also uses the notion of “example” as a methodological device. In his study, Imagining , Casey (2000) takes his own experiences as a source for constructing narrative examples to investigate the meaning of the phenomenon “imagining.” Furthermore, he affirms that it is not only fictional texts that can function as examples but also observed and fictive objects, events, and actions.

Phenomenological method takes objects, events, or acts—whether real or imagined—as exemplifying an essence or essential structure. In this way their basic constitution is made perspicuous, and examples become the specific vehicles or privileged media of eidetic insights. ( Casey, 2000 , p. 24)

Casey wants to make the strong case that examples that exhibit an essence or essential structure with a maximum of evidential lucidity can achieve eidetic insights. Even carefully selected factual or empirical material may serve as phenomenological examples, but only after they have been fictionalized through the application or performance of the reduction ( Husserl, 1913/1983 ).

It is important to keep in mind that phenomenology does not deal with facts. Accordingly, we may need to allow that some examples only partially serve the purpose of the phenomenological reduction; while they present evidentially perspicacious examples, they may remain linguistically ambiguous or enigmatic. For the Utrecht phenomenologists, the methodological power of the “example” also serves an analytic purpose. The “example” does not express what one knows through argument or conceptual explication, but, in a vocative manner, an “example” lets one experience what one does not know. There is an indirectness in the turn to the narrative meaningfulness of phenomenological examples (see also van Manen, 2014 ).

The example can make the singular experienceable and thus knowable as an indite method of phenomenological writing. While the methods of the epoché and the reduction are engaged in an attempt to gain insights into the originary meaning of a phenomenon, it is the indite methods, the vocative aspects of writing, that assist in bringing phenomenological insights to textual understanding. The online Oxford English Dictionary defines the term “indite” in this way: “to put into words, compose (a poem, tale, speech, etc.); to give a literary or rhetorical form to (words, an address); to express or describe in a literary composition.” We use indite here to focus on the semiotic or writing practices that present the linguistic, methodological dimension to phenomenological thinking, inquiring, and writing. An “example” often takes shape as a story (as in existential literary fiction) and thus orients to the singular. Indeed, any literary story or novel is always some unique narrative that brings out the particularity or singularity of a certain phenomenon, event, or life.

In the exegetical phenomenological literature, little attention appears to be paid to the methodological significance of the “example” in phenomenological writing. But, some of the leading phenomenologists commonly speak of and reach for an “example” when examining a phenomenon or event for its phenomenal features. Unfortunately, many of Husserl’s (1913/1983) “examples” are seemingly overly simple, such as a reference to seeing a tree, in his explication of the noema and intentionality (pp. 214, 215). But Husserl’s (1964) most famous and extended “example” is probably contained in his study of time consciousness. In his description of our inner consciousness of time, Husserl uses the example of hearing a familiar melody. In hearing a well-known musical melody, the present notes of the melody and the notes just past are retained in retention while the notes about to be heard are already anticipated as protention. Thus, Husserl explicates and shows the streaming structure of ongoing retentions and protentions as primal impressional consciousness in the exemplary experience of hearing a familiar melody.

Similarly, when Heidegger (2001) reflects on the meaning of the “thing,” he uses the example of a jug. When Henry (1988/2009) presents the aesthetic revelation of the invisible essence of “life,” he uses the paintings of Wassily Kandinsky as an example. When Sartre (1956) discusses the experience of “negation and nothingness,” he says that he needs an example, and he describes having an appointment with Pierre in the café where they are supposed to meet at 4 o’clock (p. 9). But as he arrives at the café and looks around, Sartre discovers, “He is not here.” Next, Sartre (1956) explores how it is that we “see” this absence that is a nothing (a not-being-there) and yet not a nothing (the absence of not being there) (1956, p. 10). Interestingly, all of these aforementioned examples have acquired iconic fame in the phenomenological literature. They have become classic or well-known phenomenological anecdotes, vignettes, narratives, or images, and it matters not whether they are fictional, imagined, or real, in an empirical or biographic sense.

In contrast, in the traditional and qualitative social sciences, examples are usually employed as concrete or illustrative “cases-in-point” to clarify an abstract idea or theory. This commonly used form of example-as-case-in-point is meant to make theoretical knowledge more accessible, concrete, or intelligible, although the example itself may not contribute to the knowledge. Indeed, examples are often used as informative illustrations. But, an example-as-illustration can be left out of the text without compromising the text. So, it is essential to realize that “phenomenological examples” differ radically from such explanatory, clarifying, or illustrative uses of examples. The phenomenological notion of “example” is methodologically a unique semiotic figure for phenomenological inquiry.

Examples in phenomenological texts have evidential significance because the example is the example of something experientially knowable or understandable that is not directly expressible—it is a universal singularity. If a singularity were to be expressed in ordinary prose, it would immediately vanish. Why? Because language cannot really express a singularity by naming or describing it. A singularity cannot be grasped directly through words because words are already generalized bits of language. Language universalizes. However, and this is paradoxical, the “phenomenological example” as a story can provide access to the phenomenon in its universal singularity. It makes the “singular” knowable and understandable. Every fictional story or novel has at its core a singularity: a unique theme or signification.

The etymology of the Greek word for model is to “show something in something and thus make it present” in an interpretive methodical sense. Günther Figal makes special use of the term “model” as an equivalent term for “example.” He says, “a model is a definitive example” ( Figal, 2010 , p. 29). To reflect in a hermeneutic phenomenological manner on the meaning of something is to examine it as an originary model. The model is like an incept (as opposed to a concept). It points toward the originary meaning of something. Some models are more appropriate or better suited to get at the originary meaning of something. And so, models (as examples) must be well-chosen because the essence of the matter has to be expressed in the model. In the words of Figal (2010) , “models are supposed to be distinguished by their pregnancy; they must prove themselves as such by really letting something be shown in them” (p. 30).

Similarly, Giorgio Agamben (2002) uses the term “example” interchangeably with paradigm: “example” means para-deigma . Agamben says, “paradigm means simply ‘example’ . . . a single phenomenon, a singularity.” A singularity is, by definition, single and unique—it does not share properties in common with anything else. In other words, a singularity has no specifiable identity (idem); it has no recognizable sameness except that it is self-same. A singularity is only identical to itself (ipseity). Interestingly, Agamben (1995) points out that a true example is neither particular nor universal.

To reiterate, it would be wrong to assume that the “example” in phenomenological inquiry is used as an illustration in an argument, or as a particular instance of a general idea, or as an empirical datum from which to develop a conceptual or theoretical understanding. Instead, the phenomenological example is a philological device that holds in a certain tension the intelligibility of the singular. How can the example do this? It can do this because the example mediates our intuitive (self-evidential) grasp of a singularity, which is precisely the project of phenomenology. Again, we need to sense the paradoxicality of this explication of a critical methodological aspect of phenomenological inquiry, thinking, and writing.

The singularity of the singular may show itself by way of the example. “The example lets the singular be seen,” says Agamben (1995 , p. 10). But one could perhaps equally say that the phenomenological example reconciles the incommensurable couplet of the particular and the universal. In other words, singularity emerges in the deconstructive fusion of the particular with the universal. In this sense, the phenomenological example expresses the singular as universal. So, the example is somewhat of an enigma and contradiction. This idea may be seen as a phenomenological variation on Georg Wilhelm Friedrich Hegel’s notion that a lived experience originates as particularity but becomes recognizable as universal.

Previously, we showed how Langeveld used the story of the feather as an example of a child’s gift. Spiegelberg (1972) speaks of these anecdotes as “colorful vignettes that are characteristic of Dutch phenomenology” (p. 87). In Doing Phenomenology , Spiegelberg employs vignette-style expressions to provide concrete contexts for his phenomenological analysis of the phenomenon of approval . Joseph Kockelmans, too, observes how the phenomenologists of the Utrecht School frequently make use of poetry and literature. He sees three reasons: First, many “great poets and novelists have seen something very important and have spoken of it in a remarkably adequate way” that is useful for phenomenological explication. Second, phenomenologists may use literary sources “to illustrate a point on which the phenomenologists wish to focus attention.” And third, most important, “poetic language . . . is able to refer beyond the realm of what can be said ‘clearly and distinctly’” ( Kockelmans, 1987 , pp. viii, ix).

Experiential descriptions, in the form of colorful vignettes, should not be taken as mere embellishing or illustrative examples of points made in a text. We must avoid confusing phenomenological examples as if they are mere didactical explanations. Rather, these narrative stories should be approached as fictional vignettes or narrative anecdotes or aesthetic and poetic objects. Phenomenology reflects on “examples” to discover what is originary, singular, or essential about a phenomenon or event. The example is the presencing of something experientially knowable or understandable that is not easily directly expressible—a singularity or an essence. In other words, the “phenomenological example” as fictionalized story provides access to the eidetic meaning of the phenomenon in its singularity. It makes the essence as the “singular” knowable and understandable.

We have pointed out that the example is indeed a way that phenomenology may proceed. Buytendijk, Spiegelberg, Kockelmans, Casey, Figal, and Agamben have made clear, in different ways, that the example is a powerful methodological device to reveal eidetic and intentional phenomenological meaning. Skilled and eloquent phenomenologists perfected the use of concrete “examples” to evoke understandings inherent in concrete but phenomenologically universal narrative descriptions, gained from or modeled on fictional, poetic, mythological, and aesthetic sources.

Putting Phenomenology Back Into Phenomenology

We have highlighted that the phenomenological attitude and the use of examples are two key methodological features for doing phenomenology on phenomena as described by Kockelmans and Spiegelberg. As Kockelmans indicated, these phenomenological studies done directly on the phenomena or concrete things are the type of phenomenological inquiries intended by the founding scholars like Husserl, Heidegger, Merleau-Ponty, and other original phenomenological thinkers. We are indeed struck by the uncanny observations made by Herbert Spiegelberg who, in his later years, found that so much philosophical scholarship of phenomenology lacks the vitality of what phenomenology could be. So, our aim is to try to put phenomenology back into phenomenology by showing how this had been practiced by the Utrecht proponents and how it may inspire our present-day and future phenomenological research projects; see Classic Writings for a Phenomenology of Practice ( van Manen & van Manen, 2021 ). We propose that these classic writings demonstrate a way of doing phenomenology directly on the “phenomena” or on the “things” themselves. We also propose that these publications are guided by a phenomenological attitude aimed to arrive at meaningful insights, sensitive to concrete experience, and proceeding through phenomenological examples.

Author Biographies

Michael van Manen is associate professor in the Department of Paediatrics, Faculty of Medicine and Dentistry, and Endowed Chair of Health Ethics and Director of the John Dossetor Health Ethics Centre at the University of Alberta, Canada. He has a clinical practice as a physician in neonatal-perinatal medicine with the Stollery Children’s Hospital, Edmonton, Alberta, Canada.

Max van Manen is emeritus professor in Research Methods, Pedagogy, and Curriculum Studies in the Faculty of Education at the University of Alberta, Canada. His interests include phenomenological pedagogy, childhood’s secrets, pedagogical tact, and phenomenological human science method.

Declaration of Conflicting Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding: The authors received no financial support for the research, authorship, and/or publication of this article.

Author’s Note: This article contains material published as Classic Writings for a Phenomenology of Practice , by Michael van Manen and Max van Manen, copyrighted 2021, by Routledge 52 Vanderbilt Avenue, New York, NY 10017.

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• Alison Rodriguez ,
• Joanna Smith
• School of Healthcare , School of Healthcare, University of Leeds , Leeds , UK
• Correspondence to Dr Joanna Smith, School of Healthcare, University of Leeds, Leeds LS2 9UT, UK; j.e.smith1{at}leeds.ac.uk

https://doi.org/10.1136/eb-2018-102990

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Qualitative research methodologies focus on meaning and although use similar methods have differing epistemological and ontological underpinnings, with each approach offering a different lens to explore, interpret or explain phenomena in real-world contexts and settings. In this article, we provide a brief overview of phenomenology and outline the main phenomenological approaches relevant for undertaking healthcare research.

What is phenomenology?

Edmund Husserl (1859–1938), a philosopher, established the discipline of phenomenology. In Husserl’s approach to phenomenology, now labelled descriptive phenomenology , experiences are described and researcher perceptions are set aside or ‘bracketed’ in order to enter into the life world of the research participant without any presuppositions. 1 Experience is recognised to involve perception, thought, memory, imagination and emotion, each involving ‘intentionality’, as the individual focuses their gaze on a specific ‘thing’ or event. 1 Martin Heidegger (1889–1976), a student of Husserl, rejected the theory of knowledge or ‘epistemology’ that influenced Husserl’s work, and instead adopted ‘ontology’, the science of being. In relation to research, ‘epistemology’ is concerned with what constitutes valid knowledge, and how knowledge is gained with a distinction between justified belief and opinion, while ‘ontology’ ‘is more concerned with the nature of reality and now we understand what exists and is experienced.

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Key differences between Husserl’s and Heidegger’s approaches to phenomenology

What is phenomenological research?

The philosophy of phenomenology resides within the naturalistic paradigm; phenomenological research asks: ‘ What is this experience like? ’, ‘ What does this experience mean? ’, and ‘ How does the lived world present itself to the participant or to me as the researcher? ’ Not all health research questions that seek to describe patient or professional experiences will be best met by a phenomenological approach; for example, service evaluations may be more suited to a descriptive qualitative design, where highly structured questions aim to find out participant’s views, rather than their lived experience.

Building on the work of Husserl and Heidegger, different approaches and applications of phenomenological to research have been developed. Table 2 , adapted from Rodriguez, 2 highlights the differences between the main traditions of phenomenology.

Comparison of the main phenomenological traditions

Is phenomenology an appropriate approach to undertaking healthcare research?

We will use a study that explored the lived experience of parenting a child with a life-limiting condition to outline the application of van Manen’s approach to phenomenology, 3 and the relevance of the findings to health professionals. The life expectancy of children with life-limiting conditions has increased because of medical and technical advances, with care primarily delivered at home by parents. Evidence suggests that caregiving demands can have a significant impact on parents’ physical, emotional and social well-being. 4 While both qualitative and quantitative research designs can be useful to explore the quality of life for parents living with a child with a life-limiting conditions, a phenomenological approach offers a way to begin to understand the range of factors that can effect parents, from their perspective and experience, revealing meanings that can be ‘hidden’, rather than making inferences. van Manen’s approach was chosen because the associated methods do not ‘break down’ the experience being studied into disconnected parts, but provides rich narrative descriptions and interpretations that describe what it means to be a person in their particular life-world. The phenomenological aim was to develop a ‘pathic’ understanding; the researcher was therefore committed to understanding the experience of the phenomena as a whole, rather than parts of that experience. In addition, van Manen’s approach was chosen because it offers a flexibility to data collection, where there is more of an emphasis on the facilitation of participants to share their views in a non-coercive way and the production of meaning between the researcher and researched compared to other phenomenological approaches ( table 2 ).

Central to data analysis is how the researcher develops a dialogue with the text, rather than using a structured coding approach. Phenomenological themes are derived but are also understood as the structures of experience that contribute to the whole experience. van Manen’s approach draws on a dynamic interplay of six activities, that assist in gaining a deeper understanding of the nature of meaning of everyday experience:

Turning to a phenomenon, a commitment by the researcher to understanding that world.

Investigating experience as we live it rather than as we conceptualise it.

Reflecting on the essential themes, which characterise the phenomenon.

Describing the phenomenon through the art of writing and rewriting.

Maintaining a strong and oriented relation to the phenomenon.

Balancing the research context by considering the parts and the whole. 8

These activities guide the researcher, alongside drawing on the four-life world existentials ( table 2 ), as lenses to explore the data and unveil meanings.

Ten parents of children with life-limiting conditions were interviewed with the aim of gathering lived experiences and generating thick descriptions of what it is like to be a parent of a child with a life-limiting condition. The essential meaning of the phenomenon ‘the lived experience of parenting a child with a life limiting condition’ can be understood as a full-time emotional struggle involving six continuous constituents, presented in figure 1 . Health professional supporting families where a child has a life limiting condition need to be aware of the isolation faced by parents and the strain of constant care demands. Parents innate parental love and commitment to their child can make it challenging to admit they are struggling; support and the way care and services are delivered should be considerate of the holistic needs of these families ( figure 1 ). 

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Lived experience of parenting a child with a life-limiting condition. 

In summary, in Husserlian (or descriptive)derived approaches, the researcher from the outset has a concrete ‘example’ of the phenomenon being investigated, presuppositions are bracketed and the researcher imaginatively explores the phenomena; a ‘pure’ description of the phenomena’s essential features as it is experienced can then be unveiled. While in Heideggerian, hermeneutic (or interpretive) approaches, the researcher’s perspectives, experiences and interpretations of the data are interwoven, allowing the phenomenologist to provide an ‘interpretation’ rather than just a description of the phenomena as it is experienced. In all phenomenological approaches, the researcher’s role in self-reflection and the co-creativity (between researcher and researched) is required to produce detailed descriptions and interpretations of a participant’s lived experience and are acknowledged throughout the researcher’s journey and the research process. These reflections are deliberated to a greater degree in heuristic and relational approaches, as the self and relational dialogue are considered crucial to the generated understanding of the phenomena being explored.

We will provide more specific details of interpretative phenomenological analysis in the next Research Made Simple series.

• Rodriguez A
• Rodriguez A ,
• Cheater F ,
• Moustakas C
• van Manen M
• Flowers P ,
• Larkin M , et al
• Langridge D

Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

Competing interests None declared.

Patient consent Not required.

Provenance and peer review Commissioned; internally peer reviewed.

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Chapter 6: Phenomenology

Darshini Ayton

Learning outcomes

Upon completion of this chapter, you should be able to:

• Identify the key terms, concepts and approaches used in phenomenology.
• Explain the data collection methods and analysis for phenomenology.
• Discuss the advantages and disadvantages of phenomenological research.

What is phenomenology ?

The key concept in phenomenological studies is the individual .

Phenomenology is a method and a philosophical approach, influenced by different paradigms and disciplines. 1

Phenomenology is the everyday world from the viewpoint of the person. In this viewpoint, the emphasis is on how the individual constructs their lifeworld and seeks to understand the ‘taken for granted-ness’ of life and experiences. 2,3 Phenomenology is a practice that seeks to understand, describe and interpret human behaviour and the meaning individuals make of their experiences; it focuses on what was experienced and how it was experienced. 4 Phenomenology deals with perceptions or meanings, attitudes and beliefs, as well as feelings and emotions. The emphasis is on the lived experience and the sense an individual makes of those experiences. Since the primary source of data is the experience of the individual being studied, in-depth interviews are the most common means of data collection (see Chapter 13). Depending on the aim and research questions of the study, the method of analysis is either thematic or interpretive phenomenological analysis (Section 4).

Types of phenomenology

Descriptive phenomenology (also known as ‘transcendental phenomenology’) was founded by Edmund Husserl (1859–1938). It focuses on phenomena as perceived by the individual. 4 When reflecting on the recent phenomenon of the COVID-19 pandemic, it is clear that there is a collective experience of the pandemic and an individual experience, in which each person’s experience is influenced by their life circumstances, such as their living situation, employment, education, prior experiences with infectious diseases and health status. In addition, an individual’s life circumstances, personality, coping skills, culture, family of origin, where they live in the world and the politics of their society also influence their experience of the pandemic. Hence, the objectiveness of the pandemic is intertwined with the subjectiveness of the individual living in the pandemic.

Husserl states that descriptive phenomenological inquiry should be free of assumption and theory, to enable phenomenological reduction (or phenomenological intuiting). 1 Phenomenological reduction means putting aside all judgements or beliefs about the external world and taking nothing for granted in everyday reality. 5 This concept gave rise to a practice called ‘bracketing’ — a method of acknowledging the researcher’s preconceptions, assumptions, experiences and ‘knowing’ of a phenomenon. Bracketing is an attempt by the researcher to encounter the phenomenon in as ‘free and as unprejudiced way as possible so that it can be precisely described and understood’. 1(p132) While there is not much guidance on how to bracket, the advice provided to researchers is to record in detail the process undertaken, to provide transparency for others. Bracketing starts with reflection: a helpful practice is for the researcher to ask the following questions and write their answers as they occur, without overthinking their responses (see Box 1). This is a practice that ideally should be done multiple times during the research process: at the conception of the research idea and during design, data collection, analysis and reporting.

Box 6.1 Example s of bracketing prompts

How does my education, family background (culture), religion, politics and job relate to this topic or phenomenon?

What is my previous experience of this topic or phenomenon? Do I have negative and/or positive reactions to this topic or phenomenon? What has led to this reaction?

What have I read or understood about this topic or phenomenon?

What are my beliefs and attitudes about this topic or phenomenon? What assumptions am I making?

Interpretive or hermeneutic phenomenology was founded by Martin Heidegger (1889–1976), a junior colleague of Husserl. It focuses on the nature of being and the relationship between an individual and their lifeworld. While Heidegger’s initial work and thinking aligned with Husserl’s, he later challenged several elements of descriptive phenomenology, leading to a philosophical separation in ideas. Husserl’s descriptive phenomenology takes an epistemological (knowledge) focus while Heidegger’s interest was in ontology 4 (the nature of reality), with the key phrase ‘being-in-the-world’ referencing how humans exist, act or participate in the world. 1 In descriptive phenomenology, the practice of bracketing is endorsed and experience is stripped from context to examine and understand it.

Interpretive or hermeneutic phenomenology embraces the intertwining of an individual’s subjective experience with their social, cultural and political contexts, regardless of whether they are conscious of this influence. 4 Interpretive or hermeneutic phenomenology moves beyond description to the interpretation of the phenomenon and the study of meanings through the lifeworld of the individual. While the researcher’s knowledge, experience, assumptions and beliefs are valued, they do need to be acknowledged as part of the process of analysis. 4

For example, Singh and colleagues wanted to understand the experiences of managers involved in the implementation of quality improvement projects in an assisted living facility, and thus they conducted a hermeneutic phenomenology study. 6 The objective was to ‘understand how managers define the quality of patient care and administrative processes’, alongside an exploration of the participant’s perspectives of leadership and challenges to the implementation of quality improvement strategies. (p3) Semi-structured interviews (60–75 minutes in duration) were conducted with six managers and data was analysed using inductive thematic techniques.

New phenomenology , or American phenomenology , has initiated a transition in the focus of phenomenology from the nature and understanding of the phenomenon to the lived experience of individuals experiencing the phenomenon. This transition may seem subtle but fundamentally is related to a shift away from the philosophical approaches of Husserl and Heidegger to an applied approach to research. 1 New phenomenology does not undergo the phenomenological reductionist approach outlined by Husserl to examine and understand the essence of the phenomenon. Dowling 1 emphasises that this phenomenological reduction, which leads to an attempt to disengage the researcher from the participant, is not desired or practical in applied research such as in nursing studies. Hence, new phenomenology is aligned with interpretive phenomenology, embracing the intersubjectivity (shared subjective experiences between two or more people) of the research approach. 1

Another feature of new phenomenology is the positioning of culture in the analysis of an individual’s experience. This is not the case for the traditional phenomenological approaches 1 ;  hence, philosophical approaches by European philosophers Husserl and Heidegger can be used if the objective is to explore or understand the phenomenon itself or the object of the participant’s experience. The methods of new phenomenology, or American phenomenology, should be applied if the researcher seeks to understand a person’s experience(s) of the phenomenon. 1

See Table 6.1. for two different examples of phenomenological research.

Advantages and disadvantages of phenomenological research

Phenomenology has many advantages, including that it can present authentic accounts of complex phenomena; it is a humanistic style of research that demonstrates respect for the whole individual; and the descriptions of experiences can tell an interesting story about the phenomenon and the individuals experiencing it. 7 Criticisms of phenomenology tend to focus on the individuality of the results, which makes them non-generalisable, considered too subjective and therefore invalid. However, the reason a researcher may choose a phenomenological approach is to understand the individual, subjective experiences of an individual; thus, as with many qualitative research designs, the findings will not be generalisable to a larger population. 7,8

Table 6.1. Examples of phenomenological studies

Phenomenology focuses on understanding a phenomenon from the perspective of individual experience (descriptive and interpretive phenomenology) or from the lived experience of the phenomenon by individuals (new phenomenology). This individualised focus lends itself to in-depth interviews and small scale research projects.

• Dowling M. From Husserl to van Manen. A review of different phenomenological approaches. Int J Nurs Stud . 2007;44(1):131-42. doi:10.1016/j.ijnurstu.2005.11.026
• Creswell J, Hanson W, Clark Plano V, Morales A. Qualitative research designs: selection and implementation. Couns Psychol . 2007;35(2):236-264. doi:10.1177/0011000006287390
• Morse JM, Field PA. Qualitative Research Methods for Health Professionals. 2nd ed. SAGE; 1995.
• Neubauer BE, Witkop CT, Varpio L. How phenomenology can help us learn from the experiences of others. Perspect Med Educ . 2019;8(2):90-97. doi:10.1007/s40037-019-0509-2
• Merleau-Ponty M, Landes D, Carman T, Lefort C. Phenomenology of Perception . 1st ed. Routledge; 2011.
• Singh J, Wiese A, Sillerud B. Using phenomenological hermeneutics to understand the experiences of managers working with quality improvement strategies in an assisted living facility. Healthcare (Basel) . 2019;7(3):87. doi:10.3390/healthcare7030087
• Liamputtong P, Ezzy D. Qualitative Research Methods: A Health Focus . Oxford University Press; 1999.
• Liamputtong P. Qualitative Research Methods . 5th ed. Oxford University Press; 2020.
• Abbaspour Z, Vasel G, Khojastehmehr R. Investigating the lived experiences of abused mothers: a phenomenological study. Journal of Qualitative Research in Health Sciences . 2021;10(2)2:108-114. doi:10.22062/JQR.2021.193653.0
• Engberink AO, Mailly M, Marco V, et al. A phenomenological study of nurses experience about their palliative approach and their use of mobile palliative care teams in medical and surgical care units in France. BMC Palliat Care . 2020;19:34. doi:10.1186/s12904-020-0536-0

Qualitative Research – a practical guide for health and social care researchers and practitioners Copyright © 2023 by Darshini Ayton is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License , except where otherwise noted.

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8 Advantages and Disadvantages of Phenomenological Research

In broad terms, phenomenological research refers to researching how an individual perceives the meaning of an event, as opposed to how the event exists beyond the perception of people. This form of research endeavors to understand what a group of people felt during a phenomenon. Perceptions, perspectives, and understandings are all going to be analyzed, and then used to create an understanding of what it’s like to experience an event.

Deeply rooted in philosophy, this form of research is certainly not without its benefits. At the same time, there are some downsides you will need to keep in mind.

The Pros of Phenomenological Research

When it comes to phenomenological research pros and cons, here are some of the pros that are important to understand:

1. Unique Perspectives To be sure, there is some value to be found in focusing research on how people perceive an event or phenomena, rather than simply how the phenomena exists in a vacuum.

2. Understanding Perhaps the biggest benefit of phenomenological research is the fact that it can provide us with a profound, detailed understanding of a single phenomena.

3. Rich Data Culled from enough individuals, the data one can receive through phenomenological research is rich and impressive. This is a form of research that allows for a truly unique approach to understanding a phenomena.

The Cons of Phenomenological Research

While there are a number of uses with phenomenological research, you can’t say there aren’t some notable downsides:

1. Subjectivity Establishing the reliability and validity of the approaches can be challenging, which makes subjective research difficult.

2. Bias Researcher-induced bias can influence studies, and this is particularly true with phenomenological research.

3. Pure Bracketing Interference with the interpretation of the data can lead to a number of headaches in trying to establish and maintain pure bracketing.

4. Presentation Presenting the findings of this research is more often than not difficult, if not impossible. The results of such research can prove to be highly qualitative, which makes it hard to present the findings in a fashion practitioners would consider to be useful.

5. Typical Is it even possible with phenomenological research to say that the experiences are typical? Considering the fact that this form of research generally works with small groups, it can be dubious to claim the results are typical in any meaningful way

Qualitative study design: Phenomenology

• Qualitative study design

Phenomenology

• Grounded theory
• Ethnography
• Narrative inquiry
• Action research
• Case Studies
• Field research
• Focus groups
• Observation
• Surveys & questionnaires
• Study Designs Home

Used to describe the lived experience of individuals.

• Now called Descriptive Phenomenology, this study design is one of the most commonly used methodologies in qualitative research within the social and health sciences.
• Used to describe how human beings experience a certain phenomenon. The researcher asks, “What is this experience like?’, ‘What does this experience mean?’ or ‘How does this ‘lived experience’ present itself to the participant?’
• Attempts to set aside biases and preconceived assumptions about human experiences, feelings, and responses to a particular situation.
• Experience may involve perception, thought, memory, imagination, and emotion or feeling.
• Usually (but not always) involves a small sample of participants (approx. 10-15).
• Analysis includes an attempt to identify themes or, if possible, make generalizations in relation to how a particular phenomenon is perceived or experienced.

Methods used include:

• participant observation
• in-depth interviews with open-ended questions
• conversations and focus workshops. 

Researchers may also examine written records of experiences such as diaries, journals, art, poetry and music.

Descriptive phenomenology is a powerful way to understand subjective experience and to gain insights around people’s actions and motivations, cutting through long-held assumptions and challenging conventional wisdom.  It may contribute to the development of new theories, changes in policies, or changes in responses.

Limitations

• Does not suit all health research questions.  For example, an evaluation of a health service may be better carried out by means of a descriptive qualitative design, where highly structured questions aim to garner participant’s views, rather than their lived experience.
• Participants may not be able to express themselves articulately enough due to language barriers, cognition, age, or other factors.
• Gathering data and data analysis may be time consuming and laborious.
• Results require interpretation without researcher bias.
• Does not produce easily generalisable data.

Example questions

• How do cancer patients cope with a terminal diagnosis?
• What is it like to survive a plane crash?
• What are the experiences of long-term carers of family members with a serious illness or disability?
• What is it like to be trapped in a natural disaster, such as a flood or earthquake? 

Example studies

• The patient-body relationship and the "lived experience" of a facial burn injury: a phenomenological inquiry of early psychosocial adjustment . Individual interviews were carried out for this study.
• The use of group descriptive phenomenology within a mixed methods study to understand the experience of music therapy for women with breast cancer . Example of a study in which focus group interviews were carried out.
• Understanding the experience of midlife women taking part in a work-life balance career coaching programme: An interpretative phenomenological analysis . Example of a study using action research.
• Holloway, I. & Galvin, K. (2017). Qualitative research in nursing and healthcare (Fourth ed.): John Wiley & Sons Inc.
• Rodriguez, A., & Smith, J. (2018). Phenomenology as a healthcare research method . Journal of Evidence Based Nursing , 21(4), 96-98. doi: 10.1136/eb-2018-102990
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• Last Updated: Apr 8, 2024 11:12 AM
• URL: https://deakin.libguides.com/qualitative-study-designs

Putting phenomenology in its place: some limits of a phenomenology of medicine

Affiliation.

• 1 Centre for Logic and Analytic Philosophy, Institute of Philosophy, University of Leuven (KU Leuven), Kardinaal Mercierplein 2, Box 3200, 3000, Leuven, Belgium. [email protected].
• PMID: 26576964
• DOI: 10.1007/s11017-015-9345-5

Several philosophers have recently argued that phenomenology is well-suited to help understand the concepts of health, disease, and illness. The general claim is that by better analysing how illness appears to or is experienced by ill individuals--incorporating the first-person perspective--some limitations of what is seen as the currently dominant third-person or 'naturalistic' approaches to understand health and disease can be overcome. In this article, after discussing some of the main insights and benefits of the phenomenological approach, I develop three general critiques of it. First, I show that what is often referred to as naturalism tends to be misunderstood and/or misrepresented, resulting in straw-man arguments. Second, the concept of normality is often problematically employed such that some aspects of naturalism are actually presupposed by many phenomenologists of medicine. Third, several of the key phenomenological insights and concepts, e.g. having vs. being a body, the alienation of illness, the epistemic role of the first-person perspective, and the idea of health within illness, each bring with them new problems that limit their utility. While acknowledging the possible contributions of phenomenology, these criticisms point to some severe limitations of bringing phenomenological insights to bear on the problems facing philosophy of medicine that should be addressed if phenomenology is to add anything substantially new to its debates.

Keywords: Disease; Illness; Naturalism; Normality; Phenomenology; Philosophy of medicine.

Publication types

• Research Support, Non-U.S. Gov't
• Philosophy, Medical*

ORIGINAL RESEARCH article

Living in fear at the unpredictability of mental health issues in the classroom: a phenomenological study of secondary school teachers in encountering students with mental health issues.

• 1 School of Nursing, The Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR, China
• 2 Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, China
• 3 The Interdisciplinary Centre for Qualitative Research, The Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR, China

Background: The prevalence of mental health issues among secondary school students is on the rise. Secondary school teachers, outside the home environment, are often in a prime position to identify adolescents facing mental health challenges. Limited knowledge regarding the experiences and perspectives of secondary school teachers when encountering this particular group of students, particularly in Asian countries.

Objectives: This study aimed to describe the lived experiences of secondary school teachers exposed to students with mental health issues in the classroom in a Chinese context.

Methods: A descriptive phenomenological approach within the tradition of Husserl was used. A purposive sampling method was used to collect the participants in Changsha, Hunan, China. Sixteen secondary school teachers participated in this study. Individual, face-to-face interviews were conducted, tape-recorded, and transcripted. Colaizzi’s seven-step descriptive phenomenological method was used to do the data analysis.

Results: One Central theme: Living in fear at the unpredictability of mental health issues in the classroom and four sub-themes emerged: (1) Worried and anxious by the uncertainty of student mental health issues; (2) Scared and afraid by students’ unpredictable behaviors; (3) Afraid of students’ failure and its potential outcome; (4) Students having mental health issues are dangerous.

Conclusions and implications: The teachers in this study found managing the unpredictability of mental health issues in the classroom deeply distressing and challenging. A comprehensive approach to address the cultural, social, and educational factors influencing secondary school teachers’ experiences is encouraged.

1 Introduction

Over the past few years, there has been a growing global concern regarding the increasing prevalence of mental health issues among secondary school students. This rising trend not only has an impact on the academic performance of students but also affects their general well-being and long-term life outcomes ( 1 ). Abundant research suggests that approximately 20% of adolescents experience a diagnosable mental disorder, and around 50% of all lifetime cases of mental illness commence before the age of 14 ( 2 ). The intricate interaction of biological, psychological, and social factors during the adolescent developmental stage makes teenagers especially susceptible to mental health difficulties. Furthermore, the present-day environment, marked by heightened academic demands, cyberbullying, and societal expectations, has additionally contributed to the escalation of mental health issues among young individuals ( 3 ).

Based on Bronfenbrenner’s ecological systems theory, schools (along with other microsystems, including the family) are the most immediate developmental context for adolescents ( 4 ). Teachers are expected to play a significant role in school mental health. However, previous studies found that secondary school teachers experience the challenges by observing students with mental health issues ( 5 – 7 ). Secondary school teachers mostly rely on their prior training or judgment to identify students with mental health issues ( 8 ). In addition, criteria reported by secondary school teachers in China, such as “tired of learning”, “rebellious”, and “falling in love” at a young age, none of these would be considered to be a symptoms of mental illness by mental health professionals, however, some established signs of mental illness appeared to be normalized by some teachers, such as “self-harm” ( 9 ). Indeed, secondary school teachers were just trying their best to identify students with mental health issues despite not knowing what they were doing. Therefore, it is vital to explore their lived experience when encountering adolescents with mental health issues.

Although Western scholars have used a variety of qualitative research methods to examine teachers’ experiences from different perspectives, limited studies have been conducted in the Asian context. The Chinese government has recognized the importance of mental health in schools and has implemented various policies to promote mental health well-being. However, the school mental health system in China faces several challenges: There is often a shortage of trained mental health professionals in schools, the quality and availability of mental health services can vary significantly between different regions and schools. Moreover, as there is a difference in the education system and culture in the Chinese context, the secondary school teachers’ experience of encountering students’ mental health in China could be very different. Therefore, this study aims to understand secondary school teachers’ lived experiences of encountering students with mental health issues in a Chinese context.

2.1 Research question

What is the experience of encountering students with mental health issues in the classroom?

Based on Husserlian descriptive phenomenology ( 10 ), this study aims to understand the essence of encountering students with mental health issues based on the lived experience of secondary school teachers. This study was conducted in Changsha City, Hunan, China. China is a country where public education is the mainstay, with approximately 82% of students enrolled in public institutions. Therefore, secondary school teachers interviewed for this study all come from public schools in Changsha City.

2.3 Data collection and sampling

To select the participants for this study, purposive sampling was used. The inclusion criterion for this study was individuals who were particularly familiar with or experienced in a relevant phenomenon. In this context, the relevant phenomenon refers to secondary school teachers who had supported students with psychological issues ( 11 ). Sixteen secondary school teachers voluntarily participated in the study. Each participant was invited for a 45–60 minute face-to-face interview, which was audio-recorded. Subsequently, the recorded interviews were transcribed verbatim, and the accuracy of the transcripts was verified by comparing them with the original audio recordings. The interview had been completed when data saturation is achieved. Saturation means there was a sufficient understanding of the phenomenon. The interviews were conducted by the first author, who used to work as a psychiatric nurse in a public hospital. The study received ethical approval from the Hong Kong Polytechnic University’s Human Research Ethics Committee (HSEARS20221215002).

2.4 Data analysis

The transcripts underwent an initial reading using Colazzi’s seven-step analysis method to gain a comprehensive understanding of the data ( 12 ). Phenomenological reduction was employed during this stage to ensure that the author’s personal experiences did not influence the interpretation of the data. Following Whitting’s approach, meaningful units within the transcripts were identified, leading to the development of significant statements ( 13 ). These statements were then formulated into meaningful themes, which were further organized into theme clusters. Ultimately, a central theme emerged from the analysis. Throughout this process, reflection was crucial in ensuring that the formulated meanings, sub-themes, and central themes accurately reflected the phenomenon being investigated (refer to Appendix Table 1 for further details).

3.1 Participants’ socio-demographic characteristics

The mean age of secondary school teachers was 40.06 years old, and the mean teaching period in secondary school was 16.63 years. There were 11 female teachers and 5 male teachers. The teaching subjects were Math, English, Biology, Physics, Chemistry, Geograph, Computer, Political, etc. ( Appendix Table 2 ).

3.2 Findings regarding secondary school teachers’ experiences

One central theme was formed: living in fear at the unpredictability of mental health issues in the classroom. Four sub-theme were: “Worried and anxious by the uncertainty of student mental health issues”; “ Scared and afraid by students’ unpredictable behaviors”; “ Afraid of students’ failure and its potential outcome”; “Students having mental health issues are dangerous”.

3.2.1 Worried and anxious by the uncertainty of student mental health issues

The participant highlighted the uncertainty of when these students may face problems. Many of them acknowledged that initially, they may not be aware of the students’ mental health issues. Some of the participants further explained that under normal circumstances, students with mental health issues tended to exhibit reserved behavior in the classroom. The participant described those students as a “transparent” presence in the classroom, meaning that they were easily overlooked or blended into the background. This can be challenging for teachers as they may not be fully aware of the specific challenges these students face or how their mental health issues may manifest. As a result, it became difficult for teachers to anticipate or predict the situations that may arise when these students were dealing with mental health problems. As Guoa and Luo stated:

You never know when they might encounter problems. Therefore, you must constantly pay attention to them. Initially, we may not be aware that these children have mental health issues. (Guo) In regular circumstances, due to his classroom behavior, he tends to be introverted. However, his behavior does not significantly impact the overall pace of the class or the teacher’s instruction. In the classroom , he is not the type to actively participate in answering questions, but he also does not disrupt the order of the class. Therefore, in the classroom, he somewhat resembles a ‘transparent’ presence. (Luo)

The teacher also expressed surprise and a sense of disbelief because the unwell student did not exhibit any previous indications or signs of mental health issues. They acknowledged that educators may not possess the professional expertise to fully comprehend what was happening inside a student’s mind. Additionally, they noted that another challenging part was that issues could only be identified after they had already happened. As Liao said:

I was surprised because the student did not show any signs of this situation before. I genuinely thought he was a normal person. Usually, whether he was interacting with teachers, other children, or classmates, he appeared very normal and behaved in a typical manner. (Liao)

Moreover, the participant expressed a genuine feeling of being overwhelmed and inadequate in handling the situation when students had suicidal thoughts. They mentioned that the suicide attempt signs were extremely subtle, especially given the heavy workload of being a teacher. They felt that the sheer volume of tasks makes it difficult to effectively address the subtle signs exhibited by students. Additionally, they highlighted that students did not directly seek help in an obvious manner but instead hint at their issues indirectly. As a result, the participant found it particularly challenging to navigate the complexities of the situation. As Chen mensioned:

I genuinely feel that I am unable to handle it because it’s simply impossible to find out, right? Some signs are subtle, especially with the workload of being a head teacher being so heavy. There are various tedious tasks, constant complaints, numerous activities, meetings to attend, and still the need to teach classes. There are just too many things to handle. It is really difficult to effectively address these subtle signs because the students won’t directly seek help in an obvious manner. They will only hint at the issue indirectly. So, it becomes quite challenging, I believe it is quite challenging. (Chen)

3.2.2 Scared and afraid by students’ unpredictable behaviors

The participants like Hu, expressed her lack of comprehension and confusion regarding self-harm. She stated that she did not understand why this particular emotion and behavior had emerged. She questioned the motive behind self-harm, as she believed that hurting oneself would naturally cause pain. The participant further expressed her inability to grasp why some students would resort to cutting their wrists as a form of self-harm.

I don’t understand. I don’t know why this emotion arises. I mean, why? Doesn’t hurting oneself cause pain? Why would someone resort to self-harm? I don’t understand why someone would want to cut their wrists. (Hu)

Xie also described being greatly scared by the severity of the situation when she received a letter written in blood. Xie was concerned about the student’s health and mental state, recognizing that the act of writing such a letter may indicate significant distress and a cry for help. Additionally, the sight of blood and the disturbing nature of the situation evoked feelings of disgust and nausea in Xie. As she said:

I was scared. There was one time when I received a letter written in blood. She said she wanted to go home and handed it to someone else. When I saw that blood, I couldn’t even dare to open my eyes. It was truly nauseating to see it. (Xie)

Others like Yang expressed profound shock and disbelief at how the students reached a state where they took their own lives. The participant was left with a deep sense of confusion, questioning what thoughts might have been going through the students’ minds and how they arrived at such a drastic decision. Yang struggled to understand the complex factors that led to such a tragic outcome and the lasting impact it had on them. As he said:

I am deeply shocked by how this young person ended up in such a state (commit suicide). He had a promising future ahead, yet he didn’t seem to value his own life. How could a person become like this? What thoughts were going through his mind? How did he come to make such a drastic decision? This profound shock lingers in my heart. (Yang)

3.2.3 Afraid of students’ failure and its potential outcome

Participants believed that mental health issues had an impact on students’ learning abilities. They observed that students with mental health problems tended to be introverted and face challenges in their studies. At the same time, participants agreed with parents’ perspectives that lower expectations for students’ academic performance. Others expressed the belief that the child previously had the potential to be admitted to a more prestigious school, but their mental health issues hindered their academic progress. As Peng stated:

Because he has mental health issues, his learning abilities are naturally affected. From what I observed, including one very introverted student in the class, his learning abilities have always been in this state since childhood. His parents also don’t have high expectations for him. (Peng)

Some participants indicated a concern about the student’s ability to cope with adversity and negative feedback. They expressed their observation that the psychological resilience of the students they teach was relatively low. The students tended to attribute setbacks solely to external factors, such as difficult exam questions, instead of their understanding and mastery of the knowledge. The participants further highlighted that these students were more responsive to praise and encouragement, but they found it difficult to effectively handle criticism. Indeed, some participants observed that the students displayed weaker psychological resilience in urban cities and lots of students lacked any significant personal responsibilities for their families’ tasks or chores. As Li said:

Some students may have difficulty accepting setbacks and failures. I feel that the psychological resilience of the students we teach is quite low, which may be closely related to their experiences in junior high school. They are only receptive to praise and encouragement, but they struggle to handle criticism. If you try to criticize or provide feedback, they tend to have significant stress reactions. (Li)

Other participants expressed their concern about a prevalent trend within the education system. The participants expressed a sense of frustration and acknowledged the existence of a general atmosphere among educators characterized by fear of potential issues and a reluctance to address students’ weaknesses. This atmosphere resulted in a lack of constructive criticism and hesitancy in providing feedback that could contribute to students’ growth and improvement. The teacher also noted a shift in the perspectives of the student’s parents, who now prioritize encouragement above all else. As Yangmensioned:

We all have become only focused on discussing the strengths of students and dare not talk about their weaknesses. This situation exists throughout the entire education system, including what I have observed in other schools and our school. It seems that there is a general atmosphere among teachers where they are afraid of potential issues and hesitant to criticize or talk about students’ shortcomings. (Yang)

3.2.4 Students having mental health issues are dangerous

Some teachers highlighted that when students with mental health issues were faced with triggering events or circumstances, their ability to regulate their emotions becomes greatly compromised. This can manifest as intense emotional outbursts, difficulty managing anger or frustration, feeling overwhelmed by sadness or anxiety, and even self-harm or suicide. Others noted that students facing mental health challenges displayed reluctance to share their problems with others. This hesitance can create a situation where emotions and experiences were suppressed over an extended period, potentially resulting in a dangerous build-up, comparable to a hidden time bomb. Some participants worried about their safety and were afraid that the student might physically assault them or engage in other aggressive behaviors. As Wang and Zhu described:

Students with mental health issues are similar to normal individuals when nothing has triggered their emotions. However, if something happens that triggers an emotional explosion, their emotional control becomes extremely poor. (Wang) I believe this is a mental health issue. Many people are reluctant to share their mental health problems, experiences, and thoughts with others to have effective communication. As a result, this problem remains like a time bomb. (Zhu)

The majority of the participants felt they were concerned about the safety of students both during school hours and beyond. For example, some participants mentioned that they had noticed an increase in her phone usage, both at school and at home. On the other hand, Luo also expressed concern about a student’s absence from the classroom and the potential risks or dangers that the student may face outside of the school environment. Some of the participants expressed their genuine fear regarding the possibility of their students engaging in self-harm unexpectedly. Others, like Chen, also spoke of her fear and worry when a student openly expressed thoughts of self-harm or suicide in front of her.

The first time he disappeared was during our orientation program when he just entered the first year of middle school. He went missing for the whole afternoon, and that was the first time I faced his situation of being absent. At that moment, I felt very worried, and my mind was filled with thoughts of news stories about such incidents. I was afraid that something bad might have happened, and I felt a sense of fear. (Luo) He sat there and said, “The teacher wants me to stay, but I might just jump from here.” He said it right in front of me, and I was quite scared at that moment because I was genuinely afraid that he might be unstable and do such a thing. (Chen)

Some participants expressed concerns about the potential consequences that may arise if safety issues occur. Participants were genuinely concerned that their reputation and professional image would be damaged as a result. Others recognized that the loss of a student’s life affected the entire school community. Some explained that since they were all located on the same floor if a student from an adjacent class experiences a mental health problem or difficulty, it would inevitably have an impact on the students in the neighboring class. As Peng shared:

If a serious issue arises, particularly involving personal harm, it would greatly impact me in terms of my reputation. Since I will be staying in this institution for many years, should I prioritize the preservation of my professional image? (Peng) I feel a bit worried myself. I’m afraid that the student might engage in more intense behaviors towards me in the future. Because he is a boy, I perceive him as having significant physical strength and height, which added to my apprehension. I was afraid that he might strike me or engage in other aggressive behaviors towards me. (Peng)

Having taught students with mental health problems, teachers were inclined to amplify the students’ problems. For example, when they noticed that a student was exhibiting some unusual behavior or phenomena, they became overly concerned about the problem and tended to amplify it. Other participants felt anxious and concerned about the prospect of having a student with mental health issues appear in their classroom again. They anticipated that it could be a challenging experience, causing them distress and making it difficult to manage the student’s behavior or academic performance. As Yang and Liao articulated:

As soon as you see that the student has some abnormal behavior, you will think in that way, that is, it is easy to expand this matter. It is easy to cause sensitivity and hypersensitivity. (Yang) I don’t know if the student (with mental health issues) will be assigned to my class next semester. If they are, I feel it would still be tormenting. If they are not in my class, perhaps they would be a torment for another teacher. (Liao)

4 Discussion

Mental health issues in the classroom for the secondary school teachers in this study were unpredictable — something they were unaware and students usually did not show any signs. They did not know what signs or symptoms they should be looking for, especially for the signs of attempting suicide. Besides being unaware of the mental health issues, factors such as class size and the subject matter of the course seemed to affect faculty members’ capacity to identify and assist students with mental health illnesses. For instance, due to the class size ranging from 50 to 60 students, participants in our study tend to pay more attention to students at the top, who excel in various aspects such as academic performance, or students at the bottom, who struggle with poor grades and disciplinary issues. However, students who fall in the middle receive comparatively less attention from teachers, making it even more challenging to predict whether this group of students may have mental health issues. The participants in Kalkbrenner’s study also highlighted the challenges of recognizing students facing mental health illness in a large lecture hall (150 students) compared to a smaller classroom setting (10–15 students) ( 14 ). Like Buchanan, secondary school teachers decided to assume that every student in the school might be experiencing some form of crisis due to the impossibility of accurately identifying all at-risk students ( 15 ). Due to the uncertainty of students’ mental health issues, teachers in our study felt astonished when they aware certain students had mental health issues. Buchanan also found that secondary school teachers expressed shock and surprise upon being informed about the attempted suicide, particularly because they did not expect such an incident to occur and did not know the student even had emotional problems or issues at all ( 15 ).

Despite the difficulty in identifying students with mental health issues, teachers were afraid of unwell students’ failure and its potential impact on the classroom. Teachers observed the psychological resilience of the students was relatively low, students tended to attribute setbacks solely to external factors and had difficulty in handling criticism, they behaved indifferently and broke the school regulations and rules without any sense of concern, and they even lacked responsibility for the home chores and tasks in their family, especially for the students in the urban Changsha city. Therefore, teachers concerned about unwell students impacted other students, and worried about their ability to adjust and overcome challenges as they transition into society in the future. There was also a perception that university students today are less resilient compared to previous generations ( 16 ). Furthermore, if children’s social, emotional, and behavioral challenges were left unaddressed, it could hindered their ability to learn and thrive academically ( 17 ).

Despite their fear of student failure and the adverse effects on the classroom and school environment, teachers harbored fear towards students with mental health issues due to concerns for their safety and the potential negative impact on their professional reputation. On the one hand, they expressed apprehension that the student’s behavior might escalate and become more severe. The teachers were particularly concerned about their own safety and harbored fears of potential physical assault or other aggressive actions from the students. Some college teachers in Allie White’s study also justified their reluctance to initiate conversations about university students’ mental health, as they harbored concerns that such discussions could potentially trigger violent behavior from the students ( 18 ). They feared that addressing a university student’s mental health could lead to aggression towards the faculty member, themselves, or others—both during and after the conversation initiated by the teacher ( 18 ). On the other hand, teachers expressed apprehension regarding the potential ramifications that could arise from significant incidents, especially those related to students’ safety. Therefore, they were genuinely concerned that their reputation and professional image would be negatively impacted as a result. In addition, three adolescents in Tally Moses’s study also reported that teachers were afraid of adolescents because of their emotional or behavioral volatility ( 19 ).

One special facet of this theme, different from the participants in Buchanan’s study, experience with student suicide seemed to make secondary school teachers less shocked and more realistically address the subsequent occurrences of suicide ( 15 ). For secondary school teachers in our study, they were concerned about teaching students with mental health issues in the future. The teacher experienced anxiety and apprehension regarding the potential arrival of a new student with mental health issues in their classroom. They anticipated that this situation could present significant challenges, leading to personal distress and making it difficult to effectively handle the student’s behavior and academic performance.

The lived experiences of secondary school teachers encountering students with mental health issues in China were influenced by various cultural, social, and educational factors. In China, there is a social stigma attached to mental health issues, and many teachers fear admitting their struggles due to concerns about professional image and social perception ( 20 ). The “zero-COVID” policy in China has also been noted to contribute to increased pressure on teachers and students, impacting mental well-being. Moreover, the traditional exam-oriented education system in some parts of China has been identified as a factor contributing to the mental health challenges faced by both students and teachers ( 21 ). On the other hand, the reasons for increasing mental health issues in adolescents in China were exam-oriented education system, parental expectations, and cultural and societal stressors, stigma and misconceptions, which were different from Western countries, such as social media and technology, adverse childhood experiences, access to mental health services ( 22 , 23 ). Therefore, those differences highlight the need for a comprehensive approach to address the cultural, social, and educational factors influencing secondary school teachers’ experiences in facing students with mental health issues. Our study provide the evidence for future study and interventions.

4.1 Implications

The secondary school teachers in this study found managing the unpredictability of mental health issues in the classroom deeply distressing and challenging. The worry about student safety calls for a dual approach: improving teacher preparedness through specific training in crisis management and enhancing proactive measures within schools to identify and support students at risk before crises occur. Such training should include simulation-based learning, which could help reduce the shock factor by providing realistic scenarios for teachers to engage with in a controlled environment. Future research should explore the effectiveness of proactive mental health programs in reducing both student incidents and teacher anxiety.

4.2 Strength and limitations

There are some limitations to interpreting our study findings. The secondary school teachers all came from Changsha City in China, making the findings inapplicable to secondary school teachers in other cultures. However, the strength is that our study is the first study to use a descriptive phenomenological design to explore the lived experience of secondary school teachers in encountering students with mental health issues in a Chinese context.

5 Conclusion

The participants in our study described their feelings of uncertainty about whether students had mental health issues and found it challenging to identify students who may have such issues, leading to the potential overlooking of students with mental health problems. They also notice a decreased psychological resilience among current students. Over time, teachers begin to develop an understanding of students’ mental health issues and their impact on the classroom, they grow increasingly concerned that mental health issues as dangerous. Our recommendation is for adolescents to enroll in at least one course per semester that has a small class size, typically consisting of approximately 25 students or fewer. This approach can foster more frequent interactions between secondary school teachers and students. Additionally, the finding of our study that teachers’ experience of living in fear when encountering students with mental health issues encourages secondary school nurses to develop questionnaires and interventions for future studies.

Data availability statement

The original contributions presented in the study are included in the article/supplementary material. Further inquiries can be directed to the corresponding author.

Ethics statement

The studies involving humans were approved by Hong Kong Polytechnic University’s Human Research Ethics Committee. The studies were conducted in accordance with the local legislation and institutional requirements. The participants provided their written informed consent to participate in this study.

Author contributions

ML: Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Writing – original draft, Writing – review & editing. GH: Conceptualization, Supervision, Writing – review & editing. MC: Conceptualization, Formal analysis, Methodology, Supervision, Validation, Writing – review & editing.

The author(s) declare that no financial support was received for the research, authorship, and/or publication of this article.

Conflict of interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Publisher’s note

All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.

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Table 1 Living in fear at the unpredictability of mental illness in the Classroom – From Formulated Meaning to Central Theme.

Table 2 The demography of the secondary school teachers participated in the interviews.

Keywords: secondary school, mental health issues, phenomenology, qualitative study, teachers

Citation: Liang M, Ho GWK and Christensen M (2024) Living in fear at the unpredictability of mental health issues in the classroom: a phenomenological study of secondary school teachers in encountering students with mental health issues. Front. Psychiatry 15:1367660. doi: 10.3389/fpsyt.2024.1367660

Received: 09 January 2024; Accepted: 30 April 2024; Published: 15 May 2024.

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Copyright © 2024 Liang, Ho and Christensen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Mining Liang, [email protected]

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Cured but not well — haematological cancer survivors’ experiences of chemotherapy-induced peripheral neuropathy in everyday life: a phenomenological-hermeneutic study

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• Published: 14 May 2024

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• Mette Louise Roed   ORCID: orcid.org/0009-0005-8824-6172 1 ,
• Marianne Tang Severinsen   ORCID: orcid.org/0000-0003-0996-1812 1 , 2 ,
• Eva Futtrup Maksten   ORCID: orcid.org/0000-0002-9338-997X 1 , 2 ,
• Lone Jørgensen   ORCID: orcid.org/0000-0002-4197-3066 2 , 3 , 4 &
• Helle Enggaard   ORCID: orcid.org/0000-0002-9710-8768 2 , 3 , 4  

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To explore haematological cancer survivors’ experience of chemotherapy-induced peripheral neuropathy (CIPN) in everyday life.

Data were generated by means of individual semi-structured interviews with 12 haematological cancer survivors who experience CIPN after completion of treatment. Data were analysed using thematic analysis.

The thematic analysis yielded an in-depth description of the experience of CIPN symptoms and the influence of the symptoms on everyday life as being unwell despite being cured. Four main themes emerged from the analysis: (1) A diffuse and contradictory sensation which is impossible to ignore in everyday life , (2) Not feeling well, even though I’m cured , (3) Living with CIPN, despite limitations , and (4) An invisible companion, that everybody knows about.

The findings shows that survival from haematological cancer does not always equal well-being, as experiencing CIPN has extensive consequences on everyday life. CIPN affects haematological cancer survivors’ transition to an ordinary everyday life, with disturbances in the physical function, daily activities, social relationships, psychological aspects, and work ability. As a diffuse and contradictory symptom, CIPN appears as an invisible companion that leads to a feeling of being alone.

Implications for Cancer Survivors

A better and deeper understanding of haematological cancer survivors’ experience of CIPN in everyday life may improve communication, guidance, and treatment of CIPN symptoms. The results suggest a need for interventions and strategies to accommodate the gap in practice and to address the impact of CIPN in everyday life.

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Introduction

Survivorship among patients diagnosed with haematological cancer is of increasing importance due to improved treatment options and long-term survival [ 1 , 2 , 3 ]. Chemotherapy is an integral part of haematological cancer treatment, but for some survivors, it may affect the nervous system resulting in sensory, motor, and autonomic disturbances, overall described by the term chemotherapy-induced peripheral neuropathy (CIPN) [ 4 , 5 ]. Although it is well known that CIPN can affect haematological cancer survivors, we lack knowledge of the influence it may have on the survivors’ everyday life.

CIPN has developed into a widespread late effect of chemotherapy, affecting more than one-third of all haematological cancer survivors even after end of treatment [ 6 ]. The symptoms may develop during treatment and may occur months or years after cessation of chemotherapy [ 4 ]. CIPN is a potentially debilitating late effect which arises in the upper and lower extremities and include symptoms like pain, tingling, numbness, burning, hypersensitivity to cold and heat, and problems with balance, walking, and tasks requiring motor skills [ 7 , 8 ]. Current research shows that CIPN has a negative impact on quality of life among haematological cancer survivors because the symptoms cause disturbances in the physical function, daily activities, social relationships, psychological aspects, and work ability [ 9 , 10 , 11 , 12 , 13 ]. Despite this, its significance remains under-researched among haematological cancer survivors. In addition, no convincing evidence about how to prevent, reduce, or treat CIPN is available and CIPN remains a challenge for survivors as well as healthcare professionals [ 5 , 8 ]. At present, only duloxetine is a recommended treatment for the painful CIPN [ 14 , 15 ].

A meta-synthesis on cancer survivors’ experiences of CIPN after treatment completion shows that CIPN has an impact on many aspects of everyday life [ 16 ]. However, in this meta-synthesis, only two of the 13 studies included haematological cancer survivors [ 17 , 18 ]. These two studies showed that cancer survivors with CIPN experienced several emotional challenges such as feelings of isolation, frustration, depression, and loss of purpose, due to the inability to perform daily activities [ 17 , 18 ]. CIPN was described as a background noise and as a constant reminder of the cancer disease [ 17 ]. Even as a background noise, CIPN was distracting and demanding, affecting the emotional and physical well-being, and interfering valued activities, relationship with friends, family, and work, and the ability to participate in daily activities [ 18 ].

The above findings suggest that CIPN has serious consequences on the physical, psychological, and social aspects of haematological cancer survivors’ everyday lives. However, these studies [ 17 , 18 ] did not only study the perspectives of haematological cancer survivors but also survivors of various cancer types. Furthermore, it is difficult to distinguish whether there is a difference between the different groups and their experience with CIPN in everyday life. The current research does not make sure to inform healthcare professionals sufficiently of how it is to live with CIPN. This study aims to explore and gain an understanding of haematological cancer survivors’ experience with CIPN in their everyday life.

Methods and design

This qualitative study employed thematic analysis of semi-structured interviews with haematological cancer survivors to explore their experiences of living with CIPN. A phenomenological-hermeneutic approach was used to obtain in-depth descriptions of CIPN and interpret the meaning through prominent themes. The phenomenological approach is based on the philosopher E. Husserl’s phenomenological philosophy of pure descriptions of a given phenomenon [ 19 ] and guided the data collection. The hermeneutic approach is based on the philosopher Hans-Georg Gadamer’s hermeneutic philosophy, where understanding is an interpretation [ 20 ], processed in a thematic analysis [ 21 , 22 ]. The study is reported according to consolidated criteria for reporting qualitative research (COREQ) [ 23 ] as shown in the supplementary file (Supplementary file 1 ).

Setting and participants

The participants were recruited from a Haematological Outpatient Clinical at a public Danish University Hospital and the Danish Patient Association of Late Effects. Purposeful sample strategy [ 24 ] was used to recruit participants with experiences relevant for aim of the study, and physicians were used as gatekeepers in the outpatient clinic. Convenience sampling was also applied [ 24 ], as participants also were recruited from the patient association by a posting on their social media. The inclusion criteria were adults ≥ 18 years, who had received neurotoxic chemotherapy for a haematological cancer disease (i.e. lymphoma, multiple myeloma, or leukaemia). They had been assessed by a physician or themselves having tingling, burning, numbness, stinging, or painful sensations in the lower and/or upper extremities — symptoms that were not present prior receiving cancer treatment. Furthermore, they had to be able to read and speak Danish. The exclusion criteria were participants with pre-existing neuropathy, e.g. related to diabetes or neurological diseases unrelated to chemotherapy, and participants with cognitive impairment.

Data collection

The semi-structed interviews were conducted between March and July 2023, at a time and location (home, hospital, online, or by phone) chosen by the participants, with the purpose of creating a safe atmosphere allowing the participants to express themselves freely [ 25 ]. A semi-structed interview guide based on open-ended questions was used to capture the participants’ experiences of everyday life with CIPN, see Table 1 . An open and naïve approach was used to (further) explore the participants’ responses, paying attention to their non-verbal communication and asking probing questions, e.g. by using mirroring and paraphrasing. The interviews were conducted by the first author (nurse with a master’s degree and with experienced haematological nursing). The first author had no former relationships with the participants prior to study commencement, and no one else was present during the interview besides the participant and the interviewer. The interviews were audio recorded and lasted from 31 to 63 min (average 43 min).

Data analysis

The interviews were transcribed verbatim, and data were analysed using thematic analysis in a six-phase data-driven process inspired by Braun and Clarke [ 21 , 22 ]. The thematic analysis is a method for identifying, analysing, and reporting themes that turn out to be important to the study aim and is closely related to the data [ 21 ].

In phase one, the first author listened to the interviews and read the transcripts several times to become familiar with the wide and depth of the data. In phase two, initial codes were generated manually by reading the transcripts line by line. In this phase, quotes relevant for the study aim were assigned one or more codes and a coding tree was produced, see Table  2 . In phase three, three of the authors (MLR, LJ, and HE) searched for patterns across all coded data and formulated tentative themes. In phase four, the tentative themes were discussed in an iterative process between the previous phases to clarify and present the essence of each theme. This process led to four themes. In phases five and six, the themes were refined. Themes were defined and named, and quotes assigned to each theme were interpreted and transformed into descriptions supported by selected quotes.

Ethical consideration

The study complies with the ethical guidelines for research of The Nordic Nurses Federation [ 26 ] and the Helsinki Declaration [ 27 ]. Approval from the National Ethics Committee was not required, as interview studies not including human biological material do not have to be reported according to Danish legislation [ 28 ]. The participants were informed orally and in writing about the study and signed an informed consent before the interview. The participants were informed that participation was voluntary, and they were guaranteed anonymity and the right to withdraw from the study. Data was stored securely and was only accessible to the researchers.

12 participants in total contacted or were referred to the first author (MLR) and all consented to participate in the study. They represented diversity in age, gender, social status, working status, haematological cancer, and time since treatment cessation, see Table  3 .

The interviews were conducted at the participants’ private homes ( n  = 4), or at the hospital in a suitable room ( n  = 3), online via Zoom ( n  = 3), and on the phone ( n  = 2). Despite the variation in the participants including the time since treatment sessions, they all experienced that everyday life had been changed by CIPN, which is described in the four themes: (1) A diffuse and contradictory sensation which is impossible to ignore in everyday life , (2) Not feeling well, even though I’m cured , (3) Living with CIPN, despite limitations , and (4) An invisible companion that everybody knows about . Although the four themes are presented as separate themes, they must be seen as a unified entity in response to the aim of the study.

A diffuse and contradictory sensation which is impossible to ignore in everyday life

This theme describes and gives an understanding of how the participants perceived CIPN as a diffuse and contradictory sensation which was impossible to ignore in everyday life.

The participants had difficulty putting CIPN into words. Some participants struggled to describe the experience of CIPN and used words like “strange” and “weird”, and others could not express what CIPN feels like. One participant said: “ It’s that diffuse thing you can’t describe .” (ID 1). Other used words such as “ frozen fingers and toes ”, “ swollen and sunburnt hands ”, and “ numbness ”, “ burning ”, “ prickling ”, and “ tingling ” sensations in hands and feet to describe CIPN. Some participants even described CIPN as if the skin was penetrated by knives, glass, gravel, stones, or needles. One participant said: “ It’s prickling and tingling, as if thousands of needles are stuck in me .” (ID 8). The participants used metaphors to be able to explain their experiences of CIPN that they otherwise had difficulty expressing.

Moreover, the participants generally experienced CIPN in their hands and feet and highlighted that they felt hypersensitive and numb at the same time. “ It’s like they’re [the feet] hypersensitive, and at the same time I’ve lost some of the feeling in them. How does it sound? Sounds silly, right? ” (ID 6). Experiencing contradictory sensations of CIPN simultaneously indicated the diffuse sensation of CIPN. In addition, the participants highlighted that although their hands and feet looked normal, they felt enlarged, swollen, and tense. One expressed the experience as follows: “ Sometimes I must look down at my feet. It feels like my feet are swollen. So tense, you know. But they are not. They are completely normal. But it’s feeling .” (ID 6). The participants described a contradiction which illustrated how they experienced their bodies different from the way it physically appeared to them. This indicates that the experience of CIPN contains a contradiction between the physical body and the perception of the body, which seems difficult for the participants to relate to in their everyday life.

Furthermore, the participants described that they were conscious of CIPN all the time — both day and night. One said: “ They [the sensory disturbances] are there more or less all the time.” (ID 7). CIPN was present even when they were resting: “I feel them [the sensory disturbances] from the moment I open my eyes in the morning. I’m never in doubt that I have legs or hands. Because they are there all the time. And at night. I feel it 24 hours a day .” (ID 8). CIPN was also present when they were active. One participant expressed his experience of walking: “ It is like walking on broken glass. It simply hurts my feet so much that I cannot do it .” (ID 2). This indicates that the participants’ awareness was constantly focused on these sensations of CIPN that was always present and impossible to ignore in everyday life. In this way, CIPN affected several aspects of everyday life for haematological cancer survivors — as a diffuse and contradictory sensation which was all pervading.

Not feeling well, even though I’m cured

This theme illustrates the participants’ experience of being cured of a haematological cancer disease, and at the time same feeling unwell due to CIPN.

Not feeling well, despite being cured, was highlighted by the participants in different ways. One said: “ I was not aware that there could be this [CIPN] afterwards. The focus is to get well, but I’m surprised that you get ill from the treatment you have received .” (ID 3). Having CIPN as a consequence of the cancer treatment was unexpected to some of the participants and CIPN made them feel unwell. Others described CIPN as the price for being cured: “ It’s a price. It’s a price you pay to be allowed to be here .” (ID 7). Although the participants were thankful for being alive, they still felt that CIPN impacted their life. One participant said: “ It [CIPN] should not overshadow the rest of my life. It’s only good to have it. Life .” (ID 4). This indicated that CIPN was a downside of being cured of haematological cancer. For others, CIPN had constantly reminded them that they had suffered from haematological cancer. One participant said: “ You’re reminded of it [that I had cancer] every single day, and you just hope that it [CIPN] will get better .” (ID 3). This indicated that CIPN became an eternal reminder of their haematological cancer because CIPN was a consequence of the cancer treatment.

The participants described different activities of everyday life that were no longer possible or were negatively impacted due to CIPN. They talked about being restricted, which made them feel like they were still ill. “ I am restricted in terms of movement. There are many things, which just can’t be done anymore. It makes me feel like I’m still ill. It’s terrible that you can’t do the things that you have done before .” (ID 4). For several participants, CIPN prevented them from doing basic physical things like walking, due to problems with balance, fall, or cramps. One formulated it as follows: “ Something like going for long walks. I can’t do it anymore. I get so many cramps that I can’t move at all. It is one of the things I’m sad about, because I liked going for walks .” (ID 8). Others described reduced fine motor skills affecting their ability to dress and do household duties, like cooking, doing the laundry, and cleaning. In addition, to affecting the physical dimension, CIPN also affected the psychological and social dimensions of everyday life. Several described that their everyday life was characterised by lack of sleep due to cramps, and others could no longer participate in their leisure activities. One participant who used to enjoy her work as a chef was no longer able to work due to CIPN in her hands. “ It actually means a lot to me, that I can’t do this anymore [work] .” (ID 3). The changes in everyday life affected the participants’ physical, psychological, and social well-being. Having CIPN forces the participants to see themselves in a new way. Some are preoccupied with the things they can no longer do; others find alternative ways of living in everyday life. These contrasts illustrate an everyday life with bodily limitations, which clarify the participants’ new ways of being in the world as being unwell, despite being cured.

Living with CIPN, despite limitations

This theme demonstrates how the participants in different ways are living with CIPN in their everyday life.

Several participants used a variation of the phrase: “ I’ve learned to live with it ” to illustrate how they cope with CIPN in everyday lives. Some expressed that they had to adapt their everyday life, where pain was constantly present. “ I have learned to live with the pain being there all the time. Now four years have passed and that’s how it is. You learn to live with it .” (ID 2). This indicated that some participants accepted pain as a part of their everyday life. Others tried to live their everyday life in a way where they were not limited by CIPN. “ I do what I can possibly do. I will not be limited .” (ID 8). The participants used different approaches to handle CIPN and showed how they did things differently to avoid that CIPN limited them in their everyday life. They talked about ignoring, controlling, or minimising the negative impact of CIPN. One woman described how she tried to control her everyday life: “ If it doesn’t work out in one way, it might work out in another way. Why should we make restrictions if we can do it another way .” (ID 7). This strategy shows that some participants adjusted or modified their everyday life to minimise CIPN’s negative impact. Others planed their everyday life around CIPN, as they were conscious about how different activities increased or minimised the symptoms of CIPN. For example, they planned periods of rest as a perquisite for being able to participate in physical and social activities. “ I try to plan my everyday life when I am active. Then I am thinking in the long term. How can I relieve [my body] to complete this [activities]? ” (ID 9). The participants tried to do the things they valued in everyday life by planning and knowing that it had consequences. This balance between rest and activity required adaption, stubbornness, and fragility.

Although several participants described how they endured the pain of CIPN, they also expressed worries about CIPN. One participant reflected: “ Will it get even worse? ” (ID 10). The participants were worried whether the symptoms of CIPN would get worse, change, or never disappear. Some told that knowing about CIPN helped them minimise their worries. One participant said: “ I know what it is. If I know what it is, it’s not like I’m going to worry about it. I know where it comes from and why .” (ID 1). This indicates that worries about the long-term impact on CIPN also affected their everyday life and that some could manage these worries but also endure CIPN by knowing about CIPN.

An invisible companion that everybody knows about

This theme shows that CIPN is like an invisible companion that everybody knows about, but not always understand or address, which made the participants feel alone with CIPN.

The participants did not experience that others understood how CIPN impacted their everyday life. One participant said: “ Sometimes I think that if only there were others who could understand how … those in my surroundings. If only they had to try one day [to have CIPN]. Just one day, so they would know how it’s like .” (ID 7). Being the only one who fully understand how it’s like to have CIPN seems to make the participants feel alone with CIPN. The fact that others cannot fully understand what it is like to have CIPN seemed to reinforce the participants’ feelings of being alone with CIPN and the consequences it has for their everyday life.

Several participants expressed that they had received sufficient help from healthcare professionals to manage the side effects during treatment with chemotherapy but felt that they did not receive help to manage CIPN after their cancer course. “ I find it difficult to accept that having received cancer treatment, you get some other problems and then … well, it’s just the way it is. I can’t accept that. Could you do something, and then say that you have done what you could. But no one has done anything. But apparently that’s how it is. I don’t’ know what can be done and by whom .” (ID 2). Standing alone with CIPN after cancer treatment seemed like an integral part of the participants’ everyday life and illustrated how they had to navigate on their own in a new everyday life with CIPN. During the follow-up period, participants described that CIPN was perceived as a lower priority compared to the haematological cancer disease and other symptoms in the outpatient unit. One participant said: “ It [CIPN] was not prioritised .” (ID 5). Despite reporting their CIPN symptoms to the healthcare professionals, the participants described that they received little consulting or help to manage CIPN and rarely did the healthcare professionals assess how CIPN affected their daily life. “ It has not been taken care of. At all. Therefore, I hope that there will be others who will receive help from day one .” (ID 5). Several participants experienced being alone with CIPN, and they indicated that the healthcare professionals should address CIPN to help them not feeling alone with the symptoms and even help them how to deal with CIPN in their everyday life. This indicates that the participants expect the healthcare professionals to address CIPN. Although the participants tried to make CIPN visible to their relatives and the healthcare professionals, it was still invisible. It was perceived as an invisible companion that only they understood, and that there was not enough focus on CIPN in the healthcare system following a cancer course.

The study aimed to explore haematological cancer survivors’ experience of CIPN in everyday life after a haematological cancer disease. The findings make an important contribution to the knowledge about everyday life with CIPN among haematological cancer survivors and highlight the impact of CIPN in the transition to an ordinary everyday life following a cancer treatment.

In this study, it became clear that survivors with haematological cancer found it difficult to express the sensation of CIPN, but using metaphors facilitated describing their experiences. These findings align with earlier studies, showing that cancer survivors have difficulty putting CIPN into words [ 17 , 29 , 30 , 31 ]. However, using metaphors made it possible to capture CIPN symptoms [ 17 , 30 , 32 , 33 ]. When the healthcare professionals explore the symptoms of CIPN, it is important that they are aware of haematological cancer survivors’ use of metaphors as that could explain how CIPN is experienced.

Moreover, the findings indicated that CIPN has an impact on everyday life activities among haematological cancer survivors which correspond with findings among other cancer survivors with CIPN [ 16 , 29 , 30 , 31 , 32 , 33 ]. A paradoxical feature of cancer survivors is that they do not necessarily see themselves as fully recovered, despite being cured [ 30 , 34 , 35 ], which was also the conclusion in our study. Thus, the present findings show that the bodily changes of CIPN are not only affecting the living circumstances, but also haematological cancer survivors’ well-being. Their self-understanding has been changed, and the body is no longer mute, but is in in an everyday life, which make them feel unwell. Our study revealed that despite being cured of haematological cancer, CIPN interfered with both the physical, psychological, and social aspects of everyday life. CIPN was perceived as a price for being alive, but the freedom to live their lives as usual was affected. This indicates that haematological cancer survivors recognise their new self-understanding as being ill following chemotherapy, which can be interpreted as illness because it illustrates their subjective experience of still being unwell, despite being cured. According to Kleinman, “ illness ” refers to the subjective experience of symptoms and suffering [ 36 ]. It is therefore essential that the healthcare professionals are aware of haematological cancer survivors’ experience of illness and not only focus on the symptoms of CIPN, which are expressed in the concept of “ disease ” as a biophysiological abnormality of the body [ 36 ].

The findings also showed that haematological cancer survivors experienced CIPN as a downside of being cured. This may indicate that CIPN challenges the transition to an ordinary everyday life following haematological cancer treatment, because CIPN may have a major impact on several aspects of everyday life. Thus, the healthcare professionals have an important role in addressing CIPN as it affects their well-being and quality of life. Research shows that CIPN has a negative impact on quality of life for haematological cancer survivors because CIPN results in severe debilitation of physical, psychical, and social character [ 9 , 10 , 11 , 12 , 37 , 38 ]. This emphasises the importance of CIPN being addressed in the follow-up period to support haematological cancer survivors’ transition to an ordinary everyday life.

In general, CIPN appeared as a living condition that led to limitations, adaptations, and worries. The findings showed that haematological cancer survivors managed CIPN differently. This can be seen as different coping strategies. Coping is described as constantly changing cognitive and behavioural efforts to manage specific external and/or internal demands that are appraised as taxing or exceeding the resources of the person [ 39 ]. Our findings showed that haematological cancer survivors adapted to everyday activities using cognitive and behavioural processes such as ignoring, controlling, or minimising symptoms to keep CIPN at bay. These strategies described how haematological cancer survivors cope with CIPN in everyday life. Depending on symptom intensity, haematological cancer survivors could use more than one of these strategies to keep CIPN more into the background. In many ways, our findings are similar to the findings that have been found among cancer survivors in general [ 17 , 33 , 40 ]. This suggests that the experience of CIPN in everyday life does not depend on the specific cancer diagnosis and must be seen as a general living condition after a cancer disease. When healthcare professionals have to support cancer patients with CIPN, they should offers support for each individual cancer survivor and not be preoccupied of the specific cancer diagnosis.

The interviews revealed that haematological cancer survivors often feel alone with CIPN, i.e. there is no follow up when mentioning their CIPN symptoms to healthcare professionals. Previous studies report that cancer survivors’ experience that healthcare professionals primally focus on the cancer treatment and survival; they are too busy; they have no idea that CIPN is common; and they only notice CIPN when the patients cannot cope with the symptoms anymore [ 16 , 32 ]. Haematological cancer survivors do not feel seen and heard in relation to CIPN and the impact on their everyday life. For haematological cancer survivors, it seems important to be met when struggling with CIPN, even if current treatment cannot minimise the symptoms. Being alone with CIPN is challenging. The findings of loneliness, while not unexpected, adds something unique to haematological cancer survivors and is an important message for healthcare professionals who are working with haematological cancer survivors in clinical practice. However, to fully understand the collaboration between healthcare professionals and haematological cancer survivors regarding CIPN, it is important to explore the barriers and facilitators addressing CIPN from the perspective of healthcare professionals and haematological cancer survivors in future research.

Strengths and limitations

The variation in the participants’ demographic data is a strength as this included a deeper and more nuanced understanding of haematological cancer survivors’ experience of living with CIPN in everyday life. Since the study contains a focused aim and all participants ( n  = 12) had relevant experience in relation to the aim of the study, the number of participants is considered satisfactory because the participants had high information power regarding the aim of the study [ 41 ]. The fact that the participants had different haematological diagnoses may be considered both a limitation and a strength of the present study. The findings may have been more specific if the participants had shared the same diagnosis. On the other hand, it was also a strength that there was a diversity in the participants’ haematological diagnosis which was reflected in the clinical practice where haematological cancer survivors were often seen in the same outpatient clinics.

Mirroring and paraphrasing were important tools in a phenomenological-hermeneutic inspired interviews [ 42 ]. Therefore, it can be considered a limitation that five interviews were conducted online or via telephone, as it was not possible for the interviewer to mirror or react to the informant’s non-verbal communication. On the other hand, it was important to conduct the interviews according to the informant’s decision to create a safe atmosphere, which allowed them to express themselves freely. Another strength of the study was that the steps of the analysis were presented explicitly to achieve transparency, and that the analysis was continuously discussed with the co-authors in order to increase validity of the findings [ 43 ]. Overall, the study is considered credible, and it is up to the reader to assess whether the findings are transferable to other populations and contexts [ 43 ].

This study gives voice to a serious late effect following haematological cancer treatment and contributes to a better understanding of everyday life with CIPN among haematological cancer survivors. It can be concluded that survival from haematological cancer not always equals well-being, as experiencing CIPN has extensive consequences on everyday life and thus appears as a living condition. CIPN is a diffuse and contradictory symptom that impacts haematological cancer survivors’ everyday life. However, haematological cancer survivors adapt to everyday life even though CIPN causes disturbances in the physical function, daily activities, social relationships, psychological aspects, and work ability. CIPN appears as an invisible symptom and a traveling companion and is dominated by limitations, adaptions, and worries. This often leads to a feeling of lack of understanding causing the experience of being alone with this influential symptom.

Clinical implications

The National Cancer Research Institute has identified the consequences of nerve damage caused by cancer treatment as one of its top research priorities [ 44 ]. While neurotoxic chemotherapy enters as an integral part of the treatment of haematological cancer, and as more individuals survive, the incidence of CIPN among haematological cancer survivors will increase during the coming years. The importance of healthcare professionals’ knowledge and understanding of everyday life with CIPN should be recognised in order to provide adequate care and treatment of haematological cancer survivors’ needs. In clinical practice, it is important to consider strategies that enable haematological cancer survivors to identify the existence of CIPN-symptoms early in the treatment and after treatment, to report their symptoms to the healthcare professionals, and to support them in managing their symptoms. However, it is also recommended that during the follow-up period, the healthcare professionals should identify and address CIPN as a living condition of everyday life. There is a need for increased attention to articulate CIPN in everyday life. Further, healthcare professionals can help haematological cancer survivors not feeling alone by exploring their experience with CIPN in everyday life and its impact of their well-being, e.g. by focusing on haematological cancer survivors’ experience of illness despite being cured. Healthcare professionals should recognise that CIPN is not only a physical symptom, but also affects the psychical and social well-being and quality of life. In addition, it is important to assess the individual cancer survivors’ information needs and tailor the communication, advice, and guidance, as they manage CIPN differently in everyday life.

Data availability

The de-identified qualitative dataset used in the analysis are available from the first author (MLR) on reasonable request.

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Acknowledgements

The authors want to thank the haematological cancer survivors who participated in this study. We thank each of them for their willingness to share their experiences with chemotherapy-induced peripheral neuropathy in their everyday life. We also thank the Patient Association of Late Effects and the physicians at Department of Haematology, Aalborg University Hospital, for assisting with the recruitment process.

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Mette Louise Roed, Marianne Tang Severinsen & Eva Futtrup Maksten

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Marianne Tang Severinsen, Eva Futtrup Maksten, Lone Jørgensen & Helle Enggaard

Clinical Nursing Research Unit, Aalborg University Hospital, Aalborg, Denmark

Lone Jørgensen & Helle Enggaard

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All authors contributed to the conception and design of the study. Material preparation and data collection was performed by the first author Mette Louise Roed, and the analysis was continuously discussed with the co-authors Lone Jørgensen and Helle Enggaard. The first draft of the manuscript was written by Mette Louise Roed, and all authors commented on earlier versions of the manuscript. All authors have read and approved the final manuscript.

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Approval from the National Ethics Committee is not required, as interview studies do not include human biological material and do therefore not need to be approved according to Danish legislation. The study was performed in line with the principles of the Declaration of Helsinki and followed the General Protection Regulation and is a part of the North Denmark Region’s record of processing activities (ID-number: F2023-105).

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Roed, M.L., Severinsen, M.T., Maksten, E.F. et al. Cured but not well — haematological cancer survivors’ experiences of chemotherapy-induced peripheral neuropathy in everyday life: a phenomenological-hermeneutic study. J Cancer Surviv (2024). https://doi.org/10.1007/s11764-024-01612-4

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Doctoral Dissertations and Projects

A phenomenological study of the lived experiences of individuals with intellectual disabilities and their participation in postsecondary job training programs: a qualitative study.

Jami Vickers Granberry , Liberty University Follow

School of Education

Doctor of Philosophy in Education (PhD)

Susan K. Stanley

inclusion, higher education, intellectual disabilities, postsecondary education, job training

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Granberry, Jami Vickers, "A Phenomenological Study of the Lived Experiences of Individuals with Intellectual Disabilities and Their Participation in Postsecondary Job Training Programs: A Qualitative Study" (2024). Doctoral Dissertations and Projects . 5554. https://digitalcommons.liberty.edu/doctoral/5554

The purpose of this transcendental phenomenological study was to describe the lived experiences of individuals with intellectual disabilities in an inclusive postsecondary education program. The theories that guided this study are Oliver’s theory on the social model of disability and Vygotsky’s theory of social constructivism. This study used a transcendental research design and employed the use of purposeful sampling to select participants who have all experienced the same phenomenon. There were 10 participants who have all had the same experience of attending an inclusive postsecondary education program. The setting took place at P.C.C. in the C.A. program. The central research question asked, what are the lived experiences of individuals with intellectual disabilities enrolled in inclusive postsecondary career and technical training programs located on a college campus? Data collection types included interviews, journal prompts, and focus groups. A system of coding along with epoché, horizontalization of data, and structural descriptions were used for data analysis to determine major themes from the data collected. The trustworthiness, results, and findings of the study are also discussed. Findings included five themes and two sub-themes. The five themes were education and career aspirations, concept of inclusion, inclusivity and social engagement, campus engagement and support networks, and sense of belonging. The two sub-themes were career and professional development and real-world application and practice. The dissertation then moves into an overall discussion of the interpretation of the findings, the implications of the study, limitations, delimitations, and recommendations for future research. The dissertation ends with a conclusion that summarizes the full study.

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