Suggestions for Integrating Embodied Reflexivity in Public and Patient Engagement in Health Research
By Carolyn Shimmin
In previous posts, we’ve discussed the need for critical reflexive practice when it comes to public and patient engagement in health research. This includes both discursive reflexivity and embodied reflexivity. In this post, we provide researchers and public and patient partners in health research with some practical tools for beginning to incorporate embodied reflexivity in their work.
Being aware of one’s own emotions and bodily states
We don’t typically ask researchers to think about the impact and experiences of their own bodies. However, knowledge and experiences including those that are cultural, social and emotional are often lived through the body. To build trusting relationships, this means researchers must also hold themselves accountable for how their bodies impact sharing of these experiences and the knowledge they impart. It’s important for researchers to examine bodily experiences that are the outcomes of exchanges between patient/public partners and themselves (e.g. how a bodily sense of fatigue is tied to the underlying emotional state of the researcher after bearing witness to a public/patient story which may have involved trauma). In being more conscious of this reciprocal exchange of bodily experiences, an empathic connection can be formed which is foundational to creating trust. Affect and physicality can help us to understand the realities of oneself and another and become the entry point to deeper insights in the lived reality of others.
Understanding what these states reveal about you and potentially the patient/public partner
Emotions can provide significant feedback and knowledge about the environment in which people are situated. Emotions are embodied experiences that can reveal how bodies are entwined with the experiences of others. Take the example of a researcher feeling anger as a public or patient partner recounts a frustrating experience within the health care system. These emotions are a result of being present and listening to a public and patient partner’s story and lived experience. The researcher’s response validates and acknowledges the disappointment and exasperation that the public or patient partner must have felt. This demonstrates how emotions are not an individual phenomenon, but exist and are shared in relations between people. The way in which the researcher uses their voice, how they make themselves “present,” and where they sit in proximity to the public or patient partner are significant to the engagement process.
Acknowledging how nonverbal communication contributes to the co-construction of knowledge
Body memory ― perhaps practice or performance that has been embedded in a researcher’s physicality ― can suddenly be cued by the physical, emotional, and social interaction between the researcher and public or patient partner. For example, a researcher who was formerly a nurse or a social worker, may have certain nonverbal displays of emotion in relation to the stories being shared by public and patient partners.
Recognizing that our identities are multiple and complex
Researchers and public and patient partners both carry and embody a complex history of lived experiences and identities that are inseparable. In being a truly embodied researcher, it’s important to challenge the illusion of value-free, objective, and ‘safe’ approach to research — as well as the notion that one is simply a “researcher” while in the field.
Appreciating how socially constructed differences can impact on the interactions between researchers and public or patient partners
There are moments when a researcher is confronted by their body in ways that draw attention to how differences are constructed and lived (e.g. facing race, culture, religion, age or even the space occupied by one’s body). For example, a white researcher cannot silence their whiteness — ignoring their whiteness would avoid recognizing their social positioning and unearned privileges experienced within systems of power and oppression, including academic institutions and health care systems. When researchers understand how their social location is inscribed upon the materiality of their bodies and influences their bodily performance, they can then begin to collaboratively challenge the social construction of difference.
Two Takeaways to Remember
1. The body discloses
Embodied research means reflecting on the very presence of both researcher’s and public or patient partner’s bodies in the research process. The erasure of researcher’s bodies from conventional accounts of public and patient engagement in health research negates and obscures the complexities of knowledge production and yields a very deceptive and tidy account of involvement.
2. The body is the prime site of silences
To reflect upon bodily presence and interactions means to address ‘the elephant in the room’. In beginning to examine silences and omissions in the research process, we can begin to critically examine how bodies are often implied as deviant or “non-normative” (e.g. chronic illness, physical disability). It is important to address the role of silence, secrecy, and/or omission in public and patient engagement around such issues as sexuality and gender, the privilege of whiteness, etc. In each research encounter, silence informs, restrains and facilitates what can and cannot be said.
Learn more in the video recording of our Lunchtime Learning Series on Why Bodies Matter in Public and Patient Engagement: https://youtu.be/vIXg3m4g7Ug
About the Author
Carolyn Shimmin (@CarolynShimmin) is the Public and Patient Engagement Lead at the George & Fay Yee Centre for Healthcare Innovation (CHI). Her experience includes stakeholder engagement, research, writing and reporting on various health policy issues including mental health, addictions, trauma and the sexual exploitation of children and youth. Areas of interest include patient engagement, lived experience research, knowledge translation, trauma-informed approaches, intersectional analysis, and poststructuralist queer theory.
