Issue no.3, December 2010
A Swedish perspective on research ethics review
Hans Thulesius, M.D., G.P., Ph.D. I have participated in writing ethical approval applications for research projects in Sweden a dozen times. I am also since some years a member of the local ethics advisory board in a mostly rural area serving 180.000 people. From that position I advise on what types of local project applications will have to be sent further to the regional ethics committee, REPN in Sweden. With that background I will try to give a brief Swedish perspective on research ethics reviews in general and regarding CGT (classic grounded theory) studies using qualitative data in particular. The most famous Swedish example of unethical research is the 1947-1951 Vipeholm sugar trial (Krasse, 2001). Several hundred intellectually and mentally challenged persons at the Vipeholm institution were for years given an excess amount of sugar, mostly in the shape of candy. This resulted in caries that totally ruined the teeth of 50 persons. Of course participants did not give informed consent. Yet, at the time the research was not considered unethical. At least there was no debate about it. In Sweden there are 6 REPNs each with a population base of around 1.5 million people. Above the REPN is a central research ethics committee – CEPN – to which one can appeal the decisions of the REPNs (http://www.epn.se/start/startpage.aspx). The REPN consists of one judge as a chairman, 5 scientifically competent persons and 5 laymen, all ordained by the Swedish government. In order to get the REPN to even look at an application there is a fee of 5000 SEK (700 USD) to be paid by the applicant; 16000 SEK for collaborative projects involving more than one Swedish region. Yet, student projects below the Ph.D. level are not requested to apply for REPN approval although they can get advisory statements from the REPN that also require a fee. As a consequence local ethics advisory boards have sprung up to supply the need for research ethics advice in a context where the respect for personal autonomy becomes more and more important and research ethics increasingly politically correct. The EPNs are guided by research ethics principles that can be formulated in a number of rules. These research ethics rules deal with four different requirements: information, consent, confidentiality, and use. In brief: 1. The person potentially being researched should receive adequate information from the researcher about the aims, risks, advantages and costs of the research project as well as conditions for participating. 2. The person has the right to self decide about participation or non-participation at any time even after the project has begun. 3. The person should be guaranteed anonymity and that research data is kept safe and secret. 4. The data from the research may not be used outside of the research project. Ethical review boards, both regional and local, deal with research methodology apart from looking at the direct ethical integrity aspects of research. It is often emphasized that research projects with a questionable methodology are unethical since they will eventually fail to produce useful results and thus they represent a waste of, mostly public, resources. This part of the research review can actually be very useful to the researcher in order to refine the study protocol that may prove valuable when applying for grants and for publishing the study. There was a time in Sweden when projects that could be defined as societal/behavioral from a research ethics perspective were treated differently, read less critically, than projects with a more...Book Review: Kaplan, S. (2008).Children in Genocide: Extreme traumatization and affect regulation, London: International Psychoanalysis Library...
Carol Roderick, M.Ed., Ph.D. In Children in Genocide: Extreme traumatization and affect regulation (2008), Suzanne Kaplan explores the affects and memories of individuals who have survived extreme traumatization during their childhood, specifically Jewish survivors of the Holocaust and teenagers who survived the genocide in Rwanda in 1994. In the introduction, Kaplan explains that she has aimed to “write a text that can, to the greatest extent possible, convey a fraction of the feeling of what it meant to be a child during a genocide” (Kaplan, 2008, p.1). The majority of the book is devoted to presenting an analysis of the oral life histories of the survivors interviewed. The experiences are organized into three themes: 1) perforating, how the psychic shield is has been perforated by intense trauma; 2) space creating, the inner psychic processes through which the persecuted create mental space helps to survive the psychological damage and trauma; and 3) age distorting, a twisting of time that results in participants not feeling their actual chronological age. Age distorting is presented as containing aspects of perforating and space creating, and is linked to reproductive patterns of the survivors. A chronology of genocide events is used to organize these themes, through which the life histories of participants are presented in rich descriptive detail. Kaplan focuses both on the content of the interviews conducted as well as how the memories of the atrocities survived were recounted (the affects). The text provides readers with a glimpse into lived experience of these horrors in a manner that can only be achieved through narrative. The analysis of the life histories is presented as a theory in the final chapter, From conceptual models to a theory. Here, concepts previously presented as life histories are reorganized into a table and then into a diagram. The diagram represents Kaplan’s theory, the affect propellor. The affect propeller is offered as an analytic tool for the affect regulating of extremely traumatized individuals. Trauma linking, an inner psychological consequence of perforating, is contrasted with generational linking, the result of successful space creating. These four concepts are associated with levels of affect regulation, from low to high integration. These levels include affect invading, affect isolating, affect activating, and affect symbolizing. Each level of affect regulation is assigned one blade of the affect propeller diagram. Each blade is subdivided into three levels of linking processes two levels of trauma linking (destructive) and one of generational linking (constructive). The blades rotate around the center of affect regulating. Kaplan claims to have used grounded theory methodology for this research. Grounded theory is a complete package from collection, coding, analyzing, memoing, theoretical sampling, sorting, writing, and using the constant comparative method (Glaser, 1998). The result is a set of carefully grounded, well integrated hypotheses organized around a core category. The theory helps to explain as much of the behavior within the substantive area as possible with as few concepts as possible (Glaser, 1978). Kaplan’s theory falls short of a classic grounded theory in a variety of ways, three of which I will address here. The goal of grounded theory is to uncover a main concern of individuals and how these individuals attempt to resolve or process this concern (Glaser, 1998). This contrasts with qualitative research methods where the goal is description. The author states that the aim of her research was to present the life histories of individuals who have survived genocide and to communicate what it means to be a child during genocide. This aim...Theory buried under heavy description
Vivian B. Martin Ph.D. Children in Genocide: extreme traumatization and affect regulation, International Psychoanalysis Library, 2008 In journalism when a reporter puts the main news or point of the story deep down in the text, we say she’s buried the lead, the lead being the main point of the story and usually the first paragraph. In Children in Genocide: extreme traumatization and affect regulation, psychoanalyst Suzanne Kaplan buries her theory. Her study of the after effects of trauma among Holocaust survivors who were children during their persecution and survivors of atrocities during the Rwandan atrocities of the 1990s, is filled with highly descriptive material from the many interviews that serve as data. An interesting grounded theory is peeking out from under all the disciplinary discourse and historical background one must read through to get to what grounded theory readers will consider the juicy parts: concepts on affect regulation in trauma survivors. Published by the International Psychoanalysis Library, it’s clear that the author’s work was necessarily grounded in psychoanalytic assumptions and theory for the main audience. Kaplan drew on psychoanalytic theory to help her understand what is going on in the interviews. But the procedures of classic grounded theory helped the author take the mounds of data and create theory. Kaplan did some of the grounded theory analysis as part of a dissertation, later extending the work. Kaplan makes reference to grounded theory’s influence in just a few words on two pages in this book (pg. 13, 206), so grounded theory’s impact is never explicated here. The presentation of her theory suffers for this. Nevertheless, the book provides an opportunity for some discussion of the role of theoretical sensitivity in grounded theory and the challenge of navigating the preconceptions of received theories and models. The book deals with the memories of elderly Holocaust survivors who were children in hiding or concentration camps. Kaplan makes use of visual archival material as well as interviews she conducted. As a comparison group, she draws on interviews people whose trauma is still relatively recent: survivors of the Rwandan crises. By comparing the immense childhood suffering of groups whose persecution is separated by time and culture, Kaplan was able to identify recurring patterns that led to her eventual theoretical model. She states that generational collapse as the “core process.” (As will be noted shortly, she also names other concepts as core processes, making aspects of her presentation unclear). Genocides wipe out families, leaving the survivors with broken links. Kaplan introduces the concept of perforating to describe the tearing away experience, which has many indicators and invades physical and psychic space. The realization that a number of the interviewees chose to forgo reproduction (“because I was a child myself” with the disruption occurred) alerted Kaplan to a continued pattern of generational collapse. The concept pf space creating signifies the mental strategies for survival. She writes that space creating is an attempt to recapture a normal time: “Space creating refers to a psychic room that an individual, as a child, creates according to his or her needs” (p.56). The mental link may be to a hiding place or other space associated with a safer time. In much the same way that classic works such as Viktor Frankl’s Man’s Search for Meaning (1946) outlines the everyday mental strategies people used to survive life in concentration camps, Kaplan presents space creating as a survival strategy that helps people hold on to their humanity and spirit. Space creating is necessary...Comments on the reviews of Kaplan, S. (2008). Children in genocide: Extreme traumatization and affect regulation. London: International Psychoanalytical Association...
Suzanne Kaplan, Ph.D. My choice of grounded theory as research approach has been made against the background of three factors. The first and foremost is that my research interest evolved when I carried out two interviews with survivors who were children themselves during the Holocaust, i.e. from the data. The information that I obtained gave me a strong sense of urgency, a motivation, to try to understand the major concerns for child survivors, based on their own perspective. I decided to start doctoral studies after many years in clinical practice. My interest thus emerged from the interviews and not from an existing theory. Grounded theory is a method that sticks closely to the empirical and that aims to create theoretical models based on the development of concepts, of relationships between concepts and of theories concerning social and psychological processes from a certain aspect tied to a special context (Glaser, 1978). Secondly, only little research has been devoted to the area of child survivors of genocide. Even if psychodynamic theory was in the back of my head, grounded theory was of immense importance in keeping earlier professional experiences and ‘established’ theories away. Last but not least, I have received many important impulses in connection with Glaser’s lectures and workshops at Stockholm University in 1999 and 2001, respectively. There are some ongoing discussions as to how strict a researcher must be in order to designate his or her research as grounded theory named as ‘classical’ or ‘ideal’. Also Glaser states (1998, p.16), “… partial doing grounded theory by stopping before the package is finished is better than no doing at all”. The pilot study “Child survivors and child bearing” (Kaplan, 2008, Chapter 3) can be seen as a theoretical sketch to which I returned several times during the research process as this was the entry to a hyphotheses that child survivors do not seem to experience themselves being in their chronological age. Thus the code ’age distorting’ emerged. Starrin et al. (1991) stress the importance of theoretical sketches during the course of research work, since these purport to connect the data with the final analysis. Later, the dynamic between the psychological phenomena that I conceptualized as ’perforating’ and ’space creating’ respectively emerged as an explaining connection in the context of genocide. This is what I meant by ”association” in the text, a concept that may be misunderstood. The pilot study, an extended doctoral study on Holocaust child survivors and a post doctoral study in Rwanda have formed the basis for my empirically grounded theory presented in the book Children in Genocide: Extreme traumatization and affect regulation. Through the study in Rwanda I wished to find more data that could be relevant for the emerging theory. I got access to different kinds of data through the similar and different characters of the two contexts, and through the descriptions of old incidents and rather recent incidents. These were two different places and cultures, but maybe similar phenomena, thus also a widening and deepening of data. My working through of the interview material started with an ambition to be open in the face of this material, with a minimum of preconceived notions, and a refusal to describe the psychological phenomena that came forth in terms of illness. “Pattern search is survey modeled as it aggregates incidents like surveys aggregate people. And then the task is to start relating these conceptual patterns to generate a theory using theoretical codes” (Glaser, 1998 p. 31). I was...Organizational Careers: A forward theory
[ The following paper is extracted from Glaser, B.G. (1968). Organizational careers: A sourcebook for theory. Chicago: Aldine Publishing Company. The full text is available through www.sociologypress.com] Barney G. Glaser, Ph.D., Hon. Ph.D. Introduction In general, organizations obtain work from people by offering them some kind of career within their structures. The operation of organizations, therefore, depends on people’s assuming a career orientation toward them. To generate this orientation, organizations distribute rewards, working conditions, and prestige to their members according to career level; thus these benefits are properties of the organizational career. To advance in this career is to receive more or better of all or some of these benefits. Generally speaking, therefore, people work to advance their organizational careers. But also, generally speaking, people do not like to talk about their careers or to be asked about them in everyday conversations with many or unknown people. In this sense, a person’s own organizational career is a sensitive or “taboo topic.” Discussions with others about one’s career occur only under the most private, discreet conditions. As a result, while people may talk abstractly and generally about careers, these discussions are typically based on a combination of the little they know of their own career and much speculation. They often have very little particular or general knowledge based on actual careers. These observations apply also to a large sector or the sociological community, as indicated by a brief perusal of the table of contents of sociological monographs and readers on organizations. The topic of careers is seldom discussed and almost never concertedly focused upon. Several sociologists, however, have written on careers in general in their focus on problems of work and professionals. Many of their discussions, of course, clearly refer to organizational careers, though these sociologists are writing on the general topic of occupational careers. There is a difference between these two topics. An occupational career is a very general category referring to a patterned path of mobility wherever it may take people geographically, organizationally, and socially while following a certain type of work. An organizational career, in contrast, is a specific entity offered by an organization to people working in it, using its services, or buying its goods. Purpose of This Reader Since so much of what we all do is linked with organizations, it is very important to consider an organizational career as a special entity and develop our understanding of it. We hope to achieve this purpose partially by bringing together many articles on careers that fit the category of organizational work careers. This act itself will initiate much general understanding. We also wish to start the generation of a formal, grounded theory of organizational careers by initiating comparative analysis of these articles (Glaser & Strauss, 1967, Part I). In its beginning operation, a comparative analysis for generating theory starts with the general understandings gained by reading about the same problem from the perspective of several different organizational careers. Pursuit of the comparative analysis brings out several other purposes of this reader. For the interested reader, whether sociologist or non-sociologist, this book brings together a very rich body of comparative knowledge, experience, and thought on organizational careers. The general understandings, concepts, and strategies gained by merely reading it will aid the reader in “making it” in his own career. With little information on which to base our decisions, we are continually trying to decide and manage how to move through the organization to some advantage. The comparative analysis...