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The Psychologist Vol 18 No 1
Exploring lived
experience
U
NDERSTANDING experience
is the very bread and butter of
psychology, and interpretative
phenomenological analysis (IPA: Smith,
1996) offers psychologists the opportunity
to learn from the insights of the experts research
participants themselves. What is it
like to experience auditory hallucinations,
or chronic pain, for example? How can we
better understand the decisions that people
make, about issues as diverse as safe-sex
practices, genetic testing, drug use or
participation in dangerous sports? In this
article we describe the recent development
of IPA and show how it can help answer
such questions.
IPA, unlike most of traditional
psychology, offers the psychologist the
chance to engage with a research question
at an idiographic (particular) level. The
participant's `lived experience' is coupled
with a subjective and reflective process of
interpretation, in which the analyst
explicitly enters into the research process.
Importantly ­ and in contrast to some other
qualitative approaches ­ the analyst is still
on familiar territory, in terms of the
inferences that can be made from `data'
(often interview transcripts) to `persons'
(embodied and encultured beings). IPA
makes these inferences cautiously, and with
an awareness of the contextual and cultural
ground against which data are generated,
but it is willing to make interpretations that
discuss meaning, cognition, affect and
action. These interpretations may be drawn
from a range of theoretical perspectives,
provided that they are developed around
a central account of the participants'
experiences (their phenomenological
world). The adjacent box summarises
some key elements of IPA.
A brief extract from an IPA study
(Flowers et al., 1997) can show how
the method can afford us a deeper
understanding than traditional
psychological methods. The study
looked at a behaviour ­ unprotected anal
intercourse between gay men ­ that more
formal psychological theories of `health
behaviours' struggled to explain.
Dan: `I've not been in the situation,
but if we really loved somebody and
that's what you wanted to do, even if
you knew they were HIV, I think that
would even come into the equation, if
you know, if you were wanting, you
know, wanting to die with somebody, or
even if you loved somebody that much
I suppose, wanting somebody's virus
inside 'em. You know they've got it then
you want it as well...sort of thing.'
Dan describes how HIV has shaped the
KATIE REID, PAUL FLOWERS and MICHAEL LARKIN
give an introduction to interpretative phenomenological
analysis.
KEY ELEMENTS
OF IPA
 IPA is an inductive approach (it is `bottom up'
rather than `top down'). It does not test
hypotheses, and prior assumptions are avoided.
IPA aims to capture and explore the meanings
that participants assign to their experiences.
 Participants are experts on their own
experiences and can offer researchers an
understanding of their thoughts, commitments
and feelings through telling their own stories,
in their own words, and in as much detail as
possible. Participants are recruited because of
their expertise in the phenomenon being
explored (e.g. undergraduate psychology
students are usually avoided).
 Researchers reduce the complexity of
experiential data through rigorous and
systematic analysis.Analysis relies on the
process of people making sense of the world
and their experiences, firstly for the participant,
and secondly for the analyst.
 Analyses usually maintain some level of focus
on what is distinct (i.e. idiographic study of
persons), but will also attempt to balance this
against an account of what is shared (i.e.
commonalities across a group of participants).
 A successful analysis is: interpretative (and thus
subjective) so the results are not given the
status of facts; transparent (grounded in
example from the data) and plausible (to
participants, co-analysts, supervisors, and general
readers).
 Researchers should reflect upon their role in
the interpretative and collaborative nature of
the IPA interview, data analysis and subsequent
publication.
KATEGRAY
meaning of sexual behaviour, qualifying
his remarks with a quantification of love,
`if we really loved somebody'. Becoming
infected knowingly is the ultimate means
of prioritising the relationship, above and
beyond the individuals themselves and
their own health concerns. This can also
be described as the ultimate expression of
love. Through attention to language use
and an exploration of cognition, the study
therefore concluded that the rationalistic
assumptions of existing theories had failed
to accommodate the crucial
meaningfulness of intimacy and romance
for participants.
The rise of IPA
We conducted a literature review which
identified the use of IPA within 65 peerreviewed
papers between the dates of 1996
and June 2004. In the first half of 2004
there were 11 papers added to the corpus of
IPA research, reaffirming the continued rise
in use of this qualitative method. The
adjacent box illustrates the current areas
of published research and some specific
exemplars that have used IPA.
As you can see, IPA can be applied
to an extensive range of psychological
inquiry. The majority of published studies
using IPA lie within the field of health
psychology, but IPA studies exist within
applied social and clinical psychology.
While IPA is being applied in these
substantial but localised areas of
psychology, at a broader level it is possible
to see that its focus upon contextualised
and detailed accounts of experience also
make it a useful tool for cultural
psychology.
IPA's increasing popularity within
health psychology may well stem from
its ability to contribute to biopsychosocial
perspectives. It also provides a viable
alternative to the top-down (deductive
and derivative) assumptions of mainstream
health psychology, and this has great
appeal within the context of the national
service frameworks, which are now in
place across a spectrum of NHS services
and require greater efforts to listen to the
voices of service users. In keeping with the
broad premise of positive psychology (e.g.
Seligman & Csikszentmihalyi, 2000), there
is scope for IPA research to become less
disease- and deficit-focused, and for
participants to be given a chance to express
their views about strength, wellness and
quality of life.
IPA is also popular within other applied
areas of psychology, perhaps because it
shares a broadly realist ontology
compatible with other applied concerns,
in a way that some other qualitative
approaches do not. This is particularly
true of the ethnomethodological version of
discourse analysis (e.g. Potter & Wetherell,
1987). Discourse analysis (DA) emerged
during the late 1980s as a radical critique
of (then) mainstream social psychology
and social cognition (which in turn had
arisen from a rejection of behaviourism).
Most types of DA have tended to focus
upon the function of language within
specific contexts. Like behaviourism, DA
limits its focus to the observable (in this
case, linguistic behaviour). Its approach
demands a discursive psychology and
constructs a textual ontology. This means
that for discourse analysts, links between
discourse and `real'-world actions are
difficult to make, because the `real' world
can only be understood as a construction
(e.g. see Edwards et al., 1995). DA has
proved itself to be a powerful
deconstructive tool, but is still struggling
to offer viable bases for intervention in the
world (see Nightingale & Cromby, 1999;
Willig, 1999). In this respect, IPA can offer
applied researchers the opportunity to
integrate research and practice (e.g.
Duncan et al., 2001; Golsworthy & Coyle,
2001).
Who is the IPA participant?
IPA research is hearing the voices of
participants from across the sociocultural
spectrum. In our review we found that IPA
participants were recruited on the basis that
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The Psychologist Vol 18 No 1
IPA
WHERE IS IPA MAKING AN IMPACT?
Research area Examples
New genetics Genetic test results: failure to reassure (Michie et al., 2003)
Health professionals/therapists Nurses' theoretical models that shape their assessment of carers
(Carradice et al., 2002)
Dementia/degenerative disease Exploration of the `threat to self' in early stage Alzheimer's disease
(Clare, 2003)
Sexual identity and sexual health Impact of new treatments on gay men and HIV testing (Flowers et al.,
2001)
Chronic illness Chronic back pain (Osborn & Smith, 1998)
Quality of life measurement The meaning of `quality of life' from those who have undergone bone
marrow transplant (Holmes et al., 1997)
Spirituality and bereavement The role of spiritual and religious beliefs in the bereavement process
and bereavement therapy (Golsworthy & Coyle, 2001)
Palliative care Cancer patients' and relatives' views on the role of specialist palliative
care teams (Jarrett et al, 1999)
Mental health/addiction/ The self-identity issues raised by recovering addicts involved in a 12eating
disorders step programme (Larkin & Griffiths, 2000)
Reproductive decision-making A man's experience following his partner's termination of pregnancy
and adoption for fetal abnormality (Robson, 2002)
Personal and cultural identity The threat to cultural identity as told by immigrants to Britain
(Timotigevic & Breakwell, 2000)
they could understand the principles of
their involvement in the research process,
give consent, engage with the interviewer
and show a willingness to express their
experiences and opinions. The `typical' IPA
participants ranged in ages from 10 years
to 83 years. Only two of the studies
explicitly recruited from a child or
adolescent population. Participation in IPA
research was evenly distributed across
gender. Interestingly, the lucidity of
respondents did not necessarily exclude
them from participation. The search for
meaning in accounts surpasses any
objective truth or reality; this is illustrated
by the work of Rhodes and Jakes (2000),
who actively sought to include those
experiencing delusions through psychotic
illness in an attempt to assign meaning to
their accounts.
Less is more
IPA challenges the traditional linear
relationship between `number of
participants' and value of research. It
retains an idiographic focus, with 10
participants at the higher end of most
recommendations for sample sizes (Smith
et al., 1999). Elsewhere, Smith (2004) has
argued the advantages of smaller samples
and case studies. Looking at the IPA
literature base collectively, the mean
number of participants involved in IPA
research to date is 15. The largest sample
involved semi-structured interviews with
42 participants. Conversely, case studies
were employed for three pieces of research.
Larger samples were a function of the
use of focus groups or comparison groups.
In comparison studies, the exploration of
one phenomenon from multiple
perspectives can help the IPA analyst to
develop a more detailed and multifaceted
account of that phenomenon. This is one
kind of `triangulation' (see Elliot et al.,
1999).
Collecting data
The chosen method for much qualitative
data collection is a semi-structured
interview. IPA researchers are aware that
interviews are not `neutral' means of data
collection (see Rapley, 2001). The
interviewer is understood to work with
the respondent in flexible collaboration, to
identify and interpret the relevant meanings
that are used to make sense of the topic.
One-to-one interviews aid this: they are
easily managed; allow rapport to be
developed; allow participants to think,
speak and be heard; and are well suited
to in-depth and personal discussion.
Other methods have been used, and
some of these, such as postal questionnaires,
and electronic e-mail dialogue, can be
seen to share some of the advantages of
interviewing. Focus groups and
observational methods have also been used
for IPA work, but require some recognition
of the problems involved in applying
experiential analyses to more complex
social activities. There has been little
published IPA work to date using diaries.
Analysing data in IPA
It is a key commitment of IPA that analysis
should be developed around substantial
verbatim excerpts from the data. In our
review of the field there was wide variation
in the number of verbatim excerpts that
were presented, ranging from 4 to 60.
Obviously, there are further variations in
terms of both the length of these extracts
and the number of participants represented,
but this does illustrate the importance of
the participant's voice in IPA research.
The inductive and iterative procedures
of IPA are intended to help the researcher
to develop an initial `insider's perspective'
on the topic. The researcher documents this
in the form of an interpretative
commentary, using verbatim examples
for illustration and support. Taking `the
insider's perspective' is thus only one part
of the analytic process, because the analyst
also offers an interpretative account of
what it means for these participants to have
these concerns in this particular context.
This means that there is a balance of `emic'
and `etic' positions in IPA. In the former
(phenomenological, insider) position, the
researcher begins by hearing people's
stories, and prioritises the participants'
world view at the core of the account. In
the latter (interpretative, outsider) position,
the researcher attempts to make sense of
the participants' experiences and concerns,
and to illuminate them in a way that
answers a particular research question.
This is underpinned by a process of coding,
organising, integrating and interpreting of
data, which is detailed and labourintensive,
but also very rewarding.
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IPA
IPA IN ACTION
Here we present a brief extract from an IPA study
(Larkin & Griffiths, 2004) as a means of illustrating
some of the more interpretative and theorydriven
aspects of IPA.This paper sought to
explore the experiences of persons engaging in
either recreational drug use or dangerous sports.
Alison discusses speed (amphetamines) in her
account and seems to identify it as her primary
`initiation' experience. Certainly it is the first
`serious' drug which she used, and she accounts
for the moment of initiation as a `contextual
decision' (`it wasn't really a conscious decision').
Although Alison presents herself as someone who
actually prefers speed, she later went on to use
Ecstasy as well. Here she rationalises that
decision:
Alison: With Ecstasy I did have reservations about
things to do with like long-term use.And [pause]
possibly the health risks ­ the sort of immediate
health risks where I wasn't so concerned about that
as possible long-term effects but I think in the end it
just happened to be, sort of like,`Well everyone else
is at it, and well, you know, what the fuck, you know?'
In [this, and other] extracts, the initiatory
experience of Ecstasy is still represented as a
partial,`contextual' decision (`just ended up taking
it,' `just happened to be').Alison's reservations
about Ecstasy's potential long-term effects allow
us to see that these `contextual' decisions are not
non-decisions, however. Ecstasy does not simply
happen to these participants ­ the moment of
transition from non-user to user is significant,
a risky shift, but the transition is made easier by
the abandonment of agency (`what the fuck, you
know?'), the contextualising of the `decision' in
terms of cultural meaning, and the normative
influence of significant others (`well everyone
else is at it').
`One-to-one interviews...
allow participants to think,
speak and be heard'
KATEGRAY
A number of further methodological
features, such as `transparency' of the
results and `reflexivity' in the interpretation
processes, provide good benchmarks for
ascertaining whether the generic qualitative
`good practice' guidelines set down by
Elliot et al. (1999) have been adhered to.
In the published IPA work that we
reviewed, analyses were often conducted
by more than one researcher (another form
of `triangulation'). Independent audits of
the analysis were often utilised as well, or
instead. These steps provide acceptable
forms of cross-validation.
The outcome of all these analytic and
evaluative processes in IPA is a set of
themes, often organised into some form
of structure (a coding overview, table of
themes, hierarchy, or model). These themes
generally provide the topic and focus for
the analytic commentary in presentations
and published IPA reports. They represent
commonalities across the participants'
accounts, but should also attempt to
accommodate the variations within the data
set. This balance is reflected in a range of
flexible and creative approaches to writing
up the analysis.
In some articles one salient theme
provided the focus for the entire
interpretative analysis; some reported up to
10. This need not be viewed as an analytical
constraint: it is also a function of the
limitations of space available for published
work. Qualitative researchers often have to
break down their projects into smaller
components at this stage of the process.
The future for IPA
We are now seeing a steady increase in
applications of IPA beyond the field of
health psychology, and so the potential
audience for this type of qualitative
research will grow. The diversity of
literature contained within our review
suggests that its readership may be equally
diverse, with publications going beyond
traditional health psychology journals, and
into social psychology, nursing studies,
religious and existential studies, music,
art and occupational therapy, and the
`traditional' journals of the medical
profession (e.g. Duncan et al. 2001). IPA
is particularly suited to researching in
`unexplored territory,' where a theoretical
pretext may be lacking. Bypassing the
closed systems of borrowed hypotheses and
theories, it can instead provide meaningful
and unexpected analysis of psychosocial
issues.
Increasing confidence in IPA is
reflected in the accelerated rise in
published studies across a wide range of
psychological inquiry. As a methodology,
IPA advocates many of the principles of
`good practice' that signify as quality
markers in qualitative research (Elliott et
al., 1999). This in turn increases the
likelihood that IPA projects will be
publishable. Currently, many
undergraduates and postgraduates in
psychology are learning about conducting
IPA research, and so IPA is becoming
established in the minds of the next
generation. The future of IPA research
looks bright.
 Katie Reid is a PhD student at
Gartnavel Hospital Complex, Glasgow.
E-mail: gcl405@clinmed.gla.ac.uk.
 Dr Paul Flowers is a reader in the
Department of Psychology at Glasgow
Caledonian University. E-mail:
p.flowers@gcal.ac.uk.
 Dr Michael Larkin is a clinical
psychology research tutor/lecturer at the
University of Birmingham. E-mail:
m.larkin@bham.ac.uk.
January 2005
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IPA
Carradice,A., Shankland, M. & Beail,
N. (2002).A qualitative study of
the theoretical models used by
UK mental health nurses to
guide their assessments with
family caregivers of people with
dementia. International Journal of
Nursing Studies, 39, 17­26.
Clare, L. (2003). Managing threats to
self:Awareness in early stage
Alzheimer's disease. Social Science
and Medicine, 57, 1017­1029.
Duncan, B., Hart, G., Scoular,A. &
Bigrigg,A. (2001). Qualitative
analysis of psychosocial impact of
diagnosis of Chlamydia
trachomatis. British Medical
Journal, 322, 195­199.
Edwards, D.,Ashmore, M. & Potter, J.
(1995). Death and furniture.
History of the Human Sciences, 8,
25­49.
Elliott, R., Fischer, C.T. & Rennie, D.L.
(1999). Evolving guidelines for
publication of qualitative research
studies in psychology and related
fields. British Journal of Clinical
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Flowers, P., Knussen, C. & Duncan, B.
(2001). Re-appraising HIV testing
among Scottish gay men. Journal
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Flowers, P., Smith, J.A., Sheeran, P. &
Beail, N. (1997). Health and
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Golsworthy, R. & Coyle,A. (2001).
Practitioners accounts of
religious and spiritual dimensions
in bereavement therapy.
Counselling Psychology Quarterly,
14, 183­202.
Holmes, S., Coyle,A. & Thomson, E.
(1997). Quality of life in survivors
of bone marrow transplant.
Journal of Cancer Nursing, 1,
106­116.
Jarrett, N., Payne, S.,Turner, P. &
Hillier, R. (1999).`Someone to
talk to' and `pain control'.
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Larkin, M. & Griffiths, M.D. (2000).
Experiences of addiction and
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Larkin, M. & Griffiths, M.D. (2004).
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Michie, S., Smith, J.A., Senior, S. &
Marteau,T. (2003).
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Nightingale, D. & Cromby, J. (1999).
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Osborn, M. & Smith, J.A. (1998).The
personal experience of chronic
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Potter, J. & Wetherell, M. (1987).
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Beyond attitudes and behaviour.
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Robson, F. (2002).`Yes! ­ A chance to
tell my side of the story':A case
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woman undergoing termination
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Seligman, M.E.P. & Csikszentmihalyi, M.
(2000). Positive psychology:An
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Smith, J.A. (1996). Beyond the divide
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Smith, J.A. (2004). Reflecting on the
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WEBLINK
The IPA website: www.psyc.bbk.ac.uk/ipa
References