Negotiating Intimacy With a Partner as a Person Living With Limb Deficiency
Thematic analysis is ‘a method for identifying, analyzing, and reporting patterns (themes) within data’ (Braun & Clarke, 2006,). It is a way of organizing your data in streams of themes or topics to create a rich data set that cannot only be used as reference, but also as a means of interpreting the research topic. The links become more apparent between the different source materials gathered in the research phase through the simplification of labeling content through coding.
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The problem with a thematic analysis is that different researchers will qualify their themes in different ways. Thus a thematic analysis of data will never be objective in the same way as a statistical analysis.
There are several ways to approach a qualitative analysis like thematic analysus; narrative analysis (Reissman, 1993) interpretative analysis, as suggested by Smith and Osborn (2003), and theoretical. All depend upon different sources to draw its coding from. According to Braun and Clarke, a thorough thematic analysis develops in six phases:
Familiarising yourself with your data: the initial reading to search for patterns, meanings etc. Braun and Clarke comment that in cases of audio, the transcription process is an interpretive act. The whole first phase can be seen as interpretive, drawing out latent material to be made explicit.
Generating initial codes: the aim is to boil the classification of data down to the most basic element that can be assessed meaningfully (Boyatzis, 1998, p. 63) and use this element as a code label.
Searching for themes: one should attempt to collate the multitude of codes generated and put them under thematic umbrellas. The main problem faced is how to create adequate themes to fit all codes accurately.
Reviewing themes: fixing the problem of phase three. The researcher must evaluate the difficulty of the themes and their relation to each other.
Defining and naming themes: the researcher must make the definite choices of what themes to bring forward, having created a network of themes that link together and accurately encapsulates the content of the coded material. The problem again arises as to what is accurate when content is left as much to subjectivity in criteria.
Producing the report: the main issue here is to produce a report that presents the research in a way compelling enough to convince a reader of the validity of the analysis. It must therefore be coherent, logical and written in a vivid and engaging manner. The interpretive responsibility of the researcher is transferred to the reader since the merit of such an report will, to a large extent, depend upon whether the reader “gets it”.
The Incomplete Self:
Participants reported a sense of loss or a perception of themselves as an incomplete person after losing a limb. One participant explained it in this way: “When we got married I was, I had all my, I was whole if you like, in my body.” His comment on wholeness insinuates something missing, and this something is directly linked to a larger issue of who he is as a person.
He further explains: “It’s like, you know, there’s a bit of me missing. Always that bit missing and it’s the bit that always seems to, it’s all I could think about for a long time.” (p.8) It is not merely some of ‘my body’ that is missing; it’s a piece of ‘me’, mind and body.
The sense of loss extends to the basic sense of gender and is explicit in the following excerpt:
“After my surgery I’d always felt less of a person if you like. Less of a man. Like I was disabled, defective, you know, not up to scratch.
R: Did you feel less masculine […]?
P: Yep. I felt less masculine.
R: Did you feel feminine?
P: No not feminine exactly. Well, yes. I did feel in a way. […] Well women are quite dependent on men aren’t they […] In fact I was really dependant on my mum.” (p.12)
Though the subject feels emasculated, he is reluctant to align himself with a feminine self-perception. The dependency on the mother suggests a reversion to childhood, being dependent on a parent. Thus his emotion of lost masculinity is a symptom of the re-establishment of roles in a less gender-centric phase in life – childhood. Similarly, a woman interviewed told anecdotes of using her stump as a penis substitute. In the first instance:
“I went into a pub with a girlfriend of mine and there was a group of blokes and they were looking at my hand and the one I fancied said ‘oh, that would make a lovely … wish my cock was as big and fat as that’, and I shoved it through the back of his legs and another man knelt down and licked the end as if he was doing oral sex on his mate.”
By engaging in ‘laddish’ behaviour and using her amputated limb as a penis, the subject’s experience of amputation suggests a more blurred alignment of own gender.
Both subjects’ focus on gender is centred specifically around the limb, and only occurs in relation to supposed intended juxtaposition with perceived behavioural patterns of the opposite gender.
Compensating For the Missing Limb:
Several subjects spoke of compensating by taking up new hobbies like sailing, gardening or becoming more career or family focused (see comments made throughout transcripts 1 and 2 in Appendix I). A lot of the new hobbies mentioned are stereotypically gendered, compensating not only for the loss of limb, but also the loss of self. Through this, the subjects became more aware of and interacted with their surroundings. In the bedroom and in situations of general intimacy with their partner, this new awareness was reported by more than one participant to manifest itself as enhanced communication between partners and a more intimate knowledge of each other’s bodies. One participant commented that: “We talk more and we do more than we ever did before, things I never thought we’d do. We even bought a book […] it gives you tips about how to improve your sex life.”
Another explained how they “did more cuddling and kissing than anything else during that [post amputation] time, which was nice […] because usually before it was a bit wham bam, thank you mam.” Thus the lack of a ‘complete’ body and the shame and/or self-consciousness surrounding it led to increased physical intimacy with the partner.
The Awkwardness of Re-Negotiating Intimacy
The feeling of incompleteness, the sense of loss and the difficulty of navigating intimacy after the limb loss – though ultimately leading to better communication between partners – caused most of the amputees interviewed to go through an initial phase of severe anxiety surrounding their aesthetic appearance and potential attractiveness to sexual partners. One describes how he “would try to light candles before she came into the room, you know, set the mood and that but really it was to hide [his] leg.” The same man also talks of how he would try to disguise the stump by hanging it out the side of the bed and the thought of it touching his partner terrified him.
Another participant said it more explicitly: “I might see a woman that I really like or something and she just might be disgusted by it.” The difficulty in accepting the missing limb is not an internal battle, but rather a worry about the perception and/or judgement of a potential partner.
All participants reported shame or embarrassment surrounding their limb deficiency and the reaction anticipated from their partner. One woman described how she would hide her stump during sex. In her words: “It used to be really awkward. It made things, doing it [sex] really awkward. But that would be all I could think about. I thought about it all the way through and so never really enjoyed it [sex] because of that.”
One man expressed concerns that his stump would elicit pity rather than sexual arousal while the other man described how he “would still wake up with a hard on and want to do it with her, but she never wanted to.” Neither of the women interviewed expressed any concern regarding being perceived as less female, only as less attractive females. However, both men’s concern centred around the fear that their partner would see them as less of a man and where neither woman expressed an urge to compensate, both men talk of using sex manuals and toys to compensate for a loss of manhood. Further, one man told how positive attention for his prosthetics made him feel like bionic man, taking from one end off the spectrum (less than a man) to the other (superman) purely based on external perception. This indicates a predominantly male perception that physicality is linked with identity.
Successful in Navigating Intimacy
Only through feeling incomplete and awkward have the participants reached a comfortable intimacy with their partner (even the subject claiming to be fine admits to have acted out because of her “little devil”). Only one woman neglects to explicitly suggest a comfortable relationship with intimacy. However, she talks about her insecurities strictly in past tense, suggesting that phase to have passed.
Ultimately all participants suggest that in order to navigate intimacy with a partner after the loss of a limb, they re-discovered their own bodies and physicality as well as their partners’ through alternative interaction.
Braun, V. and Clarke, V. (2006) Using thematic analysis in psychology. Qualitative Research in Psychology, 3 (2). pp. 77-101.
Riessman, C. K. (1993). Narrative Analysis. Newbury Park, CA: Sage.
Smith, J. A., & Osborn, M. (2003). Interpretative phenomenological analysis. In J. A. Smith (Ed.), Qualitative Psychology: A Practical Guide to Methods. London: Sage.
Power Point presentation from Jyvaskylan Yliopisto: https://www.jyu.fi/ytk/laitokset/ihme/metodifestivaali/ohjelma/torstai/littleton [Accessed 21. February, 2013)