Because physiotherapy is so grounded in the biomedical sciences, most undergraduate students (and a fair few postgrads) tend to think that critical thinking is about the ability to analyze a research paper. At best this can result in a deep appreciation for the evidence that presently exists for a phenomenon, at worst the students follow a formulaic process to arrive at a score that is as predictable as it is banal. There is, however, another side to critical theory – a world of research and scholarship that these students are rarely, if ever, exposed to – the kinds of thinking that is commonplace in the arts, humanities, philosophy and sociology.
I spend quite a lot of time in this world and often think how great it would be if physiotherapy students could spend more time thinking about assemblages, liquid modernity and social justice. But those are just wild fantasies. I have noticed, however, that there has been a resurgence of interest in critical theory in other health disciplines in recent years – especially in nursing – but that much of this research is poor quality. Many researchers are now claiming that they are doing critical theory work, when in fact they aren’t. This came home to me this week in a presentation that I saw by a doctoral candidate.
The presentation was a summary of the researcher’s findings as they approached hand-in for their doctoral studies. Their research concerned the injustices of aged care: the way that older adults were forced to leave their homes and go into aged care facilities by their families; the way they lost control of their bodies and their futures; the way they lost their ability to have their voice heard.
All classical critical theory stuff really. Here is a study which seeks to give voice to the marginalized ‘other’ and uncover the hidden asymmetries of power operating in society.
The problem was with the presenters philosophy, methodology and execution. She presented her rationale as a very personal call to problematize our societal attitudes towards aged care and spoke of her emancipatory zeal. She talked about her extensive use of the work of Michel Foucault “and other critical theorists,” and went on to show her findings.
Now I know this candidate. Three years ago she talked to me about doing a Foucauldian study and it was clear then that she had very convoluted thoughts about the direction her study should take. Since then her study does not appear to have gained much more clarity and I don’t think her supervisors have helped. She chose a primary who was an out-and-out Heideggerian phenomenologist with a lot of experience of aged care, and a second supervisor who had done a thesis that my old mentor Julianne Cheek would have charitably called ‘methodologically slurred.’ As a result, it was clear that this candidate had really only paid lip-service to Foucault or critical theory. What she had really done was a basic descriptive ethnographic study and labelled it as critical because it dealt with a subject that outraged her.
Now I confess I am no fan of descriptive qualitative research. I know many people advocate for it (Sally Thorne and Margarete Sandelowski being two recent examples), but I think that qualitative research should tell you things you don’t already know, and descriptive qualitative research rarely does this. (We need another study telling us that pain is unpleasant and disrupts people’s lives about as much as we need a study showing the effects of hamstring stretching.) So when the presenter told us that aged care is unfair, that it marginalizes people at a vulnerable stage in their life, and that they don’t like it, I frankly felt like her three years of study had been three years wasted.
Critical theory is, first and foremost, a powerful philosophical and methodological approach that is far removed from the homespun wisdom of the descriptive qualitative study. Too many people, it seems, are eager to call their research ‘critical’ when in fact what they are doing is just basic ethnographic research. So in an attempt to clarify my argument, I’ve put together five principles that need to be evident to me for a study to be called ‘critical’. They are as follows:
For a study to be critical, it must:
- Be grounded in an asymmetrical power relationship – there must be someone being marginalized, not by choice but because of some innate unfairness.
- Have a strong foundation (and here I mean a deep reading not just a cursory mention) in the work of a critical theorist – Marx, Habermas, Butler, Freire…there are many, use them.
- Follow a suitable methodology – to emancipate the voice of the marginalized other you need to hear people’s voices, but that doesn’t mean you only use interviews. Look for the structural constraints on them too. Consider economics, environment, patterns of movement, and other material realities.
- Resonate with your philosophical and methodological approach. Ground your analysis in a coherent research framework and avoid the cliched qualitative themed categories that seem to stand on their own, detached from the research that generated them.
- Be reflexive – clearly the study derives from, and throughout is driven by, your own emotional response to injustice or unfairness, but this does not mean that the study should be your way of assuaging any guilt of impotence you might feel. If your findings tell you nothing more than you could have told me at the start of the project, you have wasted your time and mine.
Critical theory is a problematic area, not least for Foucauldian scholars like me who find the whole idea of power as oppressive problematic, but the cause of this vital approach to research is not being served by well-meaning, but ultimately superficial studies that are claiming to be critical. Physiotherapy desperately needs critical theory researchers who are brave enough to tackle some of the injustices that we perpetuate every day in our body-centred practice. My hope is that we don’t go the way of other researchers in recent years and simply call our research critical, when it is anything but.