Ellen Ramvi

Gender, Mothering And Relational Work

Relationships are fundamental to the work of teachers, nurses and social workers. Women by and large staff these occupations which are also called ‘relationship work’. In this article we compare the feminine ideal (often implicitly derived from a maternal ideal) with the ideal held by female relation workers. We suggest that taken for granted ideals of perfectionism in mothering are carried into relation work by the female relation workers themselves and the society at large. As a consequence, female relationship workers have a constrained portrait of themselves, leaving little opportunity and permission to explore the difficult emotional and situational complexities that they experience in their professional practice. Psychoanalytic and feminist perspectives allow challenging of these constraining implicit ideals. We argue the need for an expanded ideal that allows for negative feelings, creativity and uncertainty in professional relationships.

Imagining transitions in old age through the visual matrix method: thinking about what is hard to bear

Dominant discourses of ageing are often confined to what is less painful to think about and therefore idealise or denigrate ageing and later life. We present findings from an exploratory psychosocial study, in a Nordic context, into three later-life transitions: from working life to retirement, from mental health to dementia and from life to death. Because, for some, these topics are hard to bear and therefore defended against and routinely excluded from everyday awareness, we used a method led by imagery and affect – the Visual Matrix – to elicit participants’ free associative personal and collective imagination. Through analysis of data extracts, on the three transitions, we illustrate oscillations between defending against the challenges of ageing and realism in facing the anxieties it can provoke. A recurring theme includes the finality of individual life and the inter-generational continuity, which together link life and death, hope and despair, separation and connectedness.

I am only a nurse: a biographical narrative study of a nurse’s self-understanding and its implication for practice

BackgroundThe personal is a vital part of professional nursing practice. From a psycho-social perspective, nurses produce and reproduce conceptions of the Self through experience. A literature search on nurses’ self-understanding in a psycho-social perspective yields no results. Hence, the aim of this study was to investigate personal and professional experiences that may have formed the self-understanding of a nurse, and how this self-understanding may have influenced her professional practice.MethodsUsing a single case approach, I conducted a Biographical Narrative Interview with a 50-year-old experienced Norwegian nurse. I asked the nurse to tell me the story of her life and how her work has affected her and possibly changed the way she saw herself. The overall aim of the interpretation was to understand the historically situated subjectivity in terms of the nurse’s personal, social and professional constraints and chosen options.ResultsThe nurse’s narrative of her life story made it possible to trace a common theme throughout her experiences, the experience of being “only a nurse”. The nurse experienced a low status, as well as a downgrade in the competence needed to deliver quality care in professional relationships. She felt it difficult to identify with the experience of being on the bottom of the social ladder and to identify with the female, mothering ideal connected to nursing. She desired a better position, and wanted to identify with strong women. In contrast to reality, her self-understanding influenced her relationship with her patients, her professional pride and her further professional development.ConclusionsThis study shows that the professional practice of a nurse was informed by her self-understanding. This study suggests that the individual nurse must be given the opportunity to explore her professional vulnerability based on the assumption that it is both personally and socially constituted. This study indicates that the exploration of a nurse’s self-understanding is one way to contribute to professional development.

The risk of entering relationships: experiences from a Norwegian hospital

This article analyses how nursing students being trained in a Norwegian hospital interact and communicate with their patients – a task that seems to be one of the hardest of all for the students. Based on data from a fieldwork study, the article investigates the development of empathy among student nurses. In doing so, it addresses the concept of a social defence system developed by Isabel Menzies Lyth, who referred to a hypothetical construction describing certain features of a nursing hospital such as a high level of tension, distress and anxiety among the nurses. The findings point to the fact that the nursing students were constantly in danger of losing their focus on the relational aspect of their work; instead, they were being drawn towards an instrumental nursing style. This took place despite the conviction that ‘creating a relationship’ was one of the most important dimensions of being a competent nurse.

The Visual Matrix method in a study of death and dying: Methodological reflections

The visual matrix method is designed to elicit imagistic and associative contributions established collectively amongst participants in a group setting. In this article, a hard-to-reach area of experience – death and dying – illustrates the production of shared cultural images beyond individual experience. Our dual purpose was to assess the suitability of the method for this challenging topic, and to understand the ways in which death figured in the imagination of the participants. Three theorists, Wilfred Bion, Alfred Lorenzer and Gilles Deleuze, enable us to theorise psychosocial processes of symbolisation beyond cognition.

Psychosocial and Symbolic Dimensions of the Breast Explored through a Visual Matrix

ABSTRACT This article explores knowledge about the breast in lived experience, addressing a gap in empirical research on a highly gendered cultural trope and embodied organ. We present findings from a study that used a free-associative psychosocial method—the Visual Matrix—in order to stimulate expressions of tacit aspects of the breast, aiming to generate an understanding of relations between embodied and enculturated experiences. Our data revealed how an aesthetic of the grotesque in one matrix allowed the mainly female group to use humour as a “creative psychic defence” against culturally normative and idealized aspects of the breast. This was expressed through symbolizations, affectively delivered in an exuberant mode, emphasizing the breast‘s potency and its potential for nurturance and “weaponization”. Through this feminine poetic, life and death became inseparable yet ambiguous dimensions of breasts. The breast’s life-affirming qualities included the sensual, the visceral, and the joyful—a material-semiotic knowing. This was incontrast to a second matrix, which expressed a more ambivalent and troubled response, and in which associations were weighted towards the spectacular breast of an ocular-centric culture that privileges hetero-masculine looking. We discuss differences between the two matrices in terms of psychosocial tensions between embodied and enculturated experiences.

Maximizing work integration in job placement of individuals facing mental health problems: Supervisor experiences

BACKGROUND Many people confronting mental health problems are excluded from participation in paid work. Supervisor engagement is essential for successful job placement. OBJECTIVE To elicit supervisor perspectives on the challenges involved in fostering integration to support individuals with mental health problems (trainees) in their job placement at ordinary companies. METHODS Explorative, qualitative designed study with a phenomenological approach, based on semi-structured interviews with 15 supervisors involved in job placements for a total of 105 trainees (mean 7, min-max. 1-30, SD 8). Data were analysed using qualitative content analysis. RESULTS Superviors experience two interrelated dilemmas concerning knowledge of the trainee and degree of preferential treatment. Challenges to obtaining successful integration were; motivational: 1) Supervisors previous experience with trainees encourages future engagement, 2) Developing a realistic picture of the situation, and 3) Disclosure and knowledge of mental health problems, and continuity challenges: 4) Sustaining trainee cooperation throughout the placement process, 5) Building and maintaining a good relationship between supervisor and trainee, and 6) Ensuring continuous cooperation with the social security system and other stakeholders. CONCLUSIONS Supervisors experience relational dilemmas regarding pre-judgment, privacy and equality. Job placement seem to be maximized when the stakeholders are motivated and recognize that cooperation must be a continuous process.