Sage Journals: Discover world-class research

Abstract

Not all human experiences can be expressed in words. Arts-based expressions may be useful to qualitative researchers as they can disclose people’s experiences with health, illness and disability. These expressions, which connect with non-linguistic and unexplored realms of experience, may support researchers’ efforts to honor the complexities of their lives. In our study, we explored and identified modes of expression among those sharing their experiences in health care and wellbeing research and practice. We present an inventory of human expression types based on a hierarchical classification and a literature review. The expression types which involve modes of both verbal and non-verbal knowing, show a bounty of possible ways for researchers and others to extend their study designs beyond verbalized accounts. We contend that using non-verbal expression types can assist qualitative researchers in fostering the articulation of complex experiences. As drawing upon a variety of methods in the inventory of expression types comes with new methodological bounds, researchers need to explicate their paradigmatic point of departure. It is expected that researchers, other professionals, and the general public will increase their holistic understandings of a subject’s experience by being open to a variety of expression types during data collection, interpretation, and presentation.

Keywords

qualitative research arts-based methods non-verbal tacit knowledge expression type inventory creativity health research

Introduction

This painting represents what I’ve been trying to put into words, though I do not have the words to describe what I see and feel. Just now I doubt words will ever be sufficient.

(Ellis, 2004)¹

Health researchers using qualitative methods in general and phenomenological- and art based research in particular, attempt to understand lived, perceived, generated, imagined, and otherwise expressed experiences and gain insight into what it is like to live with illness, disability or other physical and mental health challenges. Using solely verbal methods has limitations. Inspired by the rhizome work of Gilles Deleuze and Felix Guattari (1980), post-structuralist and post-qualitative researchers (Gregoriou, 2004) use a variety of data collection methods to connect with the range of experiences expressed by research participants, both verbally and in many other ways (Churchill, 2018; Denzin, 2019; Lather & St. Pierre, 2013; Le Grange, 2018; Maykut & Morehouse, 1994; Pile, 2010). Researchers who depart from this phenomenological stance have also reported on the challenges involved in capturing the depth and breadth of experiences obtained through mainstream methods such as observation, shadowing, and in-depth interviews (Visse et al., 2019). Phenomena investigated by researchers “are often not to be found at the surface of the descriptions obtained, but rather in the ‘depths’ of those descriptions” (Churchill, 2018, p. 5). The implicit aspects of experiences need to be sensed and seen and, having appeared in our awareness, made explicit. Both a researcher and a respondent can benefit from better communication via more expression types and from increased awareness of subject matter otherwise remaining unexplored.

The insight, that more than words are needed to understand and connect with experience and phenomena, dates back a long time. As scholars from other fields did more than once, Butler-Kisber and Poldma (2010) concluded—quoting Eisner (2008, p. 9)—that “there must be more…” Again others have addressed the limitations of the use of traditional methods, such as interviews, in understanding the experiences of participants regardless of whether or not these are hermeneutical interviews (Plunkett et al., 2013). Van Manen (2006) even noted the destructive effects that words may have when a verbal description is used to express a subtle meaning or sensation. Some experiences remain inaccessible to researchers, especially experiences that cannot be expressed verbally, as indicated by Halling and Hansen (2014, p. 8): “we must also be sensitive to that in human life and life as such, which scientific rigor, technical words, concepts and theorizing cannot capture.”

Barbieri and Pantouvaki (2016), Connell (2003) and Popa-Blanariu (2013) claimed that there are other modes of expression in addition to verbal expression. Interpreting an interview or conducting a discourse analysis cannot be done without close listening (Arendt, 1978; Finlay, 2014). Goble (2013) emphasized that any phenomenological writing must contain some form of visual or poetic image and experience descriptions. Pre-reflective experience and pre-linguistic sensations not yet put into words, appear to be important but do not seem to fit into a phenomenological research framework whose aim it is to describe experience (Hansen, 2018; Varela & Shear, 1999; Visse et al., 2019). Researchers have noted that some aspects of experience cannot be expressed in words such as a story (Butler-Kisber & Poldma, 2010; Eisner, 1991; Richardson, 1995; Visse et al., 2019; Woods, 2011). Eisner (2008, p. 5) called this “something which cannot be articulated linguistically.” Visse et al. (2019, p. 1) referred to this as the “unsayable.”

Therefore, while qualitative and phenomenological researchers are inclined to engage in arts-based expressions the extent to which they do so is still a matter of debate (Finlay, 2009). The goal or intention of arts-based expression is to help the researcher approach experience as near as is possible, recognize it and be touched by it. The sensory aspects of various research methods address those: experiences that focus mostly on seeing and hearing. But then, how could we include our embodied ways of knowing and expressing, such as smelling, tasting, touching, and body movement via motor skills and proprioception (Bellerose, 2018; Dekkers, 2007)? The use of expression types that favor sensory and embodied ways of knowing would result in a more holistic understanding of experiences (Pink, 2015). Furthermore, phenomenologists perceive phenomenological research as a poetizing project in which they stress the collection of anecdotes and the construction of evocative ways of representation (Van Manen, 2014; Visse et al., 2019).

A variety of verbal and non-verbal expression types have already been subjected to research, are accepted as legitimate methods of data collection and are integrated in health care and wellbeing research, education, therapeutic intervention and health care practice (Busch, 2009; Feder & Feder, 1981; Gils & Willekens, 2010; Gordijn, 2007; Samaritter, 1990; Teachman & Gibson, 2018; Veale, 2005; Wang et al., 2017; Wertheim-Cahen, 2007). As of this date however, we do not know of any inventory in the field of health related research that includes these creative and otherwise non-verbal expression types. Such an inventory may assist researchers in deciding how they gather, interpret, understand and represent their qualitative data in the context of health related research. Hence, we intend to create an inventory of verbal and non-verbal expression types and their combinations, further referred to as “mixed” expression types, in support of qualitative research method design.

In this article, we therefore collect and list the range of expression types and references to existing methods that have been mentioned in several academic research approaches that stem from a variety of disciplines. These disciplines include arts-based research, phenomenological and qualitative research, education-, health care-, therapy- and wellbeing research and in practice (Busch, 2009). To this end, the research question of our article is:

Which verbal, non-verbal and mixed expression types could be relevant to qualitative health researcher’s attempts to gain a more holistic understanding of experiences and the phenomena that reside within those experiences?

We will begin with a description of the methodological approach (Methods section), after which we present the inventory of expression types, as discovered in our successive literature searches. We then construct a classification system and use a meta-synthesis to list how these types are currently used in research practice (Results section). This is followed by a discussion section in which we identify three problems that researchers may encounter in practice, as well as the limitations of this study (Discussion section). This leads to a recommendation and conclusion (Conclusions and Recommendations section).

Method

Design

Qualitative health researchers and their respondents can use methods other than exclusively verbal expression to elicit experiences. A literature study and meta-synthesis are required to explore and identify such expression types (Cronin et al., 2008; Polit & Beck, 2006). We carried out such a study, acknowledging that this is an area where a body of knowledge (Ören, 2005) has not yet been established and where terminology is not unified and settled. We did not aim for a systematic review, as we first needed to gain a deeper understanding of the area, including its major themes, terms and discourse. This inventory is, however, the first step toward a systematic review of expression types in qualitative research. We focus on health oriented research methods.

Search Terms

We developed a set of search terms which does not exclude any of the relevant research areas. To this end, we assumed that any qualitative research aims at describing the experiences of people being investigated with regard to a theme or phenomenon. An experience may consist of more than a respondent can express in words. Both this non-verbal realm in qualitative research, and the inarticulate areas, is referred to by a plethora of terms denominating various aspects of the experiences which researchers are looking for (Wollheim, 2001). These aspects include: “unspoken” (Plunkett et al., 2013, p. 1), “unarticulated” (Wheeler & Early, 2018, p. 4), “evocative” (Van Manen, 2014, p. 249), “pre-reflective” (Varela & Shear, 1999, p. 4), “liminal” (Cronin et al., 2018, p. 18; see also Lapadat, 2017), “unconsciously gained,” “unbeknown” (Uotinen, 2011, p. 1), “non-verbal performance experiences” (Barbieri & Pantouvaki, 2016, p. 5), “affects” (Pile, 2010, p. 1), “emotional feelings, bodily feelings, sensory feelings” (Blumenfeld-Jones, 2016, p. 6), the “apophatic” (Franke, 2007, p. 1; see also Arendt, 1978), “pre-linguistic” (Kapitan, 1999, p. 1; see also Hansen, 2018), “non-linguistic” (Woods, 2011, p. 8), the “unsayable” (Visse et al., 2019, p. 1; see also Leitch & Conroy, 2015), the “unspeakable” (Nguyen, 2018), and the “unviable and nonnarrativizable” (Lather, 2006, p. 41). Schick-Makaroff (2011, p. 6) also mentioned “ineffable” aspects, “too overwhelming or threatening to discuss,” and separated the unsayable into to “not being able to be expressed in words” and “not being expressed” because the subject matter is “too controversial or offensive to mention.”

In practice, some parts of an experience or phenomenon are known to the researcher. Other parts, as yet undiscovered or suspected parts are not fully known, they may even be—and will perhaps remain—completely unknown (Aydin, 2007; Peirce, 1868). Hence, the limitations of both the non-verbal and inarticulate realms are at the borders of the “unintelligible” (Lather, 2006, p. 38), “unknowable” (Levin, 2002, p. 1), “unfathomable” (Davey, 2016, p. 243) or “inexpressible” (Zimmermann, 2002, p. 205).

Successive Searches and Databases

We carried out Google Scholar, Academia, and Research Gate searches for expression types in qualitative research, phenomenological research, health care, therapy and wellbeing research, and arts-based research (Blumenfeld-Jones, 2016; Butler-Kisber, 2002, 2007, 2008; Minello, 2014; Neilsen, 2008; Savin-Baden & Wimpenny, 2014; Wang et al., 2017). For arts-based research we included areas such as third space methodology (Buttimer, 1976; Taylor, 2008) and community, public, and social art (Cartiere & Willis, 2008; Savin-Baden & Wimpenny, 2014; Vaughn et al., 2013). A suitable main classification for structuring the results of our search on expression types was developed by Wang et al. (2017), who presented five main emerging artistic expression type groups within arts-based research: 1. visual, 2. sound, 3. literary, 4. performance, and 5. new media. Since we found that combinations of all of these might exist, we extended the latter category, renaming it “new media and multiple forms.”

Inclusion/Exclusion

As we were primarily interested in expression types used in the context of research methodology, we excluded those sources that lacked a method section. This study is limited to sources dealing with a setting that involves researchers and their respondents who exchange a variety of expression types, in qualitative studies in general and in phenomenological studies in particular. We included primary and secondary scientific sources (Cronin et al., 2008). Several tertiary sources, also referred to as “gray literature” (Pandita & Singh, 2011; Wessels, 1997), were included.

We limited our search period to the years 1990–2019, although several sources outside of this time period were admitted because of their particular relevance to this study. Several additional sources originating from the counseling and psychotherapy fields were admitted since these complete the range of expression types being used in practice. We found no strict separation between verbal- and non-verbal expression types as both are often mixed. Hence, both verbal and other-than-mere-verbal expression types were included. Using verbal and non-verbal as a split line in this study necessitates a clear definition of the term verbal. For the purposes of this study, verbal includes written text, the spoken word, writing, and sign language.

Results

Search Results, Analysis and Classification

We conducted several consecutive literature searches with a successively adapted and refined set of search terms to ensure that no relevant sources would be missed. In the first search we focused on critical observations of research quality in relation to the use of expression types. The results of this search are used to underpin the introduction-, method- and discussion sections of our present study.

In the second search we focused on the identification of expression types and their classification. This resulted in a range of expression types, structured in categories according to Cronin et al. (2008) which were then allocated to the five groups in the main classification in as adapted from Wang et al. (2017). Using elements from other currently used classification systems in health care² and in education (VVKSO, 2011a, 2011b), we then refined these groups into subcategories. However, several sources listed expression types not mentioned in any of these classification systems (Bjormaekmo et al., 2018; Crowther, 2017; Gillenwater, 2012; Nguyen, 2018; Perruzza & Kinsella, 2010; Reynolds, 2002; Savin-Baden & Wimpenny, 2014; Strauven, 2003; Tilroe, 2003). Hence, we used these sources to further elaborate the subcategories. The result is a classification structure for expression types, shown in the left hand column of Table 1.

In the third search we focused on the usage of expression types in qualitative research and in health-, social- and education-related practice. We have set the search terms as: research, phenomenology, expression, painting, drawing, singing, dance, drama, sculpting, dressing, collage, pointing, music, concept mapping. We conducted this search as a series of sub-searches using multiple combinations of the search terms, all containing research and phenomenology. We subsequently searched their references and bibliographies for significant sources.

Meta-Synthesis

We screened all resulting literature sources for the manner in which the expression types are used in the research described (see Table 1). Five expression categories are shown in the first, left-hand column of Table 1, headed Description of expression. These categories are: 1 visual—2D & 3D expression, 2 sound—music & singing, 3 literary—words & drama, 4 performing—body & movement, and 5 new media—mixed & multiple forms. In The second and third columns of Table 1, headed Senses and Storage, respectively, we show the practical aspects of which senses are implicated and which storage medium is usable for the researcher. In the fourth column we indicate Research usage. In the fifth, right side column, headed Literature sources, we list references, as applicable.

Table 1.

Expression Types Inventory.

Description of Expression	Senses¹	Storage²	Research Usage	Literature Sources
1 VISUAL—2D & 3D EXPRESSION
Visual work forms/symbolic expression	Ey	Im	Instrumental, gain insight, therapy	Bagnoli (2009), Butler-Kisber & Poldma (2010), Creswell (2014), Heywood & Sandywell (1999), McNiff (2008), Rose (2001), Savin-Baden & Wimpenny (2014)
Painting	Ey	Im	Instrumental	Gillies et al. (2005), Kirkham et al. (2015)
Painting	Ey	Im	Joint interpreting	Ellis & Scott-Hoy (2004), Persons (2009), Scott-Hoy & Ellis (2005)
Drawing	Ey	Im	Instrumental, ease communication	Piliere (2018), Reynolds & Prior (2003), Wainwright (2017)
Signs/symbols/graffiti	Ey	Im	Symbolic expression	Bloch (2018), Reynolds & Lim (2007)
Painting/mural/drawing	Ey	Im	Meaning	Boydell et al. (2015), Crowther (2017), Tucker-Raymond et al. (2011)
Painting/drawing	Ey	Im	Avoid artefacts	Borgdorff (2012), Ellis (2004), Henry (1988), Merleau-Ponty (1959), Visse et al. (2019), Welten (2010)
Painting/drawing	Ey	Im	Multiple perspectives	Hatch & Yanow (2008), Henry (1988), Kandinsky (1994), Merleau-Ponty (1959), Wentworth (2004), Wollheim (2001)
Painting/drawing	Ey	Im	Reduction of reality	Slatman (2003)
Painting/drawing	Ey	Im	Different interpretations	Dahl (2010), Ingarden (1962), Wentworth (2004), Wollheim (2001)
Painting/drawing	Ey	Im	Expression or disclosure? Gain insight	Bagnoli (2009), Dahl (2010), Gadamer (1960), Hatch & Yanow (2008), Merleau-Ponty (1959), Visse et al. (2019)
Painting/drawing	Ey	Im	Boundary with aesthetics	Crowther (2017), Derrida (1978/1987), Jacquette (2006), Marion (2002)
Graphic images/photography/photocomics	Ey	Im	Make contact (care), Social art	Capous-Desillas & Bromfield (2018), Savin-Baden & Wimpenny (2014), Teachman & Gibson (2018), Toroyan & Reddy (2005), Wainwright (2017)
Collage	Ey	Im	Instrumental	Butler-Kisber & Poldma (2010), Davis & Butler-Kisber (1999), Savin-Baden & Wimpenny (2014), Vacchelli (2017)
Concept mapping	Ey	Im	Instrumental	Daughtry & Kunkel (1993)
Mind-mapping	Ey	Im	Instrumental, data collection	Noonan (2013)
Sculpting	Ey, SoT	Film, PO	Data collection, connect researcher/subject/phenomenon, focus	Blumenfeld-Jones (2016), Or (2010), Sabo & Thibeault (2012)
Play/build/tinker/sand tray	Ey, SoT	Film, PO	Activate, expression, means of communication (care), therapy	Davis & Butler-Kisber (1999), Lloyd et al. (2007), Perruzza & Kinsella (2010), Piliere (2018), Ramsey (2014), Reynolds (2002), Reynolds & Prior (2003), Roesler (2019), Stickley et al. (2007)
Textile art	Ey, SoT	Film, PO	Data collection (care, therapy)	Reynolds (2002)
Digital animation	Ey	Film, Im	Social art	Vaughn et al. (2013)
Expression via cookery	Ey, Sm, Ta	Film, Im, Txt	Data collection (Education)	VVKSO (2011b)
2 SOUND—MUSIC & SINGING
Make music, make/play instruments	Ea	Sou	Data collection	GGZStandaarden.nl (2018), VVKSO (2011a, 2011b)
Playing with sounds	Ea	Sou	Researching own experience, recognize experience/meaning	McIntosh (2006)
Music	Ea	Sou	Make contact	Randles (2012), Ridder (2003)
Experience music	Ea	Sou	Perception and expectation	Klein & Jacobsen (2012)
Singing	Ea	Sou	Data collection	GGZStandaarden.nl (2018), VVKSO (2011a, 2011b)
Soundscape	Ea	Sou	Social art	Kasat (2014)
3 LITERARY—WORDS & DRAMA
Conversation	Ea, Ey	Sou, Txt	Interaction and meaning layers	Weiher (2014)
Listening and action spaces	Ea, Ey	Sou, Txt	Multivocality	Gilligan (1982), Gilligan & Eddy (2017), Leget (2017), Savin-Baden & Wimpenny (2014)
Digital storytelling	Ey	Ea	Social art	Mumtaz (2015)
Typed words/prose/essay/anecdote/narrative/story telling/letter/reflective, descriptive, critical, dialogic-writing/fiction	Ea, Ey	Sou, Txt	Data collection/finding identities/augmentative communication/psychological diagnostics	Ashby & Causton-Theoharis (2012), Biklen (2005), GGZStandaarden.nl (2018), Savin-Baden & Wimpenny (2014), Teachman & Gibson (2018), VVKSO (2011a, 2011b)
Poetry	Ea, Ey	Txt	Data collection, invoke/recall experiences	Piirto (2002), Tucker-Raymond et al. (2011), Ucok-Sayrak (2017), Van Manen (2006, 2014)
Theater, puppet show, musical	Ea, Ey	Film, Txt	Data collection, invoke/recall experiences	Andersen & Larsen (2015), Piirto (2002), Sloane & Wallin (2013)
All literary expressions	All	All	Initiate expression, connect researcher/subject/focus on/phenomenon/invoke/recall experiences	Andersen & Larsen (2015), Blumenfeld-Jones (2016), Butler-Kisber (2002, 2007, 2008), Cole & Knowles (2008), Gillies et al. (2005), Jipson & Paley (2008), Kirkham et al. (2015), McNiff (2008), Minello (2014), Neilsen (2008), Or (2010), Piirto (2002), Reynolds & Lim (2007), Sabo & Thibeault (2012), Smith (2004)
4 PERFORMING—BODY & MOVEMENT
Mime	Ey, Pr	Film	Empathize with someone or something	Andersen & Larsen (2015), Piirto (2002)
General movement	Ey, Pr	Film	Data collection (care)	Bjorbaekmo et al. (2018), Gilsen & Willekens (2010), Samaritter (1990), Veale (2005), VVKSO (2011b)
Posture	Ey, Pr	Film	Objective/subjective body	Dekkers (2007), Merleau-Ponty (1959)
Non-verbal behavior	Ey, Pr	Film	Non-verbal communication (care)/body language/therapy	Ashby & Causton-Theoharis (2012), Connell (2003), Feder & Feder (1981), Gordijn (2007), Wertheim-Cahen (2007)
Non-verbal expression	Ey, Pr	Film	New words needed, connect researcher/subject/therapy/phenomenon/	Arnheim (1969), Blumenfeld-Jones (2016), Freeman & Vagle (2013)
Choice of clothing	Ey	Im	Data collection	Barbieri & Pantouvlaki (2016), Popa-Blanariu (2013)
Pointing	Ey	Film	Data collection	GGZStandaarden.nl (2018), VVKSO (2011a, 2011b)
Touching	SoT	Film	Data collection (care)	Van Manen (1999)
Movement and gestures	Ey, Pr	Film	Data collection, somatic experiencing	Connell (2003), Payne et al. (2015)
Movement, dance, play	Ey, Pr	Film	Recognize experience/meaning	Bjorbaekmo et al. (2018), McIntosh (2006), Parviainen (1998)
Dance	Ey, Pr	Film	Instrumental, gain insight, therapy	Bellerose (2018), Pentasugglia (2017)
Touch	SoT	Film	Data collection	GGZStandaarden.nl (2018), VVKSO (2011a, 2011b)
5 NEW MEDIA—MIXED & MULTIPLE FORMS
Color-music	Ea, Ey	Film	Data collection	Strauven (2003)
Graphic novels/sequential art	Ey	Im, Txt	Data collection	Gillenwater (2012), Savin-Baden & Wimpenny (2014)
Gesamtkunstwerk, installation art	All	All	Data collection	Nguyen (2018), Tilroe (2003)
Photo-voice projects/autophotography	Ea, Ey	Im, Sou	Data collection	Capous-Desillas & Bromfield (2018), Moreland & Cowie (2005), Plunkett et al (2013), Savin-Baden & Wimpenny (2014), Wang & Hannes (2014), Wang et al. (2017)
Virtual reality	All	All	Social art	Lally & Sclater (2013)
Multiple forms	All	All	Data collection	Skinner & Masuda (2013)
Social media/blogs	All	All	Data collection	Duneier & Carter (1999), Hookway (2008), Murthy (2008), Nardi et al. (2004)

¹ Senses: Ea = Hearing, Ey = Eyesight, SoT = sense of touch, All = All senses.

² Storage media: Sou = Sound, Txt = Text, Im = image, Film = Film footage, PO = Physical object, All = All storage media.

Expression types are used in a variety of ways. They can be used as a means to invoke or recall experiences, and to create connectedness between researchers, the experiences under investigation, and the people involved. Some are used as a means to focus on understanding particular kinds of experiences. Others can be used to assist researchers with recognition of experiences and meaning and to bring insight. There are also instrumental uses of expression types, for example, to help to make contact with others in a group, to activate people, to provide a way to express themselves and as a means of communication or to provide additional research information. Teachman and Gibson (2018) and Biklen (2005) call this “augmentative communication.”

Table 1 constitutes a hierarchical classification of expression types and their usage, linked to resources for existing methods and method development.

Next, we developed a visual and complementary tree-diagram indicating the dynamics of expression type interconnections (see Figure 1). We have drawn a trunk branching in two, with the two branches representing verbal and non-verbal expression. Further up the tree, we added branches and twigs to provide a place for allocation of all expression types encountered during our literature search. As expression types evolve, more twigs might be added. New combinations of expression types might be depicted as fruits. We have depicted multiple form types as fruits either on, or—the richer ones—fallen off the tree.

Figure 1.

The expression types tree: A hierarchical classification structure.

Discussion

In this discussion we address three topics: 1. the need to broaden the scope of this inventory so we may learn from other non-scholarly fields that work with expressions, 2. the risks of using these expression types in research, and 3. the methodological limitations of this inventory.

Scope of this Inventory

With this inventory, we illustrate that the field of qualitative research is showing increasing interest in non-verbal approaches to gain insight into accounts of participants’ experience. We aim to add to the body of knowledge (Ören, 2005) about arts-based and arts-informed research. Use of types other than mere verbal expression reveals more about experiences, as was illustrated by for example the expression of clothing (Popa-Blanariu, 2013), collage making (Vacchelli, 2017), music therapy (Ridder, 2003) or dance (Bellerose, 2018). We generated a preliminary inventory of expression types used in the diverse field of qualitative research and infused it with experiences from related fields. We should note that arts-based research follows a long, strong tradition of considering methodology, rigor, and quality. To date, however, we have not been able to find an overview of expression types providing guidance for qualitative researchers as to which one(s) to use for a specific situation.

Many researchers would probably consider these expression types to be methods that are commonly used in arts-based research (ABR). However, since expression types are used in multiple disciplines, we feel the need to distinguish the expression types listed in this inventory from the constraints posed by ABR as a methodological approach. While the expression types can of course be part of ABR, as they already are, their meaning for particular kinds of qualitative research—such as for ethnographies, and poetic approaches to research—is growing. This is due to the growing acknowledgment in the field of other modes of knowing, especially non-verbal modes of knowing that point toward non-linguistic realms of being and knowing (Visse et al., 2019).

With this inventory, we aim to contribute in particular to the field of qualitative health research. Researchers can start from existing methods as listed in Table 1, or they can use the classification to verify other options for their study method design. Solely verbal modes of knowing can make accessing illness experiences particularly challenging, as people’s experiences fluctuate significantly, depending on the moment of diagnosis, the severity of their situation, time issues and other complexities involved in dealing with their “place in the world” (Biklen, 2005). Numerous researchers have argued that an illness experience begins with having to struggle with uncertainty (Miller, 2007), which is itself a black box that can hardly be grasped through verbal expressions alone. In contrast, what does it mean when someone feels well, and experiences a homelike existence in the world? The emerging interest in using one or more expression types in health related research is highlighted not only by the growing number of publications, but by the rich variety of keynotes at conferences on health, illness and well being.³ Researchers aiming to understand illness, disease, disability, and health have been working with a wide variety of non-verbal methods for many years (Nguyen, 2018; Wang et al., 2017). Thus, while the types listed in our inventory are not new, the synthesis is.

Using Expression Types in Research

There seems to be a vast gap between the scholarly fields of qualitative and arts-based research, and how the arts are practiced and theorized in the context of art academies (De Oliveira, 2013). In art academies, artistic research focuses on the process of knowledge generation of the artist-researcher by learning through the arts. Here, researchers of both the scientific and art academies share a similar aim: enhancing their understanding through diverse forms of knowing. We carried out this inventory primarily for those who work in the field of scholarly qualitative research, but we acknowledge that much can (and should) be learned from artistic researchers who are based in the art academies (Visse et al., 2019).

Recently, artists, like Finnish arts-based health researcher Kaisu Koski,⁴ are entering the medical and health humanities field; some seek collaborations with academic scholars. This illustrates how the boundaries between universities and art academies—or, to phrase it differently,—between scholarly research practices and studio/performance spaces—are slowly dissolving. In a future version of this inventory, developments in both fields might be included. At this stage, the expression types may facilitate the emerging understandings between researchers and participants of qualitative health endeavors. They may assist researchers in reaching a more subtle and nuanced understanding of respondents’ health related experiences, perceptions, and issues. Example are photo-voice (Wang et al., 2017) and autophotography, in which the photographs that participants take of their environment are used as data. Autophotography captures the participant’s experiences (Moreland & Cowie, 2005). The photos are used during interviews to discuss the meanings of the photographs and can be interpreted more than once to add new viewpoints to what a participant would usually share by merely telling his or her story (Bigante, 2010). Photo elicitation interviews create “deep and interesting talk” (Harper, 2002, p. 23).

Methodological Limitations

On a more epistemological and methodological note, we should address three reliability issues that need to be taken into consideration when designing methods for research based on these expression types. Use of these expression types may lead to the inclusion of too much insight, too little insight or distorted insight into the experiences of participants.

Firstly, while analyzing any expression type (e.g., a drawing) a researcher might infer too much meaning, thus reaching outside the perimeter of the collected data (Borgdorff, 2012; Ellis & Scott-Hoy, 2004). Using arts-based expressions, researchers can reveal more than the work was intended to convey (Merleau-Ponty, 1959). Here it is worth elaborating upon the difference between expression and disclosure (Gadamer, 1960; Visse et al., 2019). Both the subject and the researcher may introduce any kind of expression and accept—yet not identify—imagination (Crowther, 2013) or fantasy (Ucok-Sayrak, 2017) as part of the data. This is why we need to learn how phenomenological scholars theorize about a phenomenon reaching saturation.⁵

Secondly, a researcher might obtain too little insight from an expression of the experiences under investigation. Here, the experiences would be only partly explored, this may be because the expression is found to contain little meaning, or due to methodical omissions in data collection, such as superficial interviewing or too-selective shadowing. In such a case, the use of physical, psychological, social, and spiritual layers of meaning, as proposed by Weiher (2014), may be of help to a researcher in carrying out a deeper data collection process. Next, using observation techniques for listening “for what is unspoken” (Gilligan & Eddy, 2017, p. 76) may increase the quality of the insights into the experiences (Arendt, 1978; Finlay, 2014). Moreover, in order to get closer to a comprehensible expression of the experience,⁶ researchers could increase the choice and quality of expression types by gathering multiple perspectives on experiences in a particular research setting (Hatch & Yanow, 2008; Ingarden, 1962). However, this provides no guarantee that the experience is actually expressed. Looking at a picture, a painting, an architectural building or listening to a music performance, are no linear activities with a sender and receiver. There is not one and the same piece of music, not even for one and the same person listening to consecutive performances of that piece (Ingarden, 1962). This has methodological implications (Wentworth, 2004; Wollheim, 2001), since these notions could lead to too much reduction—reduction caused by overemphasizing an artistic expression, or by using metaphors because these put the researcher’s every day perceptions of the world aside (Slatman, 2003). Van Manen (2014) implied the need for a minimum requirement by disqualifying a short, intense, one-off experience as too small to be considered a lived experience.

Thirdly, any method, if incorrectly applied by a researcher, or if having a flawed design to start with, might distort the insights into experiences. Scientific rigor is necessary to reduce the uncertainties and increase reliability and validity of empirical results obtained. Proper research quality starts with the critical attitude of the researcher while shaping the results. This is done by following quality procedures, interacting, interpreting, and communicating the data, whether obtained verbally or non-verbally through non-verbal types of expression. We contend that there is a need for advancing quality procedures such that non-verbal expressions are being considered as findings. Such procedures are available in arts-based research and can be applied in qualitative health related research.

Before we conclude, we need to mention that this study has methodological limitations. It is restricted to primary and secondary scientific sources and may therefore have neglected forms of expression that have not yet been subjected to scientific study. We contend that such an expression would likely comprise either a combination of the types identified in this study or a further variation within one of these types. Searching the so-called “grey literature”—i.e., non-scientific but credible publications—may add detail and depth to this expression types inventory (Pandita & Singh, 2011, p. 1; see also Wessels, 1997).

Researchers who draw upon these expression types share their results with others, such as participants, clients, and other stakeholders. Research reports are still the primary way of communicating research findings. Other forms of (re-)presentation are contested due to issues concerning evidence and rigor. Creativity is needed to find practical ways to share the insights that emerge from working with a plurality of expression types in reports. Here qualitative health researchers could draw inspiration from the artistic researchers who are seeking alternative modes of representation by experimenting with practice-led research.⁷

Practical limitations in recording, storing and sharing of dynamic and unique non-verbal expression—via sound, images, film footage, smell and physical objects—may constrain the quality of such research. Although repeatability may be limited due to the specific context changing in time (Fielding, 2004), we believe in the promise of experimentation that artistic researchers have already embarked upon.

Conclusion and Recommendations

This inventory provides qualitative health researchers with an overview of the plethora of expression types enabling the gathering, interpreting, understanding and (re-)presentation of data about the experiences of participants. The inventory can be used as a source of inspiration to enhance the quality of one’s research methodology via methodological and data types triangulation. It can also be used as a frame of reference for researchers to verify whether they have taken into account the complexity and ambiguities of everyday experiences regarding the themes or phenomena under scrutiny. Using a variety of existing and newly conceived combinations of expression types opens up new possibilities for researchers hoping to obtain a more holistic insight into experience.

As discussed, we recommend further research, firstly in order to learn more from existing practice in health care, education, therapy, psychology and counseling, and secondly on how artistic researchers work with and report on non-verbal expression types (painting/drawing, sculpting, dressing, cooking, collage, theater, dance, music). Building bridges between qualitative health researchers and artistic researchers opens up new possibilities to enter the tacit, sensory and unspeakable realms of our experience. These approaches can assist us in finding solutions to both methodological problems in qualitative research (too much, too little, distorted insights) and issues of data collection and (re-)presentation (recording, storing and sharing). We contend that taking steps in this direction adds depth to how qualitative health research insights are developed and communicated. In this way, the depth of our insight into experiences will hopefully increase while we continue to honor the ambiguous realms of our existence.

Footnotes

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The authors are thankful for receiving funding by the University of Humanistic Studies that supported the publication costs of this article. This research received no specific grant from any funding agency in the public, commercial, or not for-profit sectors.

ORCID iDs

Paul Lindhout

Merel Visse

Notes

References

Andersen

H. E.

Larsen

K. V.

(2015). Sculpting with people. An experiential learning technique. Nurse Education in Practice, 15(6), 556–560.

Arendt

(1978). The life of the mind. Hartcourt, Inc.

Arnheim

(1969). Visual thinking. University of California Press.

Ashby

C. E.

Causton-Theoharis

(2012). “Moving quietly through the door of opportunity”: Perspectives of college students who type to communicate. Equity & Excellence in Education, 45(2), 261–282.

Aydin

(2007). Fenomenologie van een, twee en drie [Phenomenology of one, two and three]. In Aydin

(Ed.), De vele gezichten van de fenomenologie [The many faces of phenomenology] (pp. 197–217). Klement/Pelckmans.

Bagnoli

(2009). Beyond the standard interview: The use of graphic elicitation and arts-based methods. Qualitative Research, 9(5), 547–570.

Barbieri

Pantouvaki

(2016). Towards a philosophy of costume. Studies in Costume & Performance, 1(1), 3–7. Retrieved May 24, 2020, from https://doi.org/10.1386/scp.1.1.3

Bellerose

(2018). On the lived, imagined body: A phenomenological praxis of a somatic architecture. Phenomenology & Practice, 12(1), 57–71. Retrieved May 24, 2020, from https://doi.org/10.29173/pandpr29358

Bigante

(2010). The use of photo-elicitation in field research. EchoGéo, 11, 1–20. Retrieved May 16, 2020, from https://doi.org/10.4000/echogeo.11622

10.

Biklen

(2005). Autism and the myth of the person alone (Vol. 3). NYU Press.

11.

Bjorbaekmo

W. S.

Evensen

K. V.

Groven

K. S.

Rugseth

Standahl

Ø. F.

(2018). Phenomenology of professional practices in education and health care: An empirical investigation. Phenomenology & Practice, 12(1), 18–30. Retrieved May 24, 2020, from https://journals.library.ualberta.ca/pandpr/index.php/pandpr/article/view/29355/21368

12.

Bloch

(2018). Place-based elicitation: Interviewing graffiti writers at the scene of the crime. Journal of Contemporary Ethnography, 47(2), 171–198.

13.

Blumenfeld-Jones

D. S.

(2016). The artistic process and arts-based research: A phenomenological account of the practice. Qualitative Inquiry, 22(5), 322–333.

14.

Borgdorff

(2012). The conflict of the faculties: Perspectives on artistic research and Academia. Leiden University Press.

15.

Boydell

K. M.

Gladstone

B. M.

Stasiulis

Volpe

Dhayanandhan

Cole

A. L.

(2015). The co-creation of a mural depicting experiences of psychosis. In Conrad

Sinner

(Eds.), Creating together: Participatory, community-based, and collaborative arts practices and scholarship across Canada (pp. 39–50). Wilfrid Laurier University Press.

16.

Busch

(2009). Artistic research and the poetics of knowledge. Art & Research. A Journal of Ideas, Contexts and Methods, 2(2), 1–7. Retrieved May 22, 2020 from https://laboratory.culturalinquiry.org/wp-content/uploads/2016/03/art-and-research.pdf

17.

Butler-Kisber

(2002). Artful portrayals in qualitative inquiry: The road to found poetry and beyond. Alberta Journal of Educational Research, 48(3), 229–239. Retrieved May 24, 2020, from http://cjc-rcc.ucalgary.ca/index.php/ajer/article/view/54930/41985

18.

Butler-Kisber

(2007). Collage as analysis and representation in qualitative inquiry. In Knowles

J. G.

Cole

A. L.

Neilsen

Luciani

T. C.

(Eds.), The art of visual inquiry (pp. 265–280). Backalong.

19.

Butler-Kisber

(2008). Collage as inquiry. In Knowles

J. G.

Cole

A. L.

(Eds.), Handbook of the arts in qualitative research (pp. 265–276). Sage.

20.

Butler-Kisber

Poldma

(2010). The power of visual approaches in qualitative inquiry: The use of collage making and concept mapping in experiential research. Journal of Research Practice, 6(2), 1–14. Retrieved May 16, 2020, from http://jrp.icaap.org/index.php/jrp/article/view/197/232

21.

Buttimer

(1976). Grasping the dynamism of lifeworld. Annals of the Association of American Geographers, 66(2), 277–292.

22.

Capous-Desyllas

Bromfield

N. F.

(2018). Using an arts-informed eclectic approach to photovoice data analysis. International Journal of Qualitative Methods, 17(1), 1–14.

23.

Cartiere

Willis

(Eds.) (2008). The practice of public art. Taylor & Francis.

24.

Churchill

S. D.

(2018). Explorations in teaching the phenomenological method: Challenging psychology students to grasp at meaning in human science research. Qualitative Psychology, 5(2), 207–228.

25.

Cole

A. L.

Knowles

J. G.

(2008). Visual images in research. In Knowles

G. J.

Cole

A. L.

(Eds.), Handbook of the arts in qualitative research (pp.55–70). Sage.

26.

Connell

P. J.

(2003). A phenomenological study of the lived experiences of adult caregiving daughters and their elderly mothers [Doctoral thesis, philosophy]. University of Florida.

27.

Creswell

J. W.

(2014). Research design: Qualitative, quantitative and mixed method approaches (4th ed.). Sage.

28.

Cronin

Ryrie

Huntley

Hayton

(2018). Sinking and swimming in disability coaching: An autoethnographic account of coaching in a new context. Qualitative Research in Sport, Exercise and Health, 10(3), 362–377.

29.

Cronin

Ryan

Coughlan

(2008). Undertaking a literature review: A step-by-step approach. British Journal of Nursing, 17(1), 38–43.

30.

Crowther

(2013). Imagination, language, and the perceptual world: A post-analytic phenomenology. Continental Philosophy Review, 46(1), 37–56.

31.

Crowther

(2017). What drawing and painting really mean: The phenomenology of image and gesture. Taylor & Francis.

32.

Dahl

(2010). Towards a phenomenology of painting: Husserl’s horizon and Rothko’s abstraction. Journal of the British Society for Phenomenology, 41(3), 229–245.

33.

Daughtry

Kunkel

M. A.

(1993). Experience of depression in college students: A concept map. Journal of Counseling Psychology, 40(3), 316–323.

34.

Davey

(2016). Word, image, and concept. In Keane

Lawn

(Eds.), The Blackwell companion to hermeneutics (pp. 242–247). Wiley.

35.

Davis

Butler-Kisber

(1999, April 19–23). Arts-based representation in qualitative research: Collage as a contextualizing analytic strategy [Paper presentation]. Annual Meeting of the American Educational Research Association , Montreal, Quebec, Canada. Retrieved May 16, 2020, https://files.eric.ed.gov/fulltext/ED431790.pdf

36.

De Oliveira

D. M. B.

(2013). The gesture in the art of singing of Teresa Stratas: An art-based research based on an artistic research. In Hernández-Hernández

Fendler

(Eds.), Proceedings of the first conference on Arts-Based and Artistic Research: Critical reflections on the intersection of art and research (pp. 94–95). University of Barcelona. Retrieved May 16, 2020, http://hdl.handle.net/2445/45264

37.

Dekkers

W. J. M.

(2007). Maurice merleau-ponty, fenomenologie van het lichaam [Maurice merleau-ponty, phenomenology of the body]. In Aydin

(Ed.), De vele gezichten van de fenomenologie [The many faces of phenomenology] (pp. 118–135). Kampen: Klement/Pelckmans.

38.

Deleuze

Guattari

(1980). Mille plateaux [A thousand plateaus], Volume 2 of Capitalisme et Schizophrénie [Capitalism and schizophrenia]. Les Editions de Minuit.

39.

Denzin

N. K.

(2019). The death of data in neoliberal times. Qualitative Inquiry, 25(8), 721–724.

40.

Derrida

(1987). The truth in painting. University of Chicago Press. [Originally published in 1978 as: La vérité en peinture, Paris: Flammarion]

41.

Duneier

Carter

(1999). Sidewalk. Farrar, Straus and Giroux.

42.

Eisner

E. W.

(1991). The enlightened eye: Qualitative inquiry and the enhancement of educational practice. Macmillan.

43.

Eisner

E. W.

(2008). Art and knowledge. In Knowles

J. G.

Cole

A. L.

(Eds.), Handbook of the arts in qualitative research (pp. 3–12). Sage.

44.

Ellis

(2004). The ethnographic I: A methodological novel about autoethnography. AltaMira Press.

45.

Ellis

Scott-Hoy

(2004). Art as auto-ethnography/auto-ethnography as art. In Ellis

(Ed.), The ethnographic I: À methodological novel about auto-ethnography (pp. 184–192). AltaMira Press.

46.

Feder

(1981). The expressive arts therapies. Prentice-Hall.

47.

Fielding

(2004). Getting the most from archived qualitative data: Epistemological, practical and professional obstacles. International Journal of Social Research Methodology, 7(1), 97–104.

48.

Finlay

(2009). Debating phenomenological research methods. Phenomenology & Practice, 3(1), 6–25.

49.

Finlay

(2014). Engaging phenomenological analysis. Qualitative Research in Psychology, 11(2), 121–141.

50.

Franke

W. P.

(2007). On what cannot be said (Vol. 2). University of Notre Dame Press.

51.

Freeman

Vagle

M. D.

(2013). Grafting the intentional relation of hermeneutics and phenomenology in linguisticality. Qualitative Inquiry, 19(9), 725–735.

52.

Gadamer

H.-G.

(1960). Wahrheit und Methode: Grundzüge einer philosophischen Hermeneutik [Truth and Method: Basics of a Philosophical Hermeneutics]. Mohr.

53.

GGZstandaarden.nl (2018). Vaktherapie in de zorg [Professional therapy in healthcare] . Retrieved November 16, 2019, https://www.ggzstandaarden.nl/generieke-modules/vaktherapie/vaktherapie-in-de-zorg

54.

Gillenwater

(2012). Graphic novels in advanced English/language art classrooms: A phenomenological case study. [Doctoral thesis, education]. University of North Carolina at Chapel Hill. Retrieved May 16, 2020 https://cdr.lib.unc.edu/downloads/1r66j180w

55.

Gillies

Harden

Johnson

Reavey

Strange

Willig

(2005). Painting pictures of embodied experience: The use of nonverbal data production for the study of embodiment. Qualitative Research in Psychology, 2(3), 199–212.

56.

Gilligan

(1982). In a different voice: Psychological theory and women’s development. Harvard University Press.

57.

Gilligan

Eddy

(2017). Listening as a path to psychological discovery: An introduction to the listening guide. Perspectives on Medical Education, 6(2), 76–81.

58.

Gils

J. van

Willekens

(2010). Belevingsonderzoek bij kinderen en jongeren die in armoede leven. Deel 2: De beleving van kinderen die leven in armoede in Vlaanderen [Experience research with children and adolescents lining in poverty. Part 2: Experiences of children living in poverty in Vlaanderen ]. Onderzoekscentrum Kind & Samenleving vzw.

59.

Goble

(2013). Dwelling between word and image: Using images in phenomenological writing. In Fitzsimmons

Charalambous

Wiesner

(Eds.), Spectrums and spaces of writing (pp. 33–46). Brill.

60.

Gordijn

(2007). Words imagine. Pallium, 9(3), Article 79.

61.

Gregoriou

(2004). Commencing the rhizome: Towards a minor philosophy of education. Educational Philosophy and Theory, 36(3), 233–251.

62.

Gschwandtner

C. M.

(2014). Degrees of givenness: On saturation in Jean-Luc Marion. Indiana University Press.

63.

Halling

Hansen

F. T.

(2014). Creativity as opening toward new beginnings. Akademisk kvarter, 9(12), 5–17. Retrieved May 20, 2020, http://www.akademiskkvarter.hum.aau.dk/AKsamlet/AK_Vol_09_12_2014.pdf

64.

Hansen

F. T.

(2018). At Møde verden med undren: Dannelse, innovation og organisatorisk udvikling i et værensfilosofisk perspektiv [To meet the world in wonder: Education, innovation and organizational development in an existence philosophical perspective] . Reitzels.

65.

Harper

(2002). Talking about pictures: A case for photo elicitation. Visual Studies, 17(1), 13–26.

66.

Hatch

M. J.

Yanow

(2008). Methodology by metaphor: Ways of seeing in painting and research. Organization Studies, 29(1), 23–44.

67.

Henry

(1988). Voir I’invisible: Sur Kandinsky [Seeing the invisible: About Kandinsky] . Françoise Bourin.

68.

Heywood

Sandywell

(Eds.) (1999). Interpreting visual culture. Exploration in the hermeneutics of the visual. Taylor & Francis.

69.

Hookway

(2008). Entering the blogosphere: Some strategies for using blogs in social research. Qualitative Research, 8(1), 91–113.

70.

Ingarden

(1962). Untersuchungen zur Ontologie der Kunst: Musikwerk. Bild. Architektur. Film [Investigations into ontology of art, music, image, architecture and film] . Niemeyer.

71.

Jacquette

(2006). Intention, meaning, and substance in the phenomenology of abstract painting. The British Journal of Aesthetics, 46(1), 38–58.

72.

Jipson

Paley

(2008). No style, no composition, no judgment. In Knowles

J. G.

Cole

A. L.

(Eds.), Handbook of the arts in qualitative research (pp. 435–448).Sage.

73.

Kandinsky

(1994). On the spiritual in art and point and line to plane. In Lindsay

K. C.

Vergo

(Eds.), Kandinsky, complete writings on art. Da Capo Press.

74.

Kapitan

(1999). The ubiquity of self-awareness. Grazer Philosophische Studien, 57(1), 17–43.

75.

Kasat

(2014). Tools for social transformation: Making the personal creative and political. Griffith Review, 44(2014), 7–17. Retrieved May 24, 2020, http://www.canwa.com.au/wp-content/uploads/2015/07/Tools-for-social-transformation-Griffith-Review-Cultural-Solutions-May-2014.pdf

76.

Kirkham

J. A.

Smith

J. A.

Havsteen-Franklin

(2015). Painting pain: An interpretative phenomenological analysis of representations of living with chronic pain. Health Psychology, 34(4), 398–406.

77.

Klein

Jacobsen

(2012). Music is not a language: Re-interpreting empirical evidence of musical syntax. Institute for Artistic Research.

78.

Lally

Sclater

(2013). The inter-life project: Researching the potential of art, design and virtual worlds as a vehicle for assisting young people with key life changes and transitions. British Journal of Guidance & Counselling, 41(3), 318–338. Retrieved May 24, 2020, https://doi.org/10.1080/03069885.2013.773582

79.

Lapadat

J. C.

(2017). Ethics in autoethnography and collaborative autoethnography. Qualitative Inquiry, 23(8), 589–603.

80.

Lather

(2006). Paradigm proliferation as a good thing to think with: Teaching research in education as a wild profusion. International Journal of Qualitative Studies in Education, 19(1), 35–57.

81.

Lather

St. Pierre

E. A.

(2013). Post-qualitative research. International Journal of Qualitative Studies in Education, 26(6), 629–633.

82.

Le Grange

(2018). What is (post)qualitative research? South African Journal of Higher Education, 32(5), 1–14. Retrieved May 24, 2020 http://doi.org/10.20853/32-5-3161

83.

Leget

C. J. W.

(2017). Art of living, art of dying. Spiritual care for a good death. Jessica Kingsley Publishers.

84.

Leitch

R. M.

Conroy

J. C.

(2015). Masks as methodology and the phenomenological turn: Issues of interpretation. In International handbook of interpretation in educational research (pp. 1533–1550). Springer.

85.

Levin

S. A.

(2002). Complex adaptive systems: Exploring the known, the unknown and the unknowable. Bulletin of the American Mathematical Society, 40(1), 3–19. Retrieved May 24, 2020, http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.129.7968&rep=rep1&type=pdf

86.

Lloyd

Wong

S. R.

Petchkovsky

(2007). Art and recovery in mental health: A qualitative investigation. British Journal of Occupational Therapy, 70(5), 207–214.

87.

Marion

J.-L.

(2002). Etant donné. Essai d’une phénoménologie de la donation [Being given: Towards a phenomenology of givenness] ( Kossky

J. L.

Alto

& P.

, Trans). Stanford University Press.

88.

Maykut

Morehouse

(1994). Qualitative data analysis: Using the constant comparative method. In Maykut

Morehouse

(Eds.), Beginning qualitative research: A philosophic and practical guide (pp. 126–149). Falmer Press.

89.

McIntosh

(2006). How dancing, singing and playing shape the ethnographer: Research with children in a Balinese dance studio. Anthropology Matters Journal 2006 , 8(2), 1–17.

90.

McNiff

(2008). Art-based research. In Knowles

J. G.

Cole

A. L.

(Eds.), Handbook of the arts in qualitative research (pp. 29–40). Sage.

91.

Merleau-Ponty

(1959). Signes [Signs] . Gallimard.

92.

Miller

C. M.

(1997). The lived experiences of relapsing multiple sclerosis: A phenomenological study. The Journal of Neuroscience Nursing, 29(5), 294–305.

93.

Minello

(2014). Exploring play and playfulness in the everyday lives of older women. [Master thesis, arts]. University of Waterloo. Retrieved May 16, 2020, https://uwspace.uwaterloo.ca/bitstream/handle/10012/8367/Minello_Karla.pdf?sequence=3

94.

Moreland

Cowie

(2005). Exploring the methods of auto-photography and photo-interviews: Children taking pictures of science and technology. Waikato Journal of Education, 11(1).

95.

Mumtaz

(2015). Participatory action-based design research: Designing digital stories together with new-immigrant/refugee communities for health and wellbeing. In Conrad

Sinner

(Eds.), Creating together: Participatory, community-based, and collaborative arts practices and scholarship across Canada (pp. 51–68). Wilfrid Laurier University Press.

96.

Murthy

(2008). Digital ethnography: An examination of the use of new technologies for social research. Sociology, 42(5), 837–855.

97.

Nardi

B. A.

Schiano

D. J.

Gumbrecht

Swartz

(2004). Why we blog. Communications of the ACM, 47(12), 41–46. Retrieved May 24, 2020, https://artifex.org/∼bonnie/pdf/Nardi_why_we_blog.pdf

98.

Neilsen

(2008). Lyric inquiry. In Knowles

J. G.

Cole

A. L.

(Eds.), Handbook of the arts in qualitative research (pp. 93–102). Sage.

99.

Nguyen

(2018). The creative and rigorous use of art in health care research. Forum Qualitative Sozialforschung/Forum: Qualitative Social Research, 19(2), Article 16. Retrieved May 24, 2020 http://doi.org/10.17169/fqs-19.2.2844

100.

Noonan

(2013). Mind maps: Enhancing midwifery education. Nurse Education Today, 33(8), 847–852.

101.

M. B.

(2010). Clay sculpting of mother and child figures encourages mentalization. The Arts in Psychotherapy, 37(2010), 319–327. Retrieved May 24, 2020, https://doi.org/10.1016/j.aip.2010.05.007

102.

Ören

T. I.

(2005). Toward the body of knowledge of modeling and simulation. In Interservice/industry training, simulation, and education conference (I/ITSEC) 2005 Paper No. 2025 (pp. 1–19). Retrieved May 16, 2020 http://www.site.uottawa.ca/∼oren/pubs-pres/2005/pub-0513-MSBOK-IITSEC.pdf

103.

Pandita

Singh

(2011). Grey literature: A valuable untapped stockpile of information. Journal of the Young Librarians Association, 5(2011), 52–60.

104.

Parviainen

(1998). Bodies moving and moved. A phenomenological analysis of the dancing subject and the cognitive and ethical values of dance art [Doctoral thesis, philosophy]. Tampere University. Retrieved May 16, 2020, https://trepo.tuni.fi/bitstream/handle/10024/68138/951-44-5595-9.pdf?sequence=1

105.

Payne

Levine

P. A.

Crane-Godreau

M. A.

(2015). Somatic experiencing: Using interoception and proprioception as core elements of trauma therapy. Frontiers in Psychology, 6, 93.

106.

Peirce

C. S.

(1868). On a new list of categories. Proceedings of the American Academy of Arts and Sciences, 7(1868), 287–298. Retrieved May 16, 2020, https://www.jstor.org/stable/pdf/20179567.pdf

107.

Pentassuglia

(2017). The art(ist) is present: Arts-based research perspective in educational research. Cogent Education, 4(1), 1301011. Retrieved May 24, 2020, https://www.tandfonline.com/doi/full/10.1080/2331186X.2017.1301011

108.

Perruzza

Kinsella

E. A.

(2010). Creative arts occupations in therapeutic practice: A review of the literature. British Journal of Occupational Therapy, 73(6), 261–268.

109.

Persons

R. W.

(2009). Art therapy with serious juvenile offenders. International Journal of Offender Therapy and Comparative Criminology, 53(4), 433–453.

110.

Piirto

(2002). The question of quality and qualifications: Writing inferior poems as qualitative research. International Journal of Qualitative Research in Education, 15(4), 421–445.

111.

Pile

(2010). Emotions and affect in recent human geography. Transactions of the Institute of British Geographers, 35(1), 5–20. Retrieved May 24, 2020, https://doi.org/10.1111/j.1475-5661.2009.00368.x

112.

Piliere

(2018). Art therapy interventions that facilitate non-verbal expressions and how art therapy can improve communication for children with autism. https://digitalcommons.liu.edu/cgi/viewcontent.cgi?article=1034&context=post_honors_theses

113.

Pink

(2015). Doing sensory ethnography. Sage.

114.

Plunkett

Leipert

B. D.

Ray

S. L.

(2013). Unspoken phenomena: Using the photovoice method to enrich phenomenological inquiry. Nursing Inquiry, 20(2), 156–164.

115.

Polit

D. F.

Beck

C. T.

(2006). Essentials of nursing research: Methods, appraisal and utilization (6th ed.). Lippincott Williams and Wilkins.

116.

Popa-Blanariu

(2013). Towards a framework of a semiotics of dance. CLCWeb: Comparative Literature and Culture, 15(1), Article 7. Retrieved May 24, 2020, https://docs.lib.purdue.edu/cgi/viewcontent.cgi?article=2183&context=clcweb

117.

Ramsey

L. C.

(2014). Windows and bridges of sand: Cross-cultural counseling using sand tray methods. Procedia-Social and Behavioral Sciences, 159, 541–545.

118.

Randles

(2012). Phenomenology: A review of the literature. Update: Applications of Research in Music Education, 30(2), 11–21.

119.

Reynolds

(2002). Symbolic aspects of coping with chronic illness through textile arts. The Arts in Psychotherapy, 29(2), 99–106. Retrieved May 24, 2020, https://bura.brunel.ac.uk/bitstream/2438/2070/1/SymbolFR

120.

Reynolds

Lim

K. H.

(2007). Contribution of visual art-making to the subjective wellbeing of women living with cancer: A qualitative study. Arts in Psychotherapy, 34(1), 1–10. Retrieved May 24, 2020, https://doi.org/10.1016/j.aip.2006.09.005

121.

Reynolds

Prior

(2003). A lifestyle coat-hanger: A phenomenological study of the meanings of artwork for women coping with chronic illness and disability. Disability and Rehabilitation, 25(14), 785–794.

122.

Richardson

(1995). Narrative and sociology. In Van Maanen

(Ed.), Representation in ethnography (pp. 198–221). Sage.

123.

Ridder

H. M. O.

(2003). Singing dialogue: Music therapy with persons in advanced stages of dementia: A case study research design [Doctoral dissertation, music] . Aalborg Universitet. Retrieved May 16, 2020, https://core.ac.uk/download/pdf/60336586.pdf

124.

Roesler

(2019). Sandplay therapy: An overview of theory, applications and evidence base. The Arts in Psychotherapy, 64, 84–94.

125.

Rose

(2001). Visual methodologies. Sage.

126.

Sabo

B. M.

Thibeault

(2012). I’m still who I was, creating meaning through engagement in art: The experiences of two breast cancer survivors. European Journal of Oncology Nursing, 16(2012), 203–211.

127.

Samaritter

(1990). De dans ontsprongen: dansante bewegingsmomenten in kreatieve therapie [Evade the dance, moments of dancing movement in creative therapy]. Tijdschrift voor Kreatieve Therapie, 9(4), 98–102.

128.

Savin-Baden

Wimpenny

(2014). A practical guide to arts-related research. Sense Publishers.

129.

Schick-Makaroff

K. L.

(2011). Stories of chronic kidney disease: Listening for the unsayable [Doctoral thesis, nursing]. University of Victoria. Retrieved May 16, 2020, https://dspace.library.uvic.ca/bitstream/handle/1828/3552/Schick%20Makaroff_Kara_PhD_2011.pdf?sequence=1

130.

Scott-Hoy

Ellis

(2005). Wording pictures, discovering heartful auto-ethnography. Communication Faculty Publications. https://scholarcommons.usf.edu/spe_facpub/277

131.

Skinner

Masuda

J. R.

(2013). Right to a healthy city? Examining the relationship between urban space and health inequity by Aboriginal youth artist-activists in Winnipeg. Social Science & Medicine, 91(2013), 210–218.

132.

Slatman

(2003). Filosofie en kunst [Philosophy and art]. Wijsgerig Perspectief, 43(4), 18–27. Retrieved May 24, 2020, http://www.jennyslatman.nl/download/publications/filosofieenkunst.pdf

133.

Sloane

J. A.

Wallin

(2013). Theatre of the commons: A theatrical inquiry into the democratic engagement of former refugee families in Canadian public high school communities. Educational Research, 55(4), 454–472.

134.

Smith

J. A.

(2004). Reflecting on the development of interpretative phenomenological analysis and its contribution to qualitative research in psychology. Qualitative Research in Psychology, 1(1), 39–54.

135.

Stickley

Hui

Morgan

Bertram

(2007). Experiences and constructions of art: A narrative-discourse analysis. Journal of Psychiatric and Mental Health Nursing, 14(8), 783–790.

136.

Strauven

(2003). Futuristische geluiden: vloekende kleuren + chromatische akkoorden + lawaaikunst + zang tumb tumb + gefilmde analogieën [Futuristic sounds: Swearing colors + chromatic chords + noise art + singing tumb tumb + fimed analogies]. Tijdschrift voor Mediageschiedenis, 6(2), 10–33.

137.

Taylor

P. C.

(2008). Multi-paradigmatic research design spaces for cultural studies researchers embodying postcolonial theorising. Culture Studies of Science Education, 4(4), 881–890.

138.

Teachman

Gibson

B. E.

(2018). Integrating visual methods with dialogical interviews in research with youth who use augmentative and alternative communication. International Journal of Qualitative Methods, 17(1), 1–12. Retrieved May 21, 2020, https://doi.org/10.1177%2F1609406917750945

139.

Tilroe

(2003). De kunst, de curator en de grote schoonmaak [Art, curator and the big clean-out]. In Franke

(Ed.), Nieuw engagement: in architectuur, kunst en vormgeving [New engagement: in architecture, art and design] (pp.128–136). NAi.

140.

Toroyan

Reddy

P. S.

(2005). Participation of South African youth in the design and development of AIDS photocomics. International Quarterly of Community Health Education , 25(1-2), 149–163.

141.

Tucker-Raymond

Rosario-Ramos

E. M.

Rosario

M. L.

(2011). Cultural persistence, political resistance, and hope in the community and school-based art of a Puerto Rican diaspora neighbourhood. Equity & Excellence in Education, 44(2), 270–286.

142.

Ucok-Sayrak

I. O.

(2017). Exploring poetry as philosophy of communication. Atlantic Journal of Communication, 25(5), 305–317.

143.

Uotinen

(2011). Senses, bodily knowledge, and autoethnography: Unbeknown knowledge from an ICU experience. Qualitative Health Research, 21(10), 1307–1315.

144.

Vacchelli

(2017). Embodiment in qualitative research: collage making with migrant, refugee and asylum seeking women. Qualitative Research, 18(2), 171–190.

145.

Van Manen

(1999). The pathic nature of inquiry and nursing. In Madjar

Walton

(Eds.), Nursing and the experience of illness: Phenomenology in practice (pp. 17–35). Taylor & Francis.

146.

Van Manen

(2006). Writing qualitatively, or the demands of writing. Keynote address: Third Nordic interdisciplinary conference on qualitative methods. Qualitative Health Research, 16(5), 713–722.

147.

Van Manen

(2014). Phenomenology of practice: Meaning-giving methods in phenomenological research and writing. Left Coast Press.

148.

Varela

F. J.

Shear

(1999). First-person methodologies: What, why, how? Journal of Consciousness Studies, 6(2–3), 1–14. Retrieved May 24, 2020 https://pdfs.semanticscholar.org/3852/a7981815f05f0a23e0710bbc7d6c52086ca3.pdf

149.

Vaughn

N. A.

Jacoby

S. F.

Williams

Guerra

Thomas

N. A.

Richmond

T. S.

(2013). Digital animation as a method to disseminate research findings to the community using a community-based participatory approach. American Journal of Community Psychology, 51(1), 30–42.

150.

Veale

(2005). Creative methodologies in participatory research with children. In Greene

Hogan

(Eds.), Researching children’s experience. Approaches and methods (pp. 253–272). Sage.

151.

Visse

Hansen

F. T.

Leget

(2019). The unsayable in arts-based research. On the praxis of life itself. International Journal of Qualitative Methods, 18(2019), 1–13. Retrieved May 16, 2020, https://journals.sagepub.com/doi/pdf/10.1177/1609406919851392

152.

VVKSO. (2011a). Sociale en technische wetenschappen 2de graad TSO: Leerplan secundair onderwijs [Social and technical sciences 2nd degree TSO: Teaching plan secondary education] . VVKSO-BRUSSEL D/2011/7841/041. Vlaams Verbond van het Katholiek Secundair Onderwijs. Retrieved May 24, 2020, http://ond.vvkso-ict.com/leerplannen/doc/Sociale%20en%20technische%20wetenschappen-2011-041.pdf

153.

VVSKO. (2011b). Artistieke vorming eerste graad: Tweede leerjaar—basisoptie [Artistic formation 1st degree: Second year-teaching plan secondary education baseline] . VVKSO-BRUSSEL D/2011/7841/014. Vlaams Verbond van het Katholiek Secundair Onderwijs. Retrieved May 24, 2020, http://ond.vvkso-ict.com/leerplannen/doc/Artistieke%20vorming-2011-014.pdf

154.

Wainwright

(2017). Imaging and imagining chronic obstructive pulmonary disease (COPD): Uruguayans draw their lungs. Disability and Rehabilitation, 40(26), 3094–3103. Retrieved May 16, 2020, https://www.tandfonline.com/doi/full/10.1080/09638288.2017.1376357

155.

Wang

Coemans

Siegesmund

Hannes

(2017). Arts-based methods in socially engaged research practice: A classification framework. Art/Research International: A Transdisciplinary Journal, 2(2), 5–39. Retrieved May 24, 2020, https://journals.library.ualberta.ca/ari/index.php/ari/article/view/27370/21374

156.

Wang

Hannes

(2014). Academic and socio-cultural adjustment among Asian international students in the Flemish community of Belgium: A photovoice project. International Journal of Intercultural Relations, 39(2014), 66–81.

157.

Weiher

(2014). Das Geheimnis des Lebens berühren-Spiritualität bei Krankheit, Sterben, Tod: Eine Grammatik für Helfende [Touching the secret of life-spirituality with illness, dying, death: A grammar for helpers] . Kohlhammer.

158.

Welten

(2010). Michel Henry (1922-2002). In Sepp

H. R.

Embree

L. E.

(Eds.), Handbook of phenomenological aesthetics (pp. 141–143). Springer.

159.

Wentworth

(2004). The phenomenology of painting. Cambridge University Press.

160.

Wertheim-Cahen

(2007). De inzet van vaktherapieën bij de behandeling van getraumatiseerden [The use of professional therapies in psychotrauma]. In Aarts

P. G. H.

Visser

W. D.

(Eds.), Trauma, diagnostieken behandeling [Trauma, diagnostics and treatment] (pp.313–328). ICODO/Bohn Stafleu van Loghum.

161.

Wessels

R. H. A.

(1997). Het belang en toegankelijkheid van grijze literatuur [The importance and accessibility of grey literature]. Informatie Professional, 1(3), 28–32. Retrieved May 24, 2020, https://dspace.library.uu.nl/handle/1874/2936

162.

Wheeler

K. J.

Early

J. O.

(2018). Using photovoice to explore quality of life factors of adults with Crouzon syndrome. Qualitative Health Research, 28(3), 357–370.

163.

Wollheim

(2001). Richard Wollheim on the art of painting: Art as representation and expression. Cambridge University Press.

164.

Woods

(2011). The limits of narrative: Provocations for the medical humanities. Medical Humanities, 37(2), 73–78.

165.

Zimmermann

(2002). Ignoramus: Gadamer’s “religious turn.” Symposium, 6(2), 203–217. Retrieved May 24, 2020, https://www.pdcnet.org/C12573E5003D645A/file/18DCE26BC92F8F5585257481004A693D/$FILE/symposium_2002_0006_0002_0093_0107.pdf

Inarticulate Experiences in Qualitative Health Research: Bounds and Bounty of Expression Types

Abstract

Keywords

Introduction

Method

Design

Search Terms

Successive Searches and Databases

Inclusion/Exclusion

Results

Search Results, Analysis and Classification

Meta-Synthesis

Discussion

Scope of this Inventory

Using Expression Types in Research

Methodological Limitations

Conclusion and Recommendations

Footnotes

Declaration of Conflicting Interests

Funding

ORCID iDs

Notes

References