Semiotic analysis
We analysed Berny’s photographs in relation with what he told us and the observations of the nurse and the researcher. We first looked into concrete characteristics of the photographs themselves. What photographic aspects of composition, lighting, range (long shot, medium shot) and point of view play a role in the impact the photographs have (Trevor-Midlum, )? The fact that the photographs are staged and are taken within the enclosed space of the sheltered home is of importance, as well as Berny figuring himself as central subject. There is a certain self-consciousness that speaks from the images themselves. Then we determined what the images refer to in the real world and on what level references are made. For instance, Berny’s sitting on a bicycle refers to his wish to engage in more physical activities and it does so in an indexical way, that is there is still a direct connection between the portrayed objects and that what it represents. There are unintentional symbolical overtones however where the bicycle stands for setting his life again in motion and also: taking the road, heading for change versus stagnation. The photograph of the two trousers are at first sight indexical: the picture denotes that losing weight means that he can put on trousers with a smaller size. In a symbolical reference the link would refer to cultural convention.The symbolism in this photograph is there but more implicit. In advertising people who have success in life are often portrayed as having a slim and slender figure. Images that show persons who are fat carry a connotation of indolence and being not so smart. Thus Berny’s photograph may symbolically refer to his wish to belong to the group of people with success and participate in society. This may be considered a ‘silent story’ that Berny could not voice.
From here we move on to the level of context analysis: how did Berny present himself with his photographs and what message did he bring across? The images are clearly premeditated to match his point of view: how difficult it is to lose weight, and that one is dependent on others to realize such aim. Together the four pictures make a coherent story. Beside the images oral and written text are now very important. We can determine the degree of sophistication with which Berny went about. Did shame or shyness for instance refrain him from an eloquent presentation? Did he feel anxious about his photographs: sometimes people feel unsure whether their pictures are good enough in a technical sense or feel ashamed to tell a personal story. From participant observations we recognized that at an earlier stage, when shooting the pictures, Berny had found it difficult to decide what to photograph and when, asked to select pictures that were most telling, he only chose the photographs about his struggle to lose weight after some hesitance. He does his speaking about his photographs in a laughing style as if he mocks himself. It impresses others as if he doesn’t take himself too serious. This might have to do, so we inferred from observation, with a certain uneasiness in relating to group members or the nurse facilitator. It is also likely that talking about his figure is an awkard thing to do for him. It touches on a taboo that many people (maybe men more than women) feel when the subject of their physical appearance comes up for discussion.
Beside the degree of sophistication with which Berny presented himself we can wonder what the message is: what did he want us (the public) to learn about him? How personal was his story and how did the story develop over the months that he participated in the photo group?
What we noted here is that Berny used humour as a defence mechanism against too much confrontation with his limitations, but nevertheless his texts came to show him as vulnerable and open in the course of time. From observations and what he said about this himself we recognized that Berny came to experience the group as a safe haven that helped him to let go his earlier reticence. Eventually he went about the assignment in a playful way. He enjoyed the attention from others, for instance when Carla gave some logistic support in the making of some photographs (as we can see in the photograph where she pushes him).
Hermeneutic analysis
A narrative analysis makes clear that the story excuses Berny. He explains why it so difficult to lose weight. He does so in a lightly ironical style that makes him sympathic to us. The big-sized trousers next to the smaller sized trousers: the image has a touch of pathos to it. The pointe of his story seems to be: I ‘m so eager to lose weight, but I can’t do it; I need help. At the same time the text breathes aloofness and a kind of self-consciousness. He uses the I-form: ‘I have been to the dietician. This didn’t help me.’ There is no self-victimization. Sitting on his bike he looks at us and smiles, enjoying the attention in a sphere of self-irony. There is an undertow of feeling impotent to do something about his problem, but also a stong wish not to let dominate this feeling his life too much. His pictures and texts convey this in a strong way, for instance: the image of the dachshund Max trotting down the street on his littele paws and drawing Max along. Berny plays trumps with a skilful use of a cultural repertoire of irony.
The fit with real life
Berny’s story matched real issues in his life. He developed his story from an attestation of powerlessness (theme) through self-irony (narrative tone) into a more triumphant ‘I can!’He became an agent in his own right. Somewhere in this trajectory his readiness to really make a change was born. From observations by the nurse we learned that his commitment was further strengthend by the photo exhibition and the response from his family and fellow inhabitants of the sheltered home where he lived. He took up biking with his mentor nurse. Six months later he had lost more than 20 kilo in weight. He was extremely proud of this.
Reflective notes on the methods used for producing images
In the former section we presented the content of the photos made by Berny. In this section we reconstruct the process of making photos.
Co-construction
Until now we focused on the way how Berny expressed and presented his photo story. But how were his images and the accompanying text produced in the first place? The nurse facilitator knew that Berny had consulted a dietician and that he wanted to lose weight. When Berny pondered over the assignment to take photographs of a wish that he wanted to realize, she suggested him to take it as theme for his photo story. He agreed and set about taking photographs. After failing a first effort to make the photograph with the trousers as he had planned it, she offered him assistance. At first he declined the offer, but later he accepted her help. Thus Berny’s photo story has been co-constructed with Sonja right from the beginning. This is part of the external narrative that determines the context of Berny’s photo story. Photographs are not only made with direction from an assignment that frames their subject or theme but also, in Berny’s case, with the aid of the nurse.
Photo-elicitation
Another element in the external narrative is the way how meaning making depends on the interview technique that is called photo-elicitation. Photo-elicitation uses photographs to invoke comments, memory and discussion in the course of a semi-structured interview (Banks, 2007). By using photographs made by the respondents themselves the more formal aspects of interviewing can be avoided and the succeeding reflection on one’s own photographs approaches a more intimate context that resembles a natural exchange over family snapshots. We have observed how this was the case with Berny and his fellow group members. There was an atmosphere of pleasantness and openness that helped Berny to make further steps. Photo stories are shared with others and there may be a tendency for photo stories to converge to common themes that are shared with other group members. Medication for instance and how it is a drain on your energy was a theme that Berny said he recognized in someone else’s story. At the same time the group context may refrain individuals from giving too personal an account. In the case of Berny he admitted that at first he did not like it to recount in detail what his problems were with losing weight, but then after overcoming his reticence he was very open about it.
Empowering context
Hermeneutic photography as it has been used here is an example of how visual media can aid disempowered people in gaining greater control of their lives. The assignment focussed on the formulation of a wish that one would want to realize. The representation of Berny’s wish to lose weight, for instance helped him to anchor it in mental icons that gave him the drive to actually realize his wish. Empowerment as leading principle pervades all aspects of the intervention and does colour the data. Left alone to make his own choice (without Carla entering on a dialogue with him) Berny would have probably taken other photographs or would have selected other photographs to relate to. But as we consider Berny’s story as not merely a mental representation, but as an enacted story that is part of a performed social behavior, we think that this ‘collaboration’ is indispensable. Anyway, interpretive analysis in the social science ‘rests on the notion that data do not exist autonomously and prior to the conduct of research, but are rather produced by the researcher and research subject at the moment of their encounter.’(Banks, 2007). We have taken this a step further in using the visual as a tool of social intervention, although this usage is related to the praxis of the intervention and not to the research agenda per se. Still the researcher (first author) as a nurse shares assumptions on the need to empower participants of the photography group which informed his frame of mind throughout the research process.
A researcher’s dialogue with the respondent
As a researcher Berny initially impressed us as a somewhat lethargic long stay patient who showed little initiative. My preunderstanding of his life story was that it exemplified his limited capacities to take his life in his own hands. His agency seemed extremely thin. His overweight was the physical expression of an enormous immobility that I sensed with him. His grinning and giggling way of communicating in only short phrases triggered with me old stereotyped images of forlorn and destitute psychiatric patients who lived in large asylums. From the interview with him and the nurse guiding the photo group I learned that he had felt attracted to the photo group because in the past photography had been his hobby and he had also made videofilms. For Berny it was also an opportunity to connect with old pastimes: photography. I then started to reconsider my opinion. Through a growing insight in the way Berny used photo storytelling in his struggle for maintaining integrity I recognized also the small steps Berny made towards his own empowerment. As a researcher I recognized his strength. In some way his and my understanding came together in a shared appreciation of the importance of showing who you are and find recognition for it. This shared appreciation found expression in the permission he gave me to use his photographs at workshops and lectures in academic settings.
A researcher’s dialogue with the text
We wondered if there were things Berny could not speak of or was unwilling to. The rhetorics of his speaking about his life were informed by his good-naturedness and self-irony. In earlier sessions he had photographed his scooter which meant for him that he could go and visit his family whenever he wanted. Due to the fact that his scooter had been in repair during later sessions he had a bicycle on loan and did he consider the suggestion of losing weight by biking. It offered him also an escape from disempowering reflections on his failing himself and his children because of his inability to support himself independently. He had commented his photographs of his scooter as follows:
“This is a fine picture of my scooter. It looks like a motor-cycle.[…] It gives me a feeling of freedom and openness when I ride and feel the wind.”
This is still a statement that conforms to cultural and social accepted ways of expressing freedom, but then there is a curious twist that turns his feelings towards experiences of losses.
“It is an artful machine. It runs and does not falter; it is mechanical. Me, I am not like that. I have no skills. Yes, I had at one time when making videos of weddings. I did the video-making when things were still okay with me. Shooting film all day long, that’s what I liked to do and wedding couples were always contented with the result. You know, I’m also good at..smoking.”
If we would not take into account Bernys’s life story and how he had responded to disabling psychiatric symptoms in the recent past we would be tempted to read his photographs at face value and miss the flow of meaning making that happens right on the spot. Berny’s story reflected how he had felt powerless facing the problems in his life before he moved to the sheltered home. Lacking skills to maintain himself in life he had become depressed and had slipped in self-neglect. Now he was on the road back again. There is a close interplay of reality and representation that called for a reflexive reading of text (Walsh, 1998 in: Sarah Pink, 2007). This implied also a checking of how his mentor nurse looked upon the functioning of Berny and how she interpreted his agency. All these observations came together and were related to an analysis of how his story fit his autobiography and was congruent with actual choices and challenges Berny was facing.
A rationale for research methods
We have adopted a multifaceted practice of research, using a broad set of analyses, ranging from semiotics to hermeneutics. Our approach also encompassed tools and methods of representation that are embedded within a health-political agenda of empowerment. We consider ourselves as methodological bricoleurs, piecing together methods that are fitted to specific research questions, contexts and adapting them to an interpretive practice (Denzin & Lincoln, 2000).
Images have shifting meanings not only to different individuals but also to the maker of the images himself. While subscribing to the interpretivist constructionist stance that came to the fore in social research since the nineties of the twentieth century, recognizing that reality is subjective and can only be experienced by individuals, we do however claim that we have not abandoned a realist approach altogether.
One aspect of realism is that individuals vary in their skilful use of semiotic resources. Berny’s way of representing himself is an example of a sophisticated use of the rhetoric style in communication. Representation serves psycho-social functions that, from a more objectifying perspective, we can categorize into versions of reality that can not always be shared with participants themselves. In our study we distinguished façades that exemplify how we can read photo stories as a ‘record’ of how meanings are constructed (author et al, 2010). We agree with Van Leeuwen and Jewitt (2000, p.5) when they state that: “ The issue of ‘record’ versus ‘construct’ exists because many images have an element of both and so require a mode of analysis which is sensitive to both.” That’s why we combined analytical tools that ‘recorded’ features of photo stories with a more interpretive approach. For instance verifying semiotic features as whether images have an indexical, an iconic or a symbolical references is done from a categorizing ‘recording’ perspective. Or establishing whether photographs were planned or taken at random. This informs us about the degree of someone’s naïveté or awareness of how to build a credible story. The same ‘recording’ can be done for narratological aspects of storytelling: what roles does one have in one’s story, plot development, the use of metaphorical devices, etc. Thus we were able to discern façades that have a covert relation with reality from stories that show a self-reflective stance in a more overt relation with the reality of every day life. We realized however that: ‘Photographs shouldn’t be treated as ‘mirrors’ held up to reality: reality itself is a product of social processes, and photographs can be part of the process, as well as a product, of reality construction.’(Orla Cronin, in: Prosser, 2006). We studied photo stories from both perspectives.
Façades may be the product of reality construction and have a troubled relationship with credibility in the eyes of an informed public (such as the nurse guiding the photo group or the researcher). This may cast doubt on the sophistication with which these photo stories were made. But photo stories are also part of the process and reflect one moment in a flux of meaning making. Thus we were able to show their functionality (author et al, 2010). Just the same applies to Berny. From a realist approach his photo story about his weight may be considered trite and lacking depth. His photographs have a high level of concreteness and at first sight suggest no subtle metaphoric meanings. Seen as a part of a narrative process we were able to recognize how it helped Berny to maintain his integrity and enact his call upon others to help him in a credible performance. By analysing how the photo stories were received as personal stories that confirmed that their narrators are worthy to be seen and heard, we became sensitive for issues of multivocality and the importance of face keeping. Berny, for instance, was acknowledged in his expertise of making fine photographs. He regained ‘face’ as someone who could be respected for his skills. Where he voiced his dependency on others on certain occasions his performance (his photographs more than his words) gave voice to a more resilient identity.
