1.3 What do we know?

Overview

How people working in health psychology support health, or treat illness, is shaped by the conceptual frameworks that underpin their work. Chapter 1.1, for example, discussed Māori health models and the Māori cultural conceptual frameworks underpinning these, including a holistic understanding of people as interconnected with all living things across human, physical, and spiritual realms. In Chapter 1.2, we then turned to Western concepts and considered mainstream psychology, phenomenological, social constructionist, and more–than-human approaches that offer different ways to conceptualise people. Both these chapters showed why it is important for people working in areas related to health psychology to critically reflect on how they conceptualise people. Developing these arguments, we note that in research, policy and therapeutic contexts, people working in health psychology both produce, and act on, knowledge. In this chapter, we therefore ask: What kind of knowledge do health psychologists produce and use? 

Addressing this question, we consider five traditions that conceptualise knowledge differently: (1) the objectivist science of mainstream psychology, (2) phenomenologically informed psychology, (3) social constructionism, (4) more-than-human theoretical approaches, and (5) Kaupapa Māori research. We engage with each of these systematically, exploring how they conceptualise what we can know, and our methods for knowing it. Using cancer as the health topic that threads through the chapter, each section has a research example to give you a sense of how these ideas are put into practice. We finish each section evaluating how closely these approaches align to the critical health psychology pou we use in part one of the book, which are: valuing theoretical/conceptual thinking, challenging taken–for–granted understandings, paying attention to issues of power and equity, moving beyond individualism, and considering knowledge as produced in context. In so doing, we cover the following learning objectives:

 

Introduction

As a metaphor about knowledge, the image of Armfield helps us to consider the importance of context, perspective, and interpretation. It invites us to think about the perspective of the people who generate knowledge, and the context within which they observe and interpret what they see, as well as how the knowledge they produce is subsequently interpreted by others.

The idea that perspective shapes observation, even when people are trying to be objective, produced a “mic drop” moment in mid-20^th Century humanities and social sciences, creating a “crisis of representation” based on the arguments that:

• science is not neutral because it is shaped by the perspectives of the scientists doing it
• the perspectives of scientists are shaped by their social context and social positionalities.

“Social positionalities” refers to how social categories, such as those related to a person’s gender, sexuality, ethnicity, race, class, dis/ability, and so forth, provide people certain vantage points from which to make sense of the world, as well as frameworks from which they might be understood by others. Social positions are also intersecting. For example, Black feminist scholarship has shown how gender is always racialised (Collins, 1998; Collins & Bilge, 2020; Crenshaw, 1989; Hull et al., 1982).

In the crisis of representation, scholars argued that researchers’ abilities to observe and interpret were shaped by their intersecting social positionalities. Turning a research lens onto the researchers, Haraway (1989), for example, demonstrated that studies of psychological research in primatology were profoundly shaped by the perspectives of the mostly White, male, heterosexual researchers.

It can be tempting to locate such problems in history, and imagine ourselves more enlightened. But these arguments are still relevant today, seen, for example, in research suggesting that oncology studies treat the male body as the default human body, despite female and male bodies responding differently to treatments (Florez et al., 2024).^[1]

Responses to the crisis of representation have been multiple and ongoing, with the outcome that psychologists now have multiple approaches to thinking about, and generating, knowledge. For some, it has meant identifying and correcting bias, such as increasing numbers of female bodies in clinical trials. While this is important, these practices retain the idea that scientists can create objective knowledge. This idea maintains distinctions between the subject (who is studying) and the object (being studied), reducing the likelihood of researchers reflecting on how their cultural frames of reference might shape their studies.

 

 

A different response to the crisis of representation has been to lean-into the idea that knowledge is always produced in context, and from the perspective of the producer. In this response, researchers dissolved the subject-object distinction and developed new methods for working with the idea that researchers—like all people—are embedded within their world, not separate to it. 

The idea that subjective knowledge has value underpins the disability activist aphorism “nothing about us without us”; the Kaupapa Māori research principles of “by Māori, with Māori, for Māori” (Wilson et al., 2021); and our critical health psychology pou of considering knowledge as produced in context. From this perspective, researchers need to carefully reflect on how their intersecting social positions might shape the research design decisions, observations, and conclusions they make. This reflexivity is usually an explicit quality criterion for qualitative research, but often absent in quantitative psychological research, despite arguments for that to change (Jamieson et al., 2003). Reflexivity can be practised in different ways, and at different levels (see text box below).

 

 

As you can see from the final line in the text box above, researchers are expected not just to reflect on their own positionalities, but also on the implications for how they conceptualise knowledge. This means understanding your ‘ologies.

 

Objectivist science of mainstream psychology

The objectivist science approach underpins the kind of work that is predominant in mainstream psychology journals and textbooks. Often the aim of this research is to identify distinct, measurable psychological elements shaping individual behaviour, such as self-efficacy, self-esteem, or perceived norms (see Riley et al. Chapter 1.2’s discussion of the biopsychosocial approach).

This approach addresses our chapter question about what we can know in the following ways:

What is reality? A realist ontology underpins this approach, in which a real world, or “singular reality”, exists independently of researchers perceiving that world, and which has enough constancy that stable patterns of reality exist to be discovered.

What is the nature of knowledge? We use “objectivist science” as an overarching term to describe a range of related epistemological orientations, including logical positivism, positivism, post-positivism, and neo-positivism. These terms signify variation in how strongly they adhere to the idea that a real world can be accessed unmediated, but what they share is an understanding that good knowledge is knowledge that reflects the real world (as much as possible). Because this epistemology is predominant in mainstream psychology it is often taken for granted, and unreported in publications.

Methodology: Relates to undertaking systematic observation to discover facts about the world. It involves collecting observable data and systematically processing it. Various scientific principles are drawn on, such as understanding that hypotheses are falsified (when predictions fail to materialise) or supported (when predictions are confirmed), but always with the recognition that new information may subsequently falsify a previously supported hypothesis.

Methods: When applied to psychology, objectivist scientific methods often focus on measuring atomised elements (or “variables”) of people’s thinking and behaviour. Treated as real, statistical analysis is performed on these elements to answer questions about cause-and-effect relationships, correlational relationships, or differences between groups.

Quality criteria focus on enhancing researchers’ confidence that their study is accurately describing a real thing, or a thing that can be treated as real since it creates real effects. Examples of quality criteria include:

• Designs – are these set up to minimise researcher bias and/or intervening variables?
• Validity – are researchers measuring what they say they are measuring?
• Reliability – can the researchers reliably produce the same effect?
• Replicability – can other researchers reproduce these findings?
• Triangulation – do different kinds of data point to the same finding, thus maximising researchers’ chances of best approximation to the truth?

 

 

Evaluation:

Science is exciting when it is about endeavouring to understand the world better; as is knowing that new evidence may radically change understanding, but that ultimately people are progressing towards understanding. Feasible interventions aimed at changing individuals can be developed, such as supporting people to develop better information processing. Considered against our five pou, objectivist science in health psychology:

• values theoretical/conceptual thinking in relation to developing explanatory models, often related to cognitive processing, but with limited theorising beyond these models.
• challenges taken-for-granted understandings in relatively limited ways, as the focus tends to be on meeting established criteria within the system rather than challenging the system of meaning itself
• rarely pays attention to issues of power and equity because its individualism directs attention away from structural inequities
• rarely moves beyond individualism because the focus is on thought processes happening in an individual that subsequently shape behaviour.
• considers knowledge as produced in context in terms of concerns around generalisability, such as noting a predominancy of White or well-educated people in a sample. But what is often absent is a deeper consideration of the conditions in which “facts” are produced (despite post-positivist arguments for doing so).^[4] Objectivist scientific research therefore implies that the knowledge it produces represents universal psychological processes despite significant differences across cultures (Danziger, 1997).

For researchers more informed by the crisis of representation, the objectivist science approach in psychology offers only a partial way of looking at the world. Harsh critics might even suggest it directs researchers to look in the wrong direction, and that instead of seeking to produce knowledge that is objective, value free, and generalisable, psychologists are better off focusing on subjective, lived experience, as in phenomenological psychology.

Phenomenological psychology

Phenomenological psychology takes an “idiographic” approach, with the aim of understanding various phenomena through the lived experiences of individuals. The aim is not to identify atomised, measurable elements of a psychological model, but to gain understanding of people’s holistic, contextualised interpretation of an experience.

What is reality and the nature of knowledge? Phenomenological psychologists may draw on critical realism, which combines a realist ontology (a real world exists independently of people), with a relativist epistemology (people cannot access the real world directly, because their experience of it is always mediated, though their biology, personal histories, and available social constructs). Human knowledge is thus produced through our interpretations, themselves inseparable from context, and it is these interpretations that are important for psychological research.

Methodology: Phenomenological psychology usually has two methodological aims, namely to:

• reflect participants’ lived experiences as accurately as possible (while recognising that researchers can only ever attempt an approximation of this), and
• contribute to the broader understanding of the phenomenon being studied (e.g., a cancer diagnosis).

Those informed by the critical realist philosophy of Roy Bhaskar might also distinguish between three levels of analysis:

• empirical level: the phenomena we can observe, e.g., the experiences and sensed perceptions of people as they interpret their conscious world). Using cancer as an example, a person might feel an unexpected lump, and worry.
• actual level: objects and events occurring in the real world whether they can be observed or not), e.g., cancerous cells growing that produce the lump or past exposures to carcinogens.
• “real” level: entities and structures with powers that interact to produce causal mechanisms shaping the observable phenomena in the empirical level; these operate largely independently from researcher’s ideas). This ‘real’ level is different from positivism because it is not necessarily directly observed, but deduced from research findings (Alvesson & Sköldbeerg, 2018). One example is the interactions of multiple biological, social, and psychological factors that result in the growth of the cancerous cells.

Methods. The methods phenomenological psychologists use are designed to help people articulate their holistic, contextualised understanding, and interpretation, of an experience. Often these are individual accounts of their experiences, produced through interviews or other first person research methods such as diaries or counselling recordings. Such data are analysed in terms of re-occurring patterns in individual sense making and interpretation, as well as cross-cutting patterns in accounts from people with similar experiences. To better understand, and contextualise, how people interpret a phenomenon, researchers may focus on specific elements of experience such as embodiment, temporality, spatiality, relations, and feelings (see for example, Ashworth, 2003; Willig, 2012; also see Riley et al. Chapter 1.2 Phenomenological health psychology section).

Quality criteria focus on demonstrating that a study’s design is theoretically informed by phenomenology, and that it has enabled participants to both articulate their experiences and develop interpretations of their experiences. Rich reflections by researchers on their interpretation of those interpretations are also expected (Langdridge, 2007; Nizza et al., 2021). Examples of quality criteria include:

• analysis that provides a sense of walking in another’s shoes, evidencing a “hermeneutics of empathy” in seeking to deeply understand participants’ experiences, and interpretations, of those experiences
• analysis that is not simply descriptive, but offers detailed, nuanced, contextualised, and interpreted accounts of lived experience
• evidence of close engagement with what participants say, and attention to similarities and differences across participants’ experiences
• phenomenological epistemology is claimed and explained
• reflexivity is practised deeply and explicitly, potentially using techniques linked to a specific phenomenological method or approach
• new knowledge is generated that extends existing understanding or produces novel insights.

 

 

Evaluation:

The sense of deeply listening to another to understand, and interpret, their lived experience can feel profound for both researchers and participants (see, for example, Padilla, 2003). Considered against our five pou, phenomenological psychological research:

• values theoretical/conceptual thinking in relation to engaging with phenomenological philosophy
• challenges taken for granted understandings when developing new knowledge about human experience, and its idiographic approach challenges mainstream psychology’s valuing of nomothetic approaches to knowledge. However, because it centres the individual, it often reproduces, rather than challenges, mainstream psychology’s individualistic focus
• pays attention to issues of power and equity when providing opportunities for members of marginalised communities to have their voice heard. But care needs to be taken to genuinely amplify marginalised voices, rather than the researcher capitalising on, or consuming, that marginalisation for their own personal gain. The "idiographic" approach means that the role of structural inequities in shaping experience is often absent or minimal, unless participants themselves make sense of their experiences through structural critique. Sometimes researchers connect their work to another politicised ideological framework (e.g., feminism, Marxism, critical disabilities, or fat studies), but this happens rarely (cf. Langdridge, 2004, 2007; Riley et al. Chapter 1.2 discussion of phenomenology for further elaboration)
• moving beyond individualism is limited by the focus on individual experience
• knowledge is contextualised since experience is understood to be produced within, not separate to, context including embodiment, intersubjectivity, time and space. But as noted above, how the context is conceptualised may not include social inequities or power structures.

Social constructionist psychology

Social constructionism is an overarching term; it covers a range of approaches sharing the idea that what we consider to be facts about the world are, instead, collective agreements to understand the world in a certain way. Research therefore aims to identify what social constructions we use, and with what effects.

Social constructionists argue that if our understandings were driven by the natural world, there would be little variation in human sense-making because our understandings would mirror a shared external reality. Since there is significant variation, both across cultures and within the same culture across time, the argument is that how we make sense of the world must be socially produced (see Morison & Gibson Chapter 2.1 for further discussion of this argument).

What is reality? Social constructionism has a relativist ontology, there is no singular reality that exists independent of us. For example, bees and humans see different light wavelengths, so when they look at the same flower, they see different realities. Similarly, people’s concepts for “seeing” the world shape what is possible for them to experience as reality. For example, it is only in the last hundred years that English speakers have understood motivation as a generalised internal state that we can “have” (and could improve on) (Danziger, 1997), yet it is now a “reality” of human psychology.

What is the nature of knowledge? Because there is no real world that is external to us, a social constructionist epistemology is that the knowledge we have about our world is produced within, and through, social contexts and social processes. Continuing our example, Danziger (1997) described how our current understanding of motivation was produced by U.S. experimental psychologists, competing with psychoanalysts and humanists to address the needs of emerging markets in advertising and education.

Methodology: Since knowledge is always contextual, the aim of psychology is not to search for universal truths (since these do not exist from a social constructionist perspective), but to identify the concepts we have for making sense of ourselves, and examine how these concepts enhance, or limit, our health and wellbeing. For some psychologists, this means emphasising the inseparability (or mutual constitutive-ness) of knowledge and power. This perspective also draws on poststructuralist philosophy, which we unpack in Riley et al. Chapter 1.4).

Methods involve looking at patterns of sense making occurring in a particular context, and considering their implications for subjectivity and practice, that is, what people can say, think, feel, and do. Depending on the research questions, and type of social constructionist or poststructuralist analysis being undertaken, methods of analysis may include a focus on:

• Genealogy: how ideas develop through history and the institutions involved in supporting these processes.
• Interpretative repertoires/constructions: identifying different common-sense ideas available on a topic and considering their implications for subjectivity and practice (e.g., when people talk about “winning” or “losing” a “battle with cancer”, see Chapter 1.5).
• Wider social or institutional discourses: identifying broader forms of sense making that underpin common sense (or “taken for granted”) ideas, such as “healthism” in the Willig (2011) textbox example below.
• Resistance and dilemmas: exploring how people may resist discourses or negotiate the dilemmas produced through contradictory discourses that circulate within any given moment.
• Subject positions: examining the kinds of subjects (types of people) produced within a discourse, and the vantage points they offer for people located within that subject position.
• Technologies of self: considering the work people do on themselves to produce themselves within a subject position.
• Affect: considering the relations between feelings, emotions, and discourse, including the socially constructed “feeling rules” about appropriate feelings.
• Rhetorical strategies: analysing specific patterns in talk or text for their interactive effects, especially in relation to identity claims, use of psychological language, and management of accountability.

Quality criteria vary but are likely to include producing a conceptual analysis that:

• acknowledges the contextual and constructed nature of knowledge
• de-centres the subject by focusing on patterns of meaning making across people (focusing on the patterns of talk, not the individuals, or their internalised beliefs)
• identifies multiple and contradictory discourses (contrasting with psychological research that seeks a single “truth” and the answer to the question, “What did they really mean?”)
• employs a “hermeneutics of suspicion” by considering how power shapes meaning making
• takes a critical stance towards taken-for-granted knowledge (which also requires reflexivity)
• recognises its own analysis is just one reading/interpretation of the text
• offers new insights into the constructions people use to interpret themselves, others, and their world, and the possibilities for subjectivity and practice they enable or limit.
• offers new directions for how we might facilitate better health and wellbeing.

 

 

Evaluation:

Social constructionist ideas offer a map to navigate the world that can feel new, exciting, and illuminating. It allows us to embrace complexity, since multiple discourses produce multiple (and sometimes contradictory) sense making. It also enables researchers to challenge taken-for-granted ideas that are framed positively, but which can have negative outcomes. For example, Willig’s (2011) experience of a cancer diagnosis was undermined by positive feeling rules and discourses of individual responsibility (see text box above).

Such analysis allows researchers to explore the ideas that dominate now, as a starting point from which to imagine better worlds. It also allows us to look at history differently: the past is not full of failed ideas as we move progressively forward, but full of multiple discourses that have shaped our current moment, while previous moments can give us insights into the constructions we use today.

Social constructionist researchers are often concerned with addressing social justice issues. But developing effective interventions is hard because change is required beyond individual “fixes”. Critical researchers are also at risk of critiquing others, without offering meaningful alternatives, and relativism can make it harder to make factual claims that address inequities (which is a problem in a post-truth world!).

Social constructionist and poststructuralist ideas also have implications for materiality, since how we understand something shapes our response to it, including, for example, how we design and build healthcare systems, technology, and physical infrastructure. For social constructionists, anything can be data since discourses can be read in talk, text, image, and even buildings (see for example, Bates, 2019; Gibson et al., 2015; Macdonald, 2016; Parton et al., 2019; Zhang, 2021).

Social constructionists can therefore justify their focus on discourse. But critics argue there has been too much focus on language and representation at the expense of materiality, especially in how the physical body often disappears in an analysis of discourse.

Considered against our five pou, social constructionism:

• values theoretical/conceptual thinking in relation to social constructionist or poststructuralist philosophy. Researchers also often draw on topic specific theory or concepts, such as, Willig’s (2011) discussion of healthism in our example above.
• challenges taken-for-granted understandings by reflecting on how we make sense of the world, and treating these understandings as social constructions that can be explored for the vantage points they offer or limit, from which alternatives can also be explored.
• pays attention to issues of power and equity when linked to poststructuralism or a social justice agenda, and with analysis that goes beyond “giving voice” by focusing on the social and discursive contexts that produce marginalisation.
• moves beyond individualism by de-centring the subject and focusing on meaning making between people (as represented in Figure 1.3.4). Individualism is also critiqued as a problematic discourse within psychology, and in relation to health (see healthism discussion in Riley et al.Chapter 1.4 for further details).
• knowledge is produced in context is a central principle of the social constructionist idea that knowledge is produced within and through people’s available discursive contexts, thus the idea of context-free knowledge is an impossibility.

More-than-human theory

We use the term “more-than-human-theory” (herein “MTHT”) to describe an eclectic set of interconnected theoretical approaches that are informed by a range of “post” frameworks, including posthuman, post qualitative, and new materialism. MTHT offers novel directions for thinking about issues that concern health psychologists. But as with all new forms of thinking, these ideas might feel difficult at first. If they are new to you, do not expect to understand everything at first; these ideas will become more familiar over time.

MTHT focuses on both discourse and the material world. Materiality includes human bodies, things that are non-human but human-made (e.g., technology), and non-human elements of the natural world. Discursive and material elements are conceptualised as co-produced through dynamically unfolding assemblages.

The term “assemblage” is used to conceptualise how a variety of components interact as part of a complex, open, dynamically unfolding, and (often) unpredictable system. Assemblages also interconnect with each other, or may be part of other assemblages (e.g., a hospital policy on patient care in a person’s cancer diagnosis assemblage is co-constituted through its own assemblage, including other policy documents, civil servants, secure cloud servers, and so forth).

A health assemblage can include networks of psychological, biological, cultural, and social relations (Fox, 2011). Researchers choose what elements to focus on because, as an open system, the elements of an assemblage can be ever expanding (see text box below).

 

 

All the elements of an assemblage have vitality and agency, in the sense they can affect each other. Thus, even inanimate objects have agency, such as the way furniture in a hospital waiting room might illicit feelings of anxiety or comfort (e.g., Fadyl et al., 2020). This understanding of agency means assemblages represent dynamic, mutually co-constitutive processes in an entangled and unfolding process of “becoming“.

The term “becoming” is used to emphasise an ongoing, dynamic process. It can be contrasted with the word “being” which implies something finished or static. For example, we may think of a blood test result as a clear, boundaried component of a health experience. However, through the lens of MTHT, we see it less as a fixed “thing” and more as a snapshot during its ongoing state of transformation, as blood moves from body to syringe, to chemical reactions in a lab, to digital data on a patient record. (For a discussion of becoming as a way to think about the student experience of work integrated learning see Terry Chapter 3.2).

Relatedly, the term "intra-action" may replace “interaction”, to emphasise how elements of the assemblage are not separate, pre-existing entities that subsequently interact, but are themselves produced through emerging relational entanglements that produce the boundaries of the components we might identify in an assemblage. As Barad (2007) explains, “to be entangled is not simply to be intertwined with another, as in the joining of separate entities, but to lack an independent, self-contained existence” (p. ix).

 

What is reality? MTHT theorises a “relational process” ontology in which reality exists (and which, for some theorists, is all made of the same “stuff”), but it is constantly unfolding into new configurations, which means it is not stable or singular (e.g., Deleuze & Guattari, 1987).

What is the nature of knowledge for MTHT? One concept that can be used to address this question is “agential realism” (Barad, 2007). Agential realism is the argument that although there is a reality out there, we cannot completely observe it because:

1. observations are snapshots of a moving world, and
2. observations change the observed (see for example, the famous particle-wave double slit experiment in quantum physics).^[5]

 

Knowledge produced in psychological research is thus relational, partial, and context specific. This contextualisation includes considerations of the research apparatus assemblage, including the researcher (Barad, 2007; Gibson et al., 2020; Rice et al., 2021).

Methodology: orients to examining meaning, materiality, and capacities for making connections and forming relations as produced through dynamic intra-action. In this myriad work, the focus is often less on specific elements, than on the affective flows between them. In part, this is because these flows create the possibilities for becoming, and because any element of an assemblage only momentarily takes that form in the ongoing dynamic process of becoming. Health relates to the capacities to form relations in an assemblage (Deleuze, 1988a, 1988b), since making connections increases capacities for action because more things are now possible (imagine a train system, the more train lines between the stations, the more various the journeys passengers can take).

 

 

Methods are multiple, but can include considering the topic of interest as part of an assemblage, and examining the affective flows associated with that assemblage, often with a particular interest in:

1. feelings, emotions, and bodily sensations, and/or
2. identifying what capacities for action are enabled or reduced.

 

Creative methods are encouraged, and composite stories/cases or other forms of creative writing may be used. Alternatively, researchers perform a thematic analysis on qualitative data, and then “thinking with theory” (Jackson & Mazzei, 2022), they explore how MTHT theory might provide further insights on those themes.

 

Quality criteria include:

• creating new insights that can radically shape understanding
• thinking with theory
• reflexivity, including how the research apparatus co-constitutes the findings. Reflexivity needs to be done in line with MTHT, because some ways of conceptualising reflexivity, such as facilitating unbiased analysis, are rejected (e.g., Davies & Gannon 2012)
• recognition that analysis is always partial and contextual.

 

 

Evaluation:

MTHT offers exciting directions for thinking about the complexity of health, benefitting from centring materiality, including embodiment, as well as discourse. Truly novel insights can be produced, and the recognition of non-human agency can expand our thinking of ethics in relation to human responsibility to the nonhuman (Barad, 2007).

Not having a clear method opens possibilities for creativity, but paradoxically this can produce an orthodoxy as researchers replicate recognised models of success. Sometimes high theory ­— complex, abstract theoretical frameworks — might seem pretentious or disconnected from real-world issues. In drawing on 20^th and 21^st Century European/ European Settler philosophers, MTHT theorists have (to date/mostly) failed to engage with Indigenous knowing and scholarship, which have much longer histories of more-than-human thinking (Hokowhitu, 2020; Rosiek et al., 2020).

 

Considered against our five pou, MTHT:

• values theoretical/conceptual thinking in relation to an array of complex and contextualised “post” approaches
• challenges taken for granted understandings in multiple ways, including locating agency in the nonhuman
• pays attention to issues of power and equity in multiple ways, including reflecting on forces that can constrain or enable capacities for action, and highlighting human responsibility for affirmative relations with the natural world through recognising the vitality of all things (which also speaks to climate change)
• moving beyond individualism is a central feature of MTHT – the model of a relatively coherent individual is redundant, as there is no single pre-existing unit that has clear boundaries. The focus is not on individual thinking, interpretation, or discourse, as in the approaches discussed above, but on the affective flows within a dynamic assemblage
• considering knowledge as produced in context is a core concept because MTHT conceptualises knowledge as contextual and relational.

Kaupapa Māori theory and research

Chapter 1.1  described how Māori worldviews and mātauranga inform Māori understandings of health and wellbeing, and how these then inform Kaupapa Māori approaches to health research. Here, we draw on that discussion to outline Kaupapa Māori theory and research, including a recap on questions of ontology, epistemology, methodology, and the other ‘ologies important for Kaupapa Māori theory – cosmogony and cosmology. This section should be read in conjunction with Brittain and Kora Chapter 1.1.

 

We start with a discussion of cosmogony, that is, beliefs or theories about how the universe or the cosmos began. The Big Bang Theory (that the universe suddenly came into existence) is one cosmogonical theory. Other cosmogonies posit that something caused the universe to be birthed and that this was not spontaneous, but planned or created by a higher being. For Māori, like other Indigenous peoples, rich cosmogonical narratives have provided the conceptual basis for understanding and interpreting reality, and giving meaning and purpose to everyday life (Durie, 1997; Williams & Henare, 2009).

Cosmology is similar to cosmogony, but primarily concerned with the nature of the universe rather than the birth or creation of the universe. Cosmology studies everything to do with the universe from its origins to its end, its nature, its composition, and how these came to be.

What is reality? Māori cosmogony, cosmologies, and ontologies are holistic and relational, recognising our existence as humans as deeply interconnected with the natural and spiritual realms. Our present realities are shaped by that which has come before us, and that which is yet to come. In this way, reality spans across multiple dimensions and across time. As Brittain and Kora (Chapter 1.1) state, “… we recognise our existence as part of a whole, spanning physical and spiritual, across past, present, and future. Existence does not begin, nor does it end with us.” Notions of spirituality and kin-centricity are foundational to these worldviews.

Epistemology: Knowledge to Māori is informed by the holistic and relational worldviews and values discussed above. Kaupapa Māori research recognises that all knowledge is subjective, according to the world views and value systems researchers prescribe to. Subjectivity in research is not a bad thing. Rather, values are instruments through which researchers (as with all people) can view, interpret, experience, and make sense of the world, and from which they cannot be disconnected (Marsden, 2003). 

Knowledge comes in many forms, not just intellectual, and can also be tapu (sacred) and encoded to prevent its misuse by those for whom it is not intended. Knowledge is values-based, concerned with the “ultimate why”. Knowledge must be useful, a person’s knowledge (or data) is not ontologically separate to them.

Māori have lived in synchrony with the natural environment, observing and recording patterns in the environment over time and adjusting practices accordingly. “Observation” or “coming to know” for Māori is not limited to conventional Western senses like seeing, hearing, smelling, and tasting. The term rongo (sensing) is holistic and relational and means “to know or get to know through, not only by hearing but also, touching, feeling, intuition, or any other means” (Smith, 2000, p. 55).  Being so attuned to the spiritual and natural realms, intuitive, participatory, and experiential ways of knowing are central to Indigenous Māori perspectives and understandings (Tassell-Matamua et al., 2021). For example, the puku (stomach) is where people feel intuition and instinct. People’s ability to understand and perceive tohu (signs, omens, indications) requires being attuned to what is happening in the environment, in those around us, or in our own bodies, and not rely solely on the mind for guidance (Beverland, 2023) . Discussing the role of ngākau (the heart that feels) as an example of Māori senses, Takirirangi Smith explains:

 

“Western knowledge systems are often premised upon the assumption that events occur and are conveyed by the senses to the brain where they are rationalized in the mind and stored. For Māori knowledge systems and other Pacific cultures with the same epistemological origins, memory and rational thought are perceived as occurring within the ngākau  … The ngākau is where thought is centralized and stored as memory” (2008, p. 266-267).

 

Methodology: Draws on understanding of knowledge based on aspects of a Māori worldview; under the maxim by Māori, with Māori, and for Māori.

Methods: A range of methods are used. Depending on the aims of project, these are informed by tikanga Māori (protocols and practices), often focusing on kia āta-kōrero (discussion) of practical, ethical, and spiritual dimensions, sometimes combined with participatory research or culturally valued practices of meaning making (e.g., story, song, weaving) (Pihama, et al., 2015). Research methods related to systematic observation and statistical analysis are also used (e.g., using health statistics to identify the impact of inequity). Data storage methods recognise Māori sovereignty over their data.

Quality criteria: Graham Hingangaroa Smith’s (2017) five tests of veracity for Kaupapa Māori research include:

• positionality: researchers locate themselves in time and space, explaining where one speaks from, and why one speaks
• criticality: Māori political, historical, and ongoing colonising contexts needs to be critically understood, to create a space for Māori language, knowledge, interests, and successful interventions. This includes taking a strengths based approach (e.g., Hawaiiki et al., 2024)
• structural and cultural considerations: that include ways of changing people, but also the structural impediments to Māori wellbeing
• “praxicality”: bringing theory and practice together, to create transforming praxis that is grounded in action and produced through ongoing cycles of action and reflection that tests theory against practical enactments
• transformability: positive outcomes for Māori need to be embedded within the research so that meaningful, impactful outcomes are produced, including enhancing self-determination.

 

 

Evaluation:

Kaupapa Māori research offers a strengths-based approach to research with Māori that aligns both with Māori knowledge and practices and with Te Tiriti o Waitangi, a treaty between rangatira Māori (tribal chiefs) and British settlers and the founding constitutional document of Aotearoa New Zealand (see Brittain & Kora Chapter 1.1) which includes discussion of Māori rights to rangatiratanga (self-determination). Kaupapa Māori research is used to enhance Māori wellbeing and create novel solutions in health research. It is part of an exciting revival of Māori culture, a grounding force that enables Māori to bounce back from adversity better, as well as navigate the challenges of contemporary society more resiliently (Durie, 2001, 2011; Tassell-Matamua et al., 2021). It is, however, hard to do within institutional settings that do not recognise or value te ao Māori and ongoing impacts of colonialism. As Smith has argued,

 

 

Considered against our five pou, Kaupapa Māori research:

• values theoretical/conceptual thinking in relation to the complex and contextualised cosmologies and ontologies that are underpinned by mātauranga Māori.
• challenges taken for granted understandings through kia āta-kōrero (discussion), a characteristic feature of Kaupapa Māori research. In the light of colonisation, a further challenge to taken-for-granted understandings occurs when, as Moewaka-Barnes (2015, p. 31) explains, “Kaupapa Māori researchers ask, ‘whose truth?’ and ask ‘how it constructed’”.
• pays attention to issues of power and equity in the way Kaupapa Māori researchers recognise that power flows through relationships. Kaupapa Māori health research is especially critical of the legacy of colonialism in maintaining health inequities, and emphasises the need for Māori to determine and own the knowledge and power to make sense of themselves, which includes control over all aspects of Kaupapa Māori research.
• moves beyond individualism with a holistic and relatedness approach to knowledge, both because Māori are collectivist people, with multiple levels of social relations such as whānau, hapu, and iwi, and because Kaupapa Māori research considers the wider physical, social, cultural, political, historical, and spiritual contexts within which people are embedded (Durie, 2001).
• considers knowledge as produced in context. This is a defining feature for Kaupapa Māori research because knowledge is understood as relational and contextual, produced in, and through, the local physical and social environment. For example, different iwi may celebrate Matariki (the Māori new year) at different times, in part because of geographical regional differences in when the star cluster appears over the horizon, signalling a new cycle (see text box below).

We have discussed five approaches to the nature of knowledge, and, specifically, their implications for the kind of knowledge that can be generated in the service of health psychology.

 

 

Returning to our Chapter 1.2 discussion of the expression “the map is not the territory”, we note that these approaches to knowledge act like maps, offering different (and differently useful) perspectives for how to navigate the landscape of health psychology.

We can develop this metaphor by considering what kind of glasses we might wear to read a map. Just as different glasses (e.g., 3D, coloured, bifocal, etc.) shape perception, so too can applying different theoretical lenses to the epistemological maps that we have outlined above, including queer theory, critical race theory, crip and disability scholarship, fat studies, and so forth. Other traditions of thinking not covered here, such as Asian philosophies (Liu, 2017), add further potential lenses for health researchers.

When people use a map repeatedly, they can widen some paths, while abandoning others to become overgrown. In shaping practice, maps can therefore shape the landscape. Applied to health psychology, we note that different epistemologies can fundamentally shape the ways that psychologists “produce” health. Valuing multiple ways of knowing widens our capacities for thinking—for taking different paths—as does experimenting with developing new ways of knowing (see text box below).

 

 

As the text box above shows, epistemologies are not fixed, objective, natural truths – new theories of knowledge develop, which, as the crisis of representation showed, often come from the positionalities of researchers who offer new perspectives (Bell, 2018). So although a mark of quality research is that it is conceptually strong, which usually translates as conceptual coherence between ontology, epistemology, methodology, and methods, this should not stifle innovation.^[6]

Knowledge Check

 

 

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