A frog in boiling water? A qualitative analysis of psychiatrists’ use of metaphor in relation to psychological trauma

Journal article

Isobel, Sophie, McCloughen, Andrea and Foster, Kim. (2020). A frog in boiling water? A qualitative analysis of psychiatrists’ use of metaphor in relation to psychological trauma. Australasian Psychiatry. 28(6), p. 656–659. https://doi.org/10.1177/1039856220946596
AuthorsIsobel, Sophie, McCloughen, Andrea and Foster, Kim
Abstract

Objective:
Tensions about the definition, diagnostics, and role of psychological trauma in psychiatry are long-standing. This study sought to explore what metaphor patterns in qualitative interviews may reveal about the beliefs of psychiatrists in relation to trauma.

Method:
A qualitative inquiry using systematic metaphor analysis of 13 in-depth interviews with Australian psychiatrists.

Results:
Three themes were identified: a power struggle between people, trauma, and psychiatry; trauma is not a medical condition; and serving the profession to protect society.

Conclusions:
Metaphors present trauma as a powerful force that people can manage in different ways. Psychiatrists may view trauma as a social rather than medical issue. Psychiatrists experience role pressure associated with trauma including incongruence with risk management expectations of their roles.

Keywordstrauma; metaphor; qualitative; psychiatry
Year2020
JournalAustralasian Psychiatry
Journal citation28 (6), p. 656–659
PublisherSAGE Publications Inc.
ISSN1039-8562
Digital Object Identifier (DOI)https://doi.org/10.1177/1039856220946596
Scopus EID2-s2.0-85090221357
Research or scholarlyResearch
Page range656–659
Publisher's version
License
All rights reserved
File Access Level
Controlled
Output statusPublished
Publication dates
Online03 Sep 2020
Publication process dates
Deposited01 Jul 2021
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Wiseman, Taneal, Foster, Kim Narelle and Curtis, Kate. (2016). The experience of emotional wellbeing for patients with physical injury: A qualitative follow-up study. Injury. 47(9), pp. 1983 - 1989. https://doi.org/10.1016/j.injury.2016.03.021
The experiences, unmet needs and outcomes of parents of severely injured children: A longitudinal mixed methods study protocol
Foster, Kim N., Curtis, Kate, Mitchell, Rebecca, Van, Connie and Young, Alexandra. (2016). The experiences, unmet needs and outcomes of parents of severely injured children: A longitudinal mixed methods study protocol. BMC Pediatrics. 16(152), pp. 1 - 7. https://doi.org/10.1186/s12887-016-0693-8
Paediatric trauma systems and their impact on the health outcomes of severely injured children: Protocol for a mixed methods cohort study
Curtis, Kate, McCarthy, Amy, Mitchell, Rebecca, Black, Deborah, Foster, Kim, Jan, Stephen, Burns, Brian, Tall, Gary, Rigby, Oran, Gruen, Russell, Kennedy, Belinda and Holland, Andrew J. A.. (2016). Paediatric trauma systems and their impact on the health outcomes of severely injured children: Protocol for a mixed methods cohort study. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. 24(1), pp. 1 - 8. https://doi.org/10.1186/s13049-016-0260-1
How is care provided for patients with paediatric trauma and theirfamilies in Australia? A mixed-method study
Curtis, Kate, Foster, Kim Narelle, Mitchell, Rebecca and Van, Connie. (2016). How is care provided for patients with paediatric trauma and theirfamilies in Australia? A mixed-method study. Journal of Paediatrics and Child Health. 52(8), pp. 832 - 836. https://doi.org/10.1111/jpc.13189
Models of care delivery for families of critically ill children: An integrative review of international literature
Curtis, Kate, Foster, Kim Narelle, Mitchell, Rebecca and Van, Connie. (2016). Models of care delivery for families of critically ill children: An integrative review of international literature. Journal of Pediatric Nursing. 31(3), pp. 330 - 341. https://doi.org/10.1016/j.pedn.2015.11.009
Creating walking tracks to success: A narrative analysis of Australian Aboriginal and Torres Strait Islander nursing students' stories of success
West, Roianne, Foster, Kim, Stewart, Lee and Usher, Kim. (2016). Creating walking tracks to success: A narrative analysis of Australian Aboriginal and Torres Strait Islander nursing students' stories of success. Collegian. 23(4), pp. 349 - 354. https://doi.org/10.1016/j.colegn.2016.08.001
Unfolding case study and Mask-EdTM high fidelity simulation for chronic illness education: A case study
Frost, Jane, Foster, Kim and Ranse, Kristen. (2016). Unfolding case study and Mask-EdTM high fidelity simulation for chronic illness education: A case study. Collegian: The Australian Journal of Nursing Practice, Scholarship and Research. 24(5), pp. 433 - 439. https://doi.org/10.1016/j.colegn.2016.09.004
Extending parenting education program in an early parenting centre: A mixed-methods study
Berry, Karen, Jeon, Yun-Hee, Foster, Kim Narelle and Fraser, Jennifer. (2016). Extending parenting education program in an early parenting centre: A mixed-methods study. Journal of Child Health Care. 20(4), pp. 446 - 455. https://doi.org/10.1177/1367493515603827
The injury trajectory for young people 16-24 years in the six months following injury: A mixed methods study
Foster, Kim Narelle, Ogilvie, Rebekah, McCloughen, Andrea and Curtis, Kate. (2016). The injury trajectory for young people 16-24 years in the six months following injury: A mixed methods study. Injury. 47(9), pp. 1966 - 1974. https://doi.org/10.1016/j.injury.2016.04.037
Outcomes of the ON FIRE peer support programme for children and adolescents in families with mental health problems
Foster, Kim, McPhee, Ingrid, Fethney, Judith and McCloughen, Andrea. (2016). Outcomes of the ON FIRE peer support programme for children and adolescents in families with mental health problems. Child and Family Social Work. 21(3), pp. 295 - 306. https://doi.org/10.1111/cfs.12143
Reflective practice for the graduate
Usher, Kim and Foster, Kim Narelle. (2015). Reflective practice for the graduate. In Transitions in nursing : preparing for professional practice pp. 277-292 Elsevier Australia.
How can we make the psychiatric workforce more family-focused?
Maybery, Darryl, Foster, Kim, Goodyear, Melinda, Grant, Anne, Tungpunkom, Patraporn, Skogøy, Bjørg Eva and Lees, Robert. (2015). How can we make the psychiatric workforce more family-focused? In In Reupert, Andrea, Maybery. Darryl, Nicholson, Joanne, Göpfert, Michael and Seeman, Mary V. (Ed.). Parental psychiatric disorder : Distressed parents and their families pp. 301-311 Cambridge University Press. https://doi.org/10.1017/CBO9781107707559.029
Young peoples' experience and self-management in the six months following major injury: A qualitative study
Ogilvie, Rebekah, Foster, Kim Narelle, McCloughen, Andrea and Curtis, Kate. (2015). Young peoples' experience and self-management in the six months following major injury: A qualitative study. Injury. 46(9), pp. 1841 - 1847. https://doi.org/10.1016/j.injury.2015.05.036
Family members' experience of providing support for young people with traumatic physical injury during the acute hospital phase of care: A qualitative study
Ogilvie, Rebekah, Foster, Kim Narelle, McCloughen, Andrea and Curtis, Kate. (2015). Family members' experience of providing support for young people with traumatic physical injury during the acute hospital phase of care: A qualitative study. Injury. 46(9), pp. 1834 - 1840. https://doi.org/10.1016/j.injury.2015.03.030
The journey of positioning self as both mental health nurse and qualitative researcher: A critical reflection
Brunero, Scott, Jeon, Yun-Hee and Foster, Kim Narelle. (2015). The journey of positioning self as both mental health nurse and qualitative researcher: A critical reflection. Journal of Psychiatric and Mental Health Nursing. 22(7), pp. 543 - 548. https://doi.org/10.1111/jpm.12238
Developing family rooms in mental health inpatient units: An exploratory descriptive study
Isobel, Sophie, Foster, Kim N. and Edwards, Clair. (2015). Developing family rooms in mental health inpatient units: An exploratory descriptive study. BMC Health Services Research. 15(1), pp. 1 - 9. https://doi.org/10.1186/s12913-015-0914-0
Emotional intelligence education in pre-registration nursing programmes: An integrative review
Foster, Kim Narelle, McCloughen, Andrea, Delgado, Cynthia, Kefalas, Claudia and Harkness, Emily. (2015). Emotional intelligence education in pre-registration nursing programmes: An integrative review. Nurse Education Today. 35(3), pp. 510 - 517. https://doi.org/10.1016/j.nedt.2014.11.009
Risk factors associated with the severity of injury outcome for paediatric road trauma
Mitchell, Robert J., Bambach, Mike R., Foster, Kim Narelle and Curtis, Kate. (2015). Risk factors associated with the severity of injury outcome for paediatric road trauma. Injury. 46(5), pp. 874 - 882. https://doi.org/10.1016/j.injury.2015.02.006
Incidence of depression, anxiety and stress following traumatic injury: A longitudinal study
Wiseman, Taneal A., Curtis, Kate, Lam, Mary and Foster, Kim Narelle. (2015). Incidence of depression, anxiety and stress following traumatic injury: A longitudinal study. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. 23, pp. 1 - 9. https://doi.org/10.1186/s13049-015-0109-z
Physical health risk behaviours in young people with mental illness
McCloughen, Andrea, Foster, Kim Narelle, Marabong, Nikka, Miu, David and Fethney, Judith. (2015). Physical health risk behaviours in young people with mental illness. Issues in Mental Health Nursing. 36(10), pp. 781 - 790. https://doi.org/10.3109/01612840.2015.1036480
Incidence and outcomes of major trauma patients managed in the Australian Capital Territory
Ogilvie, Rebekah, Curtis, Kate, Palmer, Cameron, Lam, Mary, McCloughen, Andrea and Foster, Kim Narelle. (2014). Incidence and outcomes of major trauma patients managed in the Australian Capital Territory. ANZ Journal of Surgery. 84(6), pp. 433 - 437. https://doi.org/10.1111/ans.12524
The burden of youth: major traumatic injury in adolescents and young adults managed in the Australian Capital Territory
Ogilvie, Rebekah, Curtis, Kate, Lam, Mary, McCloughen, Andrea and Foster, Kim. (2014). The burden of youth: major traumatic injury in adolescents and young adults managed in the Australian Capital Territory. Journal of Trauma Nursing. 21(5), pp. 218 - 227. https://doi.org/10.1097/JTN.0000000000000068
Academic staff perceptions of factors underlying program completion by Australian Indigenous nursing students
West, Roianne, Usher, Kim, Foster, Kim Narelle and Stewart, Lee. (2014). Academic staff perceptions of factors underlying program completion by Australian Indigenous nursing students. The Qualitative Report. 19(12), pp. 1 - 19.
Experiences of peer support for children and adolescents whose parents and siblings have mental illness
Foster, Kim Narelle, Lewis, Peter and McCloughen, Andrea. (2014). Experiences of peer support for children and adolescents whose parents and siblings have mental illness. Journal of Child and Adolescent Psychiatric Nursing. 27(2), pp. 61 - 67. https://doi.org/10.1111/jcap.12072
The challenges of conducting a nurse-led intervention in a randomized controlled trial with vulnerable participants
Park, Tanya, Usher, Kim and Foster, Kim Narelle. (2014). The challenges of conducting a nurse-led intervention in a randomized controlled trial with vulnerable participants. Nursing Research and Practice. https://doi.org/10.1155/2014/394237
A randomized controlled trial undertaken to test a nurse-led weight management and exercise intervention designed for people with serious mental illness who take second generation antipsychotics
Usher, Kim, Park, Tanya, Foster, Kim Narelle and Buettner, Petra. (2013). A randomized controlled trial undertaken to test a nurse-led weight management and exercise intervention designed for people with serious mental illness who take second generation antipsychotics. Journal of Advanced Nursing. 69(7), pp. 1539 - 1548. https://doi.org/10.1111/jan.12012
Indigenous Australians' participation in pre-registration tertiary nursing courses: A mixed methods study
West, Roianne, Usher, Kim, Buettner, Petra G., Foster, Kim Narelle and Stewart, Lee. (2013). Indigenous Australians' participation in pre-registration tertiary nursing courses: A mixed methods study. Contemporary Nurse. 46(1), pp. 123 - 134. https://doi.org/10.5172/conu.2013.46.1.123
Intervention programs for children whose parents have a mental illness: A review
Reupert, Andrea E., Cuff, Rose, Drost, Louisa, Foster, Kim Narelle, van Doesum, Karin T. M. and van Santvoort, Floor. (2013). Intervention programs for children whose parents have a mental illness: A review. Medical Journal of Australia. 199(3 (Suppl)), pp. S18 - S22. https://doi.org/10.5694/mja11.11145
Educating Australian registered nurses in comprehensive health assessment: A pilot study
Foster, Kim Narelle, Lewis, Melinda, Marshall, Andrea and Lewis, Peter. (2013). Educating Australian registered nurses in comprehensive health assessment: A pilot study. The Journal of Continuing Education in Nursing. 44(4), pp. 155 - 162. https://doi.org/10.3928/00220124-20130201-34
Accidental insider: Living the PhD study
West, Caryn, Stewart, Lee, Foster, Kim Narelle and Usher, Kim. (2013). Accidental insider: Living the PhD study. Accidental insider: Living the PhD study. 20(1), pp. 61 - 65. https://doi.org/10.1016/j.colegn.2012.03.005
Mental health following traumatic physical injury: An integrative literature review
Wiseman, Taneal, Foster, Kim Narelle and Curtis, Kate. (2013). Mental health following traumatic physical injury: An integrative literature review. Injury. 44(11), pp. 1383 - 1390. https://doi.org/10.1016/j.injury.2012.02.015
Through a critical lens: Indigenist research and the Dadirri method
West, Roianne, Stewart, Lee, Foster, Kim Narelle and Usher, Kim. (2012). Through a critical lens: Indigenist research and the Dadirri method. Qualitative Health Research. 22(11), pp. 1582 - 1590. https://doi.org/10.1177/1049732312457596
The meaning of resilience to persons living with chronic pain: An interpretive qualitative inquiry
West, Caryn, Stewart, Lee, Foster, Kim Narelle and Usher, Kim. (2012). The meaning of resilience to persons living with chronic pain: An interpretive qualitative inquiry. Journal of Clinical Nursing. 21(9-10), pp. 1284 - 1292. https://doi.org/10.1111/j.1365-2702.2011.04005.x
The experience of surviving lifethreatning injury: A qualitative synthesis
Ogilvie, Rebekah, McCloughen, Andrea, Curtis, Kate and Foster, Kim Narelle. (2012). The experience of surviving lifethreatning injury: A qualitative synthesis. International Nursing Review. 59(3), pp. 312 - 320. https://doi.org/10.1111/j.1466-7657.2012.00993.x
Developing resilient children and families when parents have mental illness: A family-focused approach
Foster, Kim Narelle, O'Brien, Louise and Korhonen, Teija. (2012). Developing resilient children and families when parents have mental illness: A family-focused approach. International Journal of Mental Health Nursing. 21(1), pp. 3 - 11. https://doi.org/10.1111/j.1447-0349.2011.00754.x
Mental health education programmes for generalist health professionals: An integrative review
Brunero, Scott, Jeon, Yun-Hee and Foster, Kim Narelle. (2012). Mental health education programmes for generalist health professionals: An integrative review. International Journal of Mental Health Nursing. 21(5), pp. 428 - 444. https://doi.org/10.1111/j.1447-0349.2011.00802.x
The experience of weight gain as a result of taking second-generation antipsychotic medications: The mental health consumer perspective
Usher, Kim, Park, Tanya and Foster, Kim Narelle. (2012). The experience of weight gain as a result of taking second-generation antipsychotic medications: The mental health consumer perspective. Journal of Psychiatric and Mental Health Nursing. 20(9), pp. 801 - 806. https://doi.org/10.1111/jpm.12019
Chronic pain and the family: The experience of the partners of people living with chronic pain
West, Caryn, Usher, Kim, Foster, Kim Narelle and Stewart, Lee. (2012). Chronic pain and the family: The experience of the partners of people living with chronic pain. Journal of Clinical Nursing. 21(23-24), pp. 3352 - 3360. https://doi.org/10.1111/j.1365-2702.2012.04215.x
Physical health and wellbeing of emerging and young adults with mental illness: An integrative review of international literature
McCloughen, Andrea, Foster, Kim Narelle, Huws-Thomas, Michelle and Delgado, Cynthia. (2012). Physical health and wellbeing of emerging and young adults with mental illness: An integrative review of international literature. International Journal of Mental Health Nursing. 21(3), pp. 274 - 288. https://doi.org/10.1111/j.1447-0349.2011.00796.x
Intervention programs for children whose parents have a mental illness: A review
Reupert, Andrea E., Cuff, Rose, Drost, Louisa, Foster, Kim, van Doesum, Karin T. M. and van Santvoort, Floor. (2012). Intervention programs for children whose parents have a mental illness: A review. Medical Journal of Australia. 1(1), pp. 18 - 23. https://doi.org/10.5694/mjao11.11145
Educational approaches and activities to enhance emotional intelligence
Foster, Kim Narelle and McKenzie, Heather. (2012). Educational approaches and activities to enhance emotional intelligence. In In J. Hurley and P. Linsley (Ed.). Emotional intelligence in health and social care: A guide for improving human relationships pp. 127 - 145 Radcliffe Publishing Ltd.
Resilience in families with a member with chronic pain: A mixed methods study
West, Caryn, Buettner, Petra, Stewart, Lee, Foster, Kim Narelle and Usher, Kim. (2012). Resilience in families with a member with chronic pain: A mixed methods study. Journal of Clinical Nursing. 21(23-24), pp. 3532 - 3545. https://doi.org/10.1111/j.1365-2702.2012.04271.x
Psychometric testing of the Family Impact of Pain Scale using a sample of families in Australia
West, Caryn, Buettner, Petra, Foster, Kim Narelle and Usher, Kim. (2012). Psychometric testing of the Family Impact of Pain Scale using a sample of families in Australia. Nurse Researcher. 20(2), pp. 6 - 12. https://doi.org/10.7748/nr2012.11.20.2.6.c9435
Keeping families and children in mind': An evaluation of a web-based workforce resource
Reupert, Andrea, Foster, Kim Narelle, Maybery, Darryl, Eddy, Kylie and Fudge, Elizabeth. (2011). Keeping families and children in mind': An evaluation of a web-based workforce resource. Child and Family Social Work. 16(2), pp. 192 - 200. https://doi.org/10.1111/j.1365-2206.2010.00731.x
Description of a healthy lifestyle intervention for people with serious mental illness taking second-generation antipsychotics
Park, Tanya, Usher, Kim and Foster, Kim Narelle. (2011). Description of a healthy lifestyle intervention for people with serious mental illness taking second-generation antipsychotics. International Journal of Mental Health Nursing. 20(6), pp. 428 - 437. https://doi.org/10.1111/j.1447-0349.2011.00747.x
Reduced intubation rates for infants after introduction of high-flow nasal prong oxygen delivery
Schibler, Andreas, Pham, Trang, Dunster, Kimble, Foster, Kim, Barlow, A, Gibbons, Kristen and Hough, Judith. (2011). Reduced intubation rates for infants after introduction of high-flow nasal prong oxygen delivery. Intensive Care Medicine. 37(5), pp. 847 - 852. https://doi.org/10.1007/s00134-011-2177-5
Family resilience: Towards a new model of chronic pain management
West, Caryn, Usher, Kim and Foster, Kim Narelle. (2011). Family resilience: Towards a new model of chronic pain management. Collegian. 18(1), pp. 3 - 10. https://doi.org/10.1016/j.colegn.2010.08.004
Relationships in pain: The experience of relationships to people living with chronic pain in rural areas
Tollefson, Joanne, Usher, Kim and Foster, Kim Narelle. (2011). Relationships in pain: The experience of relationships to people living with chronic pain in rural areas. International Journal of Nursing Practice. 17(5), pp. 478 - 485. https://doi.org/10.1111/j.1440-172X.2011.01963.x
Weight gain associated with taking psychotropic medication: An integrative review
McCloughen, Andrea and Foster, Kim Narelle. (2011). Weight gain associated with taking psychotropic medication: An integrative review. International Journal of Mental Health Nursing. 20(3), pp. 202 - 222. https://doi.org/10.1111/j.1447-0349.2010.00721.x
I wanted to learn how to heal my heart': Family carer experiences of receiving an emotional support service in the Well Ways programme
Foster, Kim Narelle. (2011). I wanted to learn how to heal my heart': Family carer experiences of receiving an emotional support service in the Well Ways programme. International Journal of Mental Health Nursing. 20(1), pp. 56 - 62. https://doi.org/10.1111/j.1447-0349.2010.00710.x
Introducing mental health nursing: A consumer-orientated approach
Happell, Brenda, Cowin, Leanne, Roper, Cath, Foster, Kim and McMaster, Rosanna. (2008). Introducing mental health nursing: A consumer-orientated approach Allen & Unwin.