A Discursive Dance – A Foucauldian Discourse Analysis of Caring Touch in Health Practice

Power, Nicola
Payne, Deborah
Walters, Simon
Fadyl, Joanna
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Doctor of Philosophy
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Auckland University of Technology

The act of one person touching another is an act discursively produced and, therefore, constructed as acceptable in some situations and not in others dependant on who, where, and when the touch is actioned. Challenges, therefore, have the potential to arise; particularly within the realms of health practice where acts of touch are commonplace. This study has a specific focus on caring touch. Caring touch is a form of non-verbal communication enacted between people to demonstrate compassion, support, and empathy; and is constructed by social, gender and cultural perspectives.

The aim of this inquiry was to analyse the discursive constructions of caring touch in health practice. The complexity of caring touch required a methodology that recognised the presence of multiple viewpoints, values, and practices. Therefore, this study employed post-structural discourse analysis, which drew on the work of Michel Foucault and his notions of discourse, the subject, technologies, and governmentality.

Semi-structured interviews with 20 practitioners recruited from nursing, paramedicine, midwifery, and medicine, provided the data for this inquiry. Analysis of the data demonstrated an interplay of multiple discourses that made caring touch, as an act incorporated into health practice, challenging.

Findings from this study showed constructions of caring touch were at times juxtaposed across, and within, the four health disciplines. Although scopes of practice meant participants were able to legitimately cross boundaries of interpersonal space to employ their specific acts of care, caring touch was made more complex as it was not a ‘necessary’ part of practice. At times, caring touch was constructed as part of professional identity where it was normalised as complementary to other tasks undertaken, and an important aspect of care. Conversely, caring touch was sometimes constructed as an ‘extra’, an unnecessary part of professional practice that restricted time for diagnosis and treatment. Evident for most participants were uncertainties pertaining to what acts of caring touch were doable and, what were not, in terms of their professional practice, situating these participants at a discursive impasse. Similarly, there was an underlying unknowingness that pointed to wider constructs of touching another person that dominated practice.

Contradictions in the constructions of caring touch co-existed for the participants. This created tensions and unease; particularly for the male practitioners, where an undercurrent that discourses of gender and the sexualisation of touch knowingly or otherwise, influenced their acts of caring touch. Irrespective of how the male practitioners experienced or understood caring touch, there was a hesitation regarding how acts of caring touch would be interpreted. Acts of caring touch, therefore, became too complex to negotiate and touch interactions with patients were limited.

In summary, caring touch is a social construction that permeates the working lives of many health practitioners where acts of caring touch are both taken up or marginalised according to the discourses that dominate practice for the individual. The findings from this study contribute to the body of knowledge in a topic of significant complexity. This thesis opens up possibilities for the production and circulation of alternative discourses that may broaden the potential for patient wellbeing; and specifically, may create a space for health practitioners to navigate opportunities for caring touch.

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