Some of our favorite theories for doing ethnography in health care spaces

June 16, 2020 Leave a comment

At Ethnographic Research, Inc., we always emphasize the value of social theory in ethnography and its ability to add depth and nuance to our results. It is like having the ghosts of sociology’s past prodding us to consider looking at our data this way or that way, just in case there might be a big insight around the corner. Research for the health care industry is no exception. In fact, given how challenging in-context observations of health care settings can be, it’s a crying shame not to make the most out of that data. That’s where theory lend a hand. There is a ton out there, but here are a few theories we tend to use the most:

Stigma: Emile Durkheim, Erving Goffman. Stigma is an essential variable to consider when we do projects on living with an illness. Sometimes the stigma is the result of the physical effects of an illness, its accompanying behaviors (like injecting insulin in public), or by just having the illness (like a sexually transmitted disease). The impact of stigma can be as traumatic as the physical effects of the illness itself, and Durkheim and Goffman helped us understand these dynamics.

The sick role: Talcott Parsons. Talcott Parsons’ functionalism hasn’t necessarily stood the test of time, but we still use his idea of the “sick role.” The basic notion is that when we’re deemed “sick” and take on the “sick role,” we’re excused from normal responsibilities while also being required to work towards getting better. For us, we often use it more broadly in examining how having a specific illness impacts a person’s social roles and their engagement with the world around them. Given our long history of studying different conditions, we can then compare the “sick role” of X illness with the many other illnesses we’ve studied in the past.

Gender theory: Simone de Beauvoir. We always make sure to attend to how gender roles impact the interactions and behaviors we observe. You could pick many influential gender theorists, but de Beauvoir was one of the first to draw the line between sex and gender, and this idea of the social construction of gender is arguably the fundamental starting point of most or even all current gender theory.

She also wrote that women and their bodies were the “inessential other,” deemed both alien to and lesser than men and men’s bodies. We can see this in women’s experiences of health care. In a study we did on a rare, difficult to diagnose illness, women, in trying to find out what was going on with them, weren’t taken seriously by the HCPs. Their physicians downplayed their symptoms as “just stress” or “just needing to lose some weight” when they had a condition that would be fatal if left untreated. 

Presentation of the self: Erving Goffman. Goffman is back for a second round! For Goffman, when we interact with others we act, as if in a play, and our choice of words and our body language are designed to convey a certain image to the person we’re interacting with. This concept is essential when trying to decipher the interactions that patients have with their health care providers. It helps us make sense of how both sides communicate and how those communications are interpreted, which ultimately shapes treatment decisions and patient outcomes.

These interactions usually play out in the exam room, what Goffman would call the “front stage,” the stage that our clients tend to be most interested in. We always argue that we should also observe the “backstage,” their offices, labs, and break rooms, to see what HCPs are doing outside of direct patient care, to see how they interact with other staff members, and to get the entire picture of what’s involved in their day’s work.

This front stage and backstage distinction of Goffman’s is also important when we study the experiences people have with their illnesses away from the doctor’s office. It’s our job to understand how the public face of someone’s experience of an illness might differ from the private, backstage experience they keep to themselves or just share with their closest friends and family. It is often only in this backstage space where we can see what’s really going on.

The quantified self: Deborah Lupton. Just so we can include something from this century, the quantified self has become a more influential theory in the last couple of years in both our health care research and our technology research. It basically explores how we are increasingly measuring the wellbeing of our bodies with numbers. The most common example is fitness tracking (e.g., FitBits and Apple Watches), but you can see it elsewhere, like assessing diabetes status through the numerical output of a glucometer.

The quantified self can be considered a kind of extension or offshoot of the “medicalization of society,” another valuable theory from the previous century, the 70’s. It contends that more and more aspects of our lives are falling under the umbrella of medicine. A classic example of medicalization is giving birth. Where once done with family in the comfort of the home, now having babies in hospitals is the norm. Medicalization comes up periodically in our research too, like a project we did on Restless Legs Syndrome (RLS). Our participants’ friends and family didn’t take RLS seriously; they didn’t believe it was a real condition (rather the result of the medicalization of society). This led our participants to feel the stigma of having a “fake” condition and it impeded their ability to take on the sick role.

Often we combine these theories in our quest to understand and organize our fieldwork, our analysis and our reporting. What are some theories you love to use in your work?

Four ways to help transform ethnographic insights into action

June 15, 2020 Leave a comment

Like carpenters who build dream houses from simple wood and concrete, it takes a lot of work for ethnographers to build dazzling insights from raw data. Doing analysis is where we spend the vast majority of our time. Still, an essential step in creating value for our clients is presenting our findings in a way they can easily digest and incorporate into their platforms and strategies. Here are four things we do to help our clients transform ethnographic insights into action:

  1. Insights that are compelling to begin with

First you need a good foundation. Having great data collection and analytical processes that make the most of that data goes a long way in creating compelling reporting.

We study a lot of ordinary things like cooking, cleaning, personal care, using technology, and managing health and illness. Frequently our clients have spent years working in these categories and most of their lives engaging in the behaviors themselves. It becomes our challenge to bring fresh insights to the table, powerful enough to change the ways our clients think about topics they are already very familiar with. To do that consistently takes our entire toolkit: including sociological theory, inductive data collection and analysis, and just a lot of hard work. This is step one. You can shine and shine shallow findings, but they will still be shallow.

  • Reporting for success

Once we have strong findings based on strong data, we make sure to report it in a way that’s engaging and exciting for our clients. The insights aren’t going to gain traction if people fall asleep while we are sharing them.

Typically, we have more findings than we have time, so just the fact that we have to fit a lot into our presentations makes them fast-paced and entertaining. We also make sure to pair our findings with stories from the field. Sharing real life examples helps the audience get a better sense of what an insight looks like in practice, hopefully in ways that our clients can relate to and connect with solutions.

  • Video from the field

Almost all of our presentations use video clips to illustrate key insights. Seeing our participants in action helps clients get to know their needs on a more personal level.

Video helps us to demonstrate patterns and call out opportunities for innovation visually. We try to choose video clips that are empathetic, engaging, and entertaining. This level of engagement helps make the insights sticky. Individual clips will live in clients’ memories long after the presentation is over, and ultimately, the accompanying insight might find itself shaping the direction of their brand.

  • Ideation sessions

We regularly use ideation sessions to help clients develop action steps from ethnographic work. This is an extended brainstorming session shortly after we present our findings, usually the same day or the next day. The structure of the session differs depending on how much time we have and the audience size, but usually ethnographers and client stakeholders break up into small groups and come up with lists of ideas inspired by the ethnographic insights. We then compile and refine those ideas, spending time discussing and developing a select group to move forward with. Later, we send the client a report of all of the ideas for their reference. Ideation sessions are a great way to ensure concrete, direct solutions right away.

There you have it. Four ways we help our clients transform their insights into action. What other ways have you found helpful in making the most out of your research findings?

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Improving Online Research

June 12, 2020 Leave a comment

With COVID-19 moving a lot of market research online, we thought it’d be a good idea to highlight some considerations for getting deeper insights using remote and online methodologies. Although most of our work usually includes an in-person visit, we are big fans of video diaries and generally include those in our project toolkit as well as the occasional online interview. Right now, we think pairing online interviews with video diaries makes for a great, one-two punch.

Stay in-context if possible

Just because we aren’t there, doesn’t mean that life isn’t going on and that people aren’t still doing all of the things we are interested in learning about. The key for ethnographers is always trying to capture those moments (and the context around those moments) that help us learn about how something occurs. Being able to watch a person do something is exponentially more interesting than asking them to describe it. The messiness of observing real life is not replaceable, but we have found that it is possible to do some of that remotely.

Encourage participants to show and tell you more

When we visit participants in their homes or at their workplaces, we always let them know that we will likely want to see everything. Ethnographers know that it is not enough to ask people to show you the thing that you are interested in without seeing how it fits into the daily life and the physical space of the person using it. We always go deep in trying to get a handle on the routines, rituals, and habits of our participants. We also generally ask for tours of their whole homes because we know that the front stage spaces of someone’s home or work usually tells us far less than the backstage stage spaces. Touring homes remotely is possible. We have been doing them for years, usually with video diaries.

Be inductive

We approach all of our work assuming that we don’t already know the answers. We look to our participants to show us not only what is important but also in how to think about and talk about what is important. We learned a long time ago that no matter how much we would like to be the expert, when we are trying to get a handle on how a specific person uses a product or what it is like to live with a particular disease, no one knows more than the person in question. Therefore, all of our observations, interviews, and analyses are funneled through an inductive approach, which is just as easy to do remotely as in person.

Give it some time

Deep understanding takes some time to achieve. It would be great if we could drop into someone’s life for a few hours and learn everything we needed to know to ground a brand or to design a new product, but life (and especially culture) is more complicated than that. Whether you are trying out online interviews or launching some video diaries, it is probably a good idea to plan on investing a little more time than your initial instinct. Not only does more time result in more instances of what you want to observe, it also allows for more opportunities to capture variation in routine. Allowing our participants to keep diaries for a few weeks always results in way better data. Allowing them to keep video diaries for a few months is always amazing.

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Out of the mouths of babes

May 1, 2014 Leave a comment

One of the great things about being a sociologist AND a mom is that I got to watch 3 kids grow up from scratch. If I hadn’t been so exhausted when my kids were younger, I would have taken better notes on all of the interesting and sociologically insightful things they did and said.   It was fascinating stuff. It was so cool to watch them figure out their physical and social worlds. They were always negotiating language and social norms and trying to classify and categorize EVERYTHING. I always thought that in a lot of ways, my kids were like little social scientists who were trying to figure out their social and cultural context. They were always refining their understanding of the categories and classifications to which various types of people belonged and the unspoken rules about what was and was not socially appropriate behavior.

But learning is hard, especially when you are trying to learn something as complicated as social patterns or social norms. This is because social norms are often simultaneously obvious and invisible. On the one hand, most of us know what the rules are and we do a pretty good job of following them (at least most of the time). But on the other hand, the majority of social norms are taken for granted and are often not formally taught. Young kids have to learn them through careful observation and often through a process of trial and error. This often results in kids making widely inappropriate and politically incorrect observations and (to their parents’ horror) comments as they negotiate their understanding.

Since my kids are older, I had forgotten about how interesting it was to watch them figure all of this out. But recently, my colleague, Kazuyo, shared a story with me about her five year old son, Marcel, that got me to thinking about all of this again. Marcel, who is bilingual and bicultural told Kazuyo that one of his friends (who is from Chinese decent) ate noodles for breakfast. Marcel thought it was ‘crazy’. Kazuyo was mortified and quickly set about educating Marcel on the variety of things that people from different cultures eat for breakfast. She told him that when she was growing up in Japan, many of her friends ate rice, soup, and fish for breakfast, but that her family ate toast. Marcel immediately wanted to know why her family didn’t eat soup. Kazuyo then realized that Marcel wasn’t making a judgment about his friend and that her initial fears of having raised an ethnocentric child were unfounded. Marcel was just trying to refine his understanding of how things work.

This story reminded me of a couple of times that my kids let me know they were struggling with social classifications. When my oldest daughter was about two she went to day care for the first time. She was in a class with lots of other two-year olds and one day she came home and announced “Kevin is a boy.” Smartly, I asked, “how do you know if someone is a boy?” Rebecca thought about it for a minute and then said, “boys use their outside voices when they are inside.”   I asked if there were other differences between boys and girls and Rebecca said, “boys are not very good listeners.” I asked if there was anything else and she finally said, “what is that thing?” Although I knew as a sociologist that gender differences were often more important than sex differences, I was still surprised that Rebecca listed two (stereotypical) gender differences before she got around to noting a sex difference.  

Several years later, after attending a talent show at the elementary school, my four year old, Isabel, was running around the house repeating a phrase from one of the skits that went something like “I’ve got a girlfriend.” Her five year old brother, Sam, quickly jumped in to correct her by saying, “Isabel, you are a girl, so you would have a boyfriend.” At this point, my nine year old, Rebecca, corrected Sam by saying “She can have a girlfriend if she wants to, there is nothing wrong with that.” I remember thinking that this was a perfect snapshot of three stages of social and cultural development and understanding.

There are so many social and cultural rules and classifications that we don’t talk about. This is partly because we don’t need to (because we think we know and understand the rules) and partly because we aren’t comfortable discussing differences between people. But if you ever want a quick lesson in the sociology of gender or ethnicity, or anything else for that matter, spend a few hours with a preschooler and ask them to tell you what they notice. Chances are, you will find that they are working hard to map out their social environment and therefore are noticing (and commenting on) lots of things every single day that most of us either just ignore or aren’t comfortable discussing.

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We’ve been everywhere, man: Participant observation and in-context interviewing

March 17, 2014 Leave a comment

I like to say that our theme song here at Ethnographic Research, Inc. is I’ve been everywhere man.  We travel a lot, a whole lot, but more importantly, our ‘office’ (when doing fieldwork) can be almost anywhere.  Since one of the most important mandates of ethnography is to be there to observe the thing you are interested in, while it is happening, we find ourselves ‘going to work’ in a lot of unusual places.  When we were hired to understand how oral care happens, we spent months hanging out in bathrooms watching people brush, spit, and gargle all over the world.  When we were hired to understand how Gen Y families used their cars, we logged hundreds of miles squeezed into back seats, in between car seats.  When we were hired to understand teenage gamers, we hung out in strip mall card shops observing late night Dungeons’ and Dragons’ games.  When we were hired to understand pet health, we spent the day in veterinary clinics.  In fact, we spend the majority of our time hanging out in places where we have never been before.  Each new day of fieldwork presents a new context to explore. 

For most of the best ethnographers I know, this is a fairly easy challenge.  Sure it is a little unsettling to report to work at a different ‘office’ each day, but once you get used to it, it is kind of fun.  And most of the time, the transition period is fairly short.  In fact, it is almost imperative that we hit the ground running and get comfortable as soon as possible.  In each new setting there are unique distractions that must be overcome.  And really, we never know what each setting will bring.   Sometimes there are unique sights, smells, or sounds that we have to get used to.  Often there are additional people (especially in public places) that we must filter in or out depending on our goals.  Since we approach our work assuming that everything is potentially data, we generally try to take in as much as possible in each setting whether it is someone’s kitchen or a hospital operating room.  But there are some times that the ‘background’ of a particular setting asserts itself as foreground, and ethnographers have to struggle to focus on the topic at hand. 

This happened one day when I was working on a project designed to understand travel and tourism in Atlanta.  I had spent weeks hanging out in all of the usual tourist spots, seeing historical sites, eating at great restaurants, and visiting local attractions.  Based on what I was learning about what people did when they visited Atlanta, it became increasingly clear that I needed to visit the Cheetah (a very famous high-end gentlemen’s club) if I was to get a complete understanding of what drew visitors to the ATL.  So, we set about getting the appropriate permission and finding the right contacts.  Surprisingly it was fairly easy to gain access and we scheduled a time to visit the next day.  I had never been inside a gentlemen’s club before and really didn’t know what to expect, but I approached it like any other fieldwork setting, assuming that everything was potentially data and ready to take in all that was unique to the Cheetah.  Our visit started with a tour and then we settled in and began to talk to some of the employees and customers.  Just as we sat down, a show began around us.  Several, mostly nude, women were dancing on elevated stages in front, behind, and beside us. Although the people I was talking to were saying very interesting things, things that were probably really important to my understanding of tourism in Atlanta, I found it increasingly difficult to hear what they were saying.  My attention was drawn more and more to the dancing women and I found that I really just wanted to talk to them.  It’s important to note that this rarely happens to me.  No matter what the topic, I generally find whatever it is I’m studying to be pretty riveting.  Participants are always saying ‘you must be bored to death’, but the truth is, almost everything can be interesting if you know how and what to ask.  So, I found it a little bit unsettling to be struggling to stay focused.  But then I remembered that participant observation requires me to not only make observations and conduct interviews, but also to immerse myself into the experience and to become a true participant in the action.  And so I did.  I stopped trying to focus only on the patrons (the primary target of our research), and begin to take in the experience of being at the Cheetah. 

When we left the Cheetah, I felt like I had a very good understanding of the culture and history of the space, and why the Cheetah was such an important tourist draw for Atlanta.  As we got into our car, my colleague and I began to debrief and realized that we had both had trouble applying our usual approach to fieldwork during our time at the Cheetah.  Our typical ability to ‘jump right in’ and be-at-one with the space and with our participants had been put to the test.  Although both of us had found ourselves in lots of unusual and even uncomfortable fieldwork situations, we had never tried to conduct fieldwork in a space quite like the Cheetah.  As we drove through the ATL, I felt like I had passed another ethnographic rite of passage, and knew that I had definitely gathered another interesting story.    

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How to get invited into people’s lives: Pick up lines from a corporate ethnographer

March 5, 2014 Leave a comment

I had been doing ethnographic research for almost a decade when I began working for businesses about 17 years ago.  Honestly, I wasn’t sure that the methodology would ‘transfer’ very well.  Prior to my work for corporate consumption, I had done much more traditional ethnographic fieldwork; this usually entailed spending months trying to work my way into settings, getting to know people, and building rapport.  If there was one thing I was sure of, ethnographic fieldwork could not be rushed.  Almost by definition, ethnography requires patience and a lot of persistence. 

So when my colleague suggested that we could conduct all of our fieldwork for a retail project within a few weeks, I was . . . uncomfortable.  But blessed with an open mind and a tendency to see the glass as half full, I decided to hear him out.  For this project, we were trying to learn about how certain holidays fit into modern American culture.  Our goal was to understand how consumers shopped for and celebrated these events.  Coming from a traditional ethnographic approach, I saw all sorts of problems with a research plan that assumed our access to the right people and the right contexts could be secured so quickly.  And even if we were lucky enough to find the right people and places, I was sure that it would take some time and effort to convince them to let us in. 

Part of my skepticism was based on my ethnographic training, which always seemed to tell me that gaining access to any group of which I was not a member was going to take some time and effort. I had experienced this firsthand, too.  My first ethnographic project involved spending a couple of years hanging out with police officers.  And I had seen how long it had taken for me to gain access to THAT group!   

Still, we forged ahead with a plan to begin fieldwork in retail spaces (where permission had already been granted).  As I begin to approach consumers and ask them if I could hang out with them as they shopped, I was REALLY surprised at how many said yes.  In fact, hardly anyone said no.  Not only were they letting me shop with them, they were seemingly letting me into the process in a way that went above and beyond an observational exchange.  As they pondered which greeting cards they should choose for their loved ones, they began to share wonderful stories about their relationships, their history, their feelings and values.  Within a matter of a few minutes, we were able to establish a rapport that gave me access to lots of intimate details of their lives.  I was a little bit confused.  I was accustomed to spending days, weeks, and sometimes months building relationships with my study participants before trying to segue into the ‘deep’ stuff.  

My colleagues and I, encouraged by our success, decided to take things a step further and see if some of the people we were approaching in the retail shops would allow us to follow them home in order to add some context to what we were learning in the stores. My colleague suggested that we offer to bring a pizza with us as an incentive.  Again, I was skeptical.  I remember saying “they are NOT going to let us do that.”  But, we gave it a shot.  And again, I was shocked to find that the majority of people we asked were game.  Most responded with something like this: “You are going to be so bored, I’m not very exciting, but if you want to come over, it’s fine with me.”  It was this response that started to give me some insight into exactly WHY it had been so easy to convince people to not only let us shop with them, but also to let us into their homes and into their lives.  It turns out that most of us don’t often have someone who is really interested in us, much less someone who views us as an expert.  Not only did the people I approached not find my request offensive, in many ways they found it a welcome opportunity.  It is a very compelling thing to have someone interested in your experiences, ideas, and values.  When I explained  WHY it was so important that I learn about them ‘in context’ they got it, even if they thought it was a little bit odd.   

Of course there are methodological and insight sacrifices that we corporate ethnographers make while trying to do our work within the deadlines and other constraints that come with working in the business world, but after almost two decades of working in this realm, I am convinced that gaining access to the right types of people and contexts need not be one of those sacrifices.

 

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How can you tell if someone is a stripper?

February 20, 2014 Leave a comment

A few months ago I had an interesting interaction on an airplane that illustrated how different the ethnographic approach to understanding is from the typical American’s approach to knowing.

We regularly make assumptions about situations and people in daily life, and of course we have to.  If every decision required us to systematically collect and analyze data and then carefully place our findings into the appropriate social and cultural context before acting, no one would ever get anything accomplished.

But looking around, I realize that we are a culture of know-it-alls and assumption makers who often base snap decisions on nothing but careless interpretation of limited data and hunches. In contrast, the ethnographic approach requires us to make careful systematic observations from multiple vantage points and to do rigorous methodical analysis before we can claim to understand or explain.  And this mandate is one of the things that I LOVE about my job! Because often the ‘obvious’ interpretation of an event (or person) is not so accurate.

But back to the flight that sparked this reflection.  I had just given a presentation and was looking forward to a flight home filled with nothing but reading.  I had settled into my seat, turned on my kindle, and was wrapped up in my book when my aisle partner started up a conversation.  He asked me what I was reading (Mama Lola: A Vodou Priestess in Brooklyn).  He said, “Wow, that is a new one.  How did you stumble upon that?” (I hadn’t stumbled upon it, it had been on my list of things I wanted to read for a long time).  We made small talk about books for a few minutes and then he asked me what I did for a living (I am a sociologist).  Without skipping a beat, he launched into some ‘people problems’ he was having and asked for my input in solving them.  He started with a coworker that no matter what he did or said, was always trying to ‘out-do’ or ‘out-say’ him.  He asked me why I thought she did that.  I told him that I really had no way of knowing, having never met her or having never seen the two of them interact. So he moved on to his next ‘problem’ which was a young lady sitting across the aisle from us.  He told me that she had been trying to get his attention since before we boarded.  He said he had deduced that she was obviously a stripper (based on her attire and attitude, which for the record I thought was less ‘stripper-like’ than he did), and asked me if I agreed.  I told him that I didn’t think she was a stripper.  He said, “come on, you are a people expert, right?”

I’ll be the first to admit that I think I have good instincts and that I’m probably better than the average person at quickly making assessments about people and social situations. However, it is precisely because I AM a people expert that I know how dangerous snap judgments can be, how very wrong first impressions often are, and how important it is to collect as much data as possible before making assumptions about ANYTHING.

One of the most important questions that an ethnographer asks herself/himself is:  how do you know what you think you know?  Careful attention to this question is the backbone of ethnographic analysis and how ethnographers make sure that findings are trustworthy accounts of cultural patterns and not misunderstood interpretations of observations or glimpses of esoteric events.   Ethnographers know that most people and certainly most cultural patterns are complicated and require deep examination in order to unravel meaning.  And it is really that deep examination that makes ethnography so useful and what makes my job so interesting and fun.  I’m usually surprised at the depth and complexity of the people I meet and the social situations I observe.  I truly never know what each day of fieldwork holds.

As my aisle partner and I deplaned, he asked me if I wanted to place a wager on the occupation of the young lady in question.  I declined, but I’m willing to bet that the actual story is more interesting than the assumed one.

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The In(sider)s and Out(sider)s of Shared Meaning

February 14, 2014 Leave a comment

All cultures have their own language and ways of communicating meaning that extend well beyond the spoken/written word. Signs, symbols, gestures, and icons all have varying meaning, depending on the context in which they are found. Often sub-cultures have ways of communicating that those outside of their circle don’t understand, a secret language of sorts, that allows them to pass coded information in a way that keeps outsiders unaware.

A few years ago, I got the chance to take a quick trip to India. I was only there about 4 days, and really that is not long enough to get over jet lag, let alone to really experience a place. Nonetheless, I was determined to squeeze in as much as possible. For the first three days, I was traveling and in meetings so I didn’t have much of a chance to experience India outside of a large corporate office and a fancy hotel. But on the fourth day, my colleagues and I set out to immerse ourselves in some shopping and sightseeing. We had planned to visit a local open-air market and so we jumped into a taxi and told our driver our plans. The taxi driver immediately began to try to talk us into making him our tour guide. We negotiated a price and felt really good that we had found a knowledgeable guide for the day. My colleague gave the driver the address of the market we wanted to visit, and we all sat back in and took in the sights and sounds of Delhi as our driver began our trek to the market.

After several minutes, we arrived at a high-end store that looked nothing like the market we had in mind. The driver explained that this store was in route to the market and that we were assured to find many nice things to buy there. Not wanting to be rude, we piled out of the taxi and into the store. The store was nice, but very touristy and over priced. We politely perused the shop and then got back into the taxi, assuming our next stop would be the market. But after several minutes we stopped at another shop. Again, the driver assured us that we wanted to go inside and that this shop was also on the way to the market. We went into the shop, purchased a few items, and returned to the taxi. On the way out the door, I noticed that our driver was talking to the shopkeeper. They seemed to be well acquainted and I realized that our arriving at this shop (and the previous shop) was no coincidence. And although both shops had been nice, they were not providing us with the sort of ‘authentic’ experience we were seeking. So, my colleague became insistent that our driver take us to the market we had originally wanted to visit. He agreed.

As we drove on, again, presumably towards the market this time, our driver asked us if we would like to see a beautiful temple. He said we were driving by there anyway, and really should stop to see it. Of course we didn’t want to pass up the opportunity to see a beautiful temple, so we agreed. The driver pulled up to the temple, which was actually on a very busy, noisy, dirty street. And just as promised, the temple was beautiful. We went into a side room and took off our shoes and placed our things into a locker. It had been a long morning and we were already very hot, over stimulated, sweaty, and tired. But immediately upon entering the temple, I felt a sense of calmness wash over me. It was several degrees cooler in the temple than outside (despite the fact that there was no air conditioning). It was very quiet (despite the fact that the noise of Delhi was right outside the door). And it was just so peaceful. I remember thinking that I hoped I would never forget that feeling. As we moved through the temple, a man came up to me and put a necklace of flowers around my neck and welcomed me into the temple. I felt so special to be singled out. But after a few minutes the man indicated that I should pay him! I realized that what was happening was not at all what I thought. Still, I went ahead and paid the man and became resolved to not let that interfere with the experience I was having. As soon as the man took my money, he also removed the flower necklace and put it around my colleague’s neck. He consoled me by placing a marking upon my forehead with some red powder (I assumed it was a religious ritual that everyone did upon coming to the temple).

After exploring the temple for a while, my colleagues and I returned to the taxi and continued our tour of Delhi. We visited some ancient buildings, some government offices, some opulent palaces, and saw some beautiful plant life. Finally, we arrived at the market we had set out for several hours earlier! The market was wonderful and just what we had hoped. We were getting a taste of ‘real life’ in Delhi. Most of the other customers were locals, not tourists, like ourselves. The market contained dozens of small shops and we wandered through most of them. At each shop, the worker would greet us, show us their wares, and try to make a sale. Everyone paid a lot of attention to us.

In fact, we had attracted a lot of attention virtually everywhere we had gone that day (except for the first few shops we visited). We obviously did not fit in and everyone seemed to notice us. I assumed this was due to our lighter complexions and accents. But towards the end of the day, I met a young man that let me know there was another reason there had been so much pointing, staring, and attention. He approached me and asked where I was from. I told him I lived in Kansas and asked if he had ever heard of it. He said he had and then asked me where I had gotten the red mark on my forehead. I told him that we had visited the temple earlier in the day. He explained to me that the mark was not for religious reasons but indicated that people could easily take my money. Initially, I found myself wanting to dispute his claim. I told him that I had seen others at the temple with similar markings. He explained to me that yes, the ritual does exist for religious reasons, but that in my case, the location and specific marking of the powder had been placed on my forehead as a way of branding me as someone who would easily give away money. He told me to wash it off immediately. I quickly began to replay the afternoon and all the people who had taken notice of me and realized that I had stood out for different reasons than I had assumed. I had been labeled as an ‘easy mark’ and had been treated accordingly. I was completely unaware of the hidden meaning behind the marking and with this new information was able to reevaluate the events of the day with a totally different sociological lens. Obviously I went home with a completely different story than I would have if I hadn’t run into the teenager in the market who took pity on me and shared his insider information.
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Notes on being a cultural chameleon and a pied piper

April 17, 2012 Leave a comment

In my business it is important to try to blend in.  No matter who we are hanging out with, it is essential that we look like we belong and are able to put our participants at ease.  Each ethnographer has her/his own way of achieving this goal, but generally we have to be comfortable in a variety of different types of situations and the natural ethnographer does this, well naturally.  Most of the best ethnographers I’ve known don’t have to work at blending in, they just do.

At Ethnographic Research, Inc. we started referring to ourselves as cultural chameleons a few years ago, because that is really who we are.  We have spent time with doctors as well as people who have been unable to work for years due to chronic pain.  We have hung out with academics as well as sex workers.  We have worked along side high-end sales folks and inner city social workers.  We have learned from people diagnosed with mental illness as well as suburban soccer moms.  And in each case, we have usually been invited to come back and hang out again.

It’s true that traditional ethnographic work provides ethnographers longer periods of time to work their way into a setting and into relationships.  But for those of us who work in business contexts, the time we get to make others comfortable with our presence is sometimes only a matter of minutes.  Hence our cultural chameleon abilities are even more important.  And for the most part, I’ve been very successful as a cultural chameleon.  But there was that one time. . . .

When I did fieldwork in the Philippines a few years ago, I got to experience what it feels like to really stick out.  For starters I am very white, the kind of white that glows in the dark.  In fact, my nick-name in high school was Casper.  Also, at five foot four, I’m not particularly tall, but compared to the average Filipino woman, I am gigantic.  Since I spent most of my time in neighborhoods where most westerners don’t go, I stuck out EVERYWHERE.  In many neighborhoods we created such a spectacle that people would lean out of their windows or even come out of their houses to watch us go by.  Often they called out ‘Hey Joe!’ (a reference to American GIs).  Several times, the neighborhood kids would form a pack and follow us down the street, creating a carnival like atmosphere.  I felt like the pied piper.

In this particular setting, there was no ‘blending in’ so I just embraced my status as an outsider and made observations from that vantage point. It was as the pied piper that I did most of my contextual mapping in the Philippines.  Walking around from neighborhood to neighborhood, I met up with and had the opportunity to observe hundred of people.  I was in Manila trying to understand how moms take care of their babies, so it was convenient for me that many parents brought their children outside to see me as I walked down the street.

In the end, whether we are able to blend in and be a cultural chameleon or whether we stick out like a sore thumb, the skilled ethnographer uses each status to their advantage.  The best understandings of any subject or context come from examining and analyzing data from both an insider and outsider perspective, so although ethnographers generally don’t like to stand out, acting as the pied piper once in awhile provides a nice change of pace and a nice change of perspective.

Sociological Theory Comes to Life

April 11, 2012 Leave a comment

When I was earning my undergraduate degree, there was a required class called Sociological Theory.  The first time I became aware of the class was when a bunch of my classmates were sitting around, talking about what they were going to take the next semester.   They all agreed to avoid Sociological Theory as long as possible.  None of them WANTED to take the class.  They said it was boring, difficult, and essentially a waste of time.  It sounded awful.  So, I put the class off too (even longer than statistics).  When I couldn’t put it off any longer, I enrolled in the class.  Boy was I surprised.  I LOVED the class.  It was interesting.  And so useful.

Imagine that you are trying to solve a difficult puzzle without a picture of what it looks like.  You are having trouble getting started.  But then suddenly the outer edge of the puzzle comes together and you begin to see how the inside might look.  Social theory often provides that type of tool for ethnographers.  It gives us a framework or a starting point to organize data or to understand a pattern.

I’m a little bit of a social theory junkie and I’ll admit that sometimes, for fun, I take random experiences and try a few different social theories on for size to see how well they can explain what I have seen.  It is very interesting to see how a single event can be understood in a variety of ways.  Admittedly, some social theories have more explanatory power and a wider scope of applicability than others.  One of my favorites is social exchange theory.  You know this one.  The premise is that all social relationships are based on exchanges between people and that these exchanges are based on a careful cost/benefit analysis of what each party is getting/receiving.  This particular theory is widely applicable and explains a great deal.

A few years ago I saw this theory in action when I was asked to help a client understand the lives of women at high risk for HIV infection.  I was spending time learning from a group of women who worked in the sex trade industry, hearing their stories, and learning more about how sex and protection fit into their work lives as well as their personal lives.  It was during these conversations and afterwards during analysis that I saw social exchange theory at work.  Many of the women I talked to summed up their decisions to not practice safe sex in terms of the costs and benefits they paid and reaped from their sexual exchanges.  It turned out that NOT using condoms helped them to shift the power balance of the exchange in their favor.  Obviously, at work they could demand more money if they didn’t use a condom.   But less obvious was the exchanges that they often made in their private relationships.  Not using a condom during sex with their significant others signaled trust, which was an important commodity that they paid into the relationship bank.  Using a condom would signal lack of trust and would put them further into the negative when it came to power within the relationship.   Although this seems counter-intuitive (i.e., using a condom SHOULD and does generally increase the power position of the woman), within this particular population, there were other, contextual variables at play that impacted the exchange.  For example, among this population, there was not a surplus of eligible partners and every potential partner entered into the relationship in a one up position, just by virtue of being scarce.  Also, there were cultural biases that made ‘cheating’ normal for men, but unacceptable for women.  Cheating was something that female partners were expected to not only accept, but essentially pretend not to see.  If they asked their partner to wear a condom, they were violating the agreement by pointing out that there was anything to be concerned about.  Finally, because their partners could usually leave the relationship and more easily find a replacement partner than they could, the value of ‘more pleasure’ that not using a condom provided allowed my participants to add another benefit to what they were paying into the relationship.

Social exchange theory provided a framework by which to organize the data and to explain the seemingly counter-intuitive and self-destructive behavior that my participants reported. It also encouraged me to try to understand the motivations for their decisions from a more rational perspective based on their social and cultural context.  Although I didn’t spend enough time in the field to really know whether the patterns I saw would be trustworthy in a larger population, social exchange theory provided a very interesting potential explanation for risk-taking behavior within this population and one that would probably indicate less traditional approaches to sex education and STI prevention efforts.