possible, before continuing. Semi-structured interviews were conducted at various intervals with selected members of staff, including medical officers, nursing staff and allied personnel, such as occupational therapists and the two social workers, as well as former members of staff. Normally these interviews required careful planning due to medical schedules and outpatient appointments, therefore they were usually tape-recorded and supplemented by extensive note taking during the interview process itself.
Semi-structured interviews with patients were usually taped with their consent. The open use of a tape recorder in informal situations was eventually seen to be too intrusive for general conversations after I detected that, in particular, members of staff felt uncomfortable and inhibited by the idea. Furthermore, I had the impression that the tape recorder was distracting for patients, as well as intrusive, and tended to curtail spontaneous disclosures. Reliance on an increasingly elastic memory for informal conversations meant the flow of conversation was not interrupted; and a more relaxed and confiding atmosphere could be created. Hastily but discreetly written up notes in shorthand on small notebooks usually took place in secluded corners of the ward following these valuable sessions, as like the patients I was not able to enjoy freedom of movement due to ward ‘lock-up’ procedures.
Although I had initially hoped to engage a wide range of respondents, in reality some were considerably more responsive than others. Opportunities to talk to both patients and staff were seized more on the basis of luck than design, commensurate with Burgess’ definition of ‘opportunistic sampling’ (1995: 55).
Amongst the patient population my key informants were nearly all women; male patients tended to shy away from contact or at any rate often seemed less likely to respond to my questions with relevant information. On the face of it this is in keeping with the rapport Ann Oakley discovers in her research activities through the democratisation of the interviewing process, premised on the notion of shared commonalities, of which she writes:
The women were reacting to my own evident wish for a relatively intimate and non-hierarchical relationship (Oakley, 1984: 47).
However, I lacked the basic common grounds that Oakley held; she was a British mother, interviewing British mothers. Whereas I was a foreign woman who had never been admitted to a psychiatric hospital and was attempting to develop a rapport with women and men, many of whom had spent years of their lives being processed by the Malaysian psychiatric services. Yet, despite Daphne Patai’s (1991) critique of pseudo-identification, I remain convinced on my part that empathy of sorts was created during these times, albeit fractured with misunderstandings, cultural, social and sexual dissonances. Female patients in particular were often very friendly and even affectionate to varying degrees. I was subjected to a lot of gentle physical contact, and complimented, while at least one woman attempted to develop greater intimacy with me through sexual overtures.
The enveloping, cordial, affectionate and sometimes cloying atmosphere on the female wards was not replicated on the male wards. Rachel Forrester-Jones (1995) in reference to Ann Oakley, discusses the problem of creating reciprocal relationships with informants of the opposite sex to the researcher. Here, as Bailey (1996) notes, heterosexual and gender issues permeate the platonic boundaries of the relationship. Attempts at reciprocity are jeopardised by unshared gender expectations and politics, where women researchers may face the possibility of unwanted sexual advances from male participants. Accordingly, Estroff discusses the difficulties of negotiating relationships with male psychiatric informants whose social unfamiliarity with women creates a potential for painful misunderstandings.
Being female helped and hurt. Over half of the subjects were men. My gender served as an entrée to contacting them and eliciting some interest, but it created tensions as well. Many had never had a female friend, that is, a symmetrical, platonic, heterosexual relationship. This led to some confusion of their part when their sexual advances offended me, and to reluctance on my part in entertaining situations with them that might be misconstrued. It was often inappropriate to participate with the group as the only female, and as a sexually inaccessible one, at that (Estroff, 1985: xvii).
Unlike Estroff’s case, my contact with male patients did not take place in the social context of the community, but with only one exception, took place on the ward and for the most part in full sight of other patients and staff. Nevertheless, it was awkward and embarrassing to be the regularly subjected to so much inquisitive, blatant or wistful and forlorn attention from male patients, such as dealing with those who persisted in calling, flirting and chatting to me through the bars of the locked section. I was of course very aware that I was ultimately free to stay or go and they were confined, bored and excited by any break in the tedium, which by my presence I had caused. By persisting in staying on the ward, as fieldwork demanded, I was aware that I was also guilty of encouraging and exacerbating this mortifying sexual attention in an atmosphere of palpable, claustrophobic voyeurism. This verged, as Gearing (1995) found in relation to her own study, on sexual harassment. Furthermore, evasive strategies could not be properly mobilised, such as the feigned dignified, and casual indifference of a woman passing a building site, as this directly conflicted with the research guise of keen-eyed vigilance to detail. For the most part therefore, I tried to encourage relationships with male patients that were polite, friendly and neutral, in an atmosphere where physical contact and verbal intimacy were subtly discouraged. Obviously, there were exceptions to the rule, whereby some of my relationships with male patients were mutually respectful with no hint of a sexual overture on any occasion.
Contact with staff provided a fascinating contrast, in that, as stated, while female nursing staff were often reticent, their male counterparts - the ‘medical assistants’ - on the male wards were much more willing to disclose information to me than the female nursing staff and could be, when they chose to be, cheerful, amusing and friendly in their interactions with me. Such was the peculiar and intriguing balance in that in general women patients and male nursing staff were by far the most helpful and friendly towards me, whilst male patients and female nursing staff were often distant, close-lipped and occasionally overtly suspicious of me. As others have noted, women as researchers are seen as more harmless (and usually less socially important) than male researchers by male participants and therefore as less likely to use information in a damaging way (Gurney, 1991; Warren, 1988).
Any perceived lack of status on the grounds of gender may therefore have worked against forming a good rapport with female staff, in that there were few incentives for them to overcome the insider/outsider power dichotomy in an environment of closed ranks. Furthermore, Taylor (1991) points out that in his own research in a male-dominated setting rapport with informants was built upon a foundation of male solidarity, socialising activities and initiation ceremonies, something from which I was culturally barred in my own research with men and which did not materialise with women members of staff. Yet a few friendships were developed between myself and female members of staff, where one nurse occasionally pressed on me bottles of homemade tuak (rice wine), which at first I thought I was expected to pay for and only later realised were spontaneous gifts.
The conditioning of women to cautiously observe the boundaries between the sexes will continue to mediate relations in a research encounter. These will qualify the nature and depth of disclosures by informants as well as altering the agenda of what can be discussed in comparative safety for informants and researchers alike. I was, for example, very interested in learning more about the sexuality of male patients but this proved to be a problematic area for inquiry, and one where responses from male staff and patients were unsatisfactory, superficial and laden with implications. Lesbianism, however, was a subject that could be discussed with women, once relationships of comparative trust had been satisfactorily built. Reciprocity therefore is heavily dependent on gender relations in the field and consequently influences the quality of disclosures from informants. Like Forrester-Jones (1995) I feel that a male co-worker would have been able to elicit information from male informants that was to some degree inaccessible to me as a woman researcher in the field.
In his ethnographic account of psychiatric patients in Australia, Barrett (1996) makes
