QHW 1748-2623 1748-2631 Int J Qualitative Stud Health Well-Being Vol. 6, November 2011, pp. 1–9 sici xxx PUBMED Abbreviation Annelise Norlyk PhD

Correspondence: A. Norlyk, Department of Nursing Science, Aarhus University, Høegh-Guldbergs Gade 6A, 8000 Århus C, Denmark.

Pia Dreyer PhD Anita Haahr PhD Bente Martinsen PhD Faculty of Health Sciences, Department of Nursing Science Aarhus University, Aarhus University

Aarhus Denmark

Department of Anaesthesiology and Intensive Care Aarhus University Hospital

Aarhus Denmark

Int J Qualitative Stud Health Well-Being THEORETHICAL/PHILOSOPHICAL ARTICLE Understanding the creative processes of phenomenological research The creative processes of understanding patients’ experiences in phenomenological research are difficult to articulate. Drawing on life philosophy as represented by the Danish philosopher K.E. Løgstrup (1905–1981), this article aims to illustrate Løgstrup's thinking as a way to elaborate the creation of cognition and understanding of patients’ experiences. We suggest that Løgstrup's thoughts on sensation can add new dimensions to an increased understanding of the creative process of phenomenological research, and that his thinking can be seen as an epistemological ground for these processes. We argue with Løgstrup that sense-based impressions can facilitate an flash of insight, i.e., the spontaneous, intuitive flash of an idea. Løgstrup stresses that an “flash of insight” is an important source in the creation of cognition and understanding. Relating to three empirical phenomenological studies of patients’ experiences, we illustrate how the notions of impression and flash of insight can add new dimensions to increased understanding of the creative processes in phenomenological research that have previously not been discussed. We illustrate that sense-based impressions can facilitate creative flash of insights that open for understanding of patients’ experiences in the research process as well as in the communication of the findings. The nature of impression and flash of insight and their relevance in the creation of cognition and understanding contributes to the sparse descriptions in the methodological phenomenological research literature of the creative processes of this research. An elaboration of the creative processes in phenomenological research can help researchers to articulate these processes. Thus, Løgstrup's life philosophy has proven to be valuable in adding new dimensions to phenomenological empirical research as well as embracing lived experience. Caring science phenomenological philosophy phenomenological research Løgstrup The phenomenological philosophy and ethics of the Danish philosopher K.E. Løgstrup is getting increased attention in Scandinavia. Within nursing, Martinsen (1994 2008) claimed that Løgstrup's metaphysics and ontology can form the foundation for nursing philosophy and nursing practice. Løgstrup's thinking is also gaining influence in the USA, where translations of his main works are available (Løgstrup, 1995 1997; Løgstrup & Niekerk, 2007). Additionally, discussions of Løgstrup's ethics by leading academics such as the philosopher MacIntyre (2010) and the sociologist Bauman have promoted awareness of Løgstrup's works and thoughts (Holm, 2001). Although Løgstrup is widely recognized for his writings on ethics, we draw on Løgstrup's works on sensation as an important source of creating understanding and cognition. Løgstrup was inspired by several German phenomenological philosophers, and he studied both Husserl and Heidegger extensively. There are parallels to Heidegger and his desire to employ phenomenology as the proper mode of access to the phenomena of concrete human life, and his understanding of the Greek word phainomenon that for Heidegger means “that which shows itself in itself, the manifest” (Moran, 2000, p. 229). Some Løgstrup interpreters also refer to Goethe as one of the sources for Løgstrup's inspiration (Wolf, 1990). However, his main source of inspiration was the physician and philosopher Hans Lipps, with whom he studied in Göttingen in Germany (Martinsen, 1994; Wolf, 1990). Lipps was a follower of both Husserl and Heidegger (Wolf, 1990). In a short autobiographical sketch, Løgstrup writes of Lipps: Few heard him, nobody understood him. I attended all his lectures the year I spent in Göttingen. [ … ] I did not understand much but I did realize, that-when I did not understand him-it was because I thought in schemata, while he went to the phenomenon itself, without prejudices. [ … ] Nobody has ever taught me more than Hans Lipps. Maybe I am the only one, who has actually learnt anything from him - including the whole of Germany.(Løgstrup, 1987, p. 159) Løgstrup's writings concentrate primarily on the analysis of tangible life phenomena such as trust, life courage, power and hope. Consequently, Løgstrup's philosophy is often referred to as “life philosophy” or philosophy of life because of his focus on existential phenomena related to life fulfilment (Delmar, 2006; Pahuus, 1993). Life fulfilment entails feelings of being alive, of life courage, of a sense of coherence, a joy of life itself—phenomena that relate to the deeper dimensions in life (Pahuus, 1993, p. 16). To create nuances and variations, Lög-strup prefers to present his analyses of life phenomena in everyday language and rejects scientific concepts in the analyses. He even claims that there are no scientific concepts in his doctoral dissertation. Maybe this is why Løgstrup had to hand it in several times, before it was accepted by the university and the established academic environment. However, in his writings, Løgstrup's unique use of everyday language enables him to express his thinking with a strong emotional appeal and communicative power. Løgstrup's main philosophical opponent was Kant and his highly structured epistemology. In particular, Løgstrup criticized Kant's distinction between sensation and understanding (Løgstrup, 1978 1987). For Løgstrup, all real thinking and all understanding are based on emotion and sensation—not abstract speculation. To Løgstrup, sensation is our access to the world. Sensation connects us to the world and to our existence. Our sensations carry emotions. Through sensations, something becomes alive within us, something works on us. Hence, sensation is aesthetic and refers to an emotion caused by something that moves or touches us. Løgstrup articulates this point by stating that sensation is tuned because it always involves the ambience from a situation or experience. Thus, to Løgstrup, our senses by far exceed the traditional empirical understanding of the senses as instruments by which we gain knowledge (Løgstrup, 1983). Løgstrup does not refer to conceptual understanding in a traditional logic (Wolf, 1990). From Lipps, Løgstrup learned that the fundamental sources of cognition are based on sensation and reminiscence in the form of patterns of recognition. Løgstrup compares understanding to a horizon that displays new dynamic patterns of recognition (Løgstrup, 1983; Wolf, 1990). These patterns are not necessarily of an intellectual nature as they are based on emotional experiences. We understand emotion without words. Sensation enters our understanding and makes it intuitive and to illustrate this point, Løgstrup refers to the sense of powerlessness (Løgstrup, 1983). The sense of powerlessness cannot be fully expressed verbally and intellectually. We can only understand powerlessness through the emotion or feeling of actually being powerless, as sense-based impressions carry intrinsic understanding within them (Løgstrup, 1983). Løgstrup uses the two Danish terms “indtryk” and “indfald” to elaborate his works on sensation as an important source of the creation of cognition and understanding. The term “indtryk” can be translated into “impression”. However, semantic problems arise in the translation of the term “indfald”. In Danish, the term “indfald” literally means something that “falls into you”, that is something that comes to you as a spontaneous, intuitive flash of idea or insight. In the following, we have chosen to use “a flash of insight” as the translation of the term “indfald”. Løgstrup states that there is a close relationship between an impression and a flash of insight. An impression carries the ambience of a situation or experience and can thus lead to understanding based on the senses rather than the intellect. Løgstrup's point is that sense-based impressions can create a spontaneous, intuitive flash of insight (Løgstrup 1978 1983). An impression always carries a tuned and pre-linguistic meaning. Whenever we see, hear, read or experience something, we always get an impression of what we see, hear, read or experience. A sound, for instance, is not just a sound, but always a sound of something. Sound contains a specific tone that tunes our minds and opens for a specific mode, based on past experiences and recognition of a non-intellectual nature (Løgstrup, 1983). Hence, an impression moves us bodily, it works on us and we grasp something. Something inside us comes to life; we are being reminded of something that evokes something creative inside us. We are suddenly able to see new analogies. Being reminded of something implies a creative dimension, as we think of something of that we have never thought before (Løgstrup, 1983). What we are reminded of occurs as a spontaneous, intuitive flash of insight. An example may clarify the matter: A friend suddenly reminds us of a certain type of bird. If we have never thought of this before, it connotes a creative activity that is different from automatic or mechanical recognition (Wolf, 1990). A flash of insight can never be forced. However, we can facilitate the process and create conditions in which a flash of insight may occur. According to Løgstrup, we must be sensitive and open our minds to an impression. We have to dwell on the impressions that move us. We have to reflect on our own existence to try to understand what has moved us. Løgstrup tells us to stay with the impression until it has nothing more to tell us, that is we must grasp the impression in a phenomenological descriptive and sensuous way. Although an intuitive flash of insight appears suddenly, it does not come without preparation (Løgstrup, 1987). A creative and intuitive flash of insight is not just a random association. Rather, it is the result of hard work over time. The flash of insight occurs as a consequence of systematic thinking. It is the result of a concentrated effort and an uninterrupted time span. Løgstrup stresses that articulating the meaning of an impression in everyday language facilitates the creative processes. The inexhaustible variations of everyday language create possibilities for an intuitive flash of insight to occur, and enable us to understand something in a different way. Løgstrup also stresses that an intuitive flash of insight has to be pursued immediately as it is of a unique and time-specific nature. We cannot store a flash of insight for later use, if the timing is inconvenient. We must respond to the intuitive insight when and where it occurs (Løgstrup, 1983). Accordingly, an intuitive flash of insight represents the result of creative processes and a type of thinking that excludes rigid schedules and systems. It is the result of a critical reflection that enables us to be open to new and unknown connections. In the following, we draw on our own empirical studies to demonstrate how the ideas of sense-based impressions and a flash of insight can contribute to an increased understanding of the creative processes in phenomenological research. We will illustrate our research endeavours to create sense-based impressions that convey elements of patients’ experiences. This phenomenological study focuses on assisted feeding among people with language impairment (Martinsen & Norlyk, 2011). Interviewing the participants is the preferred method to collect data in phenomenological research. However, certain requirements must be met to produce data of good quality. This means that the participants must be able to provide detailed descriptions of the phenomenon under study. As a consequence, some phenomena specifically related to people with language impairment may remain unexplored if researchers primarily collect data through interviews. Therefore, we aim to illustrate how Løgstrup's theory of sensations can facilitate understanding of a situation when using participant observation. We chose Spradley's (1980) classical method “participant observation” for data collection. This method aims to make tacit knowledge explicit by forcing the participant observer to pay attention to things that are normally excluded (Spradley, 1980). Spradley encourages the observer to adopt an approach with a heightened sense of awareness and a wide-angle lens to accommodate a broader perspective than we usually have or are aware of in our everyday life. Observing and describing things that are normally considered trivial may lead to important data. The phenomenon, assisted feeding, was observed in two neurological wards. All notes were made on the spot and started with a description of the room and its features, and gradually became more focused on the phenomenon assisted feeding as it proceeded. The strategy was to use everyday language in the descriptions, and to avoid evaluative labels and conceptualizations. In terms of Løgstrup's works on sensation, the observer was exposed to all kinds of meal-related tuned impressions during the observations: The observer watched the caregivers and the patients, heard their conversations, smelled the food and the surroundings and experienced the atmosphere in the wards. In accordance with Løgstrup, the sensations of the immediate observation implied unification between the observer and the observed situation. The sensations promoted emotions and provided the basis for the understanding of the phenomenon. As already stressed, Løgstrup's thinking implies that sensations are always tuned. In this particular study, it meant that the meals made an impression on the observer in a way that was uncontrollable and unpredictable. And so, the observer's understanding of assisted feeding became intuitive, based on the immediate emotions that the situations evoked. Forty-two incidents of assisted feeding were observed and by dwelling with the phenomenon, the process of understanding what was happening during assisted feeding was facilitated. For data analysis, the phenomenological approach Reflective Lifeworld Research was chosen (Dahlberg, Dahlberg, & Nyström, 2008). It focuses on describing the world exactly as experienced and throughout the research process, the researcher must attempt to set aside her everyday understanding of the phenomenon and remain open to the phenomenon as it emerges in its immediacy. Løgstrup's description of impression and a spontaneous, intuitive flash of insight can unfold the idea of the open attitude as described in Reflective Lifeworld Research. Løgstrup encourages us to stay with an impression until it has nothing more to tell us. An important point is that all impressions have to be considered thoroughly in a systematic way, if new insight is to be gained. The aim being neither a conceptualization nor a standardization, rather Løgstrup says that much effort and hard work are fundamental for new thinking. Reflective Lifeworld Research entails a description of one way to work systematically with impressions that are in accordance with the standards of Løgstrup. During data analysis, the impressions will give rise to other impressions, especially because we as researchers work without concrete determination and deliberately set aside our pre-conceived ideas. Impressions can stimulate our creative thinking and make it possible to see new analogies and thus facilitate a flash of insight to occur. To exemplify the outcome of the systematic work with tuned impressions, the theme Sense of joy threatened by determination is presented in the following section. Medication played an important role during assisted feeding. One or more tablets could be given with a mouthful of food, and this could happen any time during the meal. The patient was not always informed when the medication was added. In other cases, patients were surprised by the unexpected taste of medicine, “Ugh, there was a pill in my ice cream”. From the moment the patient had been given his medicine, the assisted feeding seemed to become less important. For example, the caregivers could reduce verbal encouragement to eat. Meals were announced as events, worth looking forward to, “The food will be here soon” and “Today is Sunday, so there will be lemonade with the meal”. However, the assistance could be influenced by noise from fellow patients, relatives and staff as well as bells, telephones, television, etc. Assisted feeding could be used as a means to wake a sleeping patient. Caregivers were observed to sneak some food or liquid into the patients’ mouth to wake them. This could allow for assisted feeding to proceed, succeed and promote cooperation with the assisted feeding. Another effect was that the patient's mouth was filled with food that slowly oozed out or caused coughing (Martinsen & Norlyk, 2011). Empirical researchers inspired by phenomenological philosophy have to account for the way they comply with setting aside their own presumptions. This challenges the researcher investigating experiences of people with language impairment. However, Løgstrup does not directly instruct us to hold back our prior knowledge and ideas. Instead, he encourages us to be at the disposal of the phenomenon under study and stresses that sense-based impressions are based on intrinsic understanding. The pause plays a significant role in observation studies because the pause makes it possible for a flash of insight to occur. Right after a concrete observation is finished, the researcher has a momentum. Løgstrup emphasizes the importance of hesitation. It is necessary to dwell with the experience and not just go on with the next observation to grasp the impressions in a sensuous way. The same is true in the analysis, where the researcher thoroughly has to read and re-read the field notes to make room for a flash of insight to appear. Løgstrup's framework seems to create a valuable basis for understanding the creative aspects of participant observation. According to this framework, understanding the patients’ experiences is a matter of dwelling and being sensitive to the impressions that moved the observer and allow the intuitive flash of insight to pop up. In the following, the aim is to illustrate how Løgstrup's thoughts on sense-based impression and flash of insight may help to understand and explicate the creative and often tacit processes that characterize data collection and data analysis when doing a phenomenological study based on interviews. The examples are derived from a hermeneutic phenomenological study exploring patients’ experiences of living with advanced Parkinson's disease (Haahr, Kirkevold, Hall, & Ostergaard, 2011). This study was guided by the hermeneutic phenomenological methodology of van Manen (1990) and data were collected through in-depth interviews with each participant. The lifeworld existentials: lived time, lived body, lived space and lived other served as a way to access and explore the lifeworld as experienced by the individual, and we strove to be driven by insights and a wish to really understand what it means “to be” (Haahr et al., 2011; van Manen 1990). According to van Manen, an important part of the analysis is to dwell on the interview texts, letting them speak their “own language” (van Manen, 1990). Løgstrup's work on sensation offers a way of understanding that could possibly help explicate how we create understanding during the processes of the interview and the analysis. For example, when we listened to the tone of voice in interviews, when we observed body language and acted intuitively to the character of the communication, then we were engaged in a creative process that was ongoing. According to Løgstrup's thoughts (1983), we as researchers allow ourselves to be exposed to sensations that make us able to be a sensible interviewer who is continuously alert to the situation during the interview. Thus, from the interview we are exposed to a lot of impressions that we carry with us in the processes of analysis. During the analysis, we read interview texts repeatedly, listened to audio-taped interviews and aimed to be open to new insights and statements that stood out as essential (Haahr et al., 2011). During this process, we may be said to have been open for and moved by new impressions. Following Løgstrup (1983), what happened was that we allowed impressions from the interviews and from the repeated readings to work on us to evoke something creative inside us that made us able to see new analogies. It was after hours of reading and going back and forth, that we in the terms of Løgstrup (1983) got a flash of insight that made us able to see new aspects, new paths and patterns. Sometimes, a statement or sentences from participants stood out as essential. A metaphor for example, can create a sensation in the researcher, speaking to the researcher's own experience and thus facilitate a new understanding. In the following, we aim to exemplify through examples of statements taken from the interviews, how the use of metaphors enhances the researcher's understanding of the phenomenon under study, and how dwelling on the metaphor may facilitate new impressions that may carry a sudden flash of insight. In the first example, the metaphor of “being a statue” was used by a participant to describe and explain the experience of suddenly being stiff and unable to move because of Parkinson's disease, “I will stand there like a statue, unable to move anywhere. People are looking strangely, they really are, and I don't like it” (Haahr et al., 2011). This metaphor carries intrinsic understanding. By dwelling on the metaphor and by being open to the intrinsic understanding, we allow the words to move us. The metaphor being a statue carries the strongly tuned impressions of being stiff, hard, expressionless and unable to move. Something people stare at. The metaphor can thus create a sensation in the researcher of what it must be like having physical impairment that is visible to others, and that makes you unable to move and dependent on help from others. In this way, a sensation creates an understanding based on the senses rather than the intellect. In the second metaphor, a participant described what it was like to live with Parkinson's disease when the body acted independently and uncontrollably, “When I go OFF … . Then my face ‘dies’. My mimic is gone and I am kind of gone too, because I use so much energy standing the pain” (Haahr et al., 2011). The use of the metaphor “my face dies” and the analogy “my mimic is gone and so am I” carries a tuned impression that gave rise to the flash of insight that facial expressions are essential to communicate with the world. By dwelling on this metaphor, we may be reminded of situations where we have met people and not have been able to “read” the other person. We may have had the experience of catching somebody's eye, smiling to them and not getting any response. Using metaphors as examples illustrates how Løgstrup offers a way of explicating how a certain situation moves us and helps us to gain a new understanding through a flash of insight. This section aims to highlight sense-based and tuned impressions that communicate the patients’ experiences when using narratives and making narrative presentations of findings. This phenomenological hermeneutical study focused on the lived experiences among young men living with home mechanical ventilation and Duchenne's muscular dystrophy (Dreyer & Pedersen, 2009). Using narratives makes it possible to put special emphasis on sense-based and tuned impressions. Inspired by Ricoeur's philosophical thoughts of distanciation (Ricoeur, 1973), we developed a new way of using narratives to present patient experiences (Dreyer & Pedersen, 2009). We wrote narratives based on the interpreted meaning and understanding of all the interviews and used a poetic language. Following Løgstrup, this aims to bring forward sense-based and tuned impressions and thereby facilitates an understanding of the patient's experiences in the reader. Ricoeur stressed that understanding a text is to follow its movement from sense to reference (Lindseth & Norberg, 2004; Ricoeur, 1973). Moving from what the text says to what it speaks about, we aimed to make room for what could be described as a flash of insight. Thus, by reading the interview text over and over, by concentrating and dwelling with the text and sensing the impressions, spontaneous, intuitive flashes of insight occurred facilitating a deeper understanding. In the process of re-writing the interpreted meaning, we used poetic expressions, metaphors or sayings that explicated the impression of the mood of the experience, and moved us bodily (Løgstrup, 1983). An example of such a creative process of working with the language when interpreting the interview text is the experienced difficulties in decision making when participants in the study received a ventilator. All the participants had previously made the decision that if they needed a ventilator, they wanted one. But when the day came, it proved to be a hard and difficult decision. Reading the interview text over and over, a spontaneous flash of insight occurred that the participants were talking about the difficult decision and how the ventilator gave them a new life, “I was nervous about getting the ventilator, and I think I delayed the decision a little. Then I caught a cold, and we agreed that it was best I got the ventilator” and “The ventilator just came, I had no alternative, and now I have two birthdays a year. Every year I celebrate the day I got the ventilator. It is like being reborn”. Referring to Løgstrup's thinking, a story can give the reader the impressions of the lived life with a ventilator; it can communicate the mood of the situation and the difficulties involved in decision making as described by all the participants. We wrote the story below to communicate the sense-based and tuned impressions to the reader. The story is about a boy lying in a hospital bed where he had just woken up after his tracheostomy and was on a ventilator. Thousands of small holes are flowing together in an odd pattern. Sometimes it is far away, and suddenly it is heading directly towards me, but then I close my eyes. I hope it is the ceiling. I am awake, but I don't think they know. My mum is sitting in a chair, and she is asleep. My position is all wrong, so I think she must have been sleeping for a long time. My mum knows that I don't want to lie on my back, and the little pillow under my left knee is missing.
I have feared this for more than a year, and now it has happened. I want to live, so I always said that I wanted the ventilator. I saw many of my friends go on a ventilator, and they did well, maybe even better than before they got the ventilator. So of course I wanted a ventilator. But I had all kinds of excuses. Oh it can't be done right now, because I am going on a trip with my school, and in this summer holiday I am travelling to Spain. Why didn't I say: “In the summer holidays I will get my tracheostomy and my ventilator”? No, I had to see a Spanish hospital from the inside: typical me. Luckily they quickly flew me home; otherwise I would be dead now.
I have a sore throat, and I don't think I can speak. But it doesn't matter—the feeling is fantastic. It is like bubbles, small bubbles of life, and I can feel it right down to my toes. And in my head, I am filled with energy. Hey! My thought is gone. My breathing thought—it's gone, and I am breathing.
Yes, I know it sounds odd, but I feel as if I am reborn.’ (Dreyer & Pedersen, 2009) Presenting research findings as short stories with special emphasis on Løgstrup's thoughts of sense-based and tuned impressions may provide a meaningful and powerful way to communicate patient experiences, and the stories may facilitate the creative processes of understanding in the reader. We have tried to elucidate that Løgstrup's works on sensation can contribute to an increased understanding of the creative process of phenomenological research, and that his thinking can be seen as an epistemological ground for this process. Although we have made use of different approaches in the studies exemplified, Løgstrup's ideas of impression and a flash of insight have proven to shed light on what is going on in the creative process of understanding of patients’ experiences. In the literature of phenomenological approaches, the creative processes of the research procedures are mentioned and acknowledged; however, they are sparsely explained (Dahlberg et al., 2008; Giorgi, 1997 2009; Lindseth & Norberg, 2004; van Manen, 1990). Consequently, the creative aspects of doing phenomenological research remain somewhat tacit. Phenomenological research literature stresses that the researcher is heavily dependent on linguistic ability, both that of the participants and that of the researcher (Giorgi, 2009; Halling, 2002; Todres, 2005). However, it is not only a question of linguistic ability. In the process of understanding experiences obtained from other people, Todres (2005) explained that it is a matter of not only being present “to words in themselves, but to the meanings given through the words” (p. 111). Similarly, Giorgi (2009) stated that one has a felt sense that a certain meaning unit is pregnant with possibilities, and as the analysis progresses, one tries to articulate its precise sense, it is “a matter of clarifying the sense” (p. 183). Drawing parallels to Løgstrup's terminology, a felt sense can be seen as a sense-based impression. Løgstrup expressed that an emotion contains a “hidden” understanding, and similar to Giorgi, Løgstrup literally writes that a felt sense is pregnant with a particular articulation (Løgstrup, 1983, p. 13). When we dwell and open our minds to such impressions in the text and try to articulate their precise sense, an intuitive flash of insight can occur. In this way, Løgstrup thinking contribute to elaborate the process of understanding as described by Todres (2005) and Giorgi (2009). As sensation connects us to the world, Løgstrup (1983) pointed out that in sensation, there is a unity between the person who senses and that which is sensed. Thus, no distance exists between the person who senses and the object that is sensed. This idea is clearly substantiated in the intentional relationship between the world and us (Husserl, 1982). Another fundamental point identified by Husserl (1982) is that intersubjectivity is present, prior to any encounter. Intersubjectivity allows for empathy. Empathic knowledge relies on the belief that we are able to understand other humans to some extent because we belong to the same world (Mortari, 2008). In Løgstrup's thinking, it is through sense-based impressions we are able to grasp other's experience intuitively. In general, phenomenological researchers acknowledge that writing is a part of the creative process and writing is a way of clarification throughout the research process. Writing distances us from the lifeworld, and makes it possible for us to reach a level of abstraction (Dahlberg et al., 2008; Giorgi, 2009; Halling, 2002; van Manen, 1990). Thus, writing is seen as a means to communicate findings reflectively, understandably and intelligibly (Halling, 2002; Todres, 1998; van Manen, 1990). As we have demonstrated, Løgstrup's notion of impression and flash of insight contribute to an understanding of what is important in the communication of research findings to communicate them in ways that facilitate an understanding of patients’ experiences to the reader. With references to Dilthey, Heidegger, and Merleau-Ponty, Todres (1998) argued that a phenomenological text involves an aesthetic dimension and that researchers must write in a language that aims to elicit empathy in the reader. This means communicating the mood of a situational experience and to write descriptions that are able to communicate a bodily sense of being there (Todres, 1998 2008). van Manen (1990) referrred to a good phenomenological description as something we can recognize, something that we cannot do in agreement. In line with Løgstrup, this means communicating sense-based impressions of patients’ experiences written in the everyday language. Thus, the framework of Løgstrup may facilitate the process of understanding patients’ experiences for researchers as well as for the readers of the research. The life philosophy of Løgstrup contributes to an increased understanding of how new insights into patients’ experiences are gained. We will argue that Løgstrup's work on sensation and his ideas of sense-based impression and a spontaneous, intuitive flash of insight are important sources in the creation of cognition and understanding. The ideas of impression and a flash of insight can constitute an epistemological foundation that can help researchers to articulate what is going on in the creative processes of phenomenological research. Examples from empirical studies, using different phenomenological approaches, highlight how sense-based impressions communicate patients’ experiences during the process of data collection, in the analysis process as well as in the communication of the findings. Thus, Løgstrup's elaboration of the epistemological ground for creative thinking can complement the sparse descriptions of the creative processes in the literature of phenomenological approaches. Løgstrup's work on sensation has proven to be valuable in adding new dimensions to understanding phenomenological empirical research. The authors have not received any funding or benefits from industry or elsewhere to conduct this study. Dahlberg K. Dahlberg H. Nyström M. Reflective lifeworld research Studentlitteratur Lund 2008 Delmar C. The phenomenology of life phenomena Nursing Philosophy 2006 7 4 235 246 Dreyer P. S. Pedersen B. D. Distanciation in Ricoeur's theory of interpretation: Narrations in a study of life experiences of living with chronic illness and home mechanical ventilation Nursing Inquiry 2009 16 1 64 73 Giorgi A. The theory, practice, and evaluation of the phenomenological method as a qualitative research procedure Journal of Phenomenological Psychology 1997 28 2 235 260 Giorgi A. The descriptive phenomenological method in psychology: A modified Husserlian approach Duquesne University Press Pittsburgh 2009 Haahr A. Kirkevold M. Hall E. O. Ostergaard K. Living with advanced Parkinson's disease: A constant struggle with unpredictability Journal of Advanced Nursing 2011 67 2 408 417 Halling S. Making phenomenology accessible to a wider audience Journal of Phenomenological Psychology 2002 33 1 19 38 Holm S. The phenomenological ethics of KE Løgstrup–a resource for health care ethics and philosophy? Nursing Philosophy 2001 2 1 26 33 Husserl E. Ideas pertaining to a pure phenomenology and to a phenomenological philosophy Kluwer Dordrecht 1982 Lindseth A. Norberg A. A phenomenological hermeneutical method for researching lived experience Scandinavian Journal of Caring Sciences 2004 18 2 145 153 Løgstrup K. E. Skabelse og tilintetgørelse. Metafysik IV. [Creation and annihilation. Meta-physics IV.] Gyldendal Copenhagen 1978 Løgstrup K. E. Kunst og erkendelse. Kunstfilosofiske betragtninger. Metafysik I. [Art and Epistemology. Art-philosophical considerartions. Meta-physics I.] Gyldendal Copenhagen 1983 Løgstrup K. E. Solidaritet og kærlighed. [Solidarity and love] Gyldendal Copenhagen 1987 Løgstrup K. E. Metaphysics (R. L. Dees Trans.) Marquette University Press Milwaukee 1995 Løgstrup K. E. The ethical demand. [Den etiske fordring 1956] University of Notre Dame Press Notre Dame Indiana 1997 Løgstrup K. E. Niekerk K. V. K. Beyond the ethical demand University of Notre Dame Press Notre Dame Indiana 2007 MacIntyre A. Danish ethical demands and French common goods: Two moral philosophies European Journal of Philosophy 2010 18 1 1 16 Martinsen K. Fra Marx til Løgstrup: om etik og sanselighed i sygeplejen. [From Marx to Løgstrup. About moral and sensibility in nursing] Munksgaard Copenhagen 1994 Martinsen K. Innfallet og dets betydning i liv og arbeid: metafysik inspirerte overveielser over infallets natur og måter å vise seg på. [The spontaneous flash of an idea and its meaning for life and work] Klinisk Sygepleje 2008 22 1 20 32 Martinsen, B. , & Norlyk, A. ( 2011 in press). In the shadow of institutional structures. Observations of assisted feeding. Journal of Clinical Nursing. Moran D. Introduction to phenomenology Routledge London 2000 Mortari L. The ethic of delicacy in phenomenological research International Journal of Qualitative Studies on Health and Well-being 2008 3 1 3 17 Pahuus M. Livet selv: en livsfilosofisk tolkning af kristendommen. [Life itself: A life-philosophical interpretation of Christianity] Forlaget Philosophia Aarhus 1993 Ricoeur P. The hermeneutical function of distanciation Philosophy Today 1973 17 2 129 140 Spradley J. P. Participant observation Wadsworth Thompson Learning London 1980 Todres L. The qualitative description of human experience: The aesthetic dimension Qualitative Health Research 1998 8 1 121 131 Todres L. Clarifying the life-world: Descriptive phenomenology Qualitative research in health care Holloway I. Open University Press Berkshire 2005 104 124 Todres L. Being with that: The relevance of embodied understanding for practice Qualitative Health Research 2008 18 11 1566 1579 van Manen M. Researching lived experience: Human science for an action sensitive pedagogy State University of New York Press Albany NY 1990 Wolf J. Den farvede verden: om Goethes farvelære, Hans Lipps’ fænomenologi og K.E. Løgstrups religionsfilosofi. [The colorfull world: About Goethes’ chromatology, Hans Lipps’ phenomenology and K.E. Løgstrups’ philosophy of religion] Munksgaard Copenhagen 1990