Original article

Qualitative interviewing as measurement nup_436 112..126

John Paley MA
Senior Lecturer, Department of Nursing and Midwifery, University of Stirling, Stirling, UK

Abstract The attribution of beliefs and other propositional attitudes is best under-
stood as a form of measurement, however counter-intuitive this may
seem. Measurement theory does not require that the thing measured
should be a magnitude, or that the calibration of the measuring instru-
ment should be numerical. It only requires a homomorphism between
the represented domain and the representing domain. On this basis,
maps measure parts of the world, usually geographical locations, and
belief statements measure other parts of the world, namely peoples
aptitudes. Having outlined an argument for this view, I deal with an
obvious objection to it: that self-attribution of belief cannot be an exer-
cise in measurement, because we are all aware, from introspection, that
our beliefs have an intrinsically semantic form. Subsequently, I turn to
the philosophical and methodological ramifications of the measurement
theoretic view. I argue, first, that it undermines at least one version of
constructivism and, second, that it provides an effective alternative to the
residually Cartesian philosophy that underpins much qualitative
research. Like other anti-Cartesian strategies, belief-attribution-as-
measurement implies that the objective world is far more knowable than
the subjective one, and that reality is ontologically prior to meaning. I
regard this result as both plausible and welcome.

Keywords: philosophy of science, qualitative research, epistemology,

methodology, subjective experience, social constructionism.

The claim that qualitative interviewing is a form of
measurement appears bizarre for two reasons. First,
as qualitative and quantitative are methodological
Correspondence: Mr John Paley, Senior Lecturer, Department of
Nursing and Midwifery, University of Stirling, Stirling FK9 4LA,
UK. Tel.: +44 (0) 1786 466399; fax: +44 (0) 1786 466344; e-mail:
j.h.paley@stir.ac.uk
antonyms, and as measurement is a form of quantifi-
cation, qualitative methods and measurement must
be mutually exclusive alternatives. This is the meth-
odological reason. Second, qualitative techniques
(including interviews) deal with phenomena
meaning and experience, for example which are
intrinsically resistant to quantification, and which
therefore cannot possibly be measured. This is the

112 2010 Blackwell Publishing Ltd Nursing Philosophy (2010), 11, pp. 112126

ontological reason. Nevertheless, I propose to
argue in favour of the claim, even if it seems
counter-intuitive.
The plan of the paper is as follows. I begin with basic
measurement theory, using the most familiar and
obvious example: quantitative measurement by
numerical scales. During this discussion, it will become
evident that measurement is just one kind of repre-
sentation, and that it belongs to a specific category of
representation based on homomorphism. It will also
become apparent that some forms of homomorphic
representation are non-numerical. I illustrate this idea
by describing a particular type of non-numerical mea-
surement, namely maps. Next, I suggest that attitude
measurement is a form of semantic mapping and
that, consequently, the concept of homomorphic rep-
resentation applies here, too. Because attitude mea-
surement involves the attribution of belief, it is only a
short step from here to the claim that belief attribu-
tion involves non-quantitative measurement and, cor-
relatively, that the procedures we adopt in order to
attribute beliefs for example, qualitative interview-
ing constitute a measurement process.
This discussion, taking up the first half of the paper,
may test the patience of readers who are primarily
interested in qualitative methods, as the argument is a
series of stepping stones: measurement theory, to
homomorphic representation, to maps, to attitudes, to
belief attribution, to qualitative interviewing. In the
second half, however, I turn to four matters of more
immediate interest to qualitative researchers, arguing:
that people generally, and interview respondents in
particular, do not have introspective access to their
own beliefs; that the measurement theoretic view
undercuts at least one form of constructivism; that the
adoption of this view would require us to rethink the
cognitive dynamics of interviewing; and that attach-
ing meaning to experience can be identified with
having certain beliefs about it.
The paper covers a fair amount of ground, and I
have resisted suggestions that it should focus on fewer
topics. My aim has been to provide a sketch of the
main idea, indicating what I take to be some of the
consequences and connections. I acknowledge that
several questions are left unanswered, but I hope to
answer them on another occasion.
2010 Blackwell Publishing Ltd Nursing Philosophy (2010), 11, pp. 112126
Qualitative Interviewing as Measurement 113
Measurement theory
Consider a body whose temperature is 20Celsius.
Obviously, the body does not have any intrinsic prop-
erty of a twentyish nature; and, if the scale is changed
to Fahrenheit, making the temperature 68, it will have
no intrinsic property of a sixty-eight sort of character
either. So what kind of claim does an attribution of
temperature make? How is the assignment of a
number made? What exactly are we doing when we
measure anything? And what conditions must be met
if measurement is to be possible? It is the business of
measurement theory (Stevens, 1946; Roberts, 1979;
Suppes et al., 1989) to answer questions such as these.
Measurement always involves two domains, X and
Y, with X being mapped on to Y in a way that makes
it possible for Y to represent X (the relevant sense of
represent will be further specified). In numerical
measurement, X will be an empirical system of
objects, and Y will be the domain of real numbers. If X
satisfies certain conditions, then a relation of homo-
morphism will obtain between X and Y, with the con-
sequence that reasoning about Y can act as a
surrogate for reasoning about X (Swoyer, 1991).
For example, let X be the domain of all bodies
which have mass. None of these bodies has an intrin-
sic property of 11-ness (lbs) or 5-ness (kg), but the
members of this domain do nevertheless have weight
relations with one another. For example, if two
objects, A and B, are concatenated that is, joined
together their combined weight will be greater than
the individual weight of either one (A + B > A, and
A + B > B). Similarly, if A is heavier than B, then there
is some finite number, n, such that the concatenation
of B with itself n times exceeds the weight of A (that
is, Bn > A). Or, finally, if A is heavier than B, then it
will always be possible to determine a third object, C,
which when concatenated with B is equivalent in
weight to A (C is such that B + C = A). Effectively,
then, the domain can be ordered by means of two
relations, heavier than and equal in weight to, with
all its members being locatable in a sequence running
from heaviest to lightest.
It is in virtue of these relations that the measure-
ment of weight is possible. All the members of X can
be placed in an ordered sequence, and they have a
114 John Paley
series of concatenation relations with each other. If
this is true, however, there is necessarily a homomor-
phism between X and Y, the domain of real numbers.
For these numbers can also be placed in sequence,
from largest to smallest, and also have parallel rela-
tions with one another, with addition corresponding
to concatenation. So, for example, the sum of any
two numbers, a + b, will always be greater than either
a or b; if a is greater than b, then there is always some
finite n, such that bn > a; and if a is greater than b,
there is always a third number, c, such that b + c = a.
Both domains, then, can be ordered in the same way.
Given this domain homomorphism, it is possible to
assign each member of X to a member of Y. The
procedure for achieving this requires the selection of
one object in X to serve as the conventional unit of
weight (the standard kilogram, for example). An arbi-
trary number, usually 1, is then assigned to this object.
The initial assignment having been conventionally
agreed, the remaining members of X can be assigned
corresponding numbers, in a manner which is fixed by
the initial assignment itself. Any object which is
equivalent in weight to the concatenation of two stan-
dard units will be assigned the number 2, and so on,
equivalently, for every object in the domain. The
result is a comprehensive series of one-to-one corre-
spondences between the members of X and the
members of Y.
The homomorphism between X and Y makes pos-
sible surrogative reasoning (Swoyer, 1991). We can
reason indirectly about members of domain X by
reasoning directly about members of domain Y.
The homomorphism guarantees that the relations
between objects in X will be represented and pre-
served in Y, and that inferences about members of Y
can be translated into inferences about the members
of X. Although we habitually think of magnitudes
such as weight as being intrinsically numerical, in fact
they are not.The habit only arises because surrogative
reasoning is so successful (Matthews, 2007).
Once this systematic correspondence is established,
empirical procedures are used to determine what
numeral should be assigned to what specific object:
scales in the case of weight, a thermometer in the case
of temperature. It should be noted that these assign-
ments can be carried out even if we do not know
2010 Blackwell Publishing Ltd Nursing Philosophy (2010), 11, pp. 112126
precisely what it is we are measuring. For example, in
order to measure temperature, it is not necessary to
know that the numerical assignment represents the
mean kinetic energy of the molecules in the substance
concerned. Indeed, the mercury thermometer was
invented in 1714, well in advance of the development
of kinetic theory over a century later (Middleton,
2002; Mller, 2007).
Non-numerical measurement
Qualitative studies typically ascribe beliefs, experi-
ences, and meanings to respondents. It might seem, as
I have already conceded, wildly implausible to
suppose that these ascriptions take the same form as
attributions (in numerical terms) of weight, resistance,
or temperature to physical bodies. However, let me
confirm that this is the claim I am defending. In the
first instance, the argument is presented in the context
of beliefs or, more generally, propositional attitudes.
Later, I will indicate (if only briefly) how this argu-
ment can be extended to meaning and experience.
The idea that propositional attitudes are measure-
ment predicates is not new. In various forms, it has
been suggested by several philosophers (Churchland,
1979; Field, 1981; Stalnaker, 1984; Dennett, 1987;
Davidson, 1989), but it has recently been presented in
a systematic form by Matthews (2007). What moti-
vates Matthews account is scepticism about what he
calls the received view of propositional attitudes.
According to this view, to make an attribution of
belief to say A believes that p is to say that A
adopts a certain orientation towards the proposition
p. The received view assumes that p is a representa-
tion in As mind, and that A can adopt a range of
attitudes towards it: believing, disbelieving, hoping,
and so on. Matthews reasons for rejecting this view
are beyond the scope of my paper, but one of them is
that there is no good evidence that these representa-
tions exist. Although I do not have the space to
develop this line of thought, I would still like to plant
the suggestion that representations in the mind are
equivalent to numbers in the object. Just as the
number 5 is not in a physical object that weighs 5 kg,
so the proposition p is not in a person who believes
that p.

As a preliminary observation, nothing in measure-
ment theory requires that the representing domain, Y,
should be the domain of real numbers: the require-
ment is only that there should be a homomorphism
between Y and the represented domain, X. In order to
establish that such a homomorphism exists, it is nec-
essary to prove a representation theorem (Suppes &
Zinnes, 1963) specifying the conditions X must fulfil if
it is to be represented by a structure such as Y.
However, it is not necessary that the represented
property in X should be a magnitude, or that Y should
be a number-like sequence.
Maps are an example of non-numerical measure-
ment. The London Underground map, for instance, is
a representing domain, Y, which measures the empiri-
cal network of lines and stations, X. As with other
forms of measurement, only certain relations in the
empirical domain are preserved by the Y domain
specifically, the sequence of stations on each line.
Other features of the network, such as the distance
between stations, are not mapped (just as a thermom-
eter measures only a single property of physical
objects, temperature, and excludes others). There is
obviously a one-to-one correspondence between sta-
tions in the network and the relevant symbols on the
map, and therefore a relation of homomorphism
between the two domains.
Notice three consequences of this homomorphism.
First, any station in the network can be located on the
map. This is equivalent to assigning a numeral to a
physical object when measuring temperature. Second,
on the basis of the map, it is possible to attribute an
indefinite number of relational properties to each
station. For example, Oxford Circus has the following
properties: it is on the Victoria, Central, and Bakerloo
lines; it is between Bond Street and Tottenham Court
Road on the Central Line; it is two stops from
Charing Cross on the Bakerloo Line; and so on.
Making these attributions is equivalent to noticing
the substantive relations between physical objects in
respect of, say, weight (A is twice as heavy as B, half as
heavy as C, and equal in weight to the combination of
D and E). Third, the map can be used for surrogative
reasoning, which is what the visitor to London does
when planning a journey on the network (to travel
from Oxford Circus to Russell Square, I must travel
2010 Blackwell Publishing Ltd Nursing Philosophy (2010), 11, pp. 112126
Qualitative Interviewing as Measurement 115
two stops east on the Central Line, change at
Holborn, then travel one stop north on the Picca-
dilly). This is the equivalent of surrogative reasoning
in numerical measurement (because A is twice as
heavy as B and half as heavy as C, I would need four
of B to match the weight of C).
It is admittedly unusual to think of maps as a form
of measurement; some authors have objected to
using the term in the absence of quantification (Dez,
1997). However, as Matthews (2007) observes,
nothing of substance hangs on the terminological
issue, as numerical measurement is a special case of
morphism representation. Recently, van Fraassen
(2008, pp. 1645) has offered a definition of measure-
ment which is premised on the same idea: measure-
ment is an operation that locates an item (already
classified as in the domain of a given theory) in a
logical space (provided by the theory to represent a
range of possible states or characteristics of such
items). . . . As a special case, the logical space can be a
scale. Whether the term measurement is reserved
for this special case, or whether it is applied to the
superordinate category of homomorphic representa-
tion, is more a question of lexical preference than a
metaphysical issue.
Attitudes
We measure the temperature of a physical object by
locating it on a numerical scale. We measure the posi-
tion of a London Underground station by locating it
on a network diagram. We measure a belief by locat-
ing it in a semantically specified network of sentences
which begin, typically, with a phrase such as she
believes that . . .. In all these examples, there is an
empirical domain, X (physical objects, stations,
persons), a property-to-be-measured of the domains
members (temperature, position, belief), and a repre-
senting domain, Y (positive real numbers, the London
Underground map, the spoken or written sentences of
a language). In each case, Y defines a conceptual
space into which items of X are plotted, in respect of
the property concerned.
I acknowledge that this is an unusual way of
looking at beliefs, so let me first talk about attitudes.
The history of attitude measurement begins with
116 John Paley
Thurstone (1928), and attitude remains a distinctive
and indispensable concept in social psychology
(Eagly & Chaiken, 1993) following a resurgence of
interest in the last twenty years (Wittenbrink &
Schwarz, 2007). This history echoes the development
of other, non-psychological, forms of measurement in
theoretically interesting ways. For example, it is
unclear precisely what the concept refers to. While
an attitude can be defined as a psychological
tendency, a state that is internal to the person
(Eagly & Chaiken, 1993), the underlying structures
and mechanisms implicated in this state cognitive,
physiological (Pratkanis & Breckler, 1989), or
biological (Bickle, 2003) are open to question.
Similarly, in the period during which technologies
for measuring temperature were being developed, it
was not evident (until the development of kinetic
theory) what underlying structures and mechanisms
could be identified with heat. Moreover, the debate
about the best method of measuring temperature,
extending from the creation of the water thermom-
eter in the 16th century to the invention of the
mercury thermometer in 1714 (Middleton, 2002), is
echoed in the current debate about the most reliable
means of measuring attitudes (Wittenbrink &
Schwarz, 2007).
Thurstone scaling provides an instructive link
between Y domains consisting of numbers or maps,
and Y domains consisting of semantically specified
language structures.Thurstones strategy is to devise a
carefully graduated sequence of statements, such that
the sequence defines a logical space representing pos-
sible judgments with respect to a particular topic.
Unlike Likert (1932) scaling, which requires an aggre-
gate score summed over all items of the instrument, a
Thurstone scale invites assent to only a single item
(or, more realistically, a small number of consecutive
items). The strength of the attitude is represented,
not (as in a Likert scale) by the cumulative score over
all items, but by the assented-to statement itself, as the
sequence proceeds from most favourable item to least
favourable item.The example below, from Moxham &
Plaisant (2007), is part of a Thurstone scale designed
to measure the attitudes of medical students towards
anatomy (District Line underground stations not
included in original).
2010 Blackwell Publishing Ltd Nursing Philosophy (2010), 11, pp. 112126
Earls Court It is not possible to make a reasonable
medical diagnosis without anatomy.
Gloucester Road Of all the basic sciences, anatomy
is the most clinically relevant.
South Kensington Anatomy is only of benefit in
certain medical specialities.
Sloane Square Most medical conditions do not
require a great knowledge of anatomy.
Victoria The principles of medicine are not founded
on anatomical knowledge.
St Jamess Park Anatomy is time wasted in the
medical curriculum.
It will be evident that, in this sequence, there is a
gradual shift from a very favourable attitude towards
anatomy to a very unfavourable one, the shift taking
place gradually by degrees (the example does not
include all the items; in the full instrument the steps
are more gradual, more nuanced). In effect, each item
represents a carefully defined point on a continuum
between maximally positive and maximally
negative.
Or, to vary the metaphor, each item represents a
station on the line running from pro to con. This is
not an analogy, but a direct parallel. The Y domain, in
the Thurstone case, is a semantically specified
sequence of sentences whose function is to define the
relations between possible judgments, just as the Y
domain in the London Underground map consists of
a network diagram whose function is to define the
relations between stations. In the same way that the
position of South Kensington can be specified as
between Gloucester Road and Sloane Square on the
District Line, so the position of Anatomy is only of
benefit in certain medical specialties can be specified
as falling between the two items either side of it. And
just as the London Underground map can be used for
surrogative reasoning (somebody travelling east on
the Central Line, whose destination is Russell Square,
is unlikely to leave the train before Holborn), so the
Thurstone scale can be used to make inferences of a
different kind (someone who has assented to It is not
possible to make a reasonable medical diagnosis
without anatomy is unlikely to endorse proposals to
reduce the amount of anatomy teaching in the
medical curriculum).

Parenthetically, it is worth noting the fact that Thur-
stone scales are a precursor of item response theory
(IRT) which now dominates the field in psychology
and education (Embretson & Reise, 2000; de Ayala,
2008), and which has been applied to health outcome
measures (Hobart & Cano, 2009). An account of IRT
is beyond the scope of this paper, but the idea that
statements of belief can be ordered in semantic space,
like stations on the District Line, remains the crucial
theoretical axiom linking Thurstone scales to IRT and
the related technique of Rasch modelling (Reeve &
Msse, 2004).
Beliefs
Thurstone scale items are statements expressing
beliefs, placed in a sequence which reflects the logical
relations between them, and defining a calibrated
semantic space that discriminates between one belief
and another. The extent to which this discrimination
involves nuance and fine-tuning varies, depending on
the intervals between items, intervals which in Thur-
stone scaling are specified through a numerical
assignment, but which roughly correspond to intui-
tions about logical distance. For instance, there is a
smaller distance between anatomy is only of benefit
in certain medical specialities and most medical con-
ditions do not require a great knowledge of anatomy,
than there is between, say, the principles of medicine
are not founded on anatomical knowledge and of all
the basic sciences, anatomy is the most clinically rel-
evant. In principle, one could fine-tune to a much
greater degree, distinguishing between (for example)
the medical specialties which require anatomical
knowledge and those which do not. In a discussion,
one might do this, but in scaling there are lower limits
of resolution beyond which further discrimination is
impractical or pointless just as it would be imprac-
tical and pointless, in a health care context, to cali-
brate a thermometer to three decimal places rather
than one.
This is one difference between the measurement of
belief in attitude scaling and the measurement of
belief in everyday encounters. The other is that, in
scaling, the representational space is explicitly and
fully elaborated, the attitudinal equivalent of the
2010 Blackwell Publishing Ltd Nursing Philosophy (2010), 11, pp. 112126
Qualitative Interviewing as Measurement 117
London Underground map, so that individuals can be
located at a particular point in that space, with some-
thing analogically like a you are here arrow. In
everyday encounters, however, the representational
space is more usually implicit left unelaborated
because adjacent belief stations can be taken as read
unless there is reason to distinguish carefully
between the belief being expressed and another with
which it might otherwise be confused.
This is true of numerical measurement as well as
belief measurement. One informs the patient that her
weight is 56 kg, omitting to point out that this is
midway between 54 kg and 58 kg, or that it differs
from 60 kg by 4 kg, or that it is double 28 kg. In both
cases, the implied logical space is still there and can
be elaborated if necessary. In effect, every attribution,
of either a belief or a physical property, is defined by
the relations obtaining between the range of values it
does not have and the value actually assigned.
So the shift from statements of belief incorporated
in a Thurstone scale to attributions of belief made in
everyday life is not a major one. The scale is an instru-
ment in which belief statements function as items cali-
brating a conceptual space, which is explicitly
elaborated to an appropriate degree of resolution. In
everyday belief attribution, the semantic space is
usually implicit, and the amount of resolution or fine-
tuning will vary with context. However, in other
respects, it is not obvious why it should be necessary
to insist on a difference. In both cases, to attribute a
belief is to report the findings of an exercise in mea-
surement. It is to plot the individual concerned on to
a map, a representational Y domain, which exhibits
relations corresponding to those in the relevant X
domain. It is to make an implicit or explicit compari-
sons between people positioned at various locations
in logical space, and to anticipate ways in which their
behaviour might be different. It is to undertake a
Mercator-like projection of internal states of the
person into a semantic array, a sort of network
diagram of language.
Three corollaries of this line of thought are worth
emphasizing. First, in the measurement of belief, we
are ourselves the instruments: we are biological
devices that are generally reliable in ascertaining and
reporting the propositional attitudes of ourselves and
118 John Paley
others (Matthews, 2007, p. 155). Some of this measur-
ing activity is conscious, but most of it is not. This is
true of all forms of measurement, whether it is making
inferences about other peoples beliefs, estimating the
speed of an approaching car before crossing the road,
or gauging the dimensions of a puddle as one steps
over it.
Second, the point of belief measurement, and the
measurement of other propositional attitudes such as
desires and intentions, is presumably to anticipate
what others will do. As Matthews (2007) observes,
beliefs are aptitudes, internal states that are apt to
produce predictable types of behaviour in particular
situations. There is nothing deterministic about this:
aptitudes do not unfailingly bring about the effects
with which they are associated, but are typically
subject to the presence or absence of countervailing
beliefs and desires. However, there are good evolu-
tionary reasons why a generally reliable capacity to
attribute propositional attitudes to other people
should have developed in an intensely social species
(Carruthers, 2009), including the Machiavellian intel-
ligence hypothesis, which proposes that this mind-
reading ability evolved to deal with the social
complexity of primate groups (Byrne & Whiten, 1988;
Whiten & Byrne, 1997). Still, whatever its evolution-
ary provenance, belief attribution appears to be a nec-
essary component of the ability to predict other
peoples behaviour.
The third corollary is that the semantic properties of
belief attributions the way they are articulated in
she believes that sentences are not necessarily
properties of the beliefs themselves. When weight or
temperature is attributed to an object, the measure
predicate has a numerical form, but the object does
not itself have a number in it; its heat and mass are
not intrinsically quantitative.This is equally true when
a belief is attributed to an individual. The belief predi-
cate has linguistic properties, but the belief itself is not
linguistic; there are no semantically qualified items in
the person concerned. At least, given the current state
of neuroscience, we have no reason to think there are,
and many reasons to think there are not. As Church-
land (1986) notes, there is nothing in the brain which
even remotely resembles sentence-like structures, and
the evidence implies that the mechanisms underlying
2010 Blackwell Publishing Ltd Nursing Philosophy (2010), 11, pp. 112126
belief states are very different (Churchland, 1981;
Bechtel & Abrahamsen, 2002; Bickle, 2003).This is not
to adopt eliminative materialism (there are no such
things as beliefs). Rather, it is to adopt agnostic mate-
rialism, awaiting definitive evidence as to what these
underlying mechanisms actually are, on the under-
standing that our measurement practices are unlikely
to change. This resembles the period after the inven-
tion of the mercury thermometer, but prior to the
development of the kinetic theory of heat.
Self-attribution and introspection
There is an obvious objection to the position I have
sketched. On the measurement theoretic view, the
fact that beliefs are expressed in sentences is a conse-
quence of the act of measurement. Just as weight and
temperature are not intrinsically numerical, so beliefs
are not intrinsically sentential. But surely this cannot
be right. It may look momentarily plausible in the
context of attributing beliefs to others, but it looks
much less plausible in the context of attributing
beliefs to oneself. On the contrary, each of us knows
from introspection that our beliefs are sentential. A
persons expression of her own beliefs cannot involve
anything that counts as measuring (let alone self-
measuring) because she has direct access to them and
knows from experience that they do, essentially, have
semantic properties.
So the semantic nature of ones own beliefs cannot
be the product of a belief-measuring instrument, or
the way in which that instrument is calibrated. When
someone reports that she has a particular belief, the
corresponding sentence or at least a semantically
qualified item of some sort is present to her mind.
Having the belief just is being aware that this item,
together with its semantic properties, is part of ones
mental fixtures and fittings. Introspective experience
apparently confirms this: it is tempting to say: look,
here is the belief in my head, and it has an overtly
linguistic form.
This intuition, that we have introspective access to
our own beliefs, is certainly a powerful one. It is, of
course, classically Cartesian because it implies
that the mind is transparent to itself, employing
inner perception, or some other form of mental

self-awareness, and providing incontrovertible evi-
dence of the linguistic structure of belief. However,
Descartes is hardly alone in assuming that the
attributes of ones own beliefs, judgments and deci-
sions are transparent in a way that those of other
people are not (Ayer, 1963; Rorty, 1970; Audi, 1993;
Dretske, 1995; Shoemaker, 1996; Moran, 2001,
Goldman, 2006 are among the modern philosophers
who take a similar view). Indeed, this transparency
seems so obvious that denying the possibility of
immediate, introspective access to propositional atti-
tudes is hugely counterintuitive (Carruthers, 2009).
Even so, there are good reasons to deny it.
A preliminary observation is that obviousness is
not much of a guide. As Churchland (1988) notes,
numerous things have seemed obvious that subse-
quently proved to be false. For a European living
between about 500 CE and 1500 CE, it seemed
obvious she could see with her own eyes that the
heavens formed a revolving sphere around the Earth;
it still seems obvious to many people that some organ-
isms are too complex to have evolved. These are two
examples of failed theories however obvious. The
Cartesian claim that introspective access to proposi-
tional attitudes is possible part of folk psychology
(Dennett, 1989; Ramsey et al., 1990; Davies & Stone,
1995) may be another. An inner perception is no
doubt different from an outer perception (of the
revolving heavens), but there is an extensive social
psychological literature confirming that it is easy to be
wrong about ourselves, and about our beliefs, experi-
ences, feelings and motives (Nisbett & Wilson, 1977;
Ross & Nisbett, 1991; Wilson, 2002; Haybron, 2007;
Schwitzgebel, 2008). Even if we do have a Cartesian
ability to introspect our own states of mind, it is (so
the evidence demonstrates) a remarkably fallible one.
Here, then, are some considerations implying that
propositional attitudes are not semantically qualified.
First, believing is not peculiar to language users
(Marcus, 1983); for example, beliefs are reasonably
and non-anthropomorphically attributed to animals.
Second, pre-linguistic infants have beliefs, in particu-
lar those concerning the differences between inani-
mate objects and people (Gopnik & Meltzoff, 1997).
Third, we all have an indefinitely large number of
beliefs which we are not currently articulating in
2010 Blackwell Publishing Ltd Nursing Philosophy (2010), 11, pp. 112126
Qualitative Interviewing as Measurement 119
inner speech; such beliefs are legitimately attributed
to us even when we are asleep. Fourth, each of us has
an even larger number of beliefs which we have never
articulated for example, that no elephants live at the
North Pole, and that London is bigger than St
Andrews (Cohen, 1995). Some of these beliefs we
unambiguously act on: it is not possible to roast the
Sunday joint in a dishwasher (Manfredi, 1993); or
ping pong balls will melt if dropped on the fire. As
Moran (1999, p. 187) says, tacit beliefs can be per-
fectly real beliefs, which interact with relevant desires
to produce action; and, in some cases, solving a
problem can require the making explicit of a tacit
belief which has prevented a solution being reached
(Moran, 2001). These examples demonstrate that
propositional attitudes are not intrinsically semantic,
that believing can be decoupled from inner speech
acts (Marcus, 1983). More generally, they count as
persuasive evidence against the claim that having a
belief necessarily entails having an identifiable phe-
nomenal state, a view that has few adherents today
(Moran, 2001, p. 28).
The distinction between having a belief and cur-
rently articulating a belief in inner speech is clearly
crucial. On the anti-Cartesian view, the sentences one
calls to mind in introspection are no more than effects
of the auditory or visual imagination. Indeed, phe-
nomenologically, much of what we habitually call
thinking appears to be just that: the imagination of
what sentences would sound like if spoken, or look
like if written (Hurlburt & Schwitzgebel, 2007). Argu-
ably, Cartesians have confused expressive with consti-
tutive, the (occasional) sensory accompaniment of
propositional attitudes with the attitudes themselves
(Carruthers, 2009).
Analogously, there is a distinction between Edin-
burgh Castle and a description of it provided by the
guide. The properties of the description are not the
properties of the castle. The description consists of
sentences uttered with a certain pitch, timbre, and
intonation, linguistic items which can be semantically
and syntactically parsed. None of which applies to the
large stone building at the western end of the Royal
Mile. But this is typical of differences between the
thing representing and the thing represented (compare
the differences between the Underground map and
120 John Paley
the Underground itself). In general, the attributes of
the latter cannot be read off from the attributes
of the former, irrespective of whether the representa-
tional item is a number, a map, a sentence, or an act of
auditory imagination. This would be like claiming that
an object is intrinsically twenty-ish because it has a
temperature of 20Celsius, or that Marble Arch is
intrinsically red because it is on the Central Line.
So introspective access to inner speech is not iden-
tical with introspective access to the beliefs which
inner speech may be employed to represent. Inner
speech is a form of verbal imagination: I imagine
hearing a sentence that I attribute to myself
(Machery, 2005, p. 477). These sentences naturally
possess semantic attributes, but it does not follow that
the beliefs they represent possess semantic attributes
as well. This applies to self-attributions of belief as
much as it does to the situations in which we attribute
beliefs to others. There is, effectively, a seductive illu-
sion at work here. We enjoy introspective access to
something, but that something turns out to be an act
of auditory imagination, an extract from inner speech
which represents a belief or some other propositional
attitude. The propositional attitude itself, despite the
illusion, is not something we can introspect directly.
Constructivism
The story so far. For the most part, we know what we
believe, but it does not follow that we know what
beliefs are. Attributions of belief, to oneself or others,
involve a type of non-numerical measurement, locat-
ing the individual concerned in a representational Y
domain consisting of sentences (rather than maps or
numbers), sentences which may be spoken, written, or
articulated in inner speech, and which specify the
conceptual inter-relations of items in the X domain
(that is, the beliefs themselves). These attributions can
be used in surrogative reasoning, to anticipate peo-
ples behaviour and to identify their tacit beliefs.
Having sketched an argument for this view, I will
conclude the paper with some brief comments on its
implications for our understanding of qualitative
research, first from a philosophical perspective, then
from a methodological one.
2010 Blackwell Publishing Ltd Nursing Philosophy (2010), 11, pp. 112126
Consider two different types of constructivism.
According to the first, social reality is constructed by
individuals. Social facts and institutions are, in some
ill-defined sense, the creation of individuals, on the
basis of experience, meanings, or perceptions. Accord-
ing to the second, some impersonal force culture,
society, discourse, language constructs representa-
tions: meanings, theories, subjectivities. The distinc-
tion between personal agents constructing realities
and impersonal agents constructing representations
(Mallon, 2008) marks a fundamental divide between
approaches to constructivism, constructionism, or
social constructionism (terminology varies across dis-
ciplines). The claim I shall defend is that the belief-
as-measurement view undermines one version of the
first of these approaches.
In both versions of constructivism, there are numer-
ous variations on the theme. The impersonal agent
view is adopted by authors as diverse as Parsons
(1951), Foucault (1986), and Gadamer (2004), each of
whom takes a different view of the agent concerned
respectively: social systems, discourse, tradition and
the nature of the constructing process socializa-
tion, the constitution of subjectivities, historicity (for
comments on the methodological parallels between
Parsons and Foucault, see Mouzelis, 1995). The per-
sonal agent view resolves into a number of different
positions, but I will distinguish between writers who
suggest that the constructing is done by meanings
(Schutz, 1967; Collin, 1997), and writers who argue
that behaviour is the key mechanism (Blumer, 1969;
Goffman, 1990). My remarks are directed at those
who favour the meanings view, and I have phenom-
enological and naturalistic inquiry authors princi-
pally in mind.
According to Schutz, social reality is rooted in
meanings attached to everyday life by the individual.
He defines meaning as a certain way of directing ones
gaze at an item of ones own experience (Schutz, 1967,
p. 42, italics in original), and refers to meaning-
endowing acts of which I become aware by a reflexive
glance (p. 36). He concludes that a phenomenological
sociology will study social behaviour by interpreting
its subjective meaning (p. 11). Schutz goes a step
beyond Weber, for whom meaning is the inside of
outward behaviour, but it is evident that both

authors are thinking in Cartesian terms, social reality
being the product of meaning-assignments in indi-
vidual consciousness. In a similar way, Lincoln &
Guba (1985, p. 83) see reality as a construction in the
minds of individuals, with meanings being attached
to the phenomenon; they infer that it is dubious
whether there is a reality; if there is, we can never
know it. This is an unambiguously Cartesian position.
The idea that there are conscious acts of meaning-
attachment or meaning-endowment, achieved by the
direction of an inner gaze, is as metaphorical and as
uninformative as a construction in the mind, but
serious attempts to unpack this imagery are surpris-
ingly hard to find, and the solipsistic and/or idealist
implications are rarely commented on (Fay 2003).
Still, the picture of meaning as a sort of mental ray is
clearly unsatisfactory, especially if an entire social
world is to be founded on it. A less opaque and more
plausible analysis is provided by Collin (1997), who
translates meaning talk into propositional attitude
talk. On this analysis, to attaching meanings is to
have certain beliefs and desires, which do not require
a reflexive glance; consequently, the phenomenal
aspect falls away (p. 119). This view is consistent with
that of Lincoln & Guba (1985), whose examples of
multiple realities always concern groups of people
with conflicting beliefs. (I will take Collins translation
as a legitimate point of reference for now, but I will
say more about the relation between belief and
meaning towards the end of the paper.)
However, if the measurement view outlined above
is correct, the attribution of belief cannot serve as a
basis for the construction of reality. First, attributions
of belief logically presuppose reality. At least, they
presuppose a reality in which certain forms of behav-
iour for example, measuring are already meaning-
ful; so the source of that meaning cannot be belief
attribution. Second, if we are agnostic about the
underlying nature of beliefs, we presumably cannot
explain how they construct reality, although we
should perhaps leave open the possibility of a neuro-
logical construction of reality (Reyna, 2002; Aden-
zato & Garbarini, 2006; Rilling, 2008), a biological
form of reductionism. Finally, in construing beliefs as
aptitudes, the measurement theoretic view entails
that, if anything constructs social reality, behaviour
2010 Blackwell Publishing Ltd Nursing Philosophy (2010), 11, pp. 112126
Qualitative Interviewing as Measurement 121
does. It is easy to forget this. For example, Collin
(1997) observes that money tokens are valueless in
themselves:but we bestow value upon these valueless
tokens by collectively believing them to possess value
(p. 3, italics original). However, belief per se achieves
nothing. It is behaviour, the physical exchange of
goods for tokens, that determines social reality. One
might summarize this by saying, somewhat cavalierly,
that reality is not a construct of meaning; rather,
meaning is a construct of reality.
The cognitive dynamics of interviews
Any act of measurement requires the calibration of Y
space, and a method for plotting members of the X
domain into it. The method consists of a causal trans-
action between the object being measured and an
instrument which fixes the point at which this object is
located in the Y domain. This being the case, it is
clearly necessary to ensure that the causal transaction
takes place in a reliable manner that is to say, a
manner which identifies the relevant point in Y space
correctly. The history of thermometers, for example, is
a history of attempts to identify a suitable thermo-
metric material, one which would respond to tem-
perature changes in a regular and controllable fashion
(water and alcohol were explored before mercury
proved to be the most dependable).
In the measurement of belief, the same require-
ments apply; in particular, there must be a predictably
accurate transaction between instrument and subject,
so that the belief can be precisely plotted into the
representational domain. In the context of attitude
scaling, and questionnaire design more generally, this
is widely acknowledged, and recent years have seen
increasing interest in the response process specifi-
cally, the ways in which respondents process question-
naire items cognitively with a view to improving the
quality of research instruments. Conventional pretest-
ing is now regarded as inadequate, and various alter-
natives have been studied: statistical modelling,
cognitive interviews, evaluation of response latency,
field experiments, and different methods of adminis-
tration (Tourangeau & Rasinski, 1988; Schuman &
Presser, 1996; Sirken et al., 1999; Tourangeau et al.,
2000; Presser et al., 2004).
122 John Paley
This literature demonstrates that response is highly
sensitive to changes in question wording, question
order, formatting, and interviewer tone, and that
subtle variations in syntax, semantics, and pragmatics
can affect the respondents understanding of the
questions she is asked. Cognitive approaches to
survey methodology have proposed testable explana-
tions of this response sensitivity, focusing in particular
on the cues available to the respondent, and the
extent to which the interviewees retrieval of informa-
tion is reconstructive and inferential. The cues deter-
mine what is relevant when answering a given
question which beliefs the respondent samples on
that occasion and largely account for response insta-
bility (Tourangeau et al., 2000). As a consequence,
measurement errors can be traced to psychological
and communicative processes (Ongena & Dijkstra,
2007), and survey questions can be analysed in terms
of the cognitive operations they are likely to evoke
(Lessler & Forsyth, 1995; Chessa & Holleman, 2007).
Moreover, an understanding of the cognitive pro-
cesses implicated in answering questions has made it
possible, in many cases, to control and reduce
response errors (Belli et al., 2001; Willis, 2005).
This literature is rarely acknowledged in qualitative
research (Hammersley, 2008). Indeed, those who
write on qualitative methods implicitly reject the cog-
nitive approach, believing that it is inappropriate to
see social interaction as bias which can potentially
be eradicated (Mason, 1996, p. 40). For Mason, it is
better to understand the complexities of the interac-
tion, rather than pretend that key dimensions can be
controlled for (p. 401). Ironically, cognitivists and
qualitative methodologists agree about the signifi-
cance of context, and about the importance of constru-
ing interviews as social interaction. But they disagree
about the extent to which it is possible to study the
cognitive dynamics of interviewing systematically.The
cognitivists believe that rigorous enquiry into seman-
tics and pragmatics is possible, and that response error
(bias) can be reduced by applying the results of these
enquiries to the design and conduct of interviews.
Qualitative writers, meanwhile, believe that judg-
ments about semantics and pragmatics can and must
be made in situ, on the basis of spot assessments
(Mason, 1996, p. 44). There is no tradition of research
2010 Blackwell Publishing Ltd Nursing Philosophy (2010), 11, pp. 112126
which attempts to evaluate these snap judgments.
Qualitative authors prefer to invest their faith in the
interviewers social skills (Kvale & Brinkman, 2009).
Underlying the qualitative methodologists per-
spective is an image of what the in-depth interview
achieves. Where the structured interview compels the
respondent to express herself through a grid, which
forces the data into certain shapes, an in-depth inter-
view permits the data to flow naturally. Qualitative
interviewers seek to avoid imposing a grid of any
kind; hence the insistence on respondents using their
own words, and the requirement that interviewers
abstain from overly specific questions which might
cue the respondent towards categories which do not
fit her spontaneous understanding. It is as if there is
an inner fountain of experience, which the inter-
viewer attempts to tap directly, instead of forcing
it into predetermined conceptual channels. The
qualitative interview attempts to . . . uncover [the
subjects] lived world prior to scientific explana-
tions . . . [It] gives a privileged access to peoples basic
experience of the lived world (Kvale & Brinkman,
2009, p. 1/29). The implied contrast, between imposed
structure and natural flow, is endemic to qualitative
philosophy.
On the measurement theoretic view, however, the
contrast represents a bogus dichotomy. There is no
inner fountain (or, if there is, we have no idea what it
is like), and nothing that counts as access.Any report
of propositional attitudes, whether third person or
first person, is an exercise in measurement, the plot-
ting of individuals on to a conceptual map, a Y domain
of sentences. Not recognizing this leads to a casual-
ness in reports of qualitative studies, reports in which
the cognitive dynamics of interviews are left opaque
(recent examples in nursing: Lee & Weiss, 2009; Lindh
et al., 2009; Rowse, 2009; Tregunno et al., 2009). There
are few, if any, clues concerning the way in which the
pragmatics of the interview precipitate the partici-
pants responses.
The implication of the measurement theoretic view
is that this opaqueness is both unsatisfactory and
unnecessary. Research into the cognitive dynamics
of qualitative interviews, building on cognitive
approaches to survey work, will provide greater trans-
parency; greater transparency will make it possible to

determine the relationship between the micro-
management of interviews and outcomes. It will also
help to reduce response error, however unpalatable
that concept may be to qualitative writers at present.
Belief and meaning
Throughout this paper, I have exploited the assump-
tion that the attribution of belief to respondents is a
significant output of qualitative interviewing.
However, the extent to which identifying beliefs is
the principal objective of qualitative research might
be questioned. There are, of course, studies explicitly
designed to elicit beliefs about, for example, health
and illness (Nettleton, 2006; Schofield et al., 2007;
Hjelm et al., 2009), but are there not numerous other
forms of qualitative data: reports of sensation and
emotion, narratives, generalization about events and
circumstances, anxieties, anticipations, aspirations,
agitations? Can the measurement theoretic view be
generalized to all of these?
We should not underestimate the degree to which
respondent accounts, as well as corresponding third-
person ascriptions made by researchers, incorporate
statements of belief, implicitly or explicitly. Take, as an
example, this excerpt from an interview transcript in
which an HIV-positive gay man talks about an unpro-
tected sexual relationship: I suppose I wanted
to . . . please him, I wanted to, I suppose it was some-
thing that I could give him that . . . I felt nobody else
could, I suppose that was my way of trying to show
him how much I cared (Smith et al., 2009, p. 138;
italics not in original). Here, the respondent prefaces
three narrative claims with the propositional attitude
marker, I suppose. This marker belongs to a class
including I believe, I imagine, and I assume, all of
which can be followed by that and a noun clause
expressive of what is believed, imagined or assumed.
Yet the presence of such a marker is not necessary to
convey the fact that a belief is being expressed. The
absence of I suppose in this excerpt would not signal
an absence of belief. On the contrary, it would signal a
more confident belief, a firmer commitment to the
interpretation being offered (in contrast with I
suppose, which implies a certain tentativeness).
Compare this passage with another from the same
2010 Blackwell Publishing Ltd Nursing Philosophy (2010), 11, pp. 112126
Qualitative Interviewing as Measurement 123
transcript: I felt that he was in love with me. I know
that he was, he was in love with me, I wouldnt have
felt like that if . . . it wasnt both ways . . . (p. 139). In
this case, the propositional attitude marker, I know,
replaces a more hesitant statement of the belief, he
was in love with me; a further belief (specified, this
time, without a marker) is offered in support of this
claim: [I believe that] I wouldnt have felt like that if
it wasnt both ways. As this example suggests, self-
attributions of belief are pervasive in qualitative
studies.
This should not be surprising. Qualitative research-
ers, as Smith et al. (2009) observe, are interested in
how people make sense of things, how they invest
them with meaning. But what sort of achievement is
making sense? What counts as investing with
meaning? It is unexpectedly difficult to find attempts
to answer this question in methodological texts.
Despite its importance to qualitative studies,
meaning remains a largely unexamined concept. My
suggestion, akin to Collins (1997), is that meaning is
the projection of belief. The HIV-positive respondent
interprets the behaviour of his partner, interprets his
own feelings, in terms of a belief: he was in love with
me. The meaning he ascribes to the experience just is
the belief which he has formulated, and which he
subsequently expresses to the interviewer (of course,
sometimes the belief is verbalized for the first time
during the interview). This, in the context of qualita-
tive studies, is the paradigm case of attaching a
meaning to experience. Or so I would argue.
However, there is more to be said about generaliz-
ing the measurement theoretic view. I do not imagine
that meaning-as-belief is the whole story, but space
prevents extended discussion here. Meanwhile, for a
comparable approach to the idea that all first-person
data are the result of measurement, and should not be
regarded as a set of introspective, epistemologically
privileged reports, see Piccinini (2009).
Endnote
Even if, for lexical reasons, measurement is
restricted to cases in which the Y domain is that of
real numbers, there is no metaphysical reason to dis-
tinguish between numerical measurement as a special
124 John Paley
case and homomorphic representation as a superor-
dinate category. Moreover, the arguments in the
second half of the paper are unaffected. If semantic
properties are characteristic of the representational
domain, not of beliefs, then it is hard to see how
meanings can construct reality. And if the causal
exchange between subject and instrument determines
response, then it is hard to see why this dynamic
cannot be studied systematically. Constructivism and
the fountain of experience are both residues of Car-
tesianism, but the measurement theoretic view has an
anti-Cartesian corollary: the objective world is more
knowable than the subjective one, and reality is onto-
logically prior to meaning.
Acknowledgements
I would like to express my thanks to several people,
especially Trevor Hussey, Mark Risjord and Peter
Allmark, who provided sharp questions and/or
helpful comments on an earlier draft of this paper. I
am also grateful to two anonymous referees from
Nursing Philosophy for their cogent appraisals,
although I apologize for not following all their
suggestions.
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