The intentionality of insight: The meanings given to insight in the lived experiences of AIDS dementia

Abstract

Rather than duplicating biomedical research measuring insight, or suggesting models by which one could more reliably measure a person with dementia's insight, I turn to the notion of insight reflexively. Based on ethnographic research with four `intimate circles of care', I explore the consciousness of people with AIDS dementia's insight, the intentionality of insight in the phenomenological sense. Since insight is a capacity of all humans, I also include in my unit of analysis the meanings of insight for significant others. With intentionality, what matters most are the meanings made of and the positions taken towards insight. I do not address what we understand philosophically as knowledge or question the definitions of awareness or insight. I focus on the ethnographic description of the meanings and positions that informants had of insight. Intentionality is not necessarily truth or fact, but rather a position taken. From the meanings and positions taken by informants, four themes of the intentionality of insight emerged: insight as heart-wrenching; agency, control and purpose; the hope of losing insight; and insight as life-giving. Intentionality of insight emerged in relation to intimacy, emotions and relationships. Insight was experienced within and narrated through a liminal state.