Excavating the taken-for-granted system roots of trust and vulnerability through a longitudinal trust analysis

Theoretical works on trust and vulnerability, especially those influenced by phenomenological and ethnomethodological traditions, denote the importance of taken-for-granted assumptions in how people come to trust and distrust and how they experience vulnerability. Yet these implicit assumptions remain under-examined through empirical studies in healthcare settings, not least because their very taken-for-grantedness makes these lifeworld phenomena challenging to research. In this article we explore the utility of a longitudinal approach for illuminating some of the taken-for-granted roots of trust and their complex relationship to multiple vulnerabilities. Longitudinal qualitative approaches to trust have been under-utilised but enable researchers to explore how the roots of trust sometimes become exposed as assumptions shift, or suddenly become questioned, over time. By following the narratives of a single individual at regular time points across 30 months, we explore how her trust and distrust in different mental healthcare settings were interwoven with and shaped by trust and distrust in relation to work-place, legal and other system contexts, as well as her fluctuating trust and distrust in herself. A loss of ontological security following an unexpected termination of her work contract gradually rendered an array of assumptions about deference to authority, gendered role expectations, legal justice, and the influence of these assumptions upon her trust, distrust and vulnerability more explicit. By illuminating these lifeworld structures and their influence over different interpersonal and system-oriented trust and distrust relations over time, this study contributes to conceptualising the taken-for-granted bases of trust and the value of longitudinal qualitative designs.This empirical qualitative case study illuminates how people experience vulnerability and come to trust and distrust by examining the taken-for-granted assumptions at the root of these experiences.Rather than being interview-based and providing a comparison between separate points in time, this study's longitudinal qualitative design was intervention-based and focused on the contextual, processual and subtle nature of experiences of vulnerability and trust-building.Using a longitudinal qualitative research design based on weekly or bi-weekly meetings, this study mapped processes of meaning-making linked to experiences of vulnerability, trust and distrust, identifying taken-for-granted assumptions in which they were based.Assumptions and dispositions, by which trust and distrust were enacted, were configured by wider norms of idealised performances of gender, deference, ableism, whiteness and autonomy which were configured in ways distinctive to the Brazilian cultural context of our case study.