Poem
When I fi rst stood upon the shore I knew the sea was teeming with opportunities, but the waters seem choppy and overwhelming.
I’m still learning to swim. I have arm bands on, some incredible teachers, and friends who are learning with me.
Turbulence is always worse on the surface. It’s exposure to the elements that make it so choppy; could there be calmer waters just underneath?
I see a beaming light in the distance coming from a lighthouse. The light reminds me of others, and that there are many places to go, and to be.
Little by little, we’re learning to swim, and who knows what we can put into motion?
By Kim Coulson, Afrah Abdullahi, Sureya Ali, Lauren Canvin, and Shirin Mustafa
and values people can draw upon to change their relationship to problems in their lives. This de-centring practice allows us to challenge the dominant idea that problems lie within the person, which is central to the current Western model of mental distress. Nevertheless, we acknowledge the
importance of critically evaluating our islands of safety. For instance, being aware of ‘magical voluntarism’ whereby people can not simply ‘re-story’ their lives in the face of adverse and oppressive material realities and practices of power (Harper & Spellman, 2006).
No-one is an island Engaging with community-based
approaches and social-activist movements sustains us. This can give us hope that the mental health workforce is moving towards social understandings of distress, centring marginalised voices and campaigning against inequalities and injustices. Working alongside disenfranchised individuals and communities, who hold their own expertise in managing distress, has supported our thinking in how to address power dynamics when working with stakeholders. It has also helped us consider how we may begin conversations and raise consciousness regarding diff ering levels of
Context 164, August 2019 Sureya, Kim, Lauren and Afrah (with Shirin absent)
power in the people’s relationships with services and, broadly, society. For some of us, these ways of working
are new and tentative, whereas some are more sure-footed on these islands of safety. However, we all feel privileged to have found them. We fi nd joy in discovering the other inhabitants of these islands, people who turn them from lonely, daunting places to thriving, welcoming sources of support.
Conclusion As trainees, taking our fi rst strokes in the
ocean, turbulent waters are a strong and perilous feature of our landscape. At times, we are almost overcome by the storms of limited resources, the downplaying of social determinants of distress, centring problems within a person and the limited accessibility and acceptability of universalist psychological therapies. These forces work to keep the waters dangerous and turbulent. Navigating the turbulent waters is challenging. However, we stay grounded from our ‘riverbank position’ by drawing hope, inspiration and strength from theories, practices and people we have met on our journey. Particularly drawing on ideas from non-linear, systemic and narrative practices. We hope that our collection of Islands continues to grow and stays present for us as we swim.
Acknowledgements We would like to thank Lizette Nolte
for supporting and fostering our thinking and Angela Byrne for her generosity in reviewing an earlier draft of this paper.
References Allen, J., Balfour, R., Bell, R. & Marmot, M. (2014) Social determinants of mental health. International Review of Psychiatry, 26(4): 392-407. Bateson, G. (1979) Mind and Nature. New York: Dutton. Bateson, N. (2016) Small Arcs of Larger Circles: Framing Through Other Patterns. Charmouth: Triarchy Press. Byrne, A., Mustafa, S., & Miah, I.Q. (2017) Working together to break the ‘circles of fear’ between Muslim communities and mental health services. Psychoanalytic Psychotherapy, 31(4): 393-400. Denborough, D. (2014) Retelling the Stories of our Lives: Everyday Narrative Therapy to Draw Inspiration and Transform Experience. New York: Norton. Harper, D. & Spellman, D. (2006) Social constructionist formulation: Telling a diff erent story. In: L. Johnstone & R. Dallos (eds.), Formulation in Psychology and Psychotherapy: Making Sense of People’s Problems. London, New York: Routledge. Keating, F., Robertson, D., McCulloch, A. & Frances, E. (2002) Breaking the Circles of Fear: A Review of the Relationship Between Mental Health Services and African and Caribbean Communities. London: Sainsbury Centre for Mental Health. Keeney, B.P. (1983) Aesthetics of Change. New York: Guilford Press. Newnes, C. (2014) Clinical Psychology: A Critical Examination. Monmouth: PCCS Books. Offi ce for National Statistics (2011) UK Census Data.
https://www.ons.gov.uk/census/2011census. [Accessed 13/09/2018]. Patel, N. (2003) Clinical psychology: Reinforcing inequalities or facilitating empowerment? The International Journal of Human Rights, 7(1): 16-39. Saha, S. & Fernandez A. (2007) Language barriers in health care. Journal of General Internal Medicine, 22(2): 281-282. White, M. & Epston, D. (1990) Narrative Means to Therapeutic Ends. New york: Norton.
Sureya, Afrah, Lauren, Kim and Shirin are in the second year of their doctorate in clinical psychology training, at University of Hertfordshire. They share a keen interest in social justice, community, liberation and decolonising approaches in their clinical and academic work.
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Navigating turbulent waters with hope to co-create islands of safety
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