Abstract
Resettlement practitioners are powerful advocates for resettling individuals but are often accused of relying on representational practices that promote inaccurate assumptions of psychopathology. The preoccupation with post-traumatic stress disorder and vicarious traumatisation that characterises such representations can result in resettling communities being subjected to two levels of stigmatisation within society. They are thereby simultaneously at risk and a risk in their new society of settlement and their resilience and opportunities for vicarious resilience in the sector are potentially silenced.
Informed by the transformative paradigm, this thesis recognises that positivist psychological research reinforcing assumptions of psychopathology has historically been promoted throughout the resettlement sector. The transformation anticipated in this research was to raise awareness of the range of responses to trauma and trauma work by sharing critical reflections from resettlement practitioners, obtained through socially constructed semi-structured interviews, together with recently published positivist psychiatric research. This approach to research was chosen to explore identified concerns of local resettling communities and challenge practitioners to reconsider how they represent resettling individuals and resettlement work.
The primary aim of this research was to explore how psychopathological representations are resisted and/or reproduced by practitioners working within the resettlement sector in Wellington, New Zealand. A total of 25 interviews with a cross section of resettlement practitioners (psychiatrists, psychologists, social workers, interpreters and volunteers) were conducted. Six interconnected themes were identified; “They’re people”, “This is not paradise”, “Psychotherapy”, “Pretty damaged people”, “Oh, those poor people” and “People have no idea”. The first three themes resisted the three assumptions of psychopathology which imply that the vast majority of resettling individuals suffer from PTSD, caused by their pre-displacement trauma, and require specialist psychological intervention. The remaining three themes corresponded with the implications of these assumptions, such as, promoting the ‘at risk’ status of resettling individuals and resettlement practitioners and reliance on the assumptions of psychopathology in advocacy. The conclusion of the analysis was that practitioners are potentially caught in a crisis of representation. Central to this crisis is the way in which resettling communities’ psychological wellbeing was represented and the assumptions made about the type of assistance they should receive. Subsequently, practitioners felt compelled to continue to rely on psychopathological representations of resettling communities and resettlement work, in order to obtain recognition and resources for the services they provided. Importantly, in some cases, they continued to do this, knowing that these representations did not accurately reflect the resilience of resettling communities or the realities of supporting them to settle in New Zealand. In addition, they acknowledged that such representations could compromise successful settlement outcomes by perpetuating stigma, societal prejudice and service provision that reinforces passive styles of resettlement. Such critical reflections corroborate the concerns of representatives of resettling communities as well as clinical research published during the course of this research.
The secondary aim of this thesis was to raise awareness of the assumptions of psychopathology that resettlement practitioners tend to rely on and to promote the resilience of resettling communities and realities of supporting them to successfully settle in New Zealand. My approach to sharing my research resulted in a constructive collaboration with the New Zealand Red Cross. As part of this collaboration, I conducted a regional training tour that enabled me to sensitise approximately 500 practitioners to the assumptions of psychopathology being promoted in the resettlement sector and encourage them to critically reflect on the ways in which they represent their work and resettling clients. While the research resonated with most practitioners across the country, a critical incident with one specialist mental health service, revealed contrasting perspectives consistent with the crisis of representation I had conceptualised. It also highlighted the significance of the relational context in the reception of critical research.
In light of the pervasiveness of the assumptions of psychopathology that inform service provision and pragmatism required of practitioners, the recommendation from this research is that practitioners receive ongoing professional development in order to be as critically reflexive and culturally responsive as they are required to be by their professional associations. This research also recommends future participatory research initiatives in collaboration with local resettling communities to identify alternative interventions that acknowledge their resilience and respond to their priorities for resettlement and recovery.
The first contribution of this research has been to identify and illustrate the implications of the crisis of representation within the New Zealand resettlement context during the period 2014 - 2018. The second contribution of this research has been to go beyond simply recommending initiatives to increase critical reflexivity and to actually create opportunities to do so throughout the sector. The third contribution of this research has been to conduct reciprocal research informed by the transformational paradigm – a first in the Department of Psychological Medicine at the University of Otago, Wellington.