Negotiating motherhood as a refugee: experiences of loss,love, survival and pain in the context of forced migration

The mental health of refugees has been an increasingly researched area, but has been criticised for having an individualised and symptom-focused approach to understanding the experience of forced migration. This paper attempts to respond to calls to address this culturally limited and incomplete way of conceptualising responses to experiences of persecution and terror bound up within global hegemony and power inequalities. Interpretative phenomenological analysis was employed to analyse semi-structured interviews undertaken with six refugee mothers, with the aim of exploring how participants made sense of, and created meaning around parenting and family life in the UK. Three main themes emerged from the data analysis (a) loss as a constant companion to parenting; (b) a shifting view of the self as a mother; and (c) taking the good with the bad in family life. Methodological limitations, as well as implications for future research and clinical practice are discussed.     

“Giving Back to Society What Society Gave Us”: Altruism,Coping, and Meaning Making by Two Refugee Communities in South Australia

We aimed to explore how refugee people utilised their coping resources and strategies to find meaning in their past and present experiences. Using an experience‐centred narrative approach, we analysed the stories of 24 former refugees from two African countries resettled in South Australia. Data analysis revealed altruism and helping behaviour as a prominent and recurring theme of participants' narrated lives. This meta‐theme encompassed four subthemes: (a) surviving war and exile, (b) adapting to Australian society, (c) reaching back home, and (d) meaning making through religious beliefs. Helping, cooperating, and sharing were entwined with participants' coping strategies and meaning making of experience. Participants' socio‐historical, cultural, and religious context influenced the interpretations of their experiences. Taken together, our findings identified a counter narrative in refugee mental health research beyond trauma and psychopathology. Specifically, we have shown that when the refugee experience is also accompanied by situational contingencies such as receiving help and being called upon to help, together with evaluations such as empathy, identification with suffering, and gratitude, people can be motivated to help others. Future research is needed to explore how altruism and helping behaviour can promote healing from trauma, alleviate distress of separation, and ameliorate acculturation stress among diverse refugee populations.     

“You cannot forgive and you cannot forget”: The Serbian refugee settlement experience in Australia

Currently, there is limited research on the settlement experiences of refugees from the Balkan regions and in particular Serbia. There is also a need to provide a contextual understanding of the refugee settlement experience. The current study explored the refugee experience of 12 male Serbian refugees (aged 30 to 65), who migrated to Australia following the Yugoslav Civil War (1991–2001). A qualitative, phenomenological methodology explored the experiences of the refugees from their own perspective. Thematic coding of the interview data revealed the two major themes of settlement and traumatic experiences, as central to the experiences of this group of refugees. Language difficulties, discrimination, stigmatization of Serbian identity, multiple losses and grief, and failing of the justice system to establish accountability and provide reparation to the victims were all significant obstacles to successful settlement. Most salient, however, were the experiences of torture and trauma. Participants were still trying to negotiate these memories years after the events. Nevertheless, some participants showed strong resilience and the belief that they became stronger as a consequence of their experiences. We encourage those working with Serbian refugees to help them search for meaning in their stories of trauma.     

The meaning of ‘reconstruction’ within the lived experience of mastectomy for breast cancer

This paper represents a heuristic study of the meaning and essence of ‘reconstruction’ within the lived experience of mastectomy for breast cancer. Open‐ended interviews were conducted with a sample of eight women aged 40 to 58 years, who underwent mastectomy for breast cancer. Four participants had immediate breast reconstruction; two participants had delayed breast reconstruction, and two participants decided not to have the procedure. The study demonstrates that themes of loss/change/reconstruction are inextricably linked to the experience of mastectomy. Loss of a breast was likened to bereavement and in some women caused a loss of part of their identity. The closeness of death altered the awareness the women had of their time left on earth. This awareness brought about change/reconstruction in the majority of the women, in their lives and in their relationships with others. Prior to breast reconstruction there is a place for exploring with women the meaning of ‘normal’ and ‘whole’. Implications for counselling are discussed.     

Contributions of Loss Events to Loss Distress and Trauma Symptoms in Recently Resettled Refugee Women at Risk

This research examined contributions of loss events to loss distress and trauma symptoms (accounting for trauma events) for refugee women at risk. Participants (N?=?104) responded to the Multidimensional Loss Scale (loss events and distress) and Harvard Trauma Questionnaire (trauma events and symptoms). Loss events contributed uniquely to loss distress (explaining additional 50.8% variance), and made a unique contribution to trauma symptoms (explaining additional 5.2% variance) approximately equal to trauma events. Appropriate response to psychic distress in refugee women at risk requires assessment of both loss and trauma and consideration of cultural differences in ways loss is expressed and meaning ascribed to symptoms.     

The impact of assuming the primary caregiver role following traumatic spinal cord injury: An interpretative phenomenological analysis of the spouse's experience

This study aimed to explore the lived experience of assuming the primary caregiver role in a group of spouses of individuals living with a traumatic spinal cord injury (SCI) (injuries ranged from paraplegia to quadriplegia). Individual in-depth interviews were conducted with 11 participants who were both the spouse and primary caregiver of an individual with a SCI; of these, 10 were female and 1 was male. All interviews were transcribed verbatim and were subjected to interpretative phenomenological analysis (IPA). Here we present three inter-related master themes: ‘The emotional impact of SCI’; ‘Post-injury shift in relationship dynamics’ and ‘Impact of caregiving on identity’. Regarding the emotional impact of spinal injury, participants reported an almost instantaneous sense of loss, emptiness and grief during the injured person's rehabilitative period and feelings of anxiety were reported in anticipation of their return to the family home. A distinct change in role from spouse and lover to care provider was reported and this ultimately contributed to relationship change and a loss of former identity. The findings are discussed in relation to extant caregiver literature and recommendations for future caregiver support are highlighted.     

Grieving From the Womb: Meaning Construction in Response to Father Loss Before Birth

This qualitative study examined the meanings constructed by Israeli adults to their loss of a father before birth. Using the interpretative phenomenological analysis approach, three themes of meaning were derived from in-depth semistructured interviews conducted with 12 Israeli adults who lost their fathers before they were born: (a) mother’s grief—a transmission of loss and grief; (b) defect, shame, guilt, and anxiety—congenital anomaly; and (c) ambiguous loss—phantom limb pain caused by an organ they did not have to begin with. An integrative view of all three themes highlights the notion that meaning construction in response to loss is a process forged by social and cultural forces and the use participants make in metaphoric language regarding physical aspects when constructing meanings to their loss. Practical implications are outlined.     

Difficulties adjusting to post-discharge life following a spinal cord injury: an interpretative phenomenological analysis

Individual semi-structured interviews were conducted with 17 individuals who had experienced a traumatic spinal cord injury (SCI), focusing on the participants' lived experience of SCI. The interviews were transcribed verbatim and were analysed for recurrent themes using interpretative phenomenological analysis (IPA). Here, we present three inter-related recurrent themes all concerning difficulties in adjusting to home life following hospital discharge: "loss of camaraderie", "lack of post-discharge care" and "other people's reactions to spinal cord injury". Participants reported that the camaraderie they formed with fellow patients during their rehabilitative stay in hospital generated feelings of security and community. This was discussed in stark contrast to the isolation and loneliness that they subsequently experienced post-hospital discharge. A perceived lack of physical, practical and psychological support coupled with negative and stigmatising reactions of the wider community served to make adjustment to home life post-SCI particularly difficult for the participants. The findings are discussed in relation to extant SCI literature, and recommendations for future health care of individuals with SCI are made.     

Voices of Dialogue and Directivity in Family Therapy With Refugees: Evolving Ideas About Dialogical Refugee Care

In this article, we reflect on our evolving ideas regarding a dialogical approach to refugee care. Broadening the predominant phased trauma care model and its engaging of directive expertise in symptom reduction, meaning making, and rebuilding connectedness, these developing dialogical notions involve the negotiation of silencing and disclosure, meaning and absurdity, hope and hopelessness in a therapeutic dialogue that accepts its encounter of cultural and social difference. In locating therapeutic practice within these divergent approaches, we argue an orientation on collaborative dialogue may operate together with notions from the phased trauma care model as heuristic background in engaging a polyphonic understanding of coping with individual and family sequelae of forced displacement. This locating of therapeutic practice, as informed by each perspective, invites us to remain present to fragments of therapeutic positioning that resonate power imbalance or appropriation in a therapeutic encounter imbued with a social context that silences refugees’ suffering. In a clinical case analysis, we further explore these relational complexities of negotiating directive expertise and collaborative dialogue in the therapeutic encounter with refugee clients.     

The lived experience of disability

In this paper I reflect upon my personal experience of chronic progressive multiple sclerosis in order to provide a phenomenological account of the human experience of disability. In particular, I argue that the phenomenological notion of lived body provides important insights into the profound disruptions of space and time that are an integral element of changed physical capacities such as loss of mobility. In addition, phenomenology discloses the emotional dimension of physical disorder. The lived body disruption engendered by loss of mobility includes a change in the character of surrounding space, an alteration in one's taken-for-granted awareness of (and interaction with) objects, the disruption of corporeal identity, a disturbance in one's relations with others, and a change in the character of temporal experience. The loss of upright posture is of particular significance since it not only concretely diminishes autonomy but affects the way one is treated by others. Such a change in posture is, therefore, particularly disruptive in the social world of everyday life. An understanding of the lived body disruption engendered by disability has important applications for the clinical context in devising effective therapies, as well as for the social arena in determining how best to resolve the various challenges posed by chronic disabling disorders.I should like to thank Frances Chaput Waksler for her helpful comments on my work.     

“There's a deeper level of meaning as to what suffering's all about”: experiences of religious and spiritual growth following trauma

Some survivors of trauma report experiencing beneficial changes in self-perception, relationships, and philosophy of life, and positive changes in the realm of existential, spiritual, or religious matters. The purpose of the present study was to examine participants’ phenomenological experiences of spiritual and religious posttraumatic growth (PTG). Transcribed data from semi-structured interviews with 10 women, self-identified as Christian, who had experienced spiritual or religious growth following various trauma were analysed using Interpretative Phenomenological Analysis. Results indicated how religion provided a framework that assisted participants to incorporate life changes, and to find meaning in their suffering. The most salient themes identified in relation to religious and spiritual PTG included: process of spiritual and religious growth, strengthening of religious and spiritual beliefs, and personal and spiritual growth and healing. Participants’ trauma and associated distress prompted a process of questioning and meaning-making that facilitated deeply experienced personal and spiritual growth, and was related to intrinsic religiosity.     

Chronic pain, meaning, and spirituality: A qualitative study of the healing process in relation to the role of meaning and spirituality

This qualitative study explores experiences of individuals with chronic pain in their attempt to find meaning in the presence of continual pain. Fifteen participants at Loma Linda University Behavioral Medicine Center were interviewed. Emerging themes from this study show that (1) meaning is initially defined as the ability to engage in productive activities and positive relationships; (2) chronic pain is perceived as the factor that removes meaning from the lives of sufferers; (3) medication is used to cope with pain, leading to addiction; (4) addiction results in greater loss of meaning; and (5) rediscovery of meaning takes place through a more complex understanding of the self that embraces suffering and thus is able to explain the interrelation of pain, emotions, and addiction. A change in self-understanding makes the reintegration of meaning possible.     

Spiritual Transformation: A Phenomenological Study Among Recovering Substance Abusers

As a complement to an earlier quantitative investigation, this qualitative study was concerned with describing the lived experience of spiritual transformation within the context of a 12-month resident substance abuse recovery program called the Lazarus Project, which is sponsored by a southern U.S. Pentecostal-based congregation. We conducted phenomenological interviews with 10 participants (eight European-Americans; two African-Americans) who had been in the program from six to nine?months and asked that they describe their most important spiritual experiences that brought about change. A hermeneutical analysis found that a pattern of five overlapping themes emerged consistently across all 10 protocols to describe the meaning of the experience of spiritual transformation for these participants. The themes were: (1) “Sick and Tired”, (2) Unmerited Love, (3) “I’m Changing,” (4) Fast/Gradual, and (5) Destiny. The themes are discussed from an existential perspective and related to the literature on spiritual transformation as well as the earlier quantitative study at the Lazarus Project.     

Individual differences in phenomenological experience: states of consciousness as a function of absorption

State manifestations of the trait of absorption--a trait associated with differential responsivity to hypnosis, meditation, marijuana intoxification, and electromyograph (EMG) biofeedback--were assessed to determine (a) if absorption correlates with various (sub)dimensions of phenomenological experience, and (b) if individuals of differing absorption ability experience different states of consciousness. In two experiments 249 and 304 participants completed Tellegen's absorption scale and experienced several stimulus conditions. Each condition's phenomenological state was assessed by means of a retrospective self-report questionnaire and quantified in terms of intensity and pattern parameters. The results indicated that absorption correlated with increased and more vivid imagery, inward and absorbed attention, and positive affect; decreased self-awareness; and increased alterations in state of consciousness and various aspects of subjective experience. In addition, individuals of high absorption ability, relative to lows, experienced a different state of consciousness during ordinary, waking consciousness that became an altered state with eye closure and an hypnoticlike induction. The usefulness of the results for understanding altered-state induced procedures such as hypnosis is discussed.     

Trauma and Resilience Among Refugee and Undocumented Immigrant Women

Migration and resettlement processes are often characterized by stressful and traumatic experiences. Immigrants may experience premigration trauma in their countries of origin and trauma during their migration journey. Furthermore, refugee and undocumented immigrant women navigate unique and ongoing stressors postmigration. In this study, the authors used a phenomenological approach to explore refugee and undocumented immigrant women's experiences of trauma and stress and the ways in which they develop resilience to cope with these experiences.     

Exploring adversity and the potential for growth among elite female athletes

ObjectivesThe purposes of this study were to (a) explore experiences of adversity and (b) to examine perceptions of growth following adversity among elite female athletes.MethodsSemi-structured interviews were conducted with five elite female athletes (ages 18–23 years) who competed internationally in track and field, swimming, long-distance running, and basketball. Interviews were analyzed using an interpretative phenomenological approach (Smith, Flowers, & Larkin, 2009).ResultsIncidents of performance slumps, coach conflicts, bullying, eating disorders, sexual abuse, and injuries were reported. The shared ‘essential’ features of participants’ experiences of adversity were isolation/withdrawal, emotional disruption, questioning identity as an athlete, and understanding experiences within a context of perceived expectations. It appeared that as participants sought and found meaning in their experiences, they identified opportunities for growth associated with social support and also as they realized the role of sport in their lives. Aspects of growth include realizing strength, gaining perspective of their problems, and gaining a desire to help others. Athletes’ experiences with adversity were seen as part of an ongoing journey through elite sport.ConclusionsAthletes’ experiences of adversity may have initiated a process of questioning their identities and searching for meaning in their experiences. Findings highlighted the complexity associated with social support and athletes’ growth following adversity. Growth following adversity appears to be a valuable area of research among elite athletes.     

Emerging Finnish Adults Coping with Cancer: Religious,Spiritual, and Secular Meanings of the Experience

The article presents empirical findings on religious, spiritual, and secular coping among emerging Finnish adults with cancer and seeks an understanding of the different meanings they constructed of their experience with cancer. Autobiographical interviews and life tree drawings of 16 emerging adults were analyzed utilizing a narrative approach. To gain a deeper understanding of the cancer-coping and meaning-making processes, the stories of Beth, Sophia, and Anna are explored in detail. An exploration of the meaning-making process of all the participants shows that over time many of the participants were able to find meaning in their cancer experience. Religious meaning was found when the disease was discovered as a calling from God, spiritual meaning was discovered within a buffered identity and important relationships, and secular meaning was found in the courage to make a career change. The theoretical discussion points out a gap between the disciplines of theology and psychology of religion. The gap is partly bridged by utilizing the concepts of lived religion and existentially oriented spirituality in the discussion of meaning-making theories.