Academic literature on the topic 'Psychodynamic psychotherapy for children Australia Case studies'

We shall present the development of a cohort of 40 children aged from 6 to 11 who were initially diagnosed with ADHD (T0) and then reassessed after two years of treatment with multimodal treatment in addition to stimulant medication. At the outset of the study (T0) the children underwent a complete assessment which included a child psychiatric examination, a neuropsychological evaluation of attention skills and a psychodynamic psychological assessment using the T.A.T. and Rorschach projective tests interpreted from a psychoanalytic viewpoint. An identical protocol was used for the reassessment of the children two years later (T2).Clinically, and from a strictly behavioral point of view, it is clear that there was a calming down of the symptoms associated with the ADHD. Can the same be said for the results of the neuro-psychological and projective tests as well as for the overall psychic functioning of the children?At this point in our research, and taking into account that T 2 just ended, we can affirm that the children who were assessed with neurotic disorders (according to the classification of psychopathological disorders in childhood) were those who showed the clearest signs of improvement. We shall then study in depth the majority of the population who were assessed with borderline personality disorders (BPD). As these children received a multimodal treatment over the two years time of the study which involved either individual, group or family psychotherapy, we shall use brief clinical case studies for a comparative approach to our research results.

It is important to investigate the outcomes of psychotherapy and, especially, its process. Regarding child psychodynamic psychotherapy, available studies are in smaller numbers. Therefore, we still do not fully know the mechanisms of change in treatments with this age group. The Child Psychotherapy Q-Set (CPQ) was designed to analyze the therapeutic process with children. It permits one to identify interaction structures (i.e., repetitive patterns of interaction) and how they change in the course of a treatment. Based on these assumptions, the aim of this study was to identify and to analyze the interaction structures in the psychodynamic therapy of a boy diagnosed with Asperger’s disorder and possible changes in his psychic organization. A mixed longitudinal study, based on the Systematic Case Study procedure, was performed. Approximately 30 months of the boy’s psychotherapy were analyzed using the CPQ. The Rorschach method was used as the outcome measure. Four interaction structures were identified, using the CPQ: Active, confident and lively child, competing with connected, mentalizing and accepting therapist; Withdrawn and defensive child with uncertain, unresponsive and didactic therapist; Accepting therapist with demanding, provocative and hostile child; and Reassuring, supportive, nondirective therapist with a compliant and not spontaneous child. Two interaction structures varied over time. Some changes in Rorschach variables were detected after two years of treatment.

Introduction The term ‘resilience’ is on everyone’s lips - from politicians to community service providers to the seemingly endless supply of self-help gurus. The concept is undergoing a renaissance of sorts in contemporary Western society; but why resilience now? One possible explanation is that individuals and their communities are experiencing increased and intensified levels of adversity and hardship, necessitating the accumulation and deployment of ‘more resilience’. Whilst a strong argument could made that this is in fact the case, it would seem that the capacity to survive and thrive has been a feature of human survival and growth long before we had a name for it. Rather than an inherent characteristic, trait or set of behaviours of particularly ‘resilient’ individuals or groups, resilience has come to be viewed more as a common and everyday capacity, expressed and expressible by all people. Having researched the concept for some time now, we believe that we are only marginally closer to understanding this captivating but ultimately elusive concept. What we are fairly certain of is that resilience is more than basic survival but less than an invulnerability to adversity, resting somewhere in the middle of these two extremes. Given the increasing prevalence of populations affected by war and other disasters, we are certain however that efforts to better understand the accumulative dynamics of resilience, are now, more than ever, a vital area of public and academic concern. In our contemporary world, the concept of resilience is coming to represent a vital conceptual tool for responding to the complex challenges emerging from broad scale movements in climate change, rural and urban migration patterns, pollution, economic integration and other consequences of globalisation. In this article, the phenomenon of human resilience is defined as the cumulative build-up of both particular kinds of knowledge, skills and capabilities as well as positive affects such as hope, which sediment over time as transpersonal capacities for self-preservation and ongoing growth (Wilson). Although the accumulation of positive affect is crucial to the formation of resilience, the ability to re-imagine and utilise negative affects, events and environmental limitations, as productive cultural resources, is a reciprocal and under-researched aspect of the phenomenon. In short, we argue that resilience is the protective shield, which capacitates individuals and communities to at least deal with, and at best, overcome potential challenges, while also facilitating the realisation of hoped-for objects and outcomes. Closely tied to the formation of resilience is the lived experience of hope and hoping practices, with an important feature of resilience related to the future-oriented dimensions of hope (Parse). Yet it is important to note that the accumulation of hope, as with resilience, is not headed towards some state of invulnerability to adversity; as presumed to exist in the foundational period of psychological research on the construct (Garmezy; Werner and Smith; Werner). In contrast, we argue that the positive affective experience of hopefulness provides individuals and communities with a means of enduring the present, while the future-oriented dimensions of hope offer them an instrument for imagining a better future to come (Wilson). Given the complex, elusive and non-uniform nature of resilience, it is important to consider the continued relevance of the resilience concept. For example, is resilience too narrow a term to describe and explain the multiple capacities, strategies and resources required to survive and thrive in today’s world? Furthermore, why do some individuals and communities mobilise and respond to a crisis; and why do some collapse? In a related discussion, Ungar (Constructionist) posed the question, “Why keep the term resilience?” Terms like resilience, even strengths, empowerment and health, are a counterpoint to notions of disease and disorder that have made us look at people as glasses half empty rather than half full. Resilience reminds us that children survive and thrive in a myriad of ways, and that understanding the etiology of health is as, or more, important than studying the etiology of disease. (Ungar, Constructionist 91) This productive orientation towards health, creativity and meaning-making demonstrates the continued conceptual and existential relevance of resilience, and why it will remain a critical subject of inquiry now and into the future. Early Psychological Studies of Resilience Definitions of resilience vary considerably across disciplines and time, and according to the theoretical context or group under investigation (Harvey and Delfabro). During the 1970s and early 1980s, the developmental literature on resilience focused primarily on the “personal qualities” of “resilient children” exposed to adverse life circumstances (Garmezy Vulnerability; Masten; Rutter; Werner). From this narrow and largely individualistic viewpoint, resilience was defined as an innate “self-righting mechanism” (Werner and Smith 202). Writing from within the psychological tradition, Masten argued that the early research on resilience (Garmezy Vulnerability; Werner and Smith) regularly implied that resilient children were special or remarkable by virtue of their invulnerability to adversity. As research into resilience progressed, researchers began to acknowledge the ordinariness or everydayness of resilience-related phenomena. Furthermore, that “resilience may often derive from factors external to the child” (Luthar; Cicchetti and Becker 544). Besides the personal attributes of children, researchers within the psychological sciences also began to explore the effects of family dynamics and impacts of the broader social environment in the development of resilience. Rather than identifying which child, family or environmental factors were resilient or resilience producing, they turned their attention to how these underlying protective mechanisms facilitated positive resilience outcomes. As research evolved, resilience as an absolute or unchanging attribute made way for more relational and dynamic conceptualisations. As Luthar et al noted, “it became clear that positive adaptation despite exposure to adversity involves a developmental progression, such that new vulnerabilities and/or strengths often emerge with changing life circumstances” (543-44). Accordingly, resilience came to be viewed as a dynamic process, involving positive adaptations within contexts of adversity (Luthar et al. 543). Although closer to the operational definition of resilience argued for here, there remain a number of definitional concerns and theoretical limitations of the psychological approach; in particular, the limitation of positive adaptation to the context of significant adversity. In doing so, this definition fails to account for the subjective experience and culturally located understandings of ‘health’, ‘adversity’ and ‘adaptation’ so crucial to the formation of resilience. Our major criticism of the psychodynamic approach to resilience relates to the construction of a false dichotomy between “resilient” and “non-resilient” individuals. This dichotomy is perpetuated by psychological approaches that view resilience as a distinct construct, specific to “resilient” individuals. In combating this assumption, Ungar maintained that this bifurcation could be replaced by an understanding of mental health “as residing in all individuals even when significant impairment is present” (Thicker 352). We tend to agree. In terms of economic resilience, we must also be alert to similar false binaries that place the first and low-income world into simple, apposite positions of coping or not-coping, ‘having’ or ‘not-having’ resilience. There is evidence to indicate, for example, that emerging economies fared somewhat better than high-income nations during the global financial crisis (GFC). According to Frankel and Saravelos, several low-income nations attained better rates of gross domestic product GDP, though the impacts on the respective populations were found to be equally hard (Lane and Milesi-Ferretti). While the reasons for this are broad and complex, a study by Kose and Prasad found that a broad set of policy tools had been developed that allowed for greater flexibility in responding to the crisis. Positive Affect Despite Adversity An emphasis on deficit, suffering and pathology among marginalised populations such as refugees and young people has detracted from culturally located strengths. As Te Riele explained, marginalised young people residing in conditions of adversity are often identified within “at-risk” discourses. These social support frameworks have tended to highlight pathologies and antisocial behaviours rather than cultural competencies. This attitude towards marginalised “at risk” young people has been perpetuated by psychotherapeutic discourse that has tended to focus on the relief of suffering and treatment of individual pathologies (Davidson and Shahar). By focusing on pain avoidance and temporary relief, we may be missing opportunities to better understand the productive role of ‘negative’ affects and bodily sensations in alerting us to underlying conditions, in need of attention or change. A similar deficit approach is undertaken through education – particularly civics – where young people are treated as ‘citizens in waiting’ (Collin). From this perspective, citizenship is something that young people are expected to ‘grow into’, and until that point, are seen as lacking any political agency or ability to respond to adversity (Holdsworth). Although a certain amount of internal discomfort is required to promote change, Davidson and Shahar noted that clinical psychotherapists still “for the most part, envision an eventual state of happiness – both for our patients and for ourselves, described as free of tension, pain, disease, and suffering” (229). In challenging this assumption, they asked, But if desiring-production is essential to what makes us human, would we not expect happiness or health to involve the active, creative process of producing? How can one produce anything while sitting, standing, or lying still? (229) A number of studies exploring the affective experiences of migrants have contested the embedded psychological assumption that happiness or well-being “stands apart” from experiences of suffering (Crocker and Major; Fozdar and Torezani; Ruggireo and Taylor; Tsenkova, Love, Singer and Ryff). A concern for Ahmed is how much the turn to happiness or happiness turn “depends on the very distinction between good and bad feelings that presume bad feelings are backward and conservative and good feelings are forward and progressive” (Happiness 135). Highlighting the productive potential of unhappy affects, Ahmed suggested that the airing of unhappy affects in their various forms provides people with “an alternative set of imaginings of what might count as a good or at least better life” (Happiness 135). An interesting feature of refugee narratives is the paradoxical relationship between negative migration experiences and the reporting of a positive life outlook. In a study involving former Yugoslavian, Middle Eastern and African refugees, Fozdar and Torezani investigated the “apparent paradox between high-levels of discrimination experienced by humanitarian migrants to Australia in the labour market and everyday life” (30), and the reporting of positive wellbeing. The interaction between negative experiences of discrimination and reports of wellbeing suggested a counter-intuitive propensity among refugees to adapt to and make sense of their migration experiences in unique, resourceful and life-affirming ways. In a study of unaccompanied Sudanese youth living in the United States, Goodman reported that, “none of the participants displayed a sense of victimhood at the time of the interviews” (1182). Although individual narratives did reflect a sense of victimisation and helplessness relating to the enormity of past trauma, the young participants viewed themselves primarily as survivors and agents of their own future. Goodman further stated that the tone of the refugee testimonials was not bitter: “Instead, feelings of brotherliness, kindness, and hope prevailed” (1183). Such response patterns among refugees and trauma survivors indicate a similar resilience-related capacity to positively interpret and derive meaning from negative migration experiences and associated emotions. It is important to point out that demonstrations of resilience appear loosely proportional to the amount or intensity of adverse life events experienced. However, resilience is not expressed or employed uniformly among individuals or communities. Some respond in a resilient manner, while others collapse. On this point, an argument could be made that collapse and breakdown is a built-in aspect of resilience, and necessary for renewal and ongoing growth. Cultures of Resilience In a cross continental study of communities living and relying on waterways for their daily subsistence, Arvanitakis is involved in a broader research project aiming to understand why some cultures collapse and why others survive in the face of adversity. The research aims to look beyond systems of resilience, and proposes the term ‘cultures of resilience’ to describe the situated strategies of these communities for coping with a variety of human-induced environmental challenges. More specifically, the concept of ‘cultures of resilience’ assists in explaining the specific ways individuals and communities are responding to the many stresses and struggles associated with living on the ‘front-line’ of major waterways that are being impacted by large-scale, human-environment development and disasters. Among these diverse locations are Botany Bay (Australia), Sankhla Lake (Thailand), rural Bangladesh, the Ganges (India), and Chesapeake Bay (USA). These communities face very different challenges in a range of distinctive contexts. Within these settings, we have identified communities that are prospering despite the emerging challenges while others are in the midst of collapse and dispersion. In recognising the specific contexts of each of these communities, the researchers are working to uncover a common set of narratives of resilience and hope. We are not looking for the ’magic ingredient’ of resilience, but what kinds of strategies these communities have employed and what can they learn from each other. One example that is being pursued is a community of Thai rice farmers who have reinstated ceremonies to celebrate successful harvests by sharing in an indigenous rice species in the hope of promoting a shared sense of community. These were communities on the cusp of collapse brought on by changing economic and environmental climates, but who have reversed this trend by employing a series of culturally located practices. The vulnerability of these communities can be traced back to the 1960s ‘green revolution’ when they where encouraged by local government authorities to move to ‘white rice’ species to meet export markets. In the process they were forced to abandoned their indigenous rice varieties and abandon traditional seed saving practices (Shiva, Sengupta). Since then, the rice monocultures have been found to be vulnerable to the changing climate as well as other environmental influences. The above ceremonies allowed the farmers to re-discover the indigenous rice species and plant them alongside the ‘white rice’ for export creating a more robust harvest. The indigenous species are kept for local consumption and trade, while the ‘white rice’ is exported, giving the farmers access to both the international markets and income and the local informal economies. In addition, the indigenous rice acts as a form of ‘insurance’ against the vagaries of international trade (Shiva). Informants stated that the authorities that once encouraged them to abandon indigenous rice species and practices are now working with the communities to re-instigate these. This has created a partnership between the local government-funded research centres, government institutions and the farmers. A third element that the informants discussed was the everyday practices that prepare a community to face these challenges and allow it recover in partnership with government, including formal and informal communication channels. These everyday practices create a culture of reciprocity where the challenges of the community are seen to be those of the individual. This is not meant to romanticise these communities. In close proximity, there are also communities engulfed in despair. Such communities are overwhelmed with the various challenges described above of changing rural/urban settlement patterns, pollution and climate change, and seem to have lacked the cultural and social capital to respond. By contrasting the communities that have demonstrated resilience and those that have not been overwhelmed, it is becoming increasingly obvious that there is no single 'magic' ingredient of resilience. What exist are various constituted factors that involve a combination of community agency, social capital, government assistance and structures of governance. The example of the rice farmers highlights three of these established practices: working across formal and informal economies; crossing localised and expert knowledge as well as the emergence of everyday practices that promote social capital. As such, while financial transactions occur that link even the smallest of communities to the global economy, there is also the everyday exchange of cultural practices, which is described elsewhere by Arvanitakis as 'the cultural commons': visions of hope, trust, shared intellect, and a sense of safety. Reflecting the refugee narratives citied above, these communities also report a positive life outlook, refusing to see themselves as victims. There is a propensity among members of these communities to adapt an outlook of hope and survival. Like the response patterns among refugees and trauma survivors, initial research is confirming a resilience-related capacity to interpret the various challenges that have been confronted, and see their survival as reason to hope. Future Visions, Hopeful Visions Hope is a crucial aspect of resilience, as it represents a present- and future-oriented mode of situated defence against adversity. The capacity to hope can increase one’s powers of action despite a complex range of adversities experienced in everyday life and during particularly difficult times. The term “hope” is commonly employed in a tokenistic way, as a “nice” rhetorical device in the mind-body-spirit or self-help literature or as a strategic instrument in increasingly empty domestic and international political vocabularies. With a few notable exceptions (Anderson; Bloch; Godfrey; Hage; Marcel; Parse; Zournazi), the concept of hope has received only modest attention from within sociology and cultural studies. Significant increases in the prevalence of war and disaster-affected populations makes qualitative research into the lived experience of hope a vital subject of academic interest. Parse observed among health care professionals a growing attention to “the lived experience of hope”, a phenomenon which has significant consequences for health and the quality of one’s life (vvi). Hope is an integral aspect of resilience as it can act as a mechanism for coping and defense in relation to adversity. Interestingly, it is during times of hardship and adversity that the phenomenological experience of hope seems to “kick in” or “switch on”. With similarities to the “taken-for-grantedness” of resilience in everyday life, Anderson observed that hope and hoping are taken-for-granted aspects of the affective fabric of everyday life in contemporary Western culture. Although the lived experience of hope, namely, hopefulness, is commonly conceptualised as a “future-oriented” state of mind, the affectivity of hope, in the present moment of hoping, has important implications in terms of resilience formation. The phrase, the “lived deferral of hope” is an idea that Wilson has developed elsewhere which hopefully brings together and holds in creative tension the two dominant perspectives on hope as a lived experience in the present and a deferred, future-oriented practice of hoping and hopefulness. Zournazi defined hope as a “basic human condition that involves belief and trust in the world” (12). She argued that the meaning of hope is “located in the act of living, the ordinary elements of everyday life” and not in “some future or ideal sense” (18). Furthermore, she proposed a more “everyday” hope which “is not based on threat or deferral of gratification”, but is related to joy “as another kind of contentment – the affirmation of life as it emerges and in the transitions and movements of our everyday lives and relationships” (150). While qualitative studies focusing on the everyday experience of hope have reinvigorated academic research on the concept of hope, our concept of “the lived deferral of hope” brings together Zournazi’s “everyday hope” and the future-oriented dimensions of hope and hoping practices, so important to the formation of resilience. Along similar lines to Ahmed’s (Happy Objects) suggestion that happiness “involves a specific kind of intentionality” that is “end-orientated”, practices of hope are also intentional and “end-orientated” (33). If objects of hope are a means to happiness, as Ahmed wrote, “in directing ourselves towards this or that [hope] object we are aiming somewhere else: toward a happiness that is presumed to follow” (Happy Objects 34), in other words, to a hope that is “not yet present”. It is the capacity to imagine alternative possibilities in the future that can help individuals and communities endure adverse experiences in the present and inspire confidence in the ongoingness of their existence. Although well-intentioned, Zournazi’s concept of an “everyday hope” seemingly ignores the fact that in contexts of daily threat, loss and death there is often a distinct lack of affirmative or affirmable things. In these contexts, the deferral of joy and gratification, located in the future acquisition of objects, outcomes or ideals, can be the only means of getting through particularly difficult events or circumstances. One might argue that hope in hopeless situations can be disabling; however, we contend that hope is always enabling to some degree, as it can facilitate alternative imaginings and temporary affective relief in even in the most hopeless situations. Hope bears similarity to resilience in terms of its facilities for coping and endurance. Likewise the formation and maintenance of hope can help individuals and communities endure and cope with adverse events or circumstances. The symbolic dimension of hope capacitates individuals and communities to endure the present without the hoped-for outcomes and to live with the uncertainty of their attainment. In the lives of refugees, for example, the imaginative dimension of hope is directly related to resilience in that it provides them with the ability to respond to adversity in productive and life-affirming ways. For Oliver, hope “provides continuity between the past and the present…giving power to find meaning in the worst adversity” (in Parse 16). In terms of making sense of the migration and resettlement experiences of refugees and other migrants, Lynch proposed a useful definition of hope as “the fundamental knowledge and feeling that there is a way out of difficulty, that things can work out” (32). As it pertains to everyday mobility and life routes, Parse considered hope to be “essential to one’s becoming” (32). She maintained that hope is a lived experience and “a way of propelling self toward envisioned possibilities in everyday encounters with the world” (p. 12). Expanding on her definition of the lived experience of hope, Parse stated, “Hope is anticipating possibilities through envisioning the not-yet in harmoniously living the comfort-discomfort of everydayness while unfolding a different perspective of an expanding view” (15). From Nietzsche’s “classically dark version of hope” (in Hage 11), Parse’s “positive” definition of hope as a propulsion to envisaged possibilities would in all likelihood be defined as “the worst of all evils, for it protracts the torment of man”. Hage correctly pointed out that both the positive and negative perspectives perceive hope “as a force that keeps us going in life” (11). Parse’s more optimistic vision of hope as propulsion to envisaged possibilities links nicely to what Arvanitakis described as an ‘active hope’. According to him, the idea of ‘active hope’ is not only a vision that a better world is possible, but also a sense of agency that our actions can make this happen. Conclusion As we move further into the 21st century, humankind will be faced with a series of traumas, many of which are as yet unimagined. To meet these challenges, we, as a global collective, will need to develop specific capacities and resources for coping, endurance, innovation, and hope, all of which are involved the formation of resilience (Wilson 269). Although the accumulation of resilience at an individual level is important, our continued existence, survival, and prosperity lie in the strength and collective will of many. As Wittgenstein wrote, the strength of a thread “resides not in the fact that some one fibre runs through its whole length, but in the overlapping of many fibres” (xcv). If resilience can be accumulated at the level of the individual, it follows that it can be accumulated as a form of capital at the local, national, and international levels in very real and meaningful ways. 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Hope: New Philosophies for Change. Sydney: Pluto Press, 2002.

I was born illegitimate. Born on an existential precipice. My unwed mother was 36 years old when she relinquished me. I was the fourth baby she was required to give away. After I emerged blood stained and blue tinged – abject, liminal – not only did the nurses refuse me my mother’s touch, I also lost the sound of her voice. Her smell. Her heart beat. Her taste. Her gaze. The silence was multi-sensory. When they told her I was dead, I also lost, within her memory and imagination, my life. I was adopted soon after but not told for over four decades. It was too shameful for even me to know. Imprinted at birth with a psychological ‘death’, I fell, as a Late Discovery Adoptee (LDA), into a socio-cultural and psychological abyss, frozen at birth at the bottom of a parturitive void from where, invisible within family, society, and self I was unable to form an undamaged sense of being.Throughout the 20th century (and for centuries before) this kind of ‘social abortion’ was the dominant script. An adoptee was regarded as a bastard, born of sin, the mother blamed, the father exonerated, and silence demanded (Lynch 28-74). My adoptive mother also sinned. She was infertile. But, in taking me on, she assumed the role of a womb worthy woman, good wife, and, in her case, reluctant mother (she secretly didn’t want children and was privately overwhelmed by the task). In this way, my mother, my adoptive mother, and myself are all the daughters of bereavement, all of us sacrificed on the altar of prejudice and fear that infertility, sex outside of marriage, and illegitimacy were unspeakable crimes for which a price must be paid and against which redemptive protection must be arranged. If, as Thomas Keneally (5) writes, “original sin is the mother fluid of history” then perhaps all three of us all lie in its abject waters. Grotevant, Dunbar, Kohler and Lash Esau (379) point out that adoption was used to ‘shield’ children from their illegitimacy, women from their ‘sexual indiscretions’, and adoptive parents from their infertility in the belief that “severing ties with birth family members would promote attachment between adopted children and parents”. For the adoptee in the closed record system, the socio/political/economic vortex that orchestrated their illegitimacy is born out of a deeply, self incriminating primal fear that reaches right back into the recesses of survival – the act of procreation is infested with easily transgressed life and death taboos within the ‘troop’ that require silence and the burial of many bodies (see Amanda Gardiner’s “Sex, Death and Desperation: Infanticide, Neonaticide, and Concealment of Birth in Colonial Western Australia” for a palpable, moving, and comprehensive exposition on the links between 'illegitimacy', the unmarried mother and child murder). As Nancy Verrier (24) states in Coming Home to Self, “what has to be understood is that separation trauma is an insidious experience, because, as a society, we fail to see this experience as a trauma”. Indeed, relinquishment/adoption for the baby and subsequent adult can be acutely and chronically painful. While I was never told the truth of my origins, of course, my body knew. It had been there. Sentient, aware, sane, sensually, organically articulate, it messaged me (and anyone who may have been interested) over the decades via the language of trauma, its lexicon and grammar cellular, hormonal, muscular (Howard & Crandall, 1-17; Pert, 72), the truth of my birth, of who I was an “unthought known” (Bollas 4). I have lived out my secret fatality in a miasmic nebula of what I know now to be the sequelae of adoption psychopathology: nausea, physical and psychological pain, agoraphobia, panic attacks, shame, internalised anger, depression, self-harm, genetic bewilderment, and generalised anxiety (Brodzinsky 25-47; Brodzinsky, Smith, & Brodzinsky 74; Kenny, Higgins, Soloff, & Sweid xiv; Levy-Shiff 97-98; Lifton 210-212; Verrier The Primal Wound 42-44; Wierzbicki 447-451) – including an all pervading sense of unreality experienced as dissociation (the experience of depersonalisation – where the self feels unreal – and derealisation – where the world feels unreal), disembodiment, and existential elision – all characteristics of Post Traumatic Stress Disorder (PTSD). In these ways, my body intervened, acted out, groaned in answer to the social overlay, and from beyond “the dermal veil” tried to procure access, as Vicky Kirby (77) writes, to “the body’s opaque ocean depths” through its illnesses, its eloquent, and incessantly aching and silent verbosities deepened and made impossibly fraught because I was not told. The aim of this paper is to discuss one aspect of how my body tried to channel the trauma of my secret fatality and liminality: my pre-disclosure art work (the cellular memory of my trauma also expressed itself, pre-disclosure, through my writings – poetry, journal entries – and also through post-coital glossolalia, all discussed at length in my Honours research “Womb Tongues” and my Doctoral Dissertation “The Womb Artist – A Novel: Translating Pre-verbal Late Discovery Adoption Trauma into Narrative”). From the age of thirty onwards I spent twelve years in therapy where the cause of my childhood and adult psychopathology remained a mystery. During this time, my embodied grief and memories found their way into my art work, a series of 5’ x 3’ acrylic paintings, some of which I offer now for discussion (figures 1-4). These paintings map and express what my body knew but could not verbalise (without language to express my grief, my body found other ways to vent). They are symptom and sign of my pre-verbal adoption trauma, evidence that my body ‘knew’ and laboured ceaselessly and silently to find creative ways to express the incarcerated trauma. Post disclosure, I have used my paintings as artefacts to inform, underpin, and nourish the writing of a collection of poetry “Womb Tongues” and a literary novel/memoir “The Womb Artist” (TWA) in an ongoing autoethnographical, performative, and critical inquiry. My practice-led research as a now conscious and creative witness, fashions the recontextualisation of my ‘self’ into my ‘self’ and society, this time with cognisant and reparative knowledge and facilitates the translation of my body’s psychopathology and memory (explicit and implicit) into a healing testimony that explores the traumatised body as text and politicizes the issues surrounding LDAs (Riley 205). If I use these paintings as a memoirist, I use them second hand, after the fact, after they have served their initial purpose, as the tangible art works of a baby buried beneath a culture’s prejudice, shame, and judgement and the personal cries from the illegitimate body/self. I use them now to explore and explain my subclinical and subterranean life as a LDA.My pre-disclosure paintings (Figures 1-4) – filled with vaginal, fetal, uterine, and umbilical references – provide some kind of ‘evidence’ that my body knew what had happened to me as if, with the tenacity of a poltergeist, my ‘spectral self’ found ways to communicate. Not simply clues, but the body’s translation of the intra-psychic landscape, a pictorial and artistic séance into the world, as if my amygdala – as quasar and signal, homing device and history lesson (a measure, container, and memoir) – knew how to paint a snap shot or an x-ray of the psyche, of my cellular marrow memories (a term formulated from fellow LDA Sandy McCutcheon’s (76) memoir, The Magician’s Son when he says, “What I really wanted was the history of my marrow”). If, as Salveet Talwar suggests, “trauma is processed from the body up”, then for the LDA pre-discovery, non-verbal somatic signage is one’s ‘mother tongue’(25). Talwar writes, “non-verbal expressive therapies such as art, dance, music, poetry and drama all activate the sub-cortical regions of the brain and access pre-verbal memories” (26). In these paintings, eerily divinatory and pointed traumatic, memories are made visible and access, as Gussie Klorer (213) explains in regard to brain function and art therapy, the limbic (emotional) system and the prefrontal cortex in sensorimotor integration. In this way, as Marie Angel and Anna Gibbs (168) suggest, “the visual image may serve as a kind of transitional mode in thought”. Ruth Skilbeck in her paper First Things: Reflections on Single-lens Reflex Digital Photography with a Wide-angled Lens, also discusses (with reference to her photographic record and artistic expression of her mother’s death) what she calls the “dark matter” – what has been overlooked, “left out”, and/or is inexplicable (55) – and the idea of art work as the “transitional object” as “a means that some artists use, conceptually and yet also viscerally, in response to the extreme ‘separation anxiety’ of losing a loved one, to the void of the Unknown” (57). In my case, non-disclosure prevented my literacy and the evolution of the image into language, prevented me from fully understanding the coded messages left for me in my art work. However, each of my paintings is now, with the benefit of full disclosure, a powerful, penetrating, and comprehensible intra and extra sensory cry from the body in kinaesthetic translation (Lusebrink, 125; Klorer, 217). In Figure 1, ‘Embrace’, the reference to the umbilical is palpable, described in my novel “The Womb Artist” (184) this way; “two ropes tightly entwine as one, like a dark and dirty umbilical cord snaking its way across a nether world of smudged umbers”. There is an ‘abject’ void surrounding it. The cord sapped of its colour, its blood, nutrients – the baby starved of oxygen, breath; the LDA starved of words and conscious understanding. It has two parts entwined that may be seen in many ways (without wanting to reduce these to static binaries): mother/baby; conscious/unconscious; first person/third person; child/adult; semiotic/symbolic – numerous dualities could be spun from this embrace – but in terms of my novel and of the adoptive experience, it reeks of need, life and death, a text choking on the poetic while at the same time nourished by it; a text made ‘available’ to the reader while at the same narrowing, limiting, and obscuring the indefinable nature of pre-verbal trauma. Figure 1. Embrace. 1993. Acrylic on canvas.The painting ‘Womb Tongues’ (Figure 2) is perhaps the last (and, obviously, lasting) memory of the infinite inchoate universe within the womb, the umbilical this time wrapped around in a phallic/clitorial embrace as the baby-self emerges into the constrictions of a Foucauldian world, where the adoptive script smothers the ‘body’ encased beneath the ‘coils’ of Judeo-Christian prejudice and centuries old taboo. In this way, the reassigned adoptee is an acute example of power (authority) controlling and defining the self and what knowledge of the self may be allowed. The baby in this painting is now a suffocated clitoris, a bound subject, a phallic representation, a gagged ‘tongue’ in the shape of the personally absent (but socially imposing) omni-present and punitive patriarchy. Figure 2. Womb Tongues. 1997. Acrylic on canvas.‘Germination’ (Figure 3) depicts an umbilical again, but this time as emerging from a seething underworld and is present in TWA (174) this way, “a colony of night crawlers that writhe and slither on the canvas, moving as one, dozens of them as thin as a finger, as long as a dream”. The rhizomic nature of this painting (and Figure 4), becomes a heaving horde of psychosomatic and psychopathological influences and experiences, a multitude of closely packed, intense, and dendridic compulsions and symptoms, a mass of interconnected (and by nature of the silence and lie) subterranean knowledges that force the germination of a ‘ghost baby/child/adult’ indicated by the pale and ashen seedling that emerges above ground. The umbilical is ghosted, pale and devoid of life. It is in the air now, reaching up, as if in germination to a psychological photosynthesis. There is the knot and swarm within the unconscious; something has, in true alien fashion, been incubated and is now emerging. In some ways, these paintings are hardly cryptic.Figure 3. Germination.1993. Acrylic on canvas.In Figure 4 ‘The Birthing Tree’, the overt symbolism reaches ‘clairvoyant status’. This could be read as the family ‘tree’ with its four faces screaming out of the ‘branches’. Do these represent the four babies relinquished by our mother (the larger of these ‘beings’ as myself, giving birth to the illegitimate, silenced, and abject self)? Are we all depicted in anguish and as wraithlike, grotesquely simplified into pure affect? This illegitimate self is painted as gestating a ‘blue’ baby, near full-term in a meld of tree and ‘self’, a blue umbilical cord, again, devoid of blood, ghosted, lifeless and yet still living, once again suffocated by the representation of the umbilical in the ‘bowels’ of the self, the abject part of the body, where refuse is stored and eliminated: The duodenum of the damned. The Devil may be seen as Christopher Bollas’s “shadow of the object”, or the Jungian archetypal shadow, not simply a Judeo-Christian fear-based spectre and curmudgeon, but a site of unprocessed and, therefore, feared psychological material, material that must be brought to consciousness and integrated. Perhaps the Devil also is the antithesis to ‘God’ as mother. The hell of ‘not mother’, no mother, not the right mother, the reluctant adoptive mother – the Devil as icon for the rich underbelly of the psyche and apophatic to the adopted/artificial/socially scripted self.Figure 4. The Birthing Tree. 1995. Acrylic on canvas.These paintings ache with the trauma of my relinquishment and LDA experience. They ache with my body’s truth, where the cellular and psychological, flesh and blood and feeling, leak from my wounds in unspeakable confluence (the two genital lips as the site of relinquishment, my speaking lips that have been sealed through non-disclosure and shame, the psychological trauma as Verrier’s ‘primal wound’) just as I leaked from my mother (and society) at birth, as blood and muck, and ooze and pus and death (Grosz 195) only to be quickly and silently mopped up and cleansed through adoption and life-long secrecy. Where I, as translator, fluent in both silence and signs, disclose the baby’s trauma, asking for legitimacy. My experience as a LDA sets up an interesting experiment, one that allows an examination of the pre-verbal/pre-disclosure body as a fleshed and breathing Rosetta Stone, as an interface between the language of the body and of the verbalised, painted, and written text. As a constructed body, written upon and invented legally, socially, and psychologically, I am, in Hélène Cixous’s (“To Live the Orange” 83) words, “un-forgetting”, “un-silencing” and “unearthing” my ‘self’ – I am re-writing, re-inventing and, under public scrutiny, legitimising my ‘self’. I am a site of inquiry, discovery, extrapolation, and becoming (Metta 492; Poulus 475) and, as Grosz (vii) suggests, a body with “all the explanatory power” of the mind. I am, as I embroider myself and my LDA experience into literary and critical texts, authoring myself into existence, referencing with particular relevance Peter Carnochan’s (361) suggestion that “analysis...acts as midwife to the birth of being”. I am, as I swim forever amorphous, invisible, and unspoken in my mother’s womb, fashioning a shore, landscaping my mind against the constant wet, my chronic liminality (Rambo 629) providing social landfall for other LDAs and silenced minorities. As Catherine Lynch (3) writes regarding LDAs, “Through the creation of text and theory I can formulate an intimate space for a family of adoptive subjects I might never know via our participation in a new discourse in Australian academia.” I participate through my creative, self-reflexive, process fuelled (Durey 22), practice-led enquiry. I use the intimacy (and also universality and multiplicity) and illegitimacy of my body as an alterative text, as a site of academic and creative augmentation in the understanding of LDA issues. The relinquished and silenced baby and LDA adult needs a voice, a ‘body’, and a ‘tender’ place in the consciousness of society, as Helen Riley (“Confronting the Conspiracy of Silence” 11) suggests, “voice, validation, and vindication”. Judith Herman (3) argues that, “Survivors challenge us to reconnect fragments, to reconstruct history, to make meaning of their present symptoms in the light of past events”. I seek to use the example of my experience – as Judith Durey (31) suggests, in “support of evocative, creative modes of representation as valid forms of research in their own right” – to unfurl the whole, to give impetus and precedence for other researchers into adoption and advocate for future babies who may be bought, sold, arranged, and/or created by various means. The recent controversy over Gammy, the baby boy born with Down Syndrome in Thailand, highlights the urgent and moral need for legislation with regard to surrogacy (see Kajsa Ekis Ekman’s Being and Being Bought: Prostitution, Surrogacy and the Split Self for a comprehensive examination of surrogacy issues). Indeed, Catherine Lynch in her paper Doubting Adoption Legislation links the experiences of LDAs and the children of born of surrogacy, most effectively arguing that, “if the fate that closed record adoptees suffered was a misplaced solution to the question of what to do with children already conceived how can you justify the deliberate conception of a child with the intention even before its creation of cruelly removing that child from their mother?” (6). Cixous (xxii) confesses, “All I want is to illustrate, depict fragments, events of human life and death...each unique and yet at the same time exchangeable. Not the law, the exception”. I, too, am a fragment, an illustration (a painting), and, as every individual always is – paradoxically – a communal and, therefore, deeply recognisable and generally applicable minority and exception. In my illegitimacy, I am some kind of evidence. Evidence of cellular memory. Evidence of embodiment. Evidence that silenced illegitimacies will manifest in symptom and non-verbal narratives, that they will ooze out and await translation, verification, and witness. This paper is offered with reverence and with feminist intention, as a revenant mouthpiece for other LDAs, babies born of surrogacy, and donor assisted offspring (and, indeed, any) who are marginalised, silenced, and obscured. It is also intended to promote discussion in the psychological and psychoanalytic fields and, as Helen Riley (202-207) advocates regarding late discovery offspring, more research within the social sciences and the bio-medical field that may encourage legislators to better understand what the ‘best interests of the child’ are in terms of late discovery of origins and the complexity of adoption/conception practices available today. As I write now (and always) the umbilical from my paintings curve and writhe across my soul, twist and morph into the swollen and throbbing organ of tongues, my throat aching to utter, my hands ready to craft latent affect into language in translation of, and in obedience to, my body’s knowledges. It is the art of mute witness that reverses genesis, that keeps the umbilical fat and supple and full of blood, and allows my conscious conception and creation. Indeed, in the intersection of my theoretical, creative, psychological, and somatic praxis, the heat (read hot and messy, insightful and insistent signage) of my body’s knowledges perhaps intensifies – with a ripe bouquet – the inevitably ongoing odour/aroma of the reproductive world. ReferencesAngel, Maria, and Anna Gibbs. “On Moving and Being Moved: The Corporeality of Writing in Literary Fiction and New Media Art.” Literature and Sensation, eds. Anthony Uhlmann, Helen Groth, Paul Sheehan, and Stephan McLaren. Newcastle upon Tyne, UK: Cambridge Scholars Publishing, 2009: 162-172. Bollas, Christopher. The Shadow of the Object: Psychoanalysis of the Unthought Known. New York: Columbia UP, 1987. Brodzinsky, David. “Adjustment to Adoption: A Psychosocial Perspective.” Clinical Psychology Review 7 (1987): 25-47. doi: 10.1016/0272-7358(87)90003-1.Brodzinsky, David, Daniel Smith, and Anne Brodzinsky. Children’s Adjustment to Adoption: Developmental and Clinical Issues. 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This article explores resilience as it is experienced by refugees in the context of a relational community, visiting the notions of trauma, a thicker description of resilience and the trajectory toward positive growth through community. It calls for going beyond a Western biomedical therapeutic approach of exploration and adopting more of an emic perspective incorporating the worldview of the refugees. The challenge is for service providers working with refugees (who have experienced trauma) to move forward from a ‘harm minimisation’ model of care to recognition of a facilitative, productive community of people who are in a transitional phase between homelands. Contextualising Trauma Prior to the 1980s, the term ‘trauma’ was not widely used in literature on refugees and refugee mental health, hardly existing as a topic of inquiry until the mid-1980’s (Summerfield 422). It first gained prominence in relation to soldiers who had returned from Vietnam and in need of medical attention after being traumatised by war. The term then expanded to include victims of wars and those who had witnessed traumatic events. Seahorn and Seahorn outline that severe trauma “paralyses you with numbness and uses denial, avoidance, isolation as coping mechanisms so you don’t have to deal with your memories”, impacting a person‘s ability to risk being connected to others, detaching and withdrawing; resulting in extreme loneliness, emptiness, sadness, anxiety and depression (6). During the Civil War in the USA the impact of trauma was referred to as Irritable Heart and then World War I and II referred to it as Shell Shock, Neurosis, Combat Fatigue, or Combat Exhaustion (Seahorn & Seahorn 66, 67). During the twenty-five years following the Vietnam War, the medicalisation of trauma intensified and Post Traumatic Stress Disorder (PTSD) became recognised as a medical-psychiatric disorder in 1980 in the American Psychiatric Association international diagnostic tool Diagnostic Statistical Manual (DSM–III). An expanded description and diagnosis of PTSD appears in the DSM-IV, influenced by the writings of Harvard psychologist and scholar, Judith Herman (Scheper-Hughes 38) The Diagnostic and Statistical Manual (DSM-IV) of Mental Disorders (American Psychiatric Association, 2000) outlines that experiencing the threat of death, injury to oneself or another or finding out about an unexpected or violent death, serious harm, or threat of the same kind to a family member or close person are considered traumatic events (Chung 11); including domestic violence, incest and rape (Scheper-Hughes 38). Another significant development in the medicalisation of trauma occurred in 1998 when the Victorian Foundation for Survivors of Torture (VFST) released an influential report titled ‘Rebuilding Shattered Lives’. This then gave clinical practice a clearer direction in helping people who had experienced war, trauma and forced migration by providing a framework for therapeutic work. The emphasis became strongly linked to personal recovery of individuals suffering trauma, using case management as the preferred intervention strategy. A whole industry soon developed around medical intervention treating people suffering from trauma related problems (Eyber). Though there was increased recognition for the medicalised discourse of trauma and post-traumatic stress, there was critique of an over-reliance of psychiatric models of trauma (Bracken, et al. 15, Summerfield 421, 423). There was also expressed concern that an overemphasis on individual recovery overlooked the socio-political aspects that amplify trauma (Bracken et al. 8). The DSM-IV criteria for PTSD model began to be questioned regarding the category of symptoms being culturally defined from a Western perspective. Weiss et al. assert that large numbers of traumatized people also did not meet the DSM-III-R criteria for PTSD (366). To categorize refugees’ experiences into recognizable, generalisable psychological conditions overlooked a more localized culturally specific understanding of trauma. The meanings given to collective experience and the healing strategies vary across different socio-cultural groupings (Eyber). For example, some people interpret suffering as a normal part of life in bringing them closer to God and in helping gain a better understanding of the level of trauma in the lives of others. Scheper-Hughes raise concern that the PTSD model is “based on a conception of human nature and human life as fundamentally vulnerable, frail, and humans as endowed with few and faulty defence mechanisms”, and underestimates the human capacity to not only survive but to thrive during and following adversity (37, 42). As a helping modality, biomedical intervention may have limitations through its lack of focus regarding people’s agency, coping strategies and local cultural understandings of distress (Eyber). The benefits of a Western therapeutic model might be minimal when some may have their own culturally relevant coping strategies that may vary to Western models. Bracken et al. document case studies where the burial rituals in Mozambique, obligations to the dead in Cambodia, shared solidarity in prison and the mending of relationships after rape in Uganda all contributed to the healing process of distress (8). Orosa et al. (1) asserts that belief systems have contributed in helping refugees deal with trauma; Brune et al. (1) points to belief systems being a protective factor against post-traumatic disorders; and Peres et al. highlight that a religious worldview gives hope, purpose and meaning within suffering. Adopting a Thicker Description of Resilience Service providers working with refugees often talk of refugees as ‘vulnerable’ or ‘at risk’ populations and strive for ‘harm minimisation’ among the population within their care. This follows a critical psychological tradition, what (Ungar, Constructionist) refers to as a positivist mode of inquiry that emphasises the predictable relationship between risk and protective factors (risk and coping strategies) being based on a ‘deficient’ outlook rather than a ‘future potential’ viewpoint and lacking reference to notions of resilience or self-empowerment (342). At-risk discourses tend to focus upon antisocial behaviours and appropriate treatment for relieving suffering rather than cultural competencies that may be developing in the midst of challenging circumstances. Mares and Newman document how the lives of many refugee advocates have been changed through the relational contribution asylum seekers have made personally to them in an Australian context (159). Individuals may find meaning in communal obligations, contributing to the lives of others and a heightened solidarity (Wilson 42, 44) in contrast to an individual striving for happiness and self-fulfilment. Early naturalistic accounts of mental health, influenced by the traditions of Western psychology, presented thin descriptions of resilience as a quality innate to individuals that made them invulnerable or strong, despite exposure to substantial risk (Ungar, Thicker 91). The interest then moved towards a non-naturalistic contextually relevant understanding of resilience viewed in the social context of people’s lives. Authors such as Benson, Tricket and Birman (qtd. in Ungar, Thicker) started focusing upon community resilience, community capacity and asset-building communities; looking at areas such as - “spending time with friends, exercising control over aspects of their lives, seeking meaningful involvement in their community, attaching to others and avoiding threats to self-esteem” (91). In so doing far more emphasis was given in developing what Ungar (Thicker) refers to as ‘a thicker description of resilience’ as it relates to the lives of refugees that considers more than an ability to survive and thrive or an internal psychological state of wellbeing (89). Ungar (Thicker) describes a thicker description of resilience as revealing “a seamless set of negotiations between individuals who take initiative, and an environment with crisscrossing resources that impact one on the other in endless and unpredictable combinations” (95). A thicker description of resilience means adopting more of what Eyber proposes as an emic approach, taking on an ‘insider perspective’, incorporating the worldview of the people experiencing the distress; in contrast to an etic perspective using a Western biomedical understanding of distress, examined from a position outside the social or cultural system in which it takes place. Drawing on a more anthropological tradition, intervention is able to be built with local resources and strategies that people can utilize with attention being given to cultural traditions within a socio-cultural understanding. Developing an emic approach is to engage in intercultural dialogue, raise dilemmas, test assumptions, document hopes and beliefs and explore their implications. Under this approach, healing is more about developing intelligibility through one’s own cultural and social matrix (Bracken, qtd. in Westoby and Ingamells 1767). This then moves beyond using a Western therapeutic approach of exploration which may draw on the rhetoric of resilience, but the coping strategies of the vulnerable are often disempowered through adopting a ‘therapy culture’ (Furedi, qtd. in Westoby and Ingamells 1769). Westoby and Ingamells point out that the danger is by using a “therapeutic gaze that interprets emotions through the prism of disease and pathology”, it then “replaces a socio-political interpretation of situations” (1769). This is not to dismiss the importance of restoring individual well-being, but to broaden the approach adopted in contextualising it within a socio-cultural frame. The Relational Aspect of Resilience Previously, the concept of the ‘resilient individual’ has been of interest within the psychological and self-help literature (Garmezy, qtd. in Wilson) giving weight to the aspect of it being an innate trait that individuals possess or harness (258). Yet there is a need to explore the relational aspect of resilience as it is embedded in the network of relationships within social settings. A person’s identity and well-being is better understood in observing their capacity to manage their responses to adverse circumstances in an interpersonal community through the networks of relationships. Brison, highlights the collective strength of individuals in social networks and the importance of social support in the process of recovery from trauma, that the self is vulnerable to be affected by violence but resilient to be reconstructed through the help of others (qtd. in Wilson 125). This calls for what Wilson refers to as a more interdisciplinary perspective drawing on cultural studies and sociology (2). It also acknowledges that although individual traits influence the action of resilience, it can be learned and developed in adverse situations through social interactions. To date, within sociology and cultural studies, there is not a well-developed perspective on the topic of resilience. Resilience involves a complex ongoing interaction between individuals and their social worlds (Wilson 16) that helps them make sense of their world and adjust to the context of resettlement. It includes developing a perspective of people drawing upon negative experiences as productive cultural resources for growth, which involves seeing themselves as agents of their own future rather than suffering from a sense of victimhood (Wilson 46, 258). Wilson further outlines the display of a resilience-related capacity to positively interpret and derive meaning from what might have been otherwise negative migration experiences (Wilson 47). Wu refers to ‘imagineering’ alternative futures, for people to see beyond the current adverse circumstances and to imagine other possibilities. People respond to and navigate their experience of trauma in unique, unexpected and productive ways (Wilson 29). Trauma can cripple individual potential and yet individuals can also learn to turn such an experience into a positive, productive resource for personal growth. Grief, despair and powerlessness can be channelled into hope for improved life opportunities. Social networks can act as protection against adversity and trauma; meaningful interpersonal relationships and a sense of belonging assist individuals in recovering from emotional strain. Wilson asserts that social capabilities assist people in turning what would otherwise be negative experiences into productive cultural resources (13). Graybeal (238) and Saleeby (297) explore resilience as a strength-based practice, where individuals, families and communities are seen in relation to their capacities, talents, competencies, possibilities, visions, values and hopes; rather than through their deficiencies, pathologies or disorders. This does not present an idea of invulnerability to adversity but points to resources for navigating adversity. Resilience is not merely an individual trait or a set of intrinsic behaviours that can be displayed in ‘resilient individuals’. Resilience, rather than being an unchanging attribute, is a complex socio-cultural phenomenon, a relational concept of a dynamic nature that is situated in interpersonal relations (Wilson 258). Positive Growth through a Community Based Approach Through migrating to another country (in the context of refugees), Falicov, points out that people often experience a profound loss of their social network and cultural roots, resulting in a sense of homelessness between two worlds, belonging to neither (qtd. in Walsh 220). In the ideological narratives of refugee movements and diasporas, the exile present may be collectively portrayed as a liminality, outside normal time and place, a passage between past and future (Eastmond 255). The concept of the ‘liminal’ was popularised by Victor Turner, who proposed that different kinds of marginalised people and communities go through phases of separation, ‘liminali’ (state of limbo) and reincorporation (qtd. in Tofighian 101). Difficulties arise when there is no closure of the liminal period (fleeing their former country and yet not being able to integrate in the country of destination). If there is no reincorporation into mainstream society then people become unsettled and feel displaced. This has implications for their sense of identity as they suffer from possible cultural destabilisation, not being able to integrate into the host society. The loss of social supports may be especially severe and long-lasting in the context of displacement. In gaining an understanding of resilience in the context of displacement, it is important to consider social settings and person-environment transactions as displaced people seek to experience a sense of community in alternative ways. Mays proposed that alternative forms of community are central to community survival and resilience. Community is a source of wellbeing for building and strengthening positive relations and networks (Mays 590). Cottrell, uses the concept of ‘community competence’, where a community provides opportunities and conditions that enable groups to navigate their problems and develop capacity and resourcefulness to cope positively with adversity (qtd. in Sonn and Fisher 4, 5). Chaskin, sees community as a resilient entity, countering adversity and promoting the well-being of its members (qtd. in Canavan 6). As a point of departure from the concept of community in the conventional sense, I am interested in what Ahmed and Fortier state as moments or sites of connection between people who would normally not have such connection (254). The participants may come together without any presumptions of ‘being in common’ or ‘being uncommon’ (Ahmed and Fortier 254). This community shows little differentiation between those who are welcome and those who are not in the demarcation of the boundaries of community. The community I refer to presents the idea as ‘common ground’ rather than commonality. Ahmed and Fortier make reference to a ‘moral community’, a “community of care and responsibility, where members readily acknowledge the ‘social obligations’ and willingness to assist the other” (Home office, qtd. in Ahmed and Fortier 253). Ahmed and Fortier note that strong communities produce caring citizens who ensure the future of caring communities (253). Community can also be referred to as the ‘soul’, something that stems out of the struggle that creates a sense of solidarity and cohesion among group members (Keil, qtd. in Sonn and Fisher 17). Often shared experiences of despair can intensify connections between people. These settings modify the impact of oppression through people maintaining positive experiences of belonging and develop a positive sense of identity. This has enabled people to hold onto and reconstruct the sociocultural supplies that have come under threat (Sonn and Fisher 17). People are able to feel valued as human beings, form positive attachments, experience community, a sense of belonging, reconstruct group identities and develop skills to cope with the outside world (Sonn and Fisher, 20). Community networks are significant in contributing to personal transformation. Walsh states that “community networks can be essential resources in trauma recovery when their strengths and potential are mobilised” (208). Walsh also points out that the suffering and struggle to recover after a traumatic experience often results in remarkable transformation and positive growth (208). Studies in post-traumatic growth (Calhoun & Tedeschi) have found positive changes such as: the emergence of new opportunities, the formation of deeper relationships and compassion for others, feelings strengthened to meet future life challenges, reordered priorities, fuller appreciation of life and a deepening spirituality (in Walsh 208). As Walsh explains “The effects of trauma depend greatly on whether those wounded can seek comfort, reassurance and safety with others. Strong connections with trust that others will be there for them when needed, counteract feelings of insecurity, hopelessness, and meaninglessness” (208). Wilson (256) developed a new paradigm in shifting the focus from an individualised approach to trauma recovery, to a community-based approach in his research of young Sudanese refugees. Rutter and Walsh, stress that mental health professionals can best foster trauma recovery by shifting from a predominantly individual pathology focus to other treatment approaches, utilising communities as a capacity for healing and resilience (qtd. in Walsh 208). Walsh highlights that “coming to terms with traumatic loss involves making meaning of the trauma experience, putting it in perspective, and weaving the experience of loss and recovery into the fabric of individual and collective identity and life passage” (210). Landau and Saul, have found that community resilience involves building community and enhancing social connectedness by strengthening the system of social support, coalition building and information and resource sharing, collective storytelling, and re-establishing the rhythms and routines of life (qtd. in Walsh 219). Bracken et al. suggest that one of the fundamental principles in recovery over time is intrinsically linked to reconstruction of social networks (15). This is not expecting resolution in some complete ‘once and for all’ getting over it, getting closure of something, or simply recovering and moving on, but tapping into a collective recovery approach, being a gradual process over time. Conclusion A focus on biomedical intervention using a biomedical understanding of distress may be limiting as a helping modality for refugees. Such an approach can undermine peoples’ agency, coping strategies and local cultural understandings of distress. Drawing on sociology and cultural studies, utilising a more emic approach, brings new insights to understanding resilience and how people respond to trauma in unique, unexpected and productive ways for positive personal growth while navigating the experience. This includes considering social settings and person-environment transactions in gaining an understanding of resilience. Although individual traits influence the action of resilience, it can be learned and developed in adverse situations through social interactions. Social networks and capabilities can act as a protection against adversity and trauma, assisting people to turn what would otherwise be negative experiences into productive cultural resources (Wilson 13) for improved life opportunities. The promotion of social competence is viewed as a preventative intervention to promote resilient outcomes, as social skill facilitates social integration (Nettles and Mason 363). As Wilson (258) asserts that resilience is not merely an individual trait or a set of intrinsic behaviours that ‘resilient individuals’ display; it is a complex, socio-cultural phenomenon that is situated in interpersonal relations within a community setting. References Ahmed, Sara, and Anne-Marie Fortier. “Re-Imagining Communities.” International of Cultural Studies 6.3 (2003): 251-59. Bracken, Patrick. J., Joan E. Giller, and Derek Summerfield. Psychological Response to War and Atrocity: The Limitations of Current Concepts. 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