Rozprawy doktorskie na temat „Construction of healing”

This thesis describes a portion of the ongoing development of a novel self-healing cementitious material system named LatConX originally proposed by a group of researchers at Cardiff University. The research reported was undertaken with the aim of furthering understanding of the system’s long-term behaviour, ultimately with a view to providing predictions for the performance of the system over a structure’s working life. This aim is accomplished through a combination of experimental and numerical research. An experimental series is presented which investigates the stress relaxation behaviour of polyethylene terephthalate in order to establish how the stress induced by heat-activated restrained shrinkage varies with time. Results of these experiments displayed very little stress reduction from the peak stress, with less than a 5 % loss observed over a 124 day period. The development of a new one dimensional transient thermomechanical model for viscoelastic behaviour of pre-drawn polyethylene terephthalate is then described. This model is shown to be able to reproduce the observed experimental behaviour with good accuracy. The polymer model is coupled with a number of other constitutive models for the behaviour of steel and concrete, thus forming a model for the material system as a whole. This coupling is undertaken within the framework of an idealised simply supported beam with a strong discontinuity for the simulation of a central crack hinge. The model is validated against experimental data and design code predictions. Design considerations for the LatConX system are discussed and modified design equations derived. Parametric studies are presented investigating the structural performance and material costs of beams incorporating the LatConX system compared with that of standard reinforced concrete beams. Encouraging results are reported suggesting that the LatConX system has the potential to simultaneously improve long-term durability and structural performance of reinforced concrete structures and reduce the initial material costs by replacing a percentage of the reinforcing steel with shape memory polymer.

This thesis examines the construction of healing from childhood sexual assault from the perspective of adult women who had been sexually abused in their childhood years. The purpose of the study is to provide a space to hear the stories of rural women, and a forum to allow those stories to be shared with a wider audience. Its focus is on the women’s accounts of how their lives have been shaped by those experiences, what transformation has occurred, what people and processes have helped or hindered their journey and how they construct healing. It aims to develop an understanding of the notion of healing as reported by survivors themselves and does this though an emancipatory methodology underpinned by a critical post-modern framework. This study differs from previous studies in that its focus is specifically on the construction of healing and its participants are all rural women. The qualitative research methodology demonstrated in this thesis maintained a focus on the women’s narratives. It employed a unique method – a ten week discussion group in which the women chose the issues to be examined. The presentation of the data, maintains the commitment to the primacy of the women’s accounts. It utilises the themes they decided upon as well as those which emerged from the literature. The constructions of healing, which emerged from the sharing of stories, include healing as a non-linear process where individual strengths and transformation is acknowledged. The thesis argues that healing includes all aspects of survivors’ lives such as their relationships, parenting and engagement with their community. The implication for social work practice is that service provision to assist healing must focus on more than psychological and behavioural effects of childhood sexual assault. The method of collecting the women’s stories also has great potential for social work research because as the thesis argues, while generalisations cannot be made from the findings, the actual method has great value in giving voice to marginalised groups.

Continuing an investigation on using FSP to heal stress corrosion cracks (SCC) in welds on nuclear reactors, this study seeks to use AM in addition to FSP to aid crack repair. Previous studies address that current repair technology on nuclear reactors involves the use of TIG welding which can allow helium atoms to aggregate and form voids at the grain boundaries. This weakens the material and renders the repair ineffective. Another previous study evaluated the effectiveness of FSP alone in repairing SCC which did have defects depending on the parameters used during FSP. This study evaluated the use of AM in addition to FSP. Literature is available on FSP and AM separately and literature is available on technologies that used both them together. However, the current processes that are available that use both AM and FSP can be expensive and may be impractical for some purposes. This study shows a new process that is both less expensive and more practical in SCC repair. Initial proof of concept trials was performed on 1018 mild steel using both wire fed additive and insert additive technologies. A slot would be removed and filled in with an additive process and processed using FSP. Because of poor repeatability, substantial distortion, and voids present this study went forward using insert technologies in further experiments rather than wire wed additive technologies. In addition, the depth and width of the insert or area where the added material would be placed was varied in initial trails. Tensile testing was performed on initial steel trials and the stainless steel experiments and it demonstrated a correlation between depth of the added material and the tensile strength. Micro-hardness mapping performed on initial steel trials also showed hardening in the FSP stir zone. Three-point bend tests were performed to show that an existing crack underneath the FSP zone would not propagate through the nugget. All evaluations supported a substantial increase in yield strength increased after FSP.

This thesis analyse how life-histories are expressed and reformulated in connection to a life crisis of ill health. The study is based on ten interviews with people who in connection with ill health have made use of treatments within both orthodox medicine and complementary medicine and who have also developed various forms of self-treatment. The overall aim is, with a point of departure in the concepts health, healing and trust, to analyse narratives as a practice through which the respondents create identity and a life-context. The signifi cance of constructing the (auto)biography of the healing narrative – a form of narrative and performative act – runs as the main thread through the thesis. This act makes up the practice that is recurrently discussed in several of the thesis’ chapters and is synonymously termed the telling of healing narratives or or to narrate health and healing. The analysis of the narrative’s The analysis of the narrative’s healing main themes is mirrored in the order of the chapters. The study is broadly thematic and structured as a generalised healing process beginning with upheaval, continuing with crisis and social drama, and further to the endeavour of expressing values and judgements in a public context.

The interview themes of self-treatment and alternative treatment have occasioned the investigation into what an ethno-medical perspective can bring to analyses of people’s experiences of ill health in an everyday medical context. One of the points of having the concept ethno-medicine as a starting point is that every practice or narrative formation is ascribed with a potential for interpretation in its creation of knowledge. Another chapter deals with two themes of identity and life-history construction in the practice of healing narratives – the need for a chronology and reappraised perspectives on body, health and lifestyle. Healing narratives can be understood as a genre of life-historical narratives where life is often described as a linear course of events. A model by the anthropologist Victor Turner on the course and content of social drama is used as a comment to analyses of three respondents’ narratives in another chapter. A drama can be understood as a tragic course of events, based on an accident or an upsetting incident that roughly revolves around event/crisis, chaos and the striving for restoration. The concept of other journals is then used to make visible the everyday medical administrative practice and refers to the documentation used in the form of collected documents, written notes, and diaries. As an unexpected part of healing processes, the necessity of familiarising oneself with rules, laws and health insurance systems in order to be able to claim one’s rights is brought forward.

The social transformation process of various care practices in society makes up both a context and a commonly occurring theme in the narratives that the thesis is based upon. A modern health culture that gains strength from loosely composed social movements exerts infl uence on all levels of society. With an increased individual responsibility, the need grows to fi nd one’s own healing strategies and to create one’s own life-history in narratives that mirror this transformation in an everyday context. Healing narratives can be seen as a form of evaluation of health-care practices where experiences of treatment and notions of health and cure and healing are concretised.

Background The national alcohol and drug strategies signalled a shift in national policy on how treatment for alcohol and drug addiction should be conceptualised and ultimately operationalised within Scotland. The research to inform local practice however has primarily been conducted in America or drawn from the mental health recovery field in the United Kingdom. Aims The aim of this study was therefore to develop a coherent theory of recovery from alcohol and drug addiction in order to inform policy and practice and guide the local implementation of recovery orientated systems of care. Methods The study methodology was guided by constructivist grounded theory and was thus based on the lived experience of thirty-seven individuals in recovery from addiction and twenty one people who had experience of addiction within their family. All participants were recruited via theoretical sampling from within community based recovery groups, mutual aid fellowships (Alcoholics Anonymous, Narcotics Anonymous, Al-Anon), staff working within treatment settings and the wider community. Findings The core category of recovery was identified as “Healing the Wounded Self” in the recognition that recovery from addiction was essentially a journey of personal and spiritual growth. This study demonstrates the relevance of our early years in the formation of our earliest memories of self-hood and how these can shape our life trajectory.

Anger is a significant human emotion, the management of which has far reaching implications for individual and relationship well-being. Yet there is a deficit in the clinical literature regarding the best ways to conceptualize and respond to anger (Saini, 2009). We offer a model of anger which therapists can use to help discriminate healing from harmful manifestations of anger, and which therapists can use in developing interventions for reshaping destructive anger toward constructive anger. We are specifically addressing anger in response to offense, or transactional anger which arises at points of friction in the interface between two people in a relational system. Persons perceiving a self-concept or attachment threat respond to the psychic or relational threat with physiological and emotional arousal. These reactions represent a biological signaling system informing our relationship experience. When offended, our experience of offense interacts with our view of self in relation to other. We propose that a person's view of self in relation to other is how one compares their own self-worth to other; it may be inflated, inadequate, or balanced. Either inflated or inadequate views of self in relation to other produce distinct manifestations of destructive anger. An inflated view of self in relation to other is seen as producing destructive-externalizing anger or anger turned outwards, and an inadequate view of self in relation to other is seen as producing destructive-internalizing anger, or anger turned inward. Both externalizing and internalizing anger are harmful to self (offended), other (perpetrator), and relationship well-being and healing. However, a balanced view of self in relation to other produces constructive anger, which is a healing and helpful indignation that promotes and even catalyzes self, other, and relationship healing and well-being. Use of the model in clinical settings is considered.

The thesis investigates how homeless Native American men in Salt Lake City, Utah navigate their experience of homelessness, as well as the social suffering it gives rise to, in order to affirm a sense of personhood and personal identity. It examines how this experience is constructed, presented, and mediated through a series of ambivalent spatial and agentic practices that contribute to shaping a contemporary and localized expression of Native American masculine identity. The thesis argues that, for Native Americans, the notions of personhood and identity are deeply rooted in a culturally and spiritually embodied sense of place. When this bond with place is ruptured, it not only complicates our understanding of indigenous homelessness, but the possibility for homeless Native American individuals of living fulfilling lives is fundamentally compromised and can lead to severe and debilitating forms of suffering that are difficult for us to comprehend. Their experience of homelessness also underlines the difficulties many of these individuals encounter in trying to reclaim a meaningful sense of self in order to lead ‘good’ lives. Unfortunately, it also reminds us in many cases of their failure to do so. The thesis presents these themes as multiple representations and suggests that Native American homelessness constitutes a neglected narrative within the Native American identity and healthcare discourse. It also includes an investigation of the efforts to address this complex and problematic reality on the part of the independent agencies that work with homelessness in Salt Lake City and considers possible implications for future research, practice, and advocacy.

This dissertation investigated how the Gikuyu people of central Kenya understood justice, forgiveness and trauma healing or their absence during a decade of intra-group reciprocal violence. This qualitative research study employed the narrative research method utilizing the "Williams Model" (Riessman, 2008). Field interviews were guided by a primary research question: What do the narratives of perpetrators and victims in reciprocal violence reveal about their understanding of justice, forgiveness and trauma healing or their absence? Fourteen research participants aged 78 to 92 years shared their full narratives. Current conflict analysis literature overwhelmingly centers on the victims and less on perpetrators. The reseach sample allowed perpetrator voices to be heard. The findings of this study suggest that the absence of justice as defined by the stakeholders is a primary perceived barrier towards forgiveness and trauma healing in post-conflict environments. While restorative justice literature offers hope in repairing harm, it's applicability in this study bears some complications when faced with the unreadiness of perpetrators to face their victims in a voluntary process. An extended discussion on restorative justice is offered under implications. Fair land re-distribution was identified as the most preferred response to the question of justice but is yet to be addressed. This stalemate suggests the need for a new negotiated framing and definition of justice if progress is to be expected. The study found out that forgiveness and trauma healing are desired but perceived as impossible goals. Researchers and policy makers could benefit from the findings especially in promoting native and localized restorative justice processes in order to terminate cycles of reciprocal violence.

M.A.
The aim of this study was to examine how the members of Agape came to construct themselves as a healing community. An ecosystemic epistemology and social constructionism were used as a lens by which to view the events unfolding at Agape Healing Community and to illuminate how meanings, expressed through language and ritual, are negotiated and shared. Discourse analysis was used as an analytical tool to infer meaning from the participants’ speaking and to locate these discourses in the fabric that constitutes South African society.

Thesis is submitted in partial fulfilment for the degree of Master of Architecture (Professional) to the Faculty of Engineering and the Built Environment, School of Architecture and Planning at the University of the Witwatersrand, Johannesburg, 2016
Children often find hospitalisation an intimidating experience because hospitals are not always the most child-friendly place. This research report is about understanding the way in which an environment can be created that will aid recovery of children in hospitals, in order to inform the redesign process of the pediatric facility at Chris Hani Baragwanath Hospital (CHBH). Literature on the history of hospital design, architectural and evidence based design surrounding health-care architecture, and the psychological aspects that contribute towards a healing environment, shows that important design drivers are positive distraction, personal control and social support. These devices are used in precedent studies that successfully deinstitutionalised the hospital in the eyes of a child, in order to produce comfort and less anxiety. An indepth study is conducted of CHBH, with specific emphasis on the pediatric department, compiled from literature and site research. The history and challenges of the largest hospital in Africa are explored in order to arrive at an appropriate design response, which is taken through as a design proposal for a new pediatric facility at Chris Hani Baragwanath Hospital.
GR2017

M.A.
The present study explores experiences of loss, disconnection, truth, hurting, healing, non-forgiveness and forgiveness associated with the South African Truth and Reconciliation Commission. Using a social constructionist perspective, the concepts of truth and forgiveness are explored through a theoretical background to psychology and subsequently in the stories and reflections of individuals who participated in the Commission. The issue of truth has been central to debates across the broader intellectual landscape, as well as to the theory and practice of psychology. In the following study, the historical shift from more modernist conceptions of truth to postmodern views is explored through a brief overview of the philosophy of science. These perspectives are explored further in the epistemological shifts underlying therapeutic endeavours and methodology in the field of psychology. Approaches to therapy in South Africa are subsequently reviewed, focusing particularly on positions of truth adopted by the profession in this context. The themes of truth, reconciliation, healing and hurting in the discourse surrounding the Commission are subsequently explored further. This discussion includes some of the literature regarding experiences of people who have been involved with the Commission. Following this, the narratives from interviews held with a group of mothers who attended the Truth Commission and one of the journalists working with the Commission are included. These narratives are related to participants' experiences in having attended/been involved with the Truth Commission and their experiences around truth and forgiveness. A qualitative, reflexive approach to the interviews and analysis thereof, is used. In conclusion, reflections on the process are included. These reflections present a dialectic between the importance of the ongoing nature of the journey in this multi-dimensional context, as well as the author's perspective on the need for the notion of absolute truth in this journeying.

D. Litt. et Phil.
This study is an exploration of the experiences of crisis and identity. It looks specifically at these experiences from within the context of imprisonment from the concrete to the abstract. Imprisonment is not merely looked at from the physical point of view, but also the metaphorical. This means that the sense of imprisonment is not only limited to people who are serving out sentences imposed by the courts of law. We can all experience the sense of being imprisoned at some level or another, whether though a sense of isolation, being labelled and controlled, or experiencing restriction in various forms. The post-modern worldview that underlies this study is social constructionist theory. From this perspective, our sense of what is real is communally created within specific cultural and historical contexts. Language is used as the vehicle through which our meanings are constructed between people. The social constructionist view of people holds that we are open systems so that our sense of self is not only impacted by perturbing “others”, but is also shaped and transformed in relationship. The shaping of identity takes place through language processes and is circumscribed by particular contextual constraints. Identity is not viewed as a constant entity, but as an ever-evolving narrative (story) and a product of interaction with others in the world. Whereas the modern definition of “crisis” underscores the idea that it is, at best, “something” to be avoided, social constructionists describe it as a boundary experience that is communally constructed. Furthermore, if we draw on chaos theory, crisis can also be seen as a bifurcation point. This means that it is a moment in our experiences in which we are moved to make decisions and potentially proceed into new directions. Therefore, crisis holds transformational potential. The notion of exploring the transformative potential of crisis and the construction of identity sprung from a personal crisis experience around the discomfort of progressing into a professional identity. My practical training within the Johannesburg Female Prison provided a context fertile with stories of imprisonment, crisis and how these impact on identity construction. Therefore, the context of this study is prison, so that a discussion around constructions of criminality and its treatment is important to paint a fuller picture. These are discussed from the perspectives of modern criminology theories, as well as post-modern impressions of criminality and its treatment as embedded in historical and social contexts. Since this study underscores an intervention-action research approach, the implications of crisis as a potential catalyst for therapeutic change is also considered. The social constructionist understanding of therapeutic practice is that it is a relational process. Therapy is a co-creation between the client and therapist so that new ways of moving forward is a collective, not an individual achievement. This study, as a form of action research, was born out of a one and a half-year long therapeutic endeavour with a group of women offenders in the Johannesburg Female Prison. The theoretical principles of Appreciative Inquiry were used to guide the process of inquiry. Three levels of participants were involved in the collection of data: A diverse mix of women incarcerated in the Johannesburg Female Prison, the core group of women participating in the “Who am I?” therapeutic group, as well as myself. Information was in the form of written personal texts, interviews (conducted by the core group) and a newsletter. Thematic analysis was used to scrutinise the information and the following themes were identified: Loss and gain, power and helplessness, hope and despair, differentness and sameness as well as connection and disconnection. Typical character types (identities) and whether there were progressive, regressive or stable narrative plots (directionality of stories) were considered in the various themes as points of crisis. Finally, the findings are integrated with the theory by exploring social constructionist ideas about identity as being ever-changing, multiple and created in our togetherness. The principles of first and second order cybernetics are also used as systemic explanatory models of identity transformation and/or “stuckness”. The creation of therapeutic communities was explored as a tool to facilitate the reconstruction of crisis and the transformation of healing identities of women in prison.
Dr. C.J. Oosthuizen

A journey to healing is a story of women survivors of sexual abuse. Through narrative pastoral conversations a group or community of concern was formed that witnessed how these women managed to move by re-telling from problem-saturated dominant lifestories to rich alternative stories of survival. Post-modern practical theology formed the epistemological backdrop of this study with the focus on taking a prophetically, ethical and political stance. The group deconstructed patriarchal knowledge that has been dominant in constructing understanding of women. Deconstruction lead to the centralising of previously subjugated knowledge about themselves and made multiple identities and preferred realities possible. Feminist theology's liberating spirit contributed to this participator action research where women moved from being right to doing right. The monthly celebration teas hosted by the group were instrumental in the healing of other women who have experienced sexual violation.
Practical Theology
M.Th. (Pastoral Therapy)

This insider research journey explores the meaning-making processes of female spousal caregivers in anticipatory mourning and the knowledges which they have gained in retrospect. The research traces the social constructions of meaning and how they influence the process of meaning-making. A phenomenological study was undertaken in which unstructured interviews were conducted with five bereaved participants, highlighting the unique way in which each woman made meaning of loss in anticipatory mourning. The main phenomenological themes to emerge from their meaning-making were: a) the significance of time; b) challenges and gifts; c) witnessing the decline; d) paradoxes; e) the significance of the spousal relationship; and f) spirituality. The therapeutic effect of telling the life story is explored in this study and the need for contextual pastoral care that is specific to the state of anticipatory mourning is highlighted. Finally, possibilities for co-constructive pastoral care are raised in the light of the research findings.
Practical Theology
M. Th. ( Practical Theology, with Specialisation in Pastoral Therapy)

The purpose for this research journey was twofold: (1) to discover the power of certain discourses in the charismatic church context and (2) to challenge disrespectful discursive practices in order to co-operate respectful, ethical and caring ways of being. Seven leaders in charismatic churches committed themselves to this qualitative research project. The research process resulted in a confirmation by the participants that some charismatic discursive practices can be abusive and also to the acknowledgement that they too have at times fulfilled the role of abuser, even in unknowingly. This research journey ended in Hope. Hope for more transparency and trust between leaders and members, resulting in more respectful practices.
Practical Theology
M.Th. (Pastoral Therapy)

This qualitative action research was activated at the junction between three sites of operation of modern power: the site of the woman in the family, religious and cultural power discourses and the professional discourses of therapy. Using an action research design for this study focused the research on reaping benefits in real terms for the research participants. The researcher applied a postStructuralist, feminist and narrative approach to the phenomenon of failed personhood as manifested in the lives of two White Afrikaans women. Narrative therapy methodologiElS, steeped in a religious studies ethic were valuable guides on the therapy-as-research journeys, ensuring the exposure and deconstruction of dominant cultural and religious power discourses. In the course of the therapeutic and research journeys, various narrative therapy methodologies were used with positive effect on the life world of the participants. These methodologies included the externalisation of problems and the discovery of unique outcomes that constitute alternative, preferred life stories that contradict problem-saturated life stories of failed personhood. The research participants engaged in individual and communal conversations, relanguaging their self-narratives and religious narratives as part of the coconstruction of their preferred identities of moral agency and hope. Support networks were created for the research participants, Mara and Grace, to strengthen their new self- and religious narratives and to dislodge the power of the normative cultural and religious discourses of rugged individualism. In one instance, the researcher incorporated the healing power of South African bush veld, by inviting a group of women on a series of expeditions into the wilderness as part of Mara's journey. fn Grace's narrative, we utilised the modern technologies of the internet to connect her with a virtual response team and the Anti-Anorexia/Anti-Bulimia League. Storytelling and reflecting conversations formed the basis of the therapy-asresearch processes. The research participants extended therapy conversations beyond the therapy room, by actively participating in their therapy-as-research journeys. In line with narrative approaches, the researcher encouraged them to honour their skills and knowledges on their journeys: Mara extended her therapy by making resistance quilts while Grace assimilated her art, poetry and resistance writing into her healing process.
Religious Studies and Arabic
D. Litt. et Phil. (Religious Studies)

This research journey examines the process of co-creating, along with my co-travellers (research participants), a more holistic approach to trauma debriefing. Whilst incorporating elements of Mitchell's (1983) Critical Incidence Stress Debriefing model (C.I.S.D.), our point of difference has been to adopt a narrative pastoral approach. This was achieved by introducing spirituality and narrative therapy practices. Our research pathway has been further shaped by adopting a qualitative research approach within a postmodern, social construction discourse. My research curiosity was invited by both the mind, body and soul divide expressed in psychology; and the healing possibilities of spirituality I have witnessed in both my own and in the lives of others. While my co-travellers predominantly preferred to express their spirituality in terms of Christianity, our narrative pastoral approach to trauma debriefing is offered to people of all religious persuasions.
Practical Theology
M.Th. (with specialisation in Pastoral therapy)