Beyond Resilience:
Blending Wellness and
Liberation in the Helping Professions
Isaac Prilleltensky and Ora
Prilleltensky
Chapter to appear in M. Ungar (Ed.). Pathways to Resilience: A Handbook of Theory, Methods,
and Interventions.
Correspondence should be sent to
Isaac Prilleltensky, Department of Human and Organizational Development,
Resilience typically implies the ability to cope with family and social adversity (Prilleltensky, Nelson & Peirson, 2001). Although the adversity is deplored by helping professionals, they usually limit themselves to working with the family and consider the social problems to be beyond their scope. If all of us were to follow this reasoning, nobody in the helping professions would enact practices that challenge injustice. Instead, we would resign ourselves to deal with the victims of injustice, hoping to steel our clients before the next blow. But an increasing number of helpers are growing uncomfortable with the idea that all they can do is react to environmental assaults – they want to prevent them. Furthermore, they want to redefine resilience as the ability to not only cope with adversity and injustice, but also to challenge their very existence.
Indeed, helping professionals are struggling to promote a social justice agenda. Counselors, psychologists, and social workers realize that their caring work is constantly undermined by conditions of injustice. At least for helpers working with marginalized populations, the injustice encountered by their clients has the power to undermine their caring work. Youth workers do their utmost to empower young people and to instill in them a sense of control, only to realize early in the course of counseling that the natural environment is much more powerful than the most sophisticated psychological intervention.
A growing
number of professionals understand that caring in the proximal sense is
insufficient in the absence of caring in the distal sense. Proximal caring is
expressed within the confines of the counseling session, whereas distal caring
is manifested in work to promote justice in the community. Without the latter,
the former has meager chances of success. Without distal caring, in the form of
challenging and changing unjust environments, proximal caring remains a humane
but somewhat inadequate answer to the plight of the poor and the disadvantaged.
Research has repeatedly demonstrated the effects of noxious environments on
mental health (Carr & Sloan, 2003; McCubbin, Labonte, Sullivan, &
Dallaire, 2003).
Helpers
in the mental health and social work field face a gap between their
understanding of unhealthy environments and their ability to do something about
them. While the level of critique tends to be quite complex, the level of
social justice practice tends to be quite embryonic. Critical psychologists
have been creating alternatives that go beyond the status quo and its critique.
In this chapter we introduce some lessons from critical psychology, a movement
that promotes wellness and liberation at the same time. Here we recommend
several steps for blending caring work with justice work. To illustrate the
application of these recommendations, we will discuss them in the context of
people with physical disabilities.
There is commonality in the critique
of counseling psychology put forth by Vera and Speight (2003) and Lewis, Lewis,
Daniels, and D’Andrea (2003), of social work put forth by Mullaly (2002), and
of psychology put forth by critical psychologists (Nelson & Prilleltensky,
in press; Pare & Larner, in press; Prilleltensky & Nelson, 2002; Sloan,
2000). Vera and Speight (2003) synthesize the shortcomings of an approach that
pays lip service to cultural diversity and social justice but falls short of
articulating emancipatory ways. They enumerate the barriers to acting, and not
just thinking, justly. They point out that multicultural competencies must go
beyond the recognition of oppression: a caring and competent practitioner ought
to enact alternatives that not only identify, but also, and primarily, reduce
oppression.
Helping professionals have differing
degrees of critical awareness. Some of them are indifferent to how their
profession promotes the societal status quo. Others, in turn, are painfully
aware of how their professions blame victims for their misfortune. However mindful, the latter group is at a loss when it comes to
creating alternatives. In the case of counseling, Vera and Speight
perform an invaluable service for those who may be unfamiliar with psychology’s
support for an unjust state of affairs (Prilleltensky, 1994). They adroitly summarize
the unwitting alliance between counseling psychology and the societal status
quo. In this chapter we heed their call for aligning our practice as helping
professionals with the principles of social justice. We believe that progress
can be made by (a) stressing the synergy of diverse values, (b) stressing the
synergy between wellness and liberation, (c) learning from existing critiques
within psychology and other fields, (d) promoting role reconciliation between
the helping professional as healer and agent of change, and (e) adopting
psycho-political validity as a new measure for the evaluation of our social
justice agenda.
Interdependent Values
No single value is comprehensive
enough to address the entire range of human needs. Therefore, we judge values
such as social justice, caring and compassion, and cultural diversity on their
synergistic qualities, and not on their isolated merits (James &
Prilleltensky, 2002; Prilleltensky, 2001). Vera and Speight (2003) correctly
point out that multicultural competence without social justice is insufficient.
Table 1 organizes human needs and values into three separate spheres of
wellness and liberation: personal, relational, and collective. If we
concentrate solely on relational values such as cultural diversity and
democratic participation we run the risk of neglecting both personal and
collective needs. The historical focus of psychology on self-determination and
health meant that little or no attention was paid to democratic participation,
cultural diversity, sense of community, or social justice (Fox &
Prilleltensky, 1997). Vera and Speight are justifiably alarmed that if we
concentrate on celebrating diversity without attending to power inequality and
social injustice we will undermine wellness and liberation, for they cannot
exist but in the synergy created by the composite of values.
Insert Table 1
about Here
Historically, there is a propensity
to concentrate on single values. Such proclivity is largely determined by
dominant political and cultural ideologies. During conservative times personal
values of self-determination tend to be extolled, while principles of equality
and justice come to the fore during progressive eras (Levine & Levine,
1992). It is our job to diagnose the mood of the times and realize what values
we’re missing from the equation. There is little doubt that psychology has
absorbed the zeitgeist of the last three decades and concentrated on individual
remedies for social maladies (Albee, 1990; Cushman, 1990; Fox &
Prilleltensky, 1997; Prilleltensky, 1994; Sampson, 1983; Sarason, 1981). As a
result, we have neglected social justice and support for marginalized
communities at our peril.
The current risk in terms of our
values is to extol respect for diversity above all, for cultural diversity
cannot exist in the absence of social justice. All the values presented in
Table 1 are co-dependent and inter-dependent. Extreme reliance on a single
value undermines the existence of that very value, for it cannot thrive in the
absence of others. We must be forever vigilant about what values are being
privileged and what values are being ignored. There cannot be justice in the
absence of compassion and there cannot be compassion in the absence of justice.
Striking a balance among values for personal, relational, and collective
wellness and liberation is our most pressing task as professionals and
citizens.
The values of self-determination and
social justice in particular, have been severely undermined for many people
with disabilities. So long as the problems they encounter in their daily living
are attributed to the impairment itself efforts to enhance wellness are
conceptualized and enacted at the individual level alone. Those who require
assistance with daily living often have to fight for control over what services
they will receive, their mode of delivery, and who will assist them with the
most intimate self-care tasks. The inability to carry out physical tasks
unassisted is often taken as deficiency in the ability to make important
decisions about one’s life.
Unfair distribution of power has
implications not only for how independence is defined (in primarily physical
terms), but how it is actually enacted in various medical and rehabilitation
settings. Much of the work carried out by counselors, occupational and physical
therapists is focused on patients' ability to independently carry out
activities of daily living, or to come to terms with their inability to do so.
Whereas most people would prefer to be as independent as they can in self-care,
it is critical that this is not regarded as necessary for autonomous adult
functioning. I, Ora, am reminded of a patient I worked with who had to
negotiate with one of his treating therapists that it is pointless for him to
attend a breakfast group. A stroke had left this man with significant physical
impairments, while his cognitive functioning remained relatively intact. It was
very clear to him that he would not be attending to his own breakfast at home
given the time and energy that this required of him. Given the emphasis placed
on physical rehabilitation, convincing his therapist of this was no easy task.
Making such decisions on behalf of others is what truly robs people of dignity
and control over their lives.
Resilience stems, in part, from the
capacity and opportunity to understand the role of adversity in one’s life and
the role of individuals and groups to challenge systems of inequity and
discrimination. Coping without challenging may result in accepting the
unacceptable.
Wellness and Liberation
The helping professions have
traditionally concerned themselves with wellness, health, and well-being. Under
the aegis of the medical model, psychology and psychiatry conceptualized
problems in living in intra-psychic terms. Mental health, wellness, and most
recently positive psychology became choice metaphors. They all conjure images
of people enjoying life, worry-free and healthy. This is a most worthy goal,
which we fully support. But as with any single value, wellness could not stand
by itself. Unless it is supported by fairness and equality, it is bound to
fall. An extensive body of research documents the ill effects of inequality and
disempowerment on health and wellness (Kawachi, Kennedy, & Wilkinson, 1999;
Kim, Millen, Irwin, & Gersham, 2000; Marmot, 1999). The impact of poverty,
marginalization, exclusion, exploitation and injustice is just as deleterious
on the body as it is on the soul (Prilleltensky, 2003). To ignore this evidence
is to pretend that our psychological interventions can be potent enough to undo
the damage of structural inequality. Inequality often expressed in deficient
health services and employment opportunities for the poor. We can afford to be
humbler: our psychological interventions are not that powerful.
Wellness is a positive state of
affairs, brought about by the simultaneous satisfaction of personal, relational
and collective needs. To meet these needs we have to attend to power dynamics
operating at micro, meso, and macro levels of analysis (Nelson &
Prilleltensky, in press). Empowerment does not take place only at the personal
level. Relational and collective empowerment support personal empowerment and
vice versa (Kiefer, 1984; Lord & Hutchison, 1993). Power equalization must
take place at all these levels.
Liberation needs wellness as much as
wellness needs liberation from oppressive forces. Liberation, like freedom, has
two aims: Liberation from and liberation to (Fromm, 1960). Whereas the former
strives to eliminate oppression and abuse at the personal, relational, and
collective levels, the latter seeks to pursue wellness for self and others.
People with disabilities have long
struggled to attain wellness and liberation at the same time. They have claimed
that disability is not a personal tragedy that requires medical solutions, but
a social issue requiring social intervention. They have decried the medical
model of disability that regarded the problem as residing solely within the
disabled individual. The focus on bodily abnormality meant that
medically-driven solutions were called for. Treatment was designed, implemented
and evaluated by a host of professionals, with the disabled individual having
little input regarding the process. What could not be cured had to be
rehabilitated, and what could not be rehabilitated had to be accepted. Psychological
theories focused on the need to adjust to one's misfortune and make the best
out of a tragic and limited life. Those who did not despair despite their
disability were often perceived as being in a state of denial (Oliver, 1996;
Olkin, 1999).
People with disabilities have argued
that it is society, rather than the impairment itself, which is the source of
their disablement: "In our view, it is society which disables physically
impaired people. Disability is … imposed on top of our impairments by the way
we are unnecessarily isolated and excluded from full participation in society.
Disabled people are therefore an oppressed group in society," declared the
Proponents of this alternative social
model of disability have demonstrated the multiple ways in which people with
disabilities are socially and economically disadvantaged. Being historically
excluded from mainstream schooling, many did not attain the necessary skills in
order to further their education and make them competitive within the job
market. Some encounter discriminatory attitudes and a lack of willingness to
make simple accommodations within the work place. Those who require assistive
devices and/or attendant care often come against paternalistic policies
designed to retain professional control over resources. Physical barriers have
also been a source of exclusion, as public spaces were historically designed
with able-bodied people in mind. A shortage of affordable accessible housing
and inaccessible public transportation further marginalize people with
disabilities (Barton, 1998; Morris, 1993; Olkin, 1999; Oliver, 1996).
In Ora’s research on women with
physical disabilities and motherhood, most participants reported that they did
not envision that they would lead a life similar to nondisabled peers
(Prilleltensky, in press, 2003, 2004). One participant
who spent most of her childhood in an institution described the difficulty in
imagining an adult life beyond that setting: "You didn't see kids there
leaving, or getting married, or having kids...they just left and you never
heard from them again..." At the time of the participants' birth some four
decades ago, most of their parents were encouraged to institutionalize them
(although few did), were told to expect little in the way of progress and
growth, and were generally painted a grim picture of life with a disability.
Not surprisingly, few parents expected that their children would lead typical
adult lives and some ignored or actively discouraged daughters' emergent
sexuality.
Michael Oliver, a disabled academic
in the
OPCS: 'Can you tell me what is wrong
with you?'
Oliver: 'Can you tell me what is
wrong with society?'
OPCS: 'Do you have a scar, blemish,
or deformity which limits your daily activities?'
Oliver: 'Do other people's reactions
to any scar, blemish, or deformity you may have limit your daily activities?'
OPCS: 'Does your health
problem/disability make it difficult for you to travel by bus?'
Oliver: 'Are there any transport or
financial problems which prevent you from going out as often or as far as you
would like?'
The political action and struggle of
disabled people around the world has resulted in significant progress. No
longer willing to put up with inadequate resources and professional control,
people with disabilities have collectively fought for economic, legislative,
and social gains. In the
The legislation of the American with
Disabilities Act in 1990 has ensured that many of the aforementioned gains are
not contingent upon people's goodwill, but are enforceable by law. For example,
it is illegal to discriminate against a worker based on disability status, to
hold a civic gathering at an inaccessible venue, or to fail to accommodate the needs
of a disabled patient at a health clinic.
Although there is still a long way to
go, there is little doubt that these practical gains in legislation, economic
resources, and social participation, do go a long way toward the enhancement of
wellness. Furthermore, the new focus on disabling societal barriers and
systematic powerlessness has done much to improve the self-esteem and wellbeing
of people with disabilities (Morris, 1993; Oliver, 1990; Shakespeare, 1998;
White, in press). Consider the following quote of a disabled activist in the
"My life has two phases: before
the social model of disability, and after it. Discovering this way of thinking
about my experiences was the proverbial raft in stormy seas...For years now
this social model has enabled me to confront, survive, and even surmount
countless situations of exclusion and discrimination...It has played a central
role in promoting disabled people's individual self-worth, collective identity,
and political organization. I don't think it is an exaggeration to say that the
social model has saved lives" (Crow, 1996, pp. 206-207).
It is worth re-examining the concept of resilience in light
of the empowering experiences of persons with disabilities. The claim can be
made that Crow and other activists became more resilient precisely because they
challenged the status quo and not because they learned how to cope with it. In
fact, the research on empowerment demonstrates that participating in social
actions enhances sense of control, a key component of resilience and mental
health (Kieffer, 1984; Prilleltensky, Nelson, & Peirson, 2001).
Insularity and Action
Helping professionals cannot afford
to ignore critiques in other fields. The field of critical psychology has been
struggling with how to promote a social justice agenda in ways that parallel
the concerns raised by Vera and Speight (2003) in counseling and by Mullaly
(2002) in social work (Fox & Prilleltensky, 1997; Prilleltensky & Nelson,
2002; Sloan, 2000). Prilleltensky and Nelson (2002), for instance, proposed
means of promoting a social justice agenda in psychology. They made specific
recommendations for working critically in school, health, counseling, clinical,
work and community settings. Community psychology has also been highly
influential in fostering social change, prevention, cultural diversity and
empowerment for the last four decades (Nelson & Prilleltensky, in press;
Newbrough, 1992, 1995; Prilleltensky, 2001; Rappaport, 1987). Disciplinary
boundaries sometimes prevent fruitful explorations of similar agendas.
Insularity is a definite risk. We
need to apply the call for diversity to our own professional practice. There
are diverse fields within the helping professions concerned with social justice
and social change. Looking around can help us find wheels that are well oiled,
we don’t need to reinvent them.
The second question is not less
pressing. Psychology cannot afford to ignore critiques of the helping
professions and of the societal status quo mounted by people with disabilities
(Oliver, 1990), by consumer/survivors of the psychiatric system (Nelson, Lord,
& Ochocka, 2001), by sexual minorities (Kitzinger, 1997), and by other
disciplines (Fox & Prilleltensky, 1997). As psychologists, our ability to
see beyond our own psychological glasses is limited. Just as we need to expand
our definitions of wellness to incorporate other cultural perspectives, we need
to listen to critiques of the helping professions raised by non-psychologists.
But the problem of insularity goes
beyond critique: it affects action as well. We should heed Audre Lorde’s
dictum: “the master’s tools will never dismantle the master’s house.” People
with disabilities did not achieve the rights they did because of professionals.
Often, it is in spite of professionals that people with disabilities and other
marginalized groups make progress towards wellness and liberation (Oliver,
1990). If we are to make progress towards social justice, we need to create alliances
with the people we wish to help (Nelson, Prilleltensky, & MacGillivary,
2001). Much can be learned from social movements and consumers’ movements in
their efforts to declassify homosexuality as an abnormality, to obtain access
to pubic buildings and transportation, or to overcome the stigma of mental
illness (Nelson & Prilleltensky, in press). These actions, we claim, will
not materialize until counselors reconcile their roles as healers with their
role as change agents.
Insert Figure 1
about Here
Role Reconciliation
If helpers respond to the call for
action, as we hope they do, they will pretty soon face a dilemma: How to
reconcile their various roles as professional helpers on one hand, and agents
of social change on the other. Hitherto we have not articulated how these two
sets of knowledge, practices, and roles work in synergy for the promotion of
wellness and liberation (Nelson & Prilleltensky, in press). Here we propose
ways of melding professional and critical praxis (Prilleltensky, 2001;
Prilleltensky & Nelson, 2002; Prilleltensky & Prilleltensky, 2003a, b).
Our challenge is to find ways of reconciling the two sets of skills and aims.
From the perspective of the professional helper, the critical practitioner
wishes to answer three important questions:
1.
How
does our special knowledge of wellness inform our social justice work?
2.
How
does our ameliorative practice inform our transformative practice?
3.
How
does our insider role of wellness promoter in the helping system inform
our outsider role as social critic?
From the perspective of the social
change agent, the critical practitioner needs to address the following issues:
1.
How
does our knowledge of inequality and injustice inform our counseling
work?
2.
How
does our transformative practice in society inform our ameliorative work
in the helping system?
3.
How
does our outsider role as social critic inform or relate to our insider
role?
We would argue that reconciling
these diverse roles would promote the dual goals of wellness and liberation.
Whereas the former is the primary domain of the professional helper, the latter
is the main concern of the critical change agent (Nelson & Prilleltensky,
in press). Ora’s work on women with disabilities and motherhood (Prilleltensky,
O., in press a, b, c) provides some practical examples of this reconciliation
of roles. For example, the professional helper informed by a critical
perspective can encourage girls and
young women with disabilities to explore the impact of negative societal
messages pertaining to sexuality and disability. This process of
conscientization can result in de-blaming and may also lay the foundation for
taking a stand against oppression. At the same time, transformative work in the
community can be directed at changing restrictive and oppressive concepts of
female sexuality and motherhood. Narrow conceptions of motherhood limit the
scope of available resources. Different types of mothering require different
types of resources. An expanded notion of motherhood would naturally lead to a
wider definition of acceptable resources.
Wellness and liberation exist in a
dialectical relationship. Without liberation many oppressed people cannot
experience wellness, and without wellness there is no superordinate goal for
liberation. Our objective is to blend the two so that our various roles and
skills attend to emancipation and quality of life at the same time. Figure 1
describes the amalgamation of knowledge, practices and roles of the
professional helper on one hand and the critical agents of change on the other.
The argument can be made that professional helpers
cannot research or know in depth all aspects of wellness and liberation. We
agree that interdisciplinary research and action is vital. But it is entirely
possible to have interdisciplinary research and action that supports the status
quo. This is why we need critical knowledge of how power and inequality play a
role in counseling and mental health (Habermas, 1971). If we were to stay at
the level of individual wellness alone, and were not to consider the impact of
inequality, disadvantage, and oppression, or were to leave these political
domains to others, we would not be as effective as we might in our individual
work because we would obviate the role of power in mental health. There is a
need to incorporate critical insights into our daily working routine.
The type of
knowledge we pursue has been well articulated by Aristotle and recently revived
by Flyvbjerg (2001). Phronesis is the type of practical knowledge that combines
scientific understanding with political wisdom. It is an applied type of
knowledge that seeks understanding in context; contexts that are perpetually
suffused by power differentials and inequality. What we seek, in Habermas’
words, is knowledge for emancipation.
With respect
to practice, we need to articulate how the various roles would be manifested in
the actual day-to-day practice of helpers and community workers. Nelson and
Prilleltensky (in press), Prilleltensky and Nelson (2002), and
·
Creating
awareness among colleagues about how power differentials get enacted in
interactions with clients seeking counseling
·
Forming
research and action groups in the workplace to explore how practices may be
more empowering of clients
·
Increasing
political literacy of community members to empower them to scrutinize the
practices of helping professionals
·
Establishing
practices that enable participation of clients, patients and community members
in management of human services
·
Connecting
with poor communities and partnering with them in raising the level of public
health, advocating for more resources, protesting tobacco advertising,
boycotting sexist advertising and others.
As insiders
within the health and helping system, psychologists and counselors face many
barriers and limitations. While they may be aware of many oppressive policies
and practices, they may be constrained in their ability to act. Outside
critics, in turn, may feel free to point to shortcomings but may not have the
inside knowledge of how systems work, or why some practices that may seem
unnecessary from the outside may be well justified from the inside.
Whereas the
pull for the professional helper is for amelioration, wellness, and the
prevention of institutional unrest, the pull for the critical change agent is
for transformation, liberation, and disruption of unjust practices. For
critical professional praxis to emerge, these two roles need to exist in
tension and synergy, not in opposition. If wellness and liberation are to
emerge, we need specialized knowledge as much as political knowledge,
ameliorative therapies as much as social change, and people working inside the
system as much as people confronting it.
Psychopolitical Validity
How can we make sure that our
research and action live up to the ideals presented by Vera and Speight (2003),
Mullaly (2002), Prilleltensky and Nelson (2002) and others? This is a question
of importance to critical practitioners concerned with the promotion of social
justice in the mental health field. To address this concern, I, Isaac, have
recently suggested the introduction of psychopolitical validity as a tool for
the promotion of wellness and liberation. To guide our
commitment to these two priorities I proposed the concept of psychopolitical
validity (Prilleltensky,
This type of
validity is built on two complementary sets of factors: psychological and
political: hence, psychopolitical. This combination refers to the psychological
and political influences that interact to promote wellness, perpetuate
oppression, or generate resistance and liberation. Psychopolitical factors help
explain suffering and well-being. At the same time, this combination of terms
denotes the need to attend to both sets of factors in our efforts to change
individuals, groups, and societies. As a result, we propose two types of
psychopolitical validity: (a) epistemic, and (b) transformational. Whereas the
former refers to using psychology and politics in understanding social
phenomena, the latter calls on both sets of factors to make lasting social
changes.
We pay equal
attention to psychological and political factors. Psychological factors refer
to the subjective life of the person, informed by power dynamics operating at the personal, interpersonal, family,
group and cultural levels. Political factors, in turn, refer to the collective
experience of individuals and groups, informed by power dynamics and conflicts of interest at the interpersonal,
family, group, community, and societal levels. In both sets of factors we
emphasize the role of power in the subjective or collective experience of
people and groups.
Psychopolitical
validity, then, derives from the concurrent consideration and interaction of
power dynamics in psychological and political domains at various levels of
analyses. Hence, we can talk about psychopolitical validity when these
conditions are met. When this type of analysis is applied to research, we talk
about epistemic psychopolitical validity. When it is applied to social
interventions, we talk about transformational psychopolitical validity. To
illustrate these concepts, we refer you to Tables 2 and 3, respectively.
|
Insert Tables 2 and 3 about
here |
To understand
issues of well-being, oppression, and liberation at the personal, relational,
and collective domains, we turn our attention to Table 2. Each cell in the
table refers to issues of power and their manifestation in political and
psychological spheres. Needless to say, this table is not exhaustive or
inclusive of all fields in the helping professions. Rather, it concentrates on
the priorities of wellness and liberation, two issues we regard as crucial.
Table 2 may
be used to guide our commitment to emancipatory research. Furthermore, it may
be used as an accountability device. We can monitor the extent to which we
study the priority areas described in the table. In a sense, these guidelines
serve the function of a vision; a vision of what type of research we need to
pursue.
Epistemic
validity depends on the incorporation of knowledge on oppression into all
research and action in mental health. This means accounting for power dynamics
operating at psychological and political levels in efforts to understand
phenomena of interest. The following questions might guide the pursuit of
epistemic psychopolitical validity.
1.
Is there an understanding of the
impact of global, political and economic forces on the issue at hand?
2.
Is there an understanding of how
global, political, economic forces and social norms influence the perceptions
and experiences of individuals and groups affected by the issue at hand?
3.
Is there an understanding of how the
cognitions, behaviours, experiences, feelings, and perceptions of individuals,
groups, and entire communities perpetuate or transform the forces and dynamics
affecting the issue at hand?
4.
Is there an appreciation of how
interactions between political and psychological power at the personal,
relational, and collective levels affect the phenomena of interest?
Table 3
integrates levels of intervention with key concerns for mental health:
wellness, oppression, and liberation. This is a vision of preferred
interventions. We would show high degrees of commitment and accountability to
the extent that we pursue these interventions. As a monitoring system, Table 3
helps to keep track of our actions. Are we intervening primarily at the
personal level? Do we focus too much on oppression to the neglect of liberation
and well-being? Have we neglected the collective domain?
Whereas
epistemic validity referred to our understanding of psychopolitical dynamics of
oppression, transformative validity demands changes towards liberation at
personal, interpersonal, and structural domains. The following questions attend
to transformative validity:
- Do interventions promote psychopolitical
literacy?
- Do interventions educate participants on the
timing, components, targets and dynamics of best strategic actions to
overcome oppression?
- Do interventions empower participants to
take action to address political inequities and social injustice within
their relationships, settings, communities, states, and at the
international level?
- Do interventions promote solidarity and
strategic alliances and coalitions with groups facing similar issues?
- Do interventions account for the
subjectivity and psychological limitations of the agents of change?
Explicit
political aims have been often advocated for but infrequently acted upon in
mental health. Transformative validity may serve to remind us that political
literacy and social change have to be part of all interventions. We seek not
only to ameliorate social conditions but also to alter the configurations of
power that deprive citizens of their rights (Prilleltensky & Nelson, 2002).
Conclusion
People
affected with physical disabilities and psychosocial problems are better off
developing resilience and ways of coping. But resilience must go beyond coping
with adversity. It must entail a challenge to the very structures that create
disadvantage, discrimination, and oppression. This is not to pile more
responsibilities on people who already experience challenges in their lives.
Rather, it is a call to action for people with and without disabilities, and
for those who advocate with them for a more caring and just society. Their own
participation in challenging injustice, along with mental health and community
workers, can do much to enhance resilience. Professionals cannot stand back and
hope that personal resilience will emerge from their therapeutic interventions
alone. Community change, not just personal change; political change, not just
psychological change; and justice, not just caring, are urgently needed.
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Specialized
professional knowledge for wellness Insider role for
wellness Outsider role for
liberation Ameliorative practice for wellness Transformative
practice for liberation Practice for wellness and liberation Role for wellness
and liberation Knowledge for wellness and liberation Critical
Professional Praxis Professional Helper Critical Agent Critical
knowledge for liberation
Figure 1
Knowledge, Practice And Roles For Critical Professional Praxis In Mental Health
Practice
Adapted
from Prilleltensky & Prilleltensky, 2003 b.