Meaning Making Mechanisms in Women Survivors of Childhood Sexual Abuse: A Scoping Review

Childhood sexual abuse (CSA) is a complex and prevalent problem with devastating long-term consequences for survivors. Despite these consequences, some survivors seem to find a source of meaning and fulfillment throughout their recovery process, which may facilitate resilience and posttraumatic growth (PTG). However, little is known from the literature about the specific meaning making mechanisms that CSA survivors experience. A scoping review was conducted by searching relevant journals and several online databases such as EbscoHost, Scopus, ProQuest, ScienceDirect, and Google Scholar. Studies published in English and that discussed meaning making as a topic of recovery from CSA in the context of women survivors' experiences were included, where a total of 57 articles were selected including qualitative (n = 32), quantitative (n = 9), mixed method (n = 9), and review (n = 7) articles. Using thematic analysis, the results of the scoping review found four mechanisms of meaning making and seven sources of meaning describing the meaning making processes of women survivors of CSA. The mechanisms were identified as being benevolent; restoring and empowering the inner self; mobilizing external and social resources; and lastly actively integrating the trauma narrative. This study contributes toward the global knowledge base on meaning making mechanisms of women survivors of CSA by providing the first known summary of studies to date. Future research is recommended to further confirm these findings to inform treatment interventions for women survivors of CSA.

Women Survivors of Adolescent Dating Violence Describe the Maintenance of Their Abusive Relationships: First Person Stories via YouTube

The current study explores the personal stories of young women on their own experiences with adolescent dating violence and focuses on their perceptions of the relevant factors that maintained the relationship over time. To this end, we analyzed seven publicly available videos on YouTube of women explaining their experiences of adolescent dating violence, including how they perceived their relationships to be maintained over time. We identified four major sources these survivors perceived as contributing to the maintenance of adolescent dating violence: the Self, the Partner, the Relational Dynamic, and Other People.

Digital hermeneutics: scaled readings of online depression discourses

When it comes to understanding experiences of illness, humanities and social sciences research have traditionally reserved a prominent role for narrative. Yet, depression has characteristics that withstand the form of traditional narratives, such as a lack of desire and an impotence to act. How can a 'datafied' approach to online forms of depression writing pose a valuable addition to existing narrative approaches in health humanities? In this article, we analyse lay people's depression discourses online. Our approach, 'digital hermeneutics', is inspired by Gadamer's dialogical hermeneutics. It consists of a 'scaled reading' on five different scales: platform hermeneutics; contextual reading with term frequency-inverse document frequency (TF-IDF); distant reading with natural language processing topic modelling; hyper-reading with concordance views and close reading. Our corpus consisted of three data sets, from the blogs and message boards of, respectively, time-to-change.org.uk, a UK-based social organisation and movement that aims to counter mental health discrimination and alleviate social isolation by spreading awareness; Sane.org.uk, a leading UK mental health charity that seeks to help people in facing the challenges of mental illness and to improve quality of life; and the subreddit 'r/depression' on web discussion platform reddit. We found that the manner in which people express experiences of illness online is very much dependent on the specific affordances of platforms. We found degrees of 'narrativity' to be correlated to authorship and identity markers: the less 'anonymous' the writing, generally speaking, the more conventionally 'narrative' it was. Pseudonimity was related to more intimate and singular forms, with less pressure to conform to socially accepted and positive narratives of the 'restitution' type. We also found that interactive affordances of the platforms were used to a limited extent, nuancing assumptions about the polyvocality of online depression writing. We conclude by making a claim for increased cooperation between digital and medical humanities that might lead to a field of 'Digital Medical Humanities'.

Challenging the Constraints of Neoliberalism and Biomedicalism: Repositioning Social Work in Mental Health

This article explores the impact of neoliberalism and biomedicalism on social work mental health care practice through presenting the results of a Canadian provincial study which illustrates the experiences of social work service users, providers, and supervisors. While Canada has a universal health care program, the intensification of the free-market approach is evident in the shifts from public sector support to growing rationalization and marked cutbacks to the provision of social welfare services. The specific impact of neoliberal economic restraint on social justice in mental health services has pressured practitioners to adopt medicalized, short-term strategies, under efficiency-based models. The participants in this study reported significant co-occurring concerns with the state of mental health service delivery, and results suggest social work is increasingly co-opted by the conservative individualizing, pathologizing, and contextualizing dominant biomedical framework in the provision of mental health social services and lack of professional practice autonomy.

Mapping the abject: Women's embodied experiences of premenstrual body dissatisfaction through body-mapping

Women's body shame and body dissatisfaction increase in the premenstrual phase of the cycle, associated with premenstrual distress. However, the meaning and consequences of premenstrual body dissatisfaction remain underexplored. The aim of this study was to explore how women who report premenstrual body dissatisfaction construct and experience their bodies, using qualitative arts-based methods. Four hundred and sixty women completed online open-ended survey questions and 16 women took part in body-mapping and an interview. Thematic analysis identified three major themes: construction of the premenstrual body as abject, manifested by positioning of the body and self as fat, leaking and dirty; self-policing and self-regulation through increased scrutinising and concealment of the premenstrual body; and resistance of cultural constructions of idealised femininity. These findings emphasise the need to acknowledge changes in body dissatisfaction across the menstrual cycle, and the implication for women's feelings about the self. Internalisation of negative constructions of the female body plays a role in women's experience of premenstrual change and distress. There is a need for further research to examine the role of body management behaviours in premenstrual body dissatisfaction and distress.

Trans Women's Responses to Sexual Violence: Vigilance, Resilience, and Need for Support

Despite experiencing high rates of sexual violence, there is limited research that explores coping and support needs among trans women of color and those from migrant backgrounds. This article examines the impact of sexual violence, as well as responses and support needs in relation to sexual violence, among 31 trans women of color, aged between 18-54 years, living in Australia. Women were recruited using purposive and snowball sampling, local LGBTQI + networks, and social media. Study advertisements invited participation from people 18 years and older, who identified as a "trans woman of color" or "trans woman from a non-English speaking background," to take part in a study about their lives as trans women of color and experiences of sexual violence. In-depth interviews and photovoice took place between September 2018 and September 2019. Findings were analyzed through thematic analysis, drawing on intersectionality theory. Sexual violence was reported to be associated with fear, anxiety, and depression, and, for a minority of women, self-blame. While women reported hypervigilance and avoiding going out in public as measures to anticipate and protect themselves from sexual violence, they also demonstrated agency and resilience. This included putting time and effort into appearing as a cisgender woman, naming violence, seeking support, rejecting self-blame, and engaging in self-care practices to facilitate healing. Trans women highlighted the need for multi-faceted sexual violence prevention activities to encourage education, empowerment and cultural change across the general population and support services, in order to promote respect for gender, sexuality and cultural diversity.

Finding One's Footing When Everyone Has an Opinion. Negotiating an Acceptable Identity After Sexual Assault

Identities used to describe oneself after trauma may influence recovery, and searches for acceptable identities after sexual assault can be challenging. Fifteen Norwegian female survivors of sexual assault were recruited at a clinical center, and were individually interviewed about post-assault discussions with others. Our focus was on the experiences of non-blaming and believing interactions with others, and how these interactions can be understood as a process of searching for acceptable identities after sexual assault. A reflexive thematic analysis resulted in four themes: navigating between other people's stories and one's own; realizing the seriousness of the assault without drowning in the upset of others; finding a place between too much closeness and too much distance; and being more than a victim. We discuss the importance of participants retaining agency in post-assault interactions. We suggest that being a survivor of sexual assault increases the probability, even in believing and non-blaming interactions, of being cast in a subject-object relationship with less freedom and agency than before. Navigating toward acceptable identities may mean working one's way back to being a subject in a subject-subject relationship again.

In defence of not-knowing: uncertainty and contemporary narratives of sexual violence

This article models a critical method of engaging with not-knowing as it relates to discourses around sexual agency and sexual violation through an analysis of Carmen Maria Machado’s short story ‘The Husband Stitch’. I argue that sexual and gender-based violation not only enforces harmful forms of uncertainty among the women of the story. It also forecloses the potentially productive capacities of modes of not-knowing. In doing so, I respond to assertions from feminist scholars as varied Linda Martín Alcoff, Mary Gaitskill, Laura Kipnis and Joseph Fischel that we need to better account for the full ‘complexity’ of narratives of sexual encounter – including violent encounters. Broadly, in a #MeToo era in which stories of sexual and gender-based violence have received unprecedented mainstream public exposure, I contend that we can both treat the testimonies of survivors as credible and authoritative, and open up discursive space for the experience and expression of not-knowing.

Talking but not always understanding: couple communication about infertility concerns after cancer

BACKGROUND

Cancer related infertility can have an impact on couple relationships, with evidence that couple communication facilitates coping. However, little is known about the ways in which couples communicate about cancer-related fertility concerns. The aim of this article is to examine couple communication about fertility concerns in the context of cancer, and the perceived quality of such communication from the perspective of cancer survivors and their partners.

METHODS

Eight-hundred and seventy-eight cancer survivors (693 women, 185 men) and 144 partners (82 women, 62 men), across a range of tumour types and age groups, completed a survey which examined cancer related fertility concerns. Seventy-eight survivors (61 women and 17 men), and 26 partners (13 women and 13 men), participated in semi-structured interviews, in order to examine the subjective experience of fertility concerns in-depth. Thematic analysis was used to analyse the interviews and open ended survey questions. Valid percentages for single items from the relationships subscale of the Fertility Preservation Inventory (FPI) related to qualitative themes, identified frequency of responses.

RESULTS

The major theme was 'talking but not always understanding". 89.6% of cancer survivors and partners (95.1%) reported working well together handling fertility questions (FPI), but agreed that communication could be improved (65.9% survivors; 65% partners). Open and honest couple communication was associated with feelings of support, understanding and relationship growth, including perception of partner comfort (79.2% survivors, 81.6% partners). However, 32% survivors and 31.1% partners concealed fertility concerns to avoid upsetting their partner, or reported that their partner doesn't understand their fertility concerns (survivors 25.5%, partners 14.6%), with 14.1% of cancer survivors and 19.4% partners reporting fear of relationship breakdown because of fertility issues. Fear of rejection when forming new relationships, and concerns about how to talk to future partners, was reported by non-partnered individuals.

CONCLUSION

Health-care professionals should include partners of cancer survivors in fertility discussions. Couple interventions developed in general psycho-oncology should be extended to the domain of fertility, in order to facilitate effective couple communication. Communication in future relationships needs to be addressed for single people and adolescents and young adults (AYAs) who have fertility concerns.

“I feel fat and ugly and hate myself”: Self-objectification through negative constructions of premenstrual embodiment

The body is central to women’s construction of premenstrual change as premenstrual syndrome (PMS), and to experiences of premenstrual distress. Embodied change, such as bloating or breast tenderness, can act as a marker of PMS. Within biomedical models, PMS is located within the body. Women’s dissatisfaction with their bodies is also reported to be higher in the premenstrual phase of the cycle. What is absent from this analysis is the meaning and experience of embodied change, in the context of broader constructions of femininity and embodiment. In this paper, we adopt a feminist material-discursive theoretical framework to examine the role of premenstrual embodiment in women’s premenstrual distress, drawing on open-ended survey responses and interviews with 83 women who self-diagnose as “PMS sufferers”. We theorize premenstrual body hatred as subjectification, wherein women take up cultural discourse associated with idealized femininity and the stigmatization of the fat body, resulting in self-objectification, distress and dehumanization. However, women can resist negative cultural constructions of premenstrual embodiment. We describe the impact of psychological therapy which increases awareness of emotional and embodied change, resulting in greater acceptance of the premenstrual body and self-care, serving to reduce premenstrual distress and self-objectification.

What Contributions, if Any, Can Non-Indigenous Researchers Offer Toward Decolonizing Health Research?

Four non-Indigenous academics share lessons learned through our reflective processes while working with Indigenous Australian partners on a health research project. We foregrounded reflexivity in our work to raise consciousness regarding how colonizing mindsets-that do not privilege Indigenous ways of knowing or recognize Indigenous land and sovereignty-exist within ourselves and the institutions within which we operate. We share our self-analyses and invite non-Indigenous colleagues to also consider socialized, unquestioned, and possibly unconscious assumptions about the dominance of Western paradigms, asking what contributions, if any, non-Indigenous researchers can offer toward decolonizing health research. Our processes comprise of three iterative features-prioritizing attempts to decolonize ourselves, acknowledging the necessary role of discomfort in doing so, and moving through nonbinary and toward nondualistic thinking. With a nondual lens, working to decolonize ourselves may itself be seen as one contribution non-Indigenous researchers may offer to the collective project of decolonizing health research.

Doing critical feminist research: A Feminism & Psychology reader

As we approach Feminism & Psychology’s 30th anniversary, we reflect on and explore what makes the journal distinctive – its emphasis on critical feminist psychology. In this article and the accompanying Virtual Special Issue, we outline five methodological considerations that we believe are at the heart of critical feminist scholarship: 1) the politics of asking questions; 2) attention to language/discourse; 3) reflexivity; 4) representation and intersectionality; and 5) mobilizing research for social change. We then draw across a set of 15 articles published in the archives of Feminism & Psychology that showcase one or more of these key features and demonstrate the ‘doing’ of critical feminist psychology. These articles are housed on the journal’s website, as is an additional paper developed for students or those in a position of learning, which explores central ideas and debates that have culminated in critical feminist psychology.

"I Know It When I See It": Recent Victimization and Perceptions of Rape

This study examined various individual differences that influence perceptions of sexual assault (SA), specifically focusing on participants' self-reported recent experiences of rape or sexual coercion. Female college students (N = 214) read 16 short SA encounter vignettes, indicated whether what they read constituted rape, and completed individual difference measures. Results indicated that participants who confirmed a recent history of SA endorsed rape myths to a greater degree, held more adversarial sexual beliefs, reported higher levels of sociosexuality, and were less likely to construct the SA encounters as rape when compared with women who do not report recent SA or coercion. Further analyses showed that these variables interacted to predict rape perception in ambiguous SA vignettes, as identified by the participants. These findings illuminate some of the impacts of SA and coercion on women and provide suggestions for future research to further examine the relationship between recent assault history and perceptions of rape.

Polyphonies of depression: The relationship between voices-of-the-self in young professional women aka 'top girls'

While the analysis of depression narratives has become increasingly common practice within critical mental health research, this work rarely investigates how these accounts intersect with particular social identities. The recent emergence of the 'top girl' identity, a new cultural slot on offer for young women, is underpinned by the rise of neoliberal and post-feminist discourses in the Western world. To explore whether this new feminine subjectivity is indeed taken up by young women and how it shapes their experience of depression, we conducted in-depth interviews with 13 young professional women in Aotearoa/New Zealand. Based on a dialogical approach to theorising and researching subjectivity, we identified repetitive inter-relations between different voices-of-the-self and the voices of depression. The most pervasive pattern in the sample consists of what we have termed demanding voices associated with the 'top girl' position, which construct depression as an individual deficit thereby discouraging young women from exploring the sociocultural origins of their distress. In contrast, resistant voices emphasise relationality and a (re)connection with meaningful values and, therefore, seem to be productive for individual recovery.

Negotiating sexual agency in marriage: The experience of migrant and refugee women

In this study, adult migrant and refugee women's negotiation of sexual agency in the context of marriage is explored. In Sydney, Australia and Vancouver, Canada, 78 semistructured individual interviews, and 15 focus groups, comprised of 82 participants, were conducted with women who had recently migrated from Afghanistan, Iraq, Somalia, South Sudan, Sudan, Sri Lanka, and South America. Women's negotiation of sexual agency was evident with respect to husband choice, disclosure of sexual desire, pleasure, pain, and sexual consent. While some participants took up subjugated sexual subject positions reflecting dominant cultural or religious discourses, many women also resisted these discourses to enact sexual agency.

Being a mother with multiple sclerosis: Negotiating cultural ideals of mother and child

Multiple sclerosis can impact affected women’s experiences of motherhood through physical and cognitive impairment. This study examined how women construct and experience motherhood while living with multiple sclerosis. Twenty mothers diagnosed with multiple sclerosis took part in semi-structured interviews. Transcripts were analysed using theoretical thematic analysis, drawing on feminist poststructuralist theory to organise and interpret themes. Two main themes were identified: “Performing motherhood in the context of MS” and “Bringing up a ‘good’ child”. “Performing motherhood in the context of MS” comprises the subthemes, “The self-sacrificing mother: Negating women’s needs”, “The unreliable mother: Adjusting day-to-day mothering practices”, and “Resisting discourses of idealised motherhood”. “Bringing up a ‘good’ child”, comprises the subthemes, “The damaging mother: Fear of harming the child” and “The good mother: Caring and building resilience in the child”. Women positioned themselves as failing to be good mothers, because of limitations to their mothering, and fear of damaging children. Focusing on building children’s emotional resilience functioned to restore constructions of “good” mothering. Acknowledging how Western cultural ideals influence women’s experience of mothering when living with chronic illness is important. Health professionals can provide support by addressing women’s feelings of failure as mothers and supporting communication with children.

The happiness imperative: Exploring how women narrate depression and anxiety during pregnancy

This article explores how women account for their experiences of pregnancy distress in light of cultural imperatives to be the perfect, happy mother. Our analysis is based on the accounts of 18 Australian women, interviewed during pregnancy on the basis of their reports of experiencing depression and/or anxiety. Working within a feminist discursive framework, we focus on the discourses that informed (and threatened) women’s positions as a good mother. In particular, we focus on the discourses women relied on to explain their distress and the discursive strategies they used in the construction of their (“distressed”) maternal identity(ies). We ask how women articulate and label distress, and with what rhetorical effects. Our analysis explores how women’s experiences of negative moods and distress were in direct opposition to cultural imperatives for mothers to stay happy and positive during pregnancy and beyond, posing rhetorical challenges to women’s accounts and hence their capacity to make meaning of their (negative) experiences. Three discursive strategies are explored: distancing from the depressed self, speaking between/around/without words, and in search of a balance. We close by considering the implications of the complex ways in which women account for idealised motherhood and how this serves to oppress vulnerable women.

‘Normal’ and ‘failing’ mothers: Women’s constructions of maternal subjectivity while living with multiple sclerosis

Multiple sclerosis causes physical and cognitive impairment that can impact women’s experiences of motherhood. This study examined how women construct their maternal subjectivities, or sense of self as a mother, drawing on a framework of biographical disruption. A total of 20 mothers with a multiple sclerosis diagnosis took part in semi-structured interviews. Transcripts were analysed using thematic decomposition to identify subject positions that women adopted in relation to cultural discourses of gender, motherhood and illness. Three main subject positions were identified: ‘The Failing Mother’, ‘Fear of Judgement and Burdening Others’ and ‘The Normal Mother’. Women’s sense of self as the ‘Failing Mother’ was attributed to the impact of multiple sclerosis, contributing to biographical disruption and reinforced through ‘Fear of Judgement and Burdening Others’ within social interactions. In accounts of the ‘Normal Mother’, maternal subjectivity was renegotiated by adopting strategies to manage the limitations of multiple sclerosis on mothering practice. This allowed women to self-position as ‘good’ mothers. Health professionals can assist women by acknowledging the embodied impact of multiple sclerosis on maternal subjectivities, coping strategies that women employ to address potential biographical disruption, and the cultural context of mothering, which contributes to women’s experience of subjectivity and well-being when living with multiple sclerosis.

Negotiating Discourses of Shame, Secrecy, and Silence: Migrant and Refugee Women's Experiences of Sexual Embodiment

In Australia and Canada, the sexual health needs of migrant and refugee women have been of increasing concern, because of their underutilization of sexual health services and higher rate of sexual health problems. Previous research on migrant women's sexual health has focused on their higher risk of difficulties, or barriers to service use, rather than their construction or understanding of sexuality and sexual health, which may influence service use and outcomes. Further, few studies of migrant and refugee women pay attention to the overlapping role of culture, gender, class, and ethnicity in women's understanding of sexual health. This qualitative study used an intersectional framework to explore experiences and constructions of sexual embodiment among 169 migrant and refugee women recently resettled in Sydney, Australia and Vancouver, Canada, from Afghanistan, Iraq, Somalia, South Sudan, Sudan, Sri Lanka, India, and South America, utilizing a combination of individual interviews and focus groups. Across all of the cultural groups, participants described a discourse of shame, associated with silence and secrecy, as the dominant cultural and religious construction of women's sexual embodiment. This was evident in constructions of menarche and menstruation, the embodied experience that signifies the transformation of a girl into a sexual woman; constructions of sexuality, including sexual knowledge and communication, premarital virginity, sexual pain, desire, and consent; and absence of agency in fertility control and sexual health. Women were not passive in relation to a discourse of sexual shame; a number demonstrated active resistance and negotiation in order to achieve a degree of sexual agency, yet also maintain cultural and religious identity. Identifying migrant and refugee women's experiences and constructions of sexual embodiment are essential for understanding sexual subjectivity, and provision of culturally safe sexual health information in order to improve well-being and facilitate sexual agency.

Negotiating Discourses of Shame, Secrecy, and Silence: Migrant and Refugee Women's Experiences of Sexual Embodiment

In Australia and Canada, the sexual health needs of migrant and refugee women have been of increasing concern, because of their underutilization of sexual health services and higher rate of sexual health problems. Previous research on migrant women's sexual health has focused on their higher risk of difficulties, or barriers to service use, rather than their construction or understanding of sexuality and sexual health, which may influence service use and outcomes. Further, few studies of migrant and refugee women pay attention to the overlapping role of culture, gender, class, and ethnicity in women's understanding of sexual health. This qualitative study used an intersectional framework to explore experiences and constructions of sexual embodiment among 169 migrant and refugee women recently resettled in Sydney, Australia and Vancouver, Canada, from Afghanistan, Iraq, Somalia, South Sudan, Sudan, Sri Lanka, India, and South America, utilizing a combination of individual interviews and focus groups. Across all of the cultural groups, participants described a discourse of shame, associated with silence and secrecy, as the dominant cultural and religious construction of women's sexual embodiment. This was evident in constructions of menarche and menstruation, the embodied experience that signifies the transformation of a girl into a sexual woman; constructions of sexuality, including sexual knowledge and communication, premarital virginity, sexual pain, desire, and consent; and absence of agency in fertility control and sexual health. Women were not passive in relation to a discourse of sexual shame; a number demonstrated active resistance and negotiation in order to achieve a degree of sexual agency, yet also maintain cultural and religious identity. Identifying migrant and refugee women's experiences and constructions of sexual embodiment are essential for understanding sexual subjectivity, and provision of culturally safe sexual health information in order to improve well-being and facilitate sexual agency.

‘Talk about a Cunt with too Much Idle Time’: Trolling Feminist Research

Given the growing popularity of online methods for researchers and the increasing awareness of the levels of harassment and abuse directed at women online—especially women expressing feminist views—it is critical that we address the implications of online abuse for feminist researchers. Focussing on an often hidden yet significant part of our methodological decisions and recruitment, this paper details the online abuse levelled by men's rights activists against a research project on women's experiences of men's stranger intrusions in public space. It argues for the need to locate such experiences within a violence-against-women frame, extending the concept of a continuum of sexual violence. Such an extension renders visible the added labour of ‘safety work’, which forms an invisible backdrop to the methodological decisions of many feminist researchers.

“I’m Not Gonna Fake It”

Women faking orgasm has been identified as a common and widespread practice, particularly in the context of heterosexual sex. While feigning pleasure has been the subject of extensive scholarly inquiry, almost no research attention has been applied to women’s experiences of resisting this normative practice. We adopted a discourse analytic approach to explore the question: If faking orgasm is often compulsory, how do women resist this practice and what does it mean when they do? Participants were 15 undergraduate students who ranged in age from 19 to 28. We identified the mobilization of several discursive patterns in their accounts. First, participants mobilized a “future pleasures” discourse to highlight the importance of resisting faking orgasm in order to increase their chances of experiencing genuine pleasure. Second, they positioned sexual satisfaction as an “equal right” to which they were entitled. In some instances, this was discussed in terms of reciprocity, in which pleasure is given and received. In others, it was positioned as a feminist issue of gender and power. Third, participants highlighted the importance of deflecting blame for absent orgasm in order to avoid hurting one’s partner. Fourth, participants described the role of pain as either a factor that prevented them from faking pleasure or that motivated them to fake orgasm in order to end painful sex. We conclude that an equal rights discourse, framed as a feminist issue, holds the most promise as a means of discursive resistance. At the same time, we highlight the significant risks for women of both faking orgasm and not faking orgasm and the delicate discursive work required when an expected orgasm is not experienced. We suggest that efforts to support women’s sexual health and equality are enhanced by better understanding the emancipatory potential of various discursive constructions as well as their limitations and risks. The merits and challenges of each pattern of accounting are discussed in the context of broader scholarship in the area of discursive resistance.

Constructions and experiences of motherhood in the context of an early intervention for Aboriginal mothers and their children: mother and healthcare worker perspectives

BACKGROUND

The colonisation of Australia has been associated with traumatic consequences for Aboriginal health and wellbeing, including the breakdown of the traditional family unit and negative consequences for the mother/child relationship. Early-intervention programs have been developed to assist families to overcome disadvantage and strengthen mother/child attachment. However, there is no research examining Aboriginal women's subjective experiences and constructions of motherhood in the context of such programs, and no research on the perceived impact of such programs, from the perspective of Aboriginal mothers and healthcare workers (HCWs), with previous research focusing on child outcomes.

METHOD

Researchers conducted participant observation of an early intervention program for Aboriginal mothers and young children over a 6 month period, one-to-one interviews and a focus group with 10 mothers, and interviews with nine HCWs, in order to examine their perspectives on motherhood and the intervention program.

RESULTS

Thematic analysis identified 2 major themes under which subthemes were clustered. Constructions of motherhood: 'The resilient mother: Coping with life trauma and social stress' and 'The good mother: Transformation of self through motherhood'; Perspectives on the intervention: '"Mothers come to life": Transformation through therapy'; and '"I know I'm a good mum": The need for connections, skills and time for self'.

CONCLUSIONS

The mothers constructed themselves as being resilient 'good mothers', whilst also acknowledging their own traumatic life experiences, predominantly valuing the peer support and time-out aspects of the program. HCWs positioned the mothers as 'traumatised', yet also strong, and expressed the view that in order to improve mother/child attachment a therapeutic transformation is required. These results suggest that early interventions for Aboriginal mothers should acknowledge and strengthen constructions of the good and resilient mother. The differing perspectives of mothers and HCWs on the role and impact of the early intervention program reinforces the need for Aboriginal mothers to be involved in the design and implementation of services aimed at assisting their families.

"I Wanted to Rebel, But There They Hit Me Even Harder": Discourse Analysis of Israeli Women Offenders' Accounts of Their Pathways to Substance Abuse and Crime

This study examined women offenders' accounts of their pathways to substance abuse and crime and the intersection between them, to reach a holistic understanding that captures the dynamics of victimization, agency, and gender. Discourse analyses of the accounts of 11 Israeli women offenders indicated differential use of two discourses. Five participants used the victimization discourse, which viewed substance abuse as an attempt to medicate the self that was injured following victimization experiences; two used the agency discourse, which viewed substance abuse as a way to experience pleasure, leisure, and control over their destiny. Four of the participants used these two contradictory discourses simultaneously. The findings indicate the absence of a cultural discourse that encompasses women's complex experience of gender, victimization, and agency. Possible implications for intervention are discussed.

Women's Construction of Embodiment and the Abject Sexual Body After Cancer

Cancer and cancer treatments can cause significant changes to women's sexual well-being. We explored how women construct a sense of their bodies and sexual "selves" in the context of cancer. Sixteen women, across a range of ages (20-71 years), cancer types, and cancer stages, took part in in-depth semistructured interviews. We conducted a thematic discourse analysis, drawing on feminist poststructuralist theory, identifying "the abject body" as a dominant theme. Participants constructed abject bodies as being "beyond abnormality," "outside idealized discourses of embodied femininity," and "out of control." The women's accounts varied in management and resistance of the abject body discourse, through bodily practices of concealment, resisting discourses of feminine beauty, and repositioning the body as a site of personal transformation. The corporeality of the cancerous body can be seen to disrupt hegemonic discourses of femininity and sexuality, with implications for how women practice and make meaning of embodied sexual subjectivity.

Young women's construction of their post-cancer fertility

Younger women diagnosed with cancer often face compromised fertility as a result of their treatment. However, previous research has adopted a biomedical model of fertility and utilised hypothetico-deductive research methods which have not allowed for full exploration of women's subjectivity. This study explored younger women's construction of their fertility post-cancer, and their discussions of fertility with healthcare professionals, from a social constructionist epistemology. Semi-structured one-to-one interviews were conducted with eight women aged 18-26, across a variety of cancer types. Foucaultian Discourse Analysis identified three subject positions associated with fertility concerns: 'Inadequate woman: Accepting the motherhood mandate'; 'Adequate woman: Resisting the motherhood mandate'; and 'Survival of the fittest: Woman as genetically defective'. Implications of these subject positions included feelings of inadequacy, fear and devastation; feeling undesirable to romantic partners; and concern about passing on cancer-positive genes. In describing healthcare professional interactions, women adopted positions of 'Satisfied patient'; 'Passive recipient patient'; or 'Resisting the passive patient position'. Accounts of inadequate information provision were associated with anger and frustration, whereas feeling adequately informed was associated with satisfaction at making decisions about fertility preservation. These results suggest that fertility is of importance to young women cancer survivors, and that compromised fertility can negatively impact subjectivity.

Pathology or source of power? The construction and experience of premenstrual syndrome within two contrasting cases

This research examines the construction and experience of premenstrual syndrome (PMS) in the context of intimate couple relationships, through examination of two contrasting cases analysed using thematic decomposition of narrative interviews. Judith and her male partner pathologised premenstrual change, constructing the premenstrual self as out of control, and the epitome of the ‘monstrous feminine’. Judith reported feeling over-burdened and uncontrollably angry premenstrually, associated with relationship issues and absence of partner recognition or support. In contrast, Sophia normalised premenstrual change, challenging the association between PMS and the construction of woman as deviant or dysfunctional. Sophia reported heightened energy and creativity premenstrually, and engaged in self-care supported by her woman partner. These cases demonstrate that premenstrual distress is an intersubjective experience, with constructions and material practices within relationships providing the context for premenstrual women being positioned as pathological and needing to be contained, or conversely, as sensitive and needing support.

The DSM and its lure of legitimacy

The Diagnostic and Statistical Manual of Mental Disorders (DSM) offers a biomedical framing of people’s experiences of distress and impairment, and despite decades of criticism, it remains the dominant approach. This dominance is maintained not only by powerful corporate interests such as the pharmaceutical industry, but also through the everyday talk of people as they attempt to make meaning of themselves and their experiences. This paper explores how and why the DSM holds such cultural currency for individual speakers, and unpacks what is being accomplished in their taking up the language of psychiatric diagnosis. In particular, we argue that a biomedical construction of distress offers the lure, or promise, of validating persons’ pain and legitimizing their identities. However, we also argue that the very assumptions of biomedicine ensure that this promise can never entirely be fulfilled and, despite its lure, a biomedical construction of ‘mental illness’ all too frequently fails to protect individuals from delegitimation and stigma.