Psychological wellbeing and young Somali women in Sheffield

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Psychological wellbeing and young Somali women in
Sheffield

• a qualitative study with young Somali women
  around their experiences and understanding of
  emotional well-being and problems.
• Sara Whittaker et al Clinical child psychology
  and psychiatry (2005). 10(2) 177-96.

• Dr. Sara Whittaker,
• Clinical Psychologist, RHH - 2713583.
• Prof. Gillian Hardy and Dr. Linda Buchan.
• Dr. Kathryn Lewis (SCT- West Child and Family
  Therapy Service).
• 2001 - 2003.

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Method Design

• Utilise workshop-type techniques to build trust,
  engage and motivate involvement.
• Audio-Tape.
• Interpretative Phenomenological Analysis (IPA
  Smith et al) new to groups.
• Co-constructed transculturally between
  participants and researcher

• Qualitative
• 3 Group Discussions and 6 follow up Individual
  Interviews
• 2 before and 1 follow-up group to check themes
  and transcripts
• Prior and ongoing work with informants
  cross-cultural understandings.

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• Themes Sub-themes
• 1. Resilience and Protection
• 1a. Get on with it approach
• 1b. Support (family, religion, services)
• 2. Identity and Beliefs
• 2a. Conflict and convergence
• 2b. Navigation and acculturation
• 3. Concealment, Secrets and Distancing
• 3a. Concealing concepts and emotions
• 3b. Secrets

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1.Theme 1 Resilience and Protection Support
Family

• And lots of relatives so I wont feel
  lonely. They visit us quite often. (Laughs)
  Its not good to be lonely. Some people, they
  dont visit their relatives, they stay alone.
  Maybe sometimes something will enter them, and
  they feel distressed. It means sometimes they
  may talk to themselves. Anything could happen
  to you. Zeta

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Support Religion

• Every step that you take you have to refer it
  from the Quran and Islam and read chapters.
  We believe the, the religious is like a medicine
  for life. Aisha - Group 2

• Religion was another strong force in the
  participants lives, promoting psychological
  wellbeing and providing guidance in difficult
  periods.
• The Quran was a source of guidance in how to
  react, understand, and cope with loss and
  difficulties.

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Spirit Possession

• Religion Islamic jinn possession
• Culture zar or Sar Somalian traditions and
  practices
• (DSM IV, 1994 zar or zaar culture bound
  syndrome)

• Mental health
• Protection
• Treatment
• Confusing,
• complex,
• misunderstood,
• different interpretations.

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Treating spirit possession

• You have to have faith. God can help them,
  nobody else can, help them The Iman might
  recite the Quran the spirit might go. And if
  it doesnt go, you, you dont have to give up,
  just keep trying. Its just like its a
  punishment, you know, Gods give you. So the
  zar, my aunty still has it, I dont know
  whether, when its going to go, it depends on
  Allah, God. Anna

• Religious leaders can do certain spiritual
  things to kind of release her from whatevers
  possessing her. So Id just take her, I dont
  know, to a mosque or something Monique
• Zar ceremonies

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2. Theme 2. Identity and beliefs2a. Conflict
and convergence

• Conflicts between religion and culture are
  exemplified by the debates concerning spirit
  possession, gender, family responsibilities, and
  female circumcision.

• Honest to god, culture wise its just crazy.
  Culture has just gone totally wrong. So that
  shows culture is more strong than anything else.
  Aisha - Group 2

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2b. Navigation and Acculturation

• More recently arrived asylum-seekers tended to
  have more traditional beliefs, had familial
  experience of zar possession in Somalia, and were
  very concerned about and afraid of zar spirits
  possessing and controlling them.
• They believed that zar could explain anger,
  nightmares, unusual behaviours, pains, and even
  pregnancy.

• Were scared of that people sometimes they
  speak to themselves. If you touch anything of
  them, you know, what the zar likes, you know,
  he might get angry at you, and he might go to
  you. Anna - Group 2

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• The women who had been in England for longer (and
  were more acculturated to western ideologies)
  were very sceptical about the existence of zar
  and of cultural methods for dealing with
  possession.
• They were more likely to feel that spirit
  possession was freaky, weird, and silly.

• Some person will say, I want a party today
  because my zar wants this and that, and this and
  that, which is a bit!
• I think, for me its, the way I see it, its a
  crazy thing. I can remember when I was a kid and
  I used to see my aunty doing crazy things then, I
  used to say, no, silly, its just silly She
  believed it! Shabia

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• Shabia and Aisha thought that some people who
  were called possessed might actually be ill.
• The women were not sure whether features like
  having additional strength supported the
  existence of spirit possession or mental illness.
  
• It was largely felt that spirits would leave by
  reading the Quran or seeking exorcism from the
  Iman.

• For illness and mental health problems
  participants felt that religion or medicine, not
  zar ceremonies, were needed.
• However the use of religion does not forbid the
  use of medical or other services.

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3. Theme 3. Concealment, Secrets and Distancing
Concealing Concepts and Emotions

• concealing spirit possession from each other
  especially if been in UK longer
• tending to say that mental health problems and
  psychiatric medication were not for them

• appearance was important for the Somali women in
  assessing and describing psychological wellbeing

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Conclusion and outcomes

• Cultural Knowledge
• Complex insight into refugee Somali women
  tensions and confusions, particularly around
  support and concealment.
• The study details unique personal experiences and
  provides a window into the participants world
  and understanding.

• Cultural Competence
• Consider how to develop services, and one to one
  work.
• Navigate between metaphors and develop shared
  understandings trust.
• Fears re confidentiality family and
  professionals.
• Spirit possession.

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Clinical implications

• Participants asked that
• Professionals learn a little about their culture
• They could access services without Somalis
  knowing because of concerns about
  confidentiality.
• Accessing services could be seen as abandoning a
  relative.
• Clinicians need to establish whether ideas about
  spirit possession are relevant, as religious or
  traditional techniques for dealing with emotional
  problems may also be being utilised.

• Differences within and between cultures.
• Not all Somalis hold the same beliefs.
• Need to navigate between different metaphors and
  social understandings of distress, between
  training and clients understandings.
• Cultural beliefs may be helpful or unhelpful for
  different therapies.