Ko Ngongotaha te maunga
Ko Utuhina te awa
Ko Tunohopu te marae
Ko Te Arawa te waka
Ko Ngāti Whakaue te Iwi
Ko Kara Areta Alice Beckford ahau.
I wanted to start with my pepeha because it better describes who I am beyond any English language identifiers or descriptive words that I could use. My pepeha situates me in relationship to who has come before me and to the land and waters that I belong to.
Mental wellbeing is so inextricably shaped by our relationships; familial, societal, cultural. It is the story of our histories, circumstances, misfortunes and strengths. Understanding the intricacies of the dynamics that shape my mental health has been crucial in how I have learned to enhance my own wellbeing. The intersections of my identity, individual and cultural history and background tell a story about how I have moved through the world. It also shines a light on why my relationship with the mental health system is so strained.
In my experience, the mental health system in NZ and most Western societies is problematic in that it is fundamentally individual-focused, Eurocentric and inaccessible or culturally incongruous to many people who need to utilise it the most.
The dominant focus on the individual in mental health practices is not entirely detrimental. Providing a space where individuals can reflect on their struggles, trauma and pain is beneficial in a world which so often wants us externalise measures of wellbeing, success and happiness. Success in our careers, partnerships, and acquirement of material goods are considered as markers to measure just how well we are. Yet the individual-focused feature of therapy allows us to look inward to access our own wellbeing and emotional health.
But this same focus does not mirror the world that we have to walk back out into after our one-hour session is up. Our wellbeing is largely shaped by our relationships to our family, community and wider social structures. If these remain in the same condition as they did pre-therapy how then do we manage to be or stay well? Especially if we occupy marginal positions in society! Cognitive behavioural therapy gives us the tools to change the way we think and behave that might impact on our wellbeing - but there needs to be a dismantling of systems of oppression that may have led to our mental health problems in the first place.
The problem is not that individual and cognitive-focused therapies are bad, the problem is that they dominate the mental health system - including how we understand and talk about mental health. There are rarely community-based models or resistance-based models of mental health that we can access alongside individual based models.
The individual-focused approach of dominant mental health practice mirrors Eurocentric understandings of mental health. That is, that mental health is something that can be decompartmentalised from the holistic nature of human wellbeing. That there is a universal measure of successful and fulfilled living and that European cultural values best conceptualise wellness versus disorder. For example, emotionality is often positioned as something to learn to detach from through rationality or intentional and controlled reasoning.
Throughout my contact with the mental health system my emotions were always talked about as feelings that I could overcome and sit with long enough to mitigate their power over me. What I have come to understand in my late 20s is that emotionality in and of itself is often a very good call to action.
In my cultural background, emotionality is so closely related to spirituality that your emotions may be even better at letting you know what to do; what is right or wrong; whom to protect yourself from and whom to open to. Culturally incongruous messages such as this (along with the cost of therapy) adds to inaccessibility of mental health services for many ethnic groups in Aotearoa, especially Māori.
I read a quote online once that said sad white kids go to counselling and sad brown kids go to jail. The statement would be laughable if it weren’t so true. Not only that, but when we do gain access to a mental health service, most of the clinicians and practitioners we come into contact with have not had experiences like the ones we have had. They often don’t even live in the same world as us.
In order to be a clinician or psychologist you need particular cultural capital; firstly, to get through university at a graduate level; and secondly, to prescribe to or adhere to particular models of therapy which are culturally infused with values based on Western models of health. Clients who might be able to access mental health services one day will likely come into a clinical environment, and have to draw out the deepest and darkest parts of themselves in front of a stranger who shares very little about who they are. There is no meeting in the middle, no sharing, no ebb and flow of experience that might incite collective growth. There are many theories that justify this, that I won’t go into. But the premise of these Western models do not include us into its research and knowledge production.
Access to mental health care is usually allowed after something bad has happened, in my case, rape. Mental health support for people like me is then less about wellbeing, prevention and support for healthy development, and more for when shit hits the fan. In cases like this (that often thematise the experience of Brown, Black, poor and/or queer people), we have even less power over which modes of therapy might better suit us, because the ones we can afford or can gain access to are often available only remedially and oftentimes as a result of initial contact with either the judicial or social service systems, or/and because of the experience of trauma, or/and systematic disenfranchisement.
Mental unwellness is cyclical in this way for many poor, brown, Black, and/or queer people in Aotearoa, meaning that we are often born into contexts that nurture unwellness and then move into ones under the guise of a remedy that actually propagate the same system that created the circumstances of our unwellness in the beginning.
I would love to see a mental health system that reflected the diversity of the world we live in. Further, one that was based on equity; that is, those who need it the most have access - and access doesn’t just look like funding. It looks like an approach to mental health support that utilises the strengths of people instead of focusing so much on deficits, disorder and pathologies. That the emotionality and spirituality of those people would be reflected back in institutions. That community initiatives received as much funding and social capital as clinical CBT-based practices. That access to mental health services for disenfranchised and marginalised people was available to provide supportive and preventative strategies as opposed to remedial. That young people did not have to go to jail before being able to access support. Also, that mental health practitioners and systems understood how social systems work to marginalise people and keep marginalised people unwell. That the strategies we get given in therapy to go out in the real world were more than just about mindfulness, breathing exercises and medication.
If I were to reimagine a mental health system that better suited people like me, it would look like an acknowledgement of all the areas of life that impact on wellbeing: that is access to healthy food, warm safe homes, a living wage, knowledge of healthy lifestyles, active participation in social change, spiritual wellbeing and strength-based approaches to conceptualising wellness.
In line with my pepeha, my story could not be told before telling the story of the communities I belong to or without first speaking on the need for social justice within mental health systems. The personal is most definitely the political.
This is my story.
In my case, although my Māori identity speaks volumes about who I am, it does not describe all that I am, nor the subsequent history or status of my mental health. I am a Māori, Black and Queer woman who is migrating classes through tertiary education but who grew up in working class and working poor families and communities.
This is an important context to consider when I focus on my own mental health and wellbeing. My mental health cannot be separated from my body, my spirituality, to whom and where I belong, those whom I love, who have loved and hurt me, and the world that further contexualises these dynamics.
I come from a diverse and vibrant cultural background; I have drawn inspiration and learned resilience through this belonging and dislocation. In many ways, my background reflects the many factors that correlate to mental health problems. I have experienced family violence, childhood sexual abuse, racism, poverty, issues around migration and classism at both a generational and individual level.
It also reflects the ways in which I have learned to understand wellness in multidimensional and holistic terms. My background has provided me with a foundation from which I have learned to utilise aspects of the mental health system that work for me, while disregarding others.
Growing up, I become acutely aware of wellbeing; of mental problems and distress that related to these experiences. I noticed that there was excruciating silence around this distress. There was almost no information around gaining access to services which may have supported my wellbeing or that of my family members. That is not to say that we did not have our own forms of therapy - but focusing on the mental health system, there were absolutely no pathways for people in my communities growing up.
If my grandfather was hurt he would drink or lash out in violence. If my mother was sad she would stop eating. If my grandmother was worried about money she would pick at her skin. I noticed all the ways that people around me hurt and the lack of help afforded to them, along with the excruciating weight of social norms.
I taught myself to self-soothe at 11 years old through cutting. I had been raped at seven and molested a few times after that, and had struggled to find a release for the intense pain I carried around in my young body. At high school I was approached by the mental health nurse who had been informed by a teacher that I was self-mutilating.
I saw the counsellor a few times from the ages of 15 to 17, and this was the first time I had heard about depression. She talked me through the possibility of organising a script of antidepressants for me to try. After talking it through with my mum, it became apparent that I would not be taking any medication. Upon reflection, my understanding of this choice was that depression was a normal part of the human experience; it was particularly a normal and understandable experience of marginalised people who live with the realities of trauma, racism and poverty, although my mum did not know that I had been raped as a child at the time.
When I was 22 and living in Perth, Australia I spoke to my doctor about a fear of flying that I had developed. The only reason I did this was because half of my family, including my father, lived in London and I had to be able to fly if I wanted to see them.
The doctor referred me to a psychologist. This was the first time I had ever sought help for a mental problem as an adult. Fortunately the sessions I did with this psychologist were funded. This was the first time I heard the word anxiety and this label has stuck with me ever since.
In my mid 20s, my anxiety peaked; I had trouble sleeping, eating in public, going to the bathroom and had debilitating fears around abandonment. I decided to once again go and seek out therapy. At first I paid for therapy myself, it was $120.00 a session. The therapist was a lovely, middle-class Pākeha woman.
Eventually, the issue of childhood sexual abuse started to rear its ugly head. I was in a relationship at the time, and found myself in a situation where a man wanted to have sex with me and I was unable to say no. The absolute inability to think or move resulted in at best, coercive sex, and led to the breakdown of the relationship I was in at the time when it was falsely labelled as cheating. I was riddled with guilt, fear and shame over freezing and once again not being able to say no. This was the experience that propelled me into finding out about therapy for sexual abuse. I discovered ACC services and began my journey into unravelling years of trauma that I had not been able to face until that point.
My first ACC therapist diagnosed me with post-traumatic stress disorder; my second with PTSD and borderline personality disorder which she believed was in remission. The third therapist I saw was less focused on diagnoses and worked from a strengths-based approach, which considered my resilience and reimagined parts of my character or spirit which I had previously thought of as in need of fixing.
It was and still is not easy for me to access and open up in spaces which do not reflect who I am, my values and worldview. I have had lovely, well-meaning and affirming contact with therapists throughout my eight years of therapy . But I have also experienced Eurocentrism, racism, microaggressions, and presumptions about my cultural background and sexual orientation. None of these experiences are isolated. They relate to the Eurocentric Western and individual-focused culture of psy- therapies in NZ.
My journey is ongoing and I seek therapy in many different ways now; cups of tea in bed, full moon energy, whānau, womens’ circles, crystals, exercise, healthy eating and nature as well as continuing to pull from therapy what I can use to grow and heal and affirm myself with. I throw out the rest and I always remind myself of where I have come from. How far I have walked to make it here alive, whose shoulders I stand on and where to draw from for empowerment. I am never alone and that’s exactly the idea that mental health systems need to propogate. The notion that our trauma, pain, circumstances and healing is not only ours, it belongs to the whole world. Logically, aside from introspective work, that is where we need to turn for true, deep and long-lasting preventative healing - so that the very circumstances that led to our own trauma may be diminished for the people who come after us. The white supremacist capitalist patriarchy, as Bell Hooks calls it, needs dismantling - or people can never truly be well.
Mental health and wellbeing is multidimensional and is reflected by a healthy society, community, whānau, community, spirit, body, heart and environment. No therapy can work without considering this.