Social suffering and the psychological impact of structural violence and economic oppression in an ongoing conflict setting: The Gaza Strip

Structural violence and economic oppression (e.g. control over resources, politically engineered poverty and unemployment) are common features of warfare, yet there is a lack of research exploring the impact this has on civilian wellbeing in conflict-affected areas. This study, embedded within a human rights and community liberation psychology framework, aims to address this need by studying young Palestinian university graduates living under military blockade and occupation in the Gaza Strip. Semi-structured interviews were conducted. Thematic analysis indicated that economic and political domains adversely affected multiple aspects of civilian life and wellbeing. The findings revealed the deleterious effects of structural violence and economic oppression which created: human insecurity; poor psychological wellbeing and quality of life; existential, psychological and social suffering; humiliation; injuries to dignity; multiple losses; and led to life being experienced as ‘on hold’. Local expressions and idioms to express distress were identified. The findings contributed to unique insights regarding how continual, systemic, and structural oppression can be potentially more psychologically detrimental than specific incidents of conflict and violence. The implications and the relevance of the findings to mental health and disaster relief are considered. Interventions providing human security and economic security should be prioritised.     

Giving Voice to Silence: Empowerment and Disempowerment in the Developmental Shift from Trauma ‘Victim’ to ‘Survivor-Advocate’

ABSTRACT

In the past several years, a public conversation in the United States about interpersonal violence has flourished, sustained by the work of advocates who are themselves survivors. This surge in public sharing of trauma stories is a rhetorical form of resistance to ideologies in mainstream American culture that impose silence on survivors (e.g., the “just world” belief). However, the developmental progression from trauma ‘victim’ to empowered public ‘survivor/advocate’ accommodates to dominant American cultural preferences that stories of adversity have a redemptive story line. In a redemptive story, negative experiences are followed by something positive (e.g., personal growth, lessons learned, strength gained). In this paper, we draw from theory and the sparse relevant literature across multiple disciplines to conceptualize when and for whom the redemptive storying of trauma (or, redemptive master narrative) is available, advantageous, and systemically encouraged. Among the proposed advantages of redemptive storying are its psychological health benefits; potential to empower self and others; promotion of meaning-making, mission, and communal solidarity; and the larger social/political changes that can emerge from giving voice to silenced experiences. Proposed challenges to redemptive storying include layers of societal oppression and marginalization that shape the redemption stories of many survivor-advocates; ongoing connection to or dependence on relationships and communities that enable abuse; and the reality of historical trauma and other forms of intergenerational trauma, which complicate the linear, individualistic story of redemption. With this theory-driven framework, we wish to promote compassion for survivors, along with interdisciplinary, inclusive, and intersectional research in this understudied area.     

Sense of community: Community resilient responses to oppression and change

Resilience refers to the positive ways in which people respond to adversity and stressful life events. Much of the research and writing in resilience has focused on how children respond to adversity. Community resilience, however, represents an extension of this focus. Often oppressed communities are represented as lacking in resilience and competence. Models that characterize group responses to intergroup and intercultural contact often simplify the responses of communities. Drawing on these concepts, it is argued that oppressed groups do not always capitulate or assimilate to oppressive systems, but in alternative settings these groups find ways to resist oppression and experience a sense of community. In settings such as church groups, sporting clubs, extended family networks and other organizations, groups find ways to protect and propagate what is valued and central for their survival. This has implications for how we interpret and understand the ways in which groups adapt to oppressive and changed contexts and alerts us to the dangers in underemphasizing and overlooking the positive functions of alternative settings. © 1998 John Wiley & Sons, Inc.     

Psychological and political liberation: Strategies to promote power,wellness, and liberation among anti-racist activists

In recent years, there has been a robust racial justice movement in the United States, which has pursued power with the goal of promoting wellness and liberating people from racially and historically oppressed communities. Organizations such as Black Lives Matter and Showing Up for Racial Justice continue building power and promoting psychological and political liberation. The purpose of our study is to investigate the developmental processes by which anti-racist activists resist psychological and political oppression to approach wellness and liberation. We conducted 24 interviews from self-identified anti-racist activists in the United States and utilized thematic analysis to construct qualitative codes to identify the psychological and political strategies activists implemented in their racial justice work. We found that activists adopted four psychological strategies, two political strategies, and two bridging strategies to resist oppression. Psychologically, activists tended to examine political and historical contexts to understand the root causes of oppression and how their own oppressed and privileged identities fit within those larger systems. Politically, activists sought opportunities to enhance their capacity as activists and engage in critical actions to build power and seek liberation. Bridging these psychological and political domains, activists also formulated a theory of liberation and engaged in critical self-reflection, which guided their political actions.     

The cultural persona as nexus between structural marginalization and youth risk behavior

Structural marginalization exerts its effects through multiple social-ecological levels down to the individual behavior of youth violence and related risks. However, there is very little research or theoretical literature documenting or specifying mechanisms, paths, and linkages across levels. This paper traces one path in which long-term structural constraints intersect with the adolescent development process via a construct called the cultural persona—a form of archetype or model that embodies the value-structure, role, and performance of violence and related risk behavior within the kinds of underground or street economies that develop and persist in high-poverty communities as an outcome of structural marginalization. This mechanism is described, together with its limitations, along with examples and recommendations for interventions and further research.     

Understanding mental health needs of Southeast Asian refugees: historical, cultural, and contextual challenges

Research and clinical information pertaining to mental health needs of Asians residing in the United States is limited but growing. There is a tendency to group all persons of Asian descent together and, therefore, the empirical literature does not sufficiently address the mental health needs in specific subgroups. The focus of this article is to understand the mental health needs of one subgroup of Asians--Southeast Asian refugees (SEAR). The main purpose is to review the relevant literature pertaining to Southeast Asian refugees' experiences and to understand the manifestation of psychiatric disorders by examining historical, cultural, and contextual challenges. Despite the well-documented mental health needs for SEAR, most do not present for mental health services. Therefore, resilience and protective factors are discussed. Research and clinical implications are described and suggestions are offered on how to apply information obtained from Southeast Asian refugees' experiences to future refugees.     

Ethical dilemmas in skeletal collection utilization: Implications of the Black Lives Matter movement on the anatomical and anthropological sciences

The Black Lives Matter (BLM) movement has brought to the public eye longstanding issues of social and racial injustice which have permeated the experiences of individuals of African ancestry in the United States and abroad for centuries. Motivated by a desire to disassemble a framework of systemic racism, the BLM movement has infiltrated numerous social and political arenas including the sciences, demanding change. The impact of the BLM movement is evident in the attention recently garnered by protests of museum skeletal collections' acquisition and handling of African/African American human remains. It is from this vantage point that we explore the ethical issues pervasive within United States skeletal collections and forensically relevant issues surrounding the unclaimed decedents of marginalized populations; colonial/imperial ideological formations, which construct and sustain power differentials in anatomization; and conceive of a path forward that prioritizes personhood.     

Development of a barbershop based violence intervention for young Black emerging adult men

A crucial gap in the education literature are the health interventions situated for the unique experiences of Black emerging adult men (BEAM), one of the most vulnerable populations in the United States The article describes the systematic development of a theory‐based, culturally tailored, barbershop‐based violence intervention for BEAM, aged 18–24 years. The process included developing a community advisory board, selecting a theoretical framework, incorporating community‐based participatory research principles, and conducting formative research with BEAM and barbershop owners. The result was Shape Up: Barbers Building Better Brothers, a 2‐day retaliation violence risk reduction intervention focused on increasing retaliation restraint self‐efficacy beliefs and skills and reducing the number of violent incidents. Intervention sessions were facilitated by barbers who used iPads to deliver the content. As a high‐risk population, this intervention has great public health significance for the health of BEAM.     

Identifying community risk factors for violence against indigenous women: A framework of historical oppression and resilience

Violence against Indigenous women tends to be disproportionately high, yet little is known about the historical and community factors that may exacerbate and perpetuate intimate partner violence (IPV). Using a framework of historical oppression, the purpose of this article is to uncover community‐level risk factors identified by Indigenous women who have experienced IPV, and the professionals who work with them. As part of a larger critical ethnography, this study focused on data derived from 49 semistructured interviews with Indigenous women who had experienced IPV and the professionals who work with those affected by IPV. Critical thematic analysis identified various themes related to historical oppression, including cultural disruption, IPV imposed and then internalized as a community norm, community divides, and community inequity, which likely exacerbated or perpetuated IPV. Given the causes of IPV have historical and structural roots, interventions and solutions must be designed with these structural determinants in mind.     

Muslims and mental health concerns: A social ecological model perspective

Muslims in the United States experience many psychosocial issues and underutilize mental health services. This study sought to systematically identify the common issues and strengths of the Muslims affiliated with a college in the Southeast region of the United States and address them accordingly. A survey comprising 33 items and 2 open‐ended questions regarding common issues and strengths was constructed. A total of 116 participants completed the survey. The overall rating for items was quite high, whereas the satisfaction rating was very low. The most important item was, “You have prayer places/rugs, ablution stations, and water in restrooms,” with an importance rating of 94.52% and a satisfaction rating of 20.50%. Four items regarding mental health were rated as the least important, and participants reported lack of knowledge regarding mental health services. This is the first study that includes a list of common concerns and strengths of the Muslim communities affiliated with colleges in the United States.     

Resilience and Beliefs in the Effectiveness of Current Antiretroviral Therapies Among Recently Disengaged Low-Income People of Color Living with HIV

Abstract

Consistent antiretroviral adherence is key to viral suppression, but many low-income people of color living with HIV are not optimally adherent due to a wide variety of interrelated social and structural factors. Previous studies have found that HIV medication beliefs are an important facet of adherence. In contrast to the AZT era?, currently available antiretroviral therapies are significantly safer and more effective, but research suggests that negative beliefs may persist among racial and ethnic minority people. Twenty-seven semi-structured interviews were conducted with low-income Black and Latinx people living with HIV in New York City that were currently, or had been recently, disengaged from outpatient HIV medical care. This research suggests that socially and economically marginalized people living with HIV, many long-term survivors who lived through the AZT era, recognized that current treatments are very effective in making HIV a chronic, manageable illness and a significant improvement compared to the therapies early in the epidemic. Most importantly, the data suggests that people demonstrate great resilience despite their experiences of social and economic exclusion. Both clinical practice and public health interventions can benefit from these findings. HIV care providers should speak with patients about their beliefs related to HIV medication, and public health interventions should specifically address HIV medication-related beliefs in order to enhance adherence. In order to avoid reifying people’s marginalization, public health should endeavor to recognize and support people’s resilience.     

HIV testing in an ethnically diverse sample of American university students: associations with violence/abuse and covariates

Associations linking HIV infection to violence and abuse are well documented; however, little is known about how violence/abuse is related to HIV testing behavior, particularly among undergraduate university students, who test at lower rates compared to non-student peers in the United States. We assessed history of HIV testing in an ethnically diverse sample of undergraduates in California (n = 1,210); and examined potential associations between testing and various forms of violence/abuse, while controlling for covariates. Whereas 73.4 % of students were sexually active in the past year, only 26.3 % had ever tested for HIV. At the bivariate level, testing was associated with experiencing verbal abuse and sexual violence/coercion, and perpetrating verbal abuse. Experiencing verbal abuse remained significant in multivariate analysis. We discuss findings in a syndemics framework, considered in combination with social psychology-based health behavior theories. Enhanced HIV testing scale-up initiatives for undergraduates are needed and should consider integration with violence prevention programs.     

Reflections from novice youth participatory action researchers: Emphasis on critical gender perspectives

Rooted in multiracial feminist theory, this research investigated the roles of adults engaged in youth participatory action research (YPAR) projects focused on developing critical perspectives of gender, power, and critical hope with the youth of color. Across 10 weeks, two novice adult facilitators documented ethnographic observations (i.e., voice memos) of their experiences collaborating with youth in YPAR. Voice memos were transcribed and coded for emergent themes. Our findings highlight how we deconstructed adultism, prioritized humanizing youth, and integrated critical gender perspectives to understand gender as a mechanism of systemic oppression. Our purpose was to capture moments of breakthroughs, realizations, and tensions as scholars contending with inexperience in YPAR and share our journey with other researchers interested in YPAR. We provide recommendations for adults to develop pathways towards humanity for the youth of color, collective resistance and take social justice action steps towards a critically hopeful future.     

Pockets of Peace: A mixed methods,exploratory study of neighborhoods resilient to juvenile violence

Social science research has focused on hot spots of adolescent violence in marginalized urban neighborhoods for nearly a century. In contrast, in this study, we explore under-resourced urban areas that do not experience high rates of adolescent violence: “pockets of peace.” We use a mixed-method approach to identify the sociodemographic, geographic, and criminological commonalities and differences between pockets of peace and other areas of concentrated disadvantage dealing with high rates of adolescent violence in Indianapolis, IN. More than one out of every ten of Indianapolis' areas of concentrated disadvantage meet the criteria to be labeled “pockets of peace.” Quantitative data indicate that these areas have fewer prosocial institutions and experience lower homeownership rates than comparison under-resourced areas, and qualitative data point toward rental stability and residential longevity as potentially salient social factors within these contexts. As an alternative to using statistics to control for the context of structural disadvantage, studying pockets of peace and other “cold-spots” of adolescent violence presents an opportunity to understand community-level resilience within the real, lived context of structural disadvantage.     

HIV in transgender communities: syndemic dynamics and a need for multicomponent interventions

Transgender communities are among the groups at highest risk for HIV infection in the United States. Using syndemic theory, we examine how HIV risk in transgender communities is embedded in multiple co-occurring public health problems, including poor mental health, substance use, violence and victimization, discrimination, and economic hardship. Although safer sex counseling and testing programs are essential platforms for HIV intervention, these modalities alone may be insufficient in reducing new infections. Multicomponent interventions are necessary to respond to the complex interacting syndemic factors that cumulatively determine HIV vulnerability in transgender individuals.     

The resilience of Peruvian immigrants through participation in community-based organizations in urban Chile

This study explores the situational elements related to the resilience of Peruvian immigrants in Santiago, Chile. Through extensive fieldwork with Santiago community-based organizations, in-depth semistructured interviews (N = 18) completed with Peruvian leaders, and an innovative grounded theory situational analysis, a critical psychopolitical framework of community participation of Peruvian immigrants was generated. More specifically, three main themes emerged from data analysis and describe resilience processes, including, negotiating historical narratives and multiple identities; navigating to resources; and resisting racism and dehumanization. Results describe how community participation plays a role in promoting resilience by transforming immigrants' conditions and contexts while increasing their sense of mattering, and their access to resources and human rights.     

Promoting resilience in street connected young people in Guatemala: The role of psychological and educational protective factors

Street connected young people (SCYP) are at risk of encountering negative life experiences, such as abuse, neglect, violence and exploitation. Nonetheless, some demonstrate remarkable resilience. This study therefore aimed to explore protective factors that promote resilience in SCYP in Guatemala City. Using ethnographic interviews and image elicitation eight young people and four adult educational outreach project coordinators participated within this study. Three key protective factors emerged that help develop resilience; Empowerment, as educational projects support SCYP and provide opportunities; Belongingness, encapsulated creating positive relationships, a sense of affinity and positive family environments; and Motivation which highlighted the importance of the young peoples’ willpower, engagement with learning and help-seeking behaviour. Educational projects working with SCYP can help to develop resilience by empowering them for change, providing a sense of belonging, while also acknowledging their individual motivation for change.     

WOMEN'S COMMUNITY MOBILIZATION AND WELL‐BEING: LOCAL RESISTANCE TO GENDERED SOCIAL INEQUITIES IN NICARAGUA AND TANZANIA

Although it is well‐documented that globalization has exacerbated structural factors that contribute to rising levels of gender inequality, social actors from diverse local contexts demonstrate that women are not mere victims, but rather have worked actively to resist oppression and promote women's well‐being worldwide. Self‐mobilized groups of women throughout the world are engaging in complex processes of renegotiating structural and relational injustices that transform women's well‐being. The current article focuses on how two groups of women–one in Nicaragua and one in Tanzania–use land rights to reconfigure gendered power relations that have been exacerbated during realignments of global power. We examine how conscientization, or a critical consciousness surrounding experiences of gender discrimination, motivated resistance, collective mobilization, and social change. The analysis provides evidence for theories of struggle and everyday resistance that represent how community contexts enable and support women's struggle for justice in an increasingly globalized world.     

Introducing abortion patients to a culture of support: a pilot study

Currently in the United States, women who have abortions face a societal culture in which disapproval, stigma, and misinformation about the risks and sequelae of abortion are common. The purpose of this study is to pilot test an intervention that introduces abortion patients to a “culture of support” by providing validating messages and information about groups and services that support women in their reproductive decisions, addressing stigma, and providing information to help women identify and avoid sources of abortion misinformation. Twenty-two women who completed their post-operative exam after abortion were enrolled to take part in the study intervention. In-depth interviews were conducted to explore patient experiences and responses to the intervention. All (22/22) participants responded that they believed that interventions like the one studied could help women avoid letting the judgmental actions and attitudes of others “get to them so much”. All (20/20) participants felt that the intervention was personally helpful to them. An intervention that introduces women having abortions to a “culture of support” was well-received. This study provides a framework for future research about the content, strength, and effect of societal and cultural influences on women having abortions and for additional research about interventions to promote resilience after abortion.     

Understanding the burden of trauma and victimization among American Indian and Alaska native elders: historical trauma as an element of poly-victimization

ABSTRACT

Research on recognition of adverse childhood experiences (ACEs) and poly-victimization has transformed our understanding of violence and trauma exposure. Both concepts point to the importance of understanding the cumulative burden of trauma and the interconnections among forms of violence and abuse. However, there has been little conceptualization about what these two constructs mean for American Indian and Alaska Native (AI/AN) individuals, families, and communities, and even less attention to the experiences of AI/AN elders. This paper summarizes prior work on adverse childhood experiences and poly-victimization, addresses the limitations of past research on these issues, and expands these constructs to include concepts of historical trauma in order to better understand victimization and trauma among AI/AN elders. We call for the integration of historical trauma into the poly-victimization framework for AI/AN communities in order to more accurately capture the true burden of victimization among AI/AN peoples. Future research, prevention, and intervention can better incorporate historical trauma and we provide suggestions for doing so, including adding items on historical trauma to poly-victimization surveys and creating programs to promote cultural connectedness.