A University of Sussex DSW thesis Available online via Sussex Research Online: http://sro.sussex.ac.uk/ This thesis is protected by copyright which belongs to the author. This thesis cannot be reproduced or quoted extensively from without first obtaining permission in writing from the Author The content must not be changed in any way or sold commercially in any format or medium without the formal permission of the Author When referring to this work, full bibliographic details including the aut hor, title, awarding institution and date of the thesis must be given Please visit Sussex Research Online for more information and further details 1 Telling the truth? Exploring notions of self and responsibility with young people involved in treatment for harmful sexual behaviour _____________________________________________________ Matthew Ellis A thesis submitted for the Doctorate in Social Work University of Sussex December 2017 2 Statement I hereby declare that this thesis has not been and will not be, submitted in whole or in part to another University for the award of any other degree. Signature:……………………………………… 3 Acknowledgements Although their stories are sometimes difficult to hear, they are perhaps equally difficult to tell, and I am extremely grateful to the young people who have shared their time with me as part of this research. I am also thankful to many others who have supported and encouraged me over the past few years. Numerous people at the organisations where I worked have provided practical support and advice, and my professional colleagues have, on many occasions, patiently sat and listened to me talk about my research. My supervisor, Michelle Lefevre, has not only provided the continued guidance and feedback that I needed, but has sustained me many times when my confidence wobbled. I don’t know how I could have managed without her. My second supervisor, Rachel Thomson, has also kept me on track, especially in the latter stages. Working with both of them has been a privilege. It has been a pleasure to make this journey alongside my doctoral colleagues, Mark, Simon, Jo, and Alberto. Cristina made it possible for me to complete what I started. Immeasurably kind and generous, patient, and funny. Finally, I want to dedicate this thesis to my children, who give me energy, and keep me focussed on what’s important in life. 4 Summary This thesis combines autoethnography (Adams et al., 2015) with a psychosocial (Frosh, 2010; Hollway and Jefferson, 2013) approach to explore notions of self and responsibility in the self-narratives of young people involved in treatment for harmful sexual behaviour (HSB). It reflects an area of professional interest for me as a social worker involved in the assessment and treatment of young people classified as having sexual behaviour problems, and appears to be an under represented area of the research literature. Working with the psychoanalytic concept of transference I also explore how as a researcher I make sense of the ways in which professionals and young people encounter each other in treatment. Drawing on poststructuralist conceptions of self and an ethical life (Butler, 2005), I suggest that treatment operates as a form of ethical violence, if ethical violence is to require a coherent self-narrative from young people as part-evidence of them taking personal responsibility (Butler, 2005). Rather than focusing on the ‘truth’ of a ‘seamless story’, I am interested in what Butler (2005) calls ‘enigmatic articulations’ that cannot easily be narrated. From this perspective I use autoethnographic methods and psychoanalytic tools to consider how unconscious dynamics might be enacted between practitioners and young people in treatment to produce meaning, and to make sense of discomfiting, and sometimes conflictual experiences. The empirical study employed a qualitative longitudinal design (Thomson, 2012) gathering narrative data over the course of eight months from six young men aged between sixteen and eighteen, at various stages of treatment for HSB. Interviews were conducted using the ‘Free Association Narrative Interview’ method (Hollway and Jefferson, 2013), and complemented with creative/arts-based techniques, such as music and collage (Thomson, 2008). Personal reflections and insights, aroused through my own transference were also produced during data collection and analysis. Data analysis was inductive, utilising narrative (Doucet and Mauthner, 2008), and psychosocial approaches (Frosh and Baraitser, 2008; Hollway and Jefferson, 2013), informed by psychoanalytic (Laplanche and Pontalis, 1973; Zizek, 2006; Frosh, 2012) and social (Butler, 2004, 2005; Frosh, 2010) theoretical perspectives. Findings are presented in the form of three case studies, influenced by the psychoanalytic case study tradition (Forrester, 1996) and autoethnography (Ellis and Rawicki, 2013), which serve as exemplars, illustrating themes that emerged from the wider data set. Each presents my understanding and interpretation of the young person’s story, in relation to their experience of treatment as provided over the course of the interviews. The case studies also highlight some of the complex struggles involved for young people in trying to narratively locate themselves between various, and often competing discursive demands, and provide insights from my experience as a practice informed researcher and interlocutor engaged in collaborative meaning making. The narratives are analysed to reveal discordant voices characterised by contradictions and 5 inconsistencies; fears, anxieties and uncertain futures, as well as un-narrated feelings of dangerousness, which are echoed and amplified through my own highly personalised reflections. The thesis makes a number of original contributions, and develops new substantive knowledge regarding an understanding of young people attending treatment for harmful sexual behaviour, particularly in relation to how they view themselves and their treatment journeys. By writing autoethnographically, and using this to present participant stories as multivoiced narratives I am bringing both a researcher, and practitioner perspective into view regarding young people’s understanding of responsibility, truth and disclosure. The application of Lacanian-influenced, psychosocial, creative, narrative and autoethnographic methods is original in its approach to researching ‘beneath the surface’ with young people involved in treatment for HSB. The thesis also generates valuable insights in terms of the limits of narrative approaches to treatment, and the support needs of practitioners. 6 Contents Summary…………………………………………………………..……………..……………………. 4 1. Introduction and Overview……………………….………......……………………………. 10 1.1. Why research this subject? Professional background and context...... 11 1.2. Rationale and research questions…………………….……………..…….…………. 13 2. Treatment for young people with harmful sexual behaviour: A review of the literature……………………………………………………………….…….. 18 2.1. Emergence of the ‘young sexual abuser’……………………………….….………. 19 2.2. Treatment Origins…………………………………………………………………………..… 20 2.3. Current Treatment Practices………………………………………………………..…… 22 2.3.1. Treatment Approaches…………………………………………………………..……… 23 2.3.2. Abuse Specific approaches………………………………………….……………..…. 25 2.3.3. Holistic approaches………………………………………………………..…………….. 26 2.3.4. Resilience Based approaches…………………………………..……………………. 27 2.4. Reasons for treatment…………………………………………………..………….…….. 29 2.5. How Young People Account for Themselves in Relation to Treatment 31 2.6. Conclusion………………………………………………………………………………………… 32 3. Towards an ethical life. Becoming safe by making sense of life and self……………………………….……. 33 3.1. Narrative Identity. Making sense of life and self…………………………..….. 34 3.2. Taking Responsibility………………………………………………………………………… 37 3.3. Confession……………………………………………………………………..………………… 40 3.4. Ethical violence……………………………………………………………..…………………. 43 3.5. Conclusion………………………………………………………………..………………………. 46 7 4. Methodology………………………………………………………………………………………… 47 4.1. A Psychosocial Approach……………………………………………………………...….. 48 4.1.1. Transference, and Psychoanalytic Theory…………………….…………….…. 51 4.2. Autoethnography……………………………………………………………….……..…….. 56 4.3. Writing as Inquiry…………………………………………………………….………….…… 58 4.4. Representing through case studies……………………….……………………….…. 59 4.5. Conclusion………………………………………………………..…………………………..…. 61 5. Method……………………………………………………….……………………………………..... 62 5.1. Qualitative Longitudinal Approach……………………….…………………………… 62 5.2. Sampling and recruitment………………………………………..………………..…….. 63 5.3. Data set……………………………………………………………..……………………………… 64 5.4. Interview design……………………………………………..………………………………… 65 5.5. Creative, visual, and audio methods…………………………………………………. 67 5.6. Data analysis…………………………………………………………………………………….. 68 5.6.1. Analysis of the whole data: Attention to narrative………...............….. 69 5.6.2. Themes around conflict…………………………………………….……………….….. 70 5.6.3. Analysis of three participant data sets……………………..………….….…….. 71 5.7. Writing the case studies…………………………………………………………..……….. 73 5.8. Ethical considerations………………………………………………….………………..….. 74 5.8.1. Ethical approval…………………………………………………………………..…….….. 74 5.8.2. Consent………………………………………………………….……………………………… 75 5.8.3. Relational ethics……………………………………………………………………………. 75 5.8.4. Ethics of care: for self and others…………………….……………………………. 76 5.9. Conclusion………………………………………………….………………………………..….. 77 8 6. Case Study: Mike…………………………………………………………………………………… 78 6.1. Mike’s Story…………………………………………………………..…………………………. 79 6.2.