This file is part of the following reference: Moylan, Carol (2009) Treating depression: towards an Indigenous psychotherapy. PhD thesis, James Cook University. Access to this file is available from: http://eprints.jcu.edu.au/10578 Treating Depression: Towards an Indigenous Psychotherapy Thesis submitted by Carol Anne MOYLAN BA, Grad Dip Psych in July 2009 for the degree of Doctor of Philosophy in the School of Indigenous Australian Studies James Cook University Statement of Access I, the undersigned, author of this work, understand that James Cook University will make this thesis available for use within the University Library and, via the Australian Digital Theses network, for use elsewhere. I understand that, as an unpublished work, a thesis has significant protection under the Copyright Act and; I do not wish to place any further restriction on access to this work. Or I wish this work to be embargoed until : Or I wish the following restrictions to be placed on this work : _________________________ ______________ Signature Date ii Statement of Sources Declaration I declare that this thesis is my own work and has not been submitted in any form for another degree or diploma at any university or other institution of tertiary education. Information derived from the published or unpublished work of others has been acknowledged in the text and a list of references is given. ____________________ ____________________ Signature Date iii Statement of Contribution of Others Including Financial and Editorial Help Funding was provided to sponsor my attendance at three Conferences through the James Cook University School of Indigenous Australian Studies and the Graduate School. A professional administration service, Al Rinn Admin Specialists, was engaged to prepare the thesis for submission. Al Rinn's brief was to format and proof-read the document. iv Acknowledgements On a ledge above the desk in her office at James Cook University, my Supervisor, Prof Sue McGinty has a wood-carved snake. It was given to her by some Aboriginal elders as an expression of thanks and acknowledgement of her expertise as an educator. Knowing this story brought me to the realisation that I was in very good hands as I travelled through the PhD journey. Words alone cannot express my thanks to Prof McGinty for being there every step along the way. I would like to express my gratitude to my co-supervisor, Yvonne Cadet-James who so generously took the time to help me gain personal insight and about Aboriginal ways. Throughout this study, Yvonne steered me with much patience, tolerance and wisdom as I negotiated my path through the process of gathering and analysing data. I would also like to acknowledge the wider academic community of the School of Indigenous Australian Studies at James Cook University in both Townsville and Cairns for their support and for sharing their knowledge with me. Special thanks to the staff at the Townsville Aboriginal and Islanders Health Service Garbutt, in particular, Rachel Atkinson, Debbie Hart, Dianne Choikee and Angie Akee whose knowledge and guidance provided me with an experience nowhere else to be found in formal psychological training. I would also like to give recognition to the Aboriginal community at St Teresa’s in Garbutt for sharing their stories and their wisdom with me. For challenging me to open my mind to the wondrousness of Aboriginal philosophical thought, I give thanks to Dr Karen Martin. A number of friends have taken a keen interest in my studies and have encouraged me during my candidature and I wish to acknowledge their abiding friendships. On a more personal note, I give recognition to my father, who instilled in me as a young child a love of learning and of understanding the human condition. The strong and gentle women who are my two daughters, I acknowledge their love, humour and confidence which saw me through the ups and downs in managing a PhD. And lastly, but most importantly, I thank Jan for his unswerving steadfastness, love and inspiration to complete the work that I started at the beginning of 2002. I would also like to express my special thanks to the participants of this project and I want them to know that I will always remember their words of wisdom and their spirit of generosity. This thesis is dedicated to my cousins, Trevor, Ginger and Gail McDonald. It is also dedicated to my mother, Winnie McDonald. She was a north Queenslander. v Abstract There is a gap in the practice of psychotherapy that becomes clearly evident to non- Aboriginal psychologists who find themselves in the position of having to provide treatment to Aboriginal clients who present with the symptoms of depression. This is of particular importance given the increase in the incidence of depression both nationally and internationally. The problem stems from the reality that there is very little available by way of psychotherapeutic interventions that are culturally suitable in the treatment of Aboriginal clients who present with the symptoms of a depressed mood. A description of depression is given, and current psychotherapies outlined. At the same time, Aboriginal voices that explain Aboriginal culture and the expression of mental health is recognised and discussed. This study acknowledges these two culturally different systems: western psychological knowledge which often reflects individualistic, materialistic and secular philosophical underpinnings; and Australian Aboriginal knowledge which is mostly grounded in a philosophy that is communal, spiritual and ecological. This study aims to play a role in the continuation of the development of an Aboriginal psychological intervention that may be implemented by non-Aboriginal psychologists and that makes a contribution toward filling the present gap in psychotherapy. To achieve this aim this study recognises that Aboriginal people around Australia are the custodians of the knowledge relating to Aboriginal psychology and, as such, provide the voices that express their own philosophy and culture. This study accepts the invitation to learn from Aboriginal people and the site chosen to learn from is North Queensland. The limitations of western psychotherapy in non-western and multicultural settings are illuminated and current literature confirms that philosophy and culture are determinants not only of human behaviour but also of psychotherapy. Contemporary western psychotherapies and their theoretical and philosophical underpinnings are revisited so that expression may be given to the salience of the manner in which western philosophy and culture permeates western psychotherapy. By doing this, the gaze then moves toward considering the ways in which mainstream western psychotherapy has tried, in the past, to develop culturally appropriate treatments by indigenising psychotherapy. It also acknowledges the implications for the therapeutic relationship. Subsequently, good reason is given for acknowledging that other cultures have always had their own forms of psychotherapies. This opens the portals to learn and listen to Aboriginal articulations about their worldviews and culture. By doing so, justification is given to the hypothesis of this study that Aboriginal psychology is determined by its own philosophy and culture and this, by definition, determines a culturally appropriate psychotherapy. This leads to the research question which asks Aboriginal people what it is that they do to help someone who is suffering from depression. The data for this study was gathered over a two-year period (January 2002 – December 2003) in North Queensland. Interviews were conducted with Aboriginal Australians employed at an urban Community Controlled Health Service, Aboriginal academics, Aboriginal people from a North Queensland urban community and elders from that same North Queensland urban community. Because there are no Aboriginal psychologists in North Queensland, an Aboriginal psychologist from another part of vi Northern Australia was interviewed. On the advice of local Aboriginal consultants, a well- regarded non-Indigenous psychiatrist who has worked for many years with Aboriginal people in North Queensland was also interviewed. Indigenous research paradigms are discussed and a qualitative research design is implemented. The author used a ‘free association’ narrative and interview methodology and interpretive analysis to analyse the transcripts. Justification is given with regard to how data was gathered for this study and methodological issues are reviewed. The findings indicate that there is an Aboriginal psychology. It is grounded in a theory of connectedness and relatedness to all things. Through the voices of the research participants, recognition is given to Aboriginal philosophical thought and cultural worldviews. Aboriginal voices explain the importance of connectedness and relatedness to all things in their ways of healing. These findings offer a theoretical underpinning for the development of an Aboriginal psychotherapy that is available to non-Indigenous psychologists who treat Aboriginal clients. Examples of ways of applying a psychotherapeutic intervention within an Aboriginal paradigm are given. Findings also indicate the importance of resolving the tensions arising from the unconscious defence mechanisms brought to this encounter between Aboriginal participants and the non-Aboriginal psychologist, all of whom are viewed as psychosocial subjects. The concept of the ‘contact zone’ is applied to address these tensions within the asymmetrical power in this relationship that