In the AIR Interview we speak with African practitioners that are breaking ground and offering fresh insights and perspectives on violence against women and girls, HIV/AIDS and emotional well-being/mental health.
In our first edition we sat down with Dr. Taiwo Afuape is a Nigerian British-born clinical psychologist and systemic therapist currently based in London, United Kingdom to discuss her training, politics and approach to psychology and clinical practice.
AIR: What compelled you to become a psychologist?
Taiwo Afuape: This is always a very difficult question to answer because how I answer it depends so much on where I choose to start my story. My journey has no real beginning and many different beginnings, at the same time. I could start with my ancestral background and the inherent sense of being part of a collective intrinsic to my culture, or the many acts of kindness and community I witnessed from my parents, or how I was always encouraged to see my own struggles with life as linked not just to the world, but to other people who struggle.
My original intention was to become an activist and I only pursued psychology once I understood that there were movements, going back decades if not centuries, that politicised distress and wellbeing and combined psychological intervention with activism. Despite finding it hard to speak in many ways, I went into a profession based on ‘talking as therapy’, partly because I was always someone people – from total strangers to close friends- would talk to about difficult experiences and feelings, and partly because I discovered ways of deeply connecting to others, despite my glossophobia[1], being largely inarticulate and, despite at times, elective mutism. Thankfully I discovered that being truly connected to others is a privilege and a blessing and not something to hide from.
AIR: Your work draws on a broad range of perspectives and models including the tradition of liberation psychology. Could you describe your approach?
Taiwo Afuape: Liberation approaches start with the assumption that collective social action is the most effective way to prevent distress. They are based on theories of protest calling on us to directly challenge forms of social abuse that impact on our lives.
My approach is many things – it is embodied, it is political, it is committed, it is heart-based but it is fragile, in that I do not hold on to it as a truth that will be fixed in time and place. I expect it to move, grow, develop and change, the same way I expect my daughter to challenge me, move beyond me, and bring to me, my life and my limited perspectives some new and fresh insights.
Given that our embodied-ness as African and black people living in the West has been undermined by an assumption that embodied cultures are exotic, backward and inferior to cultures that emphasise the use of our minds, I have to actively reconnect to my embodied self and the deep connection to myself and others that can result from it. Rather than living inside my head, I try to be fully present and spontaneous within my relationships. Rather than focusing on problems, damage and deficit, my approach is to humanise people by viewing them as whole selves, in a relational, social and political context. I try not to be just another adult person or service provider among many, attempting to rescue, treat, change or manage people, as though the problems that they experience are problems that they have. I try to connect to people’s multiple life stresses and traumas as well as remarkable resilience and creativity. I try to develop collaborative ways of working with young people and families in context, that moves them in their preferred direction, not mine; as well as support and voice a set of experiences that have previously not been recognised.
AIR: What do you see as the limits of mainstream mental health practice around trauma in the contexts that you work in? What do you think needs to be changed?
Taiwo Afuape: Where to start?! There is so much to say on this topic, forgive me if I cannot do it in a sentence.
I work in a Child and Adolescent Mental Health Service (CAMHS) and an Adult Mental Health service in the UK. The effects of trauma and the impact of austerity (with the reduction in funding for public services) and adversity are everywhere. Mental health services are still largely about managing and/or reducing psychiatric symptoms, rather than challenging the root causes of emotional, mental and spiritual distress. You could even call it medicating away protest. It is normal and adaptive to respond to adversity, harm and oppression by being sad, angry, disoriented, hyper-vigilant, disconnected, anxious and/or suspicious. However, models of trauma in the West are based on Western assumptions about the self that are thought to be universal, as well as a medical deficit model in which the brain and mind are liken to computer hardware and software. Human beings are thought to process information about the world just as a software programme processes information and stores it in particular ways. Trauma is thought to affect our memory due to a failure in processing and as a result traumatised individuals experience intrusive thoughts and images, nightmares related to the trauma and hyper-vigilance. This model is based on an individualistic view of self where the effects of difficult life experiences are viewed as individual-centred and intrapsychic[2]. However, many other cultures emphasise psychic interdependency rather than autonomy, and spirituality rather than ideas of rationality. The fact that other cultures may have other frameworks of understanding is not considered in Western trauma frameworks generally.
The focus on internal experience ignores the political implications of traumatic experiences (for example, the need to challenge racism, sexism, classism, poverty, war and so on), turning our focus on to (passive) ‘victims’ and how to treat them. From this vantage point we don’t consider social action or ways to address the behaviour of perpetrators and the social and political contexts that support and perpetuate harm. Individualised approaches don’t allow us to consider that it is the ways we are abused by society and in our relationships that is dysfunctional – not our responses to these experiences of abuse and marginalisation.
The mental health system’s focus on psychiatric symptoms also directs our attention away from aspects of our experience we take for granted and would be traumatic if we lost. For example, when I’m teaching students about working with asylum seeking/ refugee people I often use a clip with my favourite author Toni Morrison talking to Torrene Boone about her book Home. She says:
I was trying to make his going home, his arrival wonderful …. I withheld all the colour from the book until he gets close to home …. Everything is aflame….That makes the reader feel the welcome, feel the loveliness, the home quality.
I ask the students to share their thoughts about what Toni was telling us about ‘home’ and how fundamental it is, in order to explore how devastating it is when you lose it; when in desperation you flee, only to find there is no home out there, in a world of borders. To support people who have been traumatised by violence in war and exile we have to understand the violence of racism and xenophobia, to understand what it is to experience a devastated social world, an attack on the things that give meaning to life – family relationships, dignity, social structures, cultural values, community rituals and so on. This requires us to support people to reconnect to others, to reconnect to meaning, to rebuild communities and relationships; all this requires us to challenge the social and global inequities that fuel the evil of war. It requires us to look wider and wider, rather than focus our gaze inward into people’s psyches. It requires us to be activists, which is radical, and that is why the ‘trauma industry’ in the West continues to peddle a medical view of trauma.
As trite and utopian as it may sound, I believe we just need to be kinder. By that I mean less bound by money-based politics (such as the influence of the pharmaceutical industry) and minority world imperialist assumptions that anything other than science and Western thought is relevant, valid and progressive.
AIR: In your book Power, Resistance and Liberation in Therapy with Survivors of Trauma you argue that to be effective and to be honest, therapists need to connect to be open to the vulnerability involved in bearing witness to other people’s pain. Why do you think it is critical for therapists to engage their hearts?
Taiwo Afuape: I don’t think of engaging my heart as connecting to vulnerability as such. Life is always fragile and beautiful, robust and ugly; it’s designed that way. For me, engaging our hearts means humanising ourselves and others – it means engaging all of ourselves. There is too much pressure from all areas of life, to be fragments of ourselves – from the ‘-isms’ of identity politics and various forms of viewing ‘others’ as inferior to and not like us, to consumerism, greed and the exploitative way we engage with the world. Love is everything, and everybody. If we shout that from the roof tops we risk sounding ridiculous, and yet when we look around, our lives are not always ruled by love – some people just don’t seem to deserve it – sex workers, homeless people, refugee people, ‘migrants’, women, children, the poor, people with brown skin, with disabilities, elders etc – so how can there not be a direct link between lack of love and trauma? The world is a rich and resourceful place. We have widespread poverty because of a lack of love- we (particularly people with the most power and influence) don’t engage our hearts enough . I used the term ‘we’ intentionally, because I prefer ‘we’ based politics to an ‘us and them’ based one.
At the same time, love is everywhere, under the surface of living; it cannot be used up. I treasure and savour and pause inside acts of love whenever I am part of it, whenever I see it, wherever it is around. Because love is everything.
AIR: What are some of the lessons that you have learnt from your clients?
Taiwo Afuape: It is so hard to put into words or name them all. We can, and do, learn from anyone. My parents taught me that. People called clients have taught me how to listen, how to be wrong, how to love, how to act from a place of love, courage and humility.
AIR: Your clinical practice involves engage injustice and sadness in the lives of others. What practices do you use to sustain your own emotional wellbeing as you do this?
Taiwo Afuape: The very people who share heart-breaking stories are the very people who sustain me. There is also a lot of laughter, creativity, humour, joy and celebration. I believe being a full person and allowing the other to be a full person means not fixing people inside their sadness, distress or pain. Nothing is complete and nothing is permanent. Taking away a person’s right to experience joy is as much a form of violence as anything else. When we truly connect, when we love each other, it is joyful. It is sustaining.
I found the concept of vicarious resilience really useful when I came across it – the idea that rather than trauma rubbing off on us, we connect to and grow from the experience of working with people who are the epitome of resilience and the human capacity to survive. Perhaps we need to see distress not as weakness but as meaningful protest, that highlights what we have lost, what matters most and what we wish for.
I am a Buddhist so Buddhist practice – meditation and building on my ability to be compassionate – also supports me. Before I had my daughter I was practising yoga regularly, which nourished me physically, mindfully, emotionally and spiritually. There are so many ancient healing systems that still have relevance and significance today. That is why I am interested first and foremost in what people know themselves about healing and wellbeing, what has been passed down to them, what they have learnt in the spaces they value, from the people and activities that ignite their creativities.
I normalise, humanise and politicise any anger and sadness I feel. I don’t try to therapise it away, as if I’ve been infected by clients and their stories and need a place to get it out of my system. Any sadness I feel is there for a reason and so I allow any feelings I have, space to just be, do their magic and then move out of me in their own time, in their own way. If I don’t stand in their way or hold on to them, they will move and change. Overall though my daughter sustains me, as do my family and friends. Like I said, it’s about love.
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[1] Glossophobia is a term referring to the fear or anxiety of speaking, including speaking in public
[2] Related to a person’s own individual psyche.
About Dr. Taiwo Afuape
Dr. Taiwo Afuape is a Nigerian British-born clinical psychologist and systemic therapist (family/couples therapist) working in a Community Child and Adolescent Mental Health Service (CAMHS) and at an Adult Mental Health Department in London, United Kingdom. As a Black African working class woman and coming from a political family surrounded by Anti-discrimination, Afrocentric, Feminist and Socialist ideas, she has always been a critical thinker and committed to moving closer towards ethical and socially just practice. After qualifying she worked part time in the community setting up community psychology services for transitional populations – women escaping domestic violence, homeless people, people misusing substances, travelling communities of Roma and Irish heritage and refugee people – and part time in a Human Rights charity for survivors of torture. Later she managed and practiced in an Adult Mental Health Systemic Service before working in CAMHS. She is particularly interested in liberation psychology, community psychology and Just Therapy approaches that locate the source of distress in social and political context.
Selected bibliography
Afuape, T. (2004). Challenge to Obscuring Difference: Being a black woman psychologist using self in therapy. Journal of Critical Psychology, Counselling and Psychotherapy, 4(3), 164-176.
Afuape, T. (2011). Power, Resistance and Liberation in Therapy with Survivors of Trauma: To Have our Hearts Broken. London: Routledge.
Afuape, T. & Hughes, G. (eds.) (in production – to be published in November 2015) Liberation Practices: Towards Emotional Wellbeing Through Dialogue. London: Routledge.
Afuape, T. (in press). Supervision as Relational Responsivity: The Body in Co-ordinated Meaning Making. In: G. Fredman & J. Bownas (eds.), The Body and Supervision. London: Routledge.
You can access a full bibliography of Dr. Taiwo Afuape’s writing here.
