Andrew R. Hatala

Resilience and Healing Amidst Depressive Experiences: An Emerging Four-Factor Model from Emic/Etic Perspectives

Resilience is generally understood as a pattern of positive adaptation following significant stress, adversity, or risk, and is often examined when looking to see why some individuals fall victim to despair while others seem to thrive. Previous studies highlight the biological, psychological, and sociological aspects of resilience. This article suggests these perspectives be extended by including spirituality in the current discourse on resilience. By examining etic (variable-centered or quantitative) and emic (person-centered or qualitative) perspectives within the context of individuals suffering from depressive disorders, a four-factor model of resilience is proposed, involving: (a) physical and biological strengths, (b) psychological resourcefulness, (c) interpersonal or emotional skills, and (d) spiritual capabilities. In the end, some clinical implications are discussed.

Reframing Narratives of Aboriginal Health Inequity Exploring Cree Elder Resilience and Well-Being in Contexts of Historical Trauma

A large body of literature explores historical trauma or intergenerational trauma among Aboriginal communities around the globe. This literature connects contemporary forms of social suffering and health inequity to broader historical processes of colonization and the residential school systems in Canada. There are tendencies within this literature, however, to focus on individual pathology and victimization while minimizing notions of resilience or well-being. Through a social constructionist lens, this research examined how interpersonal responses to historical traumas can be intertwined with moments of and strategies for resilience. Detailed narrative interviews occurred with four Aboriginal Cree elders living in central Saskatchewan, Canada, who all experienced historical trauma to some extent. From this analysis, we argue that health research among Aboriginal populations must be sensitive to the complex individual and social realities that necessarily involve both processes of historical and contemporary traumas as well as resilience, strength, and well-being.

Doing Resilience with “Half a Brain:” Navigating Moral Sensibilities 35 Years After Hemispherectomy

This paper investigates experiences of resilience in the context of individuals suffering from disability as a result of severe intractable seizure disorder and consequent hemispherectomy, a surgical procedure in which part or all of either the left or right cerebral hemisphere is removed. Two adults who underwent childhood hemispherectomies—one left and one right—are the focus of this study. Previous research has extensively detailed the clinical outcomes of this neurological procedure, yet the actual day-to-day experiences of individuals living post-hemispherectomy remains unexplored. Utilizing open-ended, qualitative, and narrative techniques from a phenomenology of performativity perspective, the authors question how each individual’s experiences of daily living are invariably acts of resilience, involving several different strategies that are somewhat unique to each. Rather than working as an adjective or noun signifying certain environmental or individual attributes, this paper proposes that “resilience” is best conceptualized as the individualized intentional actions which disabled, distraught, or at risk individuals perform in contextually relevant and idiosyncratic ways as they navigate health and well-being within their local social and moral worlds.

Towards a Biopsychosocial–Spiritual Approach in Health Psychology: Exploring Theoretical Orientations and Future Directions

The current status of the “biopsychosocial” model in health psychology is contested and arguably exists in a stage of infancy. Despite original goals, researchers have developed theoretical integrations across biopsychosocial domains only to a limited extent. In addition, the marginalization of “spirituality” in contemporary biopsychosocial health perspectives is questionable. This article addresses these issues by providing evidence that supports the inclusion of spirituality within current perspectives while at the same time discussing implications this inclusion bears on the concept of health. Overall, a biopsychosocial–spiritual or “holistic” perspective is advanced for use within health psychology, provided it can be approached from a multilevel integrative analysis. In the end, some clinical implications are discussed.

Ceremonies of Relationship

Indigenous communities from around the world, and particularly marginalized youth from within these communities, have not always been adequately included and valued as potential collaborators in various research processes. Instead, research has relegated Indigenous youth to subjects where adults, operating primarily from Western knowledge positions and assumptions, remain the experts. Given the role of research in informing programs and policies, the ways research meaningfully engages and includes Indigenous youth are of key concern. This article presents experiences gained throughout the duration of a study that sought to identify the knowledge, resources, and capabilities required to support the health, resilience, and well-being of Indigenous youth within an urban Canadian context. In particular, this article focuses on methods and approaches of integrating Indigenous knowledge systems throughout the research process and how this can in turn foster meaningful and transformative engagements with Indigenous youth. We argue for the importance and value of traditional cultural practices and knowledge systems and what we call ceremonies of relationships, existent within Indigenous communities around the world, and how their integration in research processes can support constructive and meaningful engagements with Indigenous youth research collaborators.

“I Have Strong Hopes for the Future”: Time Orientations and Resilience Among Canadian Indigenous Youth

In this article, we demonstrate how concepts of time and the future inform processes of resilience among Indigenous adolescents within an urban Canadian context. This study employed a modified grounded theory methodology by conducting 38 qualitative interviews with 28 Indigenous youth (ages 15–25) over the course of 1 year. The analysis revealed complex processes of and navigations between moments of distress and strategies for resilience. The distressing contexts in which Indigenous youth often find themselves can impact the development of their concepts of time and limit their abilities to conceptualize a future. A future time orientation (FTO) emerged as central to processes of resilience and was supported by (a) nurturing a sense of belonging, (b) developing self-mastery, and (c) fostering cultural continuity.

The role of sensorial processes in Q’eqchi’ Maya healing: A case study of depression and bereavement

Theory and research on the healing practices of Indigenous communities around the globe have often been influenced by models of “symbolic healing” that privilege the way patients consciously interpret or derive meaning from a healing encounter. In our work with a group of Q’eqchi’ Maya healers in southern Belize, these aspects of “symbolic healing” are not always present. Such empirical observations force us to reach beyond models of symbolic healing to understand how healing might prove effective. Through the extended analysis of a single case study of rahil ch’ool or “depression,” we propose to advance understanding of forms of healing which are not dependent on a shared “mythic” or “assumptive world” between patient and healer or where therapeutic efficacy does not rely on the patient’s ability to “believe” in or consciously “know” what is occurring during treatment. In this we demonstrate how the body, as a site of experience, transformation, and communication, becomes the therapeutic locus in healing encounters of this kind and argue that embodied mediums of sensorial experience be considered central in attempts to understand healing efficacy.

Being and Becoming a Helper: Illness Disclosure and Identity Transformations among Indigenous People Living With HIV or AIDS in Saskatoon, Saskatchewan

Saskatoon has nearly half of the diagnoses of HIV in Saskatchewan, Canada, with an incidence rate among Indigenous populations within inner-city contexts that is 3 times higher than national rates. Previous research does not adequately explore the relations between HIV vulnerabilities within these contexts and the experiences of illness disclosure that are informed by identity transformations, experiences of stigma, and social support. From an intersectionality framework and a constructivist grounded theory approach, this research involved in-depth, semistructured interviews with 21 Indigenous people living with HIV and/or AIDS in Saskatoon, both male and female. In this article, we present the key themes that emerged from the interviews relating to experiences of HIV disclosure, including experiences of and barriers to the disclosure process. In the end, we highlight the important identity transformation and role of being and becoming a “helper” in the community and how it can be seen as a potential support for effective community health interventions.

Religion, spirituality & chronic illness: A scoping review and implications for health care practitioners

ABSTRACT While the influence of institutional religion has decreased over the last 40–50 years, research suggests that a substantial proportion of those not attending religious services continue to engage in religious and spiritual practices on their own and refer to religion as a very important aspect in their lives, and as linked to more positive health outcomes, particularly for those living with chronic conditions. This article provides a scoping review to not only highlight the research that views religion and spirituality as valuable tools for coping with chronic illness conditions, but also to highlight research that explores those who may experience some religious/spiritual doubts or a gradual loss of religiosity or spirituality with the diagnosis of chronic conditions. Regardless of a clinician’s beliefs, the authors argue that some awareness training of the value of religion and spirituality for some patients, can be beneficial. In a society facing an increasing plurality of faiths, this is deemed to be an invaluable discussion. In the end, clinical implications will be discussed.

‘I’m more aware of my HIV risk than anything else’: syndemics of syphilis and HIV among gay men in Winnipeg

Abstract Despite decreased rates of HIV infection in Winnipeg, syphilis incidence continues to rise. Communities of men who have sex with men shoulder much of this burden of illness. This qualitative study aimed to better understand the co-evolution of HIV and syphilis in Winnipeg through a series of interviews with gay men. Eighteen individuals were recruited through advertising in sexual health centres and through subsequent snowball sampling. Thematic interpretive analysis and inductive reasoning were used to find individual and shared group meanings. We found that HIV formed the contextual ground on which sexual decision-making was made, with three main themes emerging during interviews: 1) bacterial STI transience being contrasted against HIV permanence; 2) syphilis being ‘dirty’ versus HIV carrying significant stigma, though being spared the label of uncleanliness; and 3) the role of pleasure and intimacy in sexual health decision-making. Based on these findings, we recommend further exploration to develop more effective strategies around syphilis prevention, in particular with regards to the longer-term illness ramifications and its relationship to HIV transmission.