A Dialogue with Three Voices
Every four seconds someone is forced to flee their homeland. In recent years immigration has become part of both the national and international landscape. Although the number of people living in the UK who would need to use an interpreter in order to access mental health services is difficult to estimate, the 2011 Census revealed that English or Welsh are not the main languages of about four million residents, or 8 per cent of the population. It found that 49 different languages were used as the main form of communication by groups of more than 15,000 people. A regional breakdown found 22 per cent of Londoners used a main language other than English. So how can the therapeutic community stretch the horizons of the healing encounter and respond effectively to this need?
Having worked with asylum seekers and interpreters for over 17 years I was aware that there has been very little research in this area. So my research has started to explore the process of working therapeutically through an interpreter, asking whether it is possible to create a profound connection in a triad, to achieve interpersonal attunement with asylum seekers and refugees who have lived through traumatic experiences. In this piece of research three perspectives are offered to examine lived experience of the triadic relationship. Four psychological therapists, four interpreters and four clients were interviewed. The themes that emerged were the therapeutic alliance, interpersonal attunement, communication and culture.
Current research evidence suggests that a key determinant of a positive therapeutic outcome is when therapist and client experience a profound connection to each other. All 12 participants in this research said that they had experienced working at interpersonal attunement, defined for the purposes of this research as a deep and profound emotional connection that creates a resonance in each participant. All of the interpreters (n=4) stressed that working at such emotional intensity was unique in their professional experience, however, this did raise issues of good practice, vicarious trauma and supervision. As well as experiencing a sense of interpersonal attunement, the participants all talked about ‘specific moments of encounter’. All 12 participants, whether therapist, interpreter or client, indicated that the elements and skills that create specific moments of encounter had little to do with linguistic issues and tended to occur in silences and emotional distress. In this research these moments were described as feelings rather than words: working inter-culturally, with different languages in a triad did not present barriers to creating interpersonal attunement
My chapter will raise issues about the specific role of the interpreter in this field, the management of emotion, new developments in neuroscience, differing cultures of mental health and verbal and non-verbal communication. When good practice guidelines are adhered to, my research findings indicate that the presence of an additional skilled professional may enhance therapy and support both counsellor and client. It will conclude that there is more that unites the human experience than divides us. Despite the trauma of the past, an uncertain present and fears about return, the healing encounter can be stretched into a new shape by a dialogue with three people.