4. RESULTS AND DISCUSSION
4.3 Conclusions regarding Grace's resiliency
Grace's story has taught us so much about resiliency. She has displayed notable strengths in the face of painful and difficult circumstances. It is
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important to note, however, that being described as resilient in one area of her life, does not mean that she does not show weaknesses in other areas
(Grossman, Cook, Kepkep & Koenen, 1999). As was demonstrated above, Grace does have many vulnerabilities, however, I believe that in the long run she had a lot to teach us about resiliency whether her strengths or
weaknesses prevailed. When choosing a participant for this study the criteria was that the individual should have found ways to "live in the world, to love and to work" (Grossman, Cook, Kepkep & Koenen, 1999) (p. viii). Having analyzed the data, this is certainly true for Grace.
Grace's history was unusual in that she had not experienced a difficult
childhood in the traditional sense. Her problems began after she was married.
As researchers such as Rutter (1987) have pointed out, her relatively happy childhood, where there were strong family bonds, could have acted as a strong protective factor, thereby fostering her resiliency in later life. Resiliency, therefore, is a dynamic concept waxing and waning over a person's lifespan (Demos, 1989). Vulnerabilities at certain stages of Grace's life may have developed into strengths at other stages of her life, or vice-versa. Resiliency's dynamic nature, therefore, means that through growth and development, there is always hope that an individual can overcome certain adverse
circumstances, or maladaptive coping strategies (Grossman, Cook, Kepkep &
Koenen, 1999).
Although Grace faces unique challenges by virtue of being a low-income woman of colour, in a post-Apartheid society, one can't help but wonder whether or not.~erstrong inclusion and identification within a particular
community, admittedly forced, has perhaps fostered her resilience, in the here
and now. Gibson (cited in Sieber&Cairns, 1991) suggests that it is important that mental health workers acknowledge the positive aspects of a woman's ethnicity, and that transculturation, rather than assimilation, should be encouraged. Similarly, Naidoo (cited in Sieber & Cairns, 1991) and McGoldrick, Garcia-Peto, Hines and Lee (1989) suggest that values and attitudes perceived as critical for cultural identity, should be retained and cultivated. This, however, leads to the question of context. Within her unique context, Grace shows resilience in certain domains. This may have been encouraged, therefore, through a strong identification with a particular community. Ifplaced in a different context, however, would Grace still show similar resilience in the same domains? Demos (1989) and Grossman, Cook, Kepkep and Koenen, (1999) have stressed, however, as previously
discussed, that resilience is contextually evoked or inhibited. It is questionable, therefore, whether Grace would be resilient in a different context.
Although I have emphasized that describing someone as resilient does not imply perfection in all aspects of functioning, I have tried to emphasize the positive in Grace's life, as opposed to malfunction and psychopathology. I do believe that both sides are crucial in understanding resilient individuals, however, I must agree with Grossman, Cook, Kepkep & Koenen (1999) who state that traditional psychology tends to overemphasize what a person is lacking, rather than what they are achieving despite stacked odds.
• In summary then, the following factors, discussed above, have contributed to Grace's resiliency in some areas of her life: work, humour, friendships with other women at work, social support, strong family bonds, a close friendship with her aunt, family gatherings, dancing, dressing up, religion, and her inclusion and identification within a particular community.
4.4 Observations and recommendations regarding mental health services for low-incorne women
Although this study concerns the issue of resiliency, I would like to highlight three particular issues regarding the provision of mental health services to low-income women, that came to my attention during this study.
The most blatant issue seems to be these women's lack of choice with regard to available services. Although mental health services do exist for them, these women are bound by geographical, financial and work constraints to use what is provided. I became aware of this issue after suggesting to Grace that she seek professional help, having touched on some very painful matters during one of our interviews. Although she was eager to consult a trained mental health professional, she was unable to exercise any choice as to who that person should be, as each farming area is allocated to a mental health worker. In most cases, this person is usually a social worker. As this person was well known to her, she did not feel comfortable consulting her. When trying to make alternative arrangements, it was clear that Grace's employer was not happywiththis, as this would be contrary to current practices on the
farm. Although psychological services are provided at certain hospitals in the surrounding areas, this was out of the question due to their proximity, the expense of transport, and her inability to take time off from work. It appears, therefore, that low-income women rarely have the luxury of making choices regarding their treatment, and few, in fact, have access to a psychologist, in particular. This example also briefly touches on the thomy issue of the, mostly, traditionally skewed distribution of power between farmers and, particularly, female farmworkers, in decision-making.
Following this discovery, however, I could not help but then wonder if perhaps it is precisely this lack of access to mental health services that has fostered resilience in Grace, and other members of her community. Although I was able to provide a safe place where she was able to articulate her distress and experiences, thereby making her aware that help is available, I have to
question whether or not my brief intervention did nothing more than disturb the sensitive equilibrium in her environment. Although I suggested she receive further counselling, in reality, this was unlikely to happen because of her financial and environmental constraints (Hirschowitz & Orkin, 1995). In order to survive in her particular environment, Grace, and the rest of her community, have developed certain coping strategies over the years, and even
generations. Although some of these coping strategies are, according to popular psychological practice, maladaptive, they have enabled her to adapt to her circumstances. If we go about trying to change these maladaptive coping strategies, will she continue to be able to survive in her environment?
Will it not reduce some of her hardiness? Furthermore, should predominantly
White, middle-class psychologists (Kriegler, 1993) decide what is maladaptive in a community so different from theirs? Perhaps the larger dilemma,
however, is whether psychologists should focus on helping women accept and cope with their existing conditions, or whether they should encourage them to actively try and change these conditions.
From the analysis of the data, it was clear that the social support provided by the female farmworkers was an integral factor in Grace's resilience.
Considering the inadequacy of current mental health service provision in her community, perhaps, an effective, and cost-effective intervention, which builds on what is already happening informally, is the development of self-help
groups, or group work, amongst these women. Landman (1992) suggests that group work can be effective in such communities as it facilitates coping
strategies that address the problems of daily life. It also reduces social isolation, the perception that problems are unique, dependency and inadequacy. Recent literature, however, suggests that mental health
interventions aimed at low-income women should be empowering (Gutrierrez, 1991). In order to be empowering, they should be developed in consultation with these women, as mutual and co-operative decision-making increases the success of these interventions, in a particular community (Desjarlais et aI.,
• 1995).