‘You are not broken; the system is’: understanding different contexts in healing

‘You are not broken; the system is’: understanding different contexts in healing

Sehar Moughal is a psychologist, activist, public speaker, teacher, and doctoral candidate at the University of Auckland. Her professional and research work centres around challenging the status quo and advocating for people on the fringes.

Mehwish Mughal, who leads our Asian Mental Health project, asks Sehar what makes her so passionate about the work she does.

You mentioned how you arrived at this work because of your journey of not receiving appropriate care or, as you like to say, your context was left out.

I quickly noticed the disparities in how support was provided – a significantly individualised way of thinking about mental health. I was the sum of my symptoms. I was seen as someone who needed to be fixed. Experiencing poverty, aloneness, and adversity was seldom part of the discussion in the therapy room. Looking back, I was not asked the right questions, such as, what will support your healing? These were brief experiences but enough to leave a mark, a catalyst to get into the field. So there you have it; I admit that I direly needed to enter the field of psychology for selfish reasons: to begin my healing process.

I would be lying if I said the journey into psychology was a piece of cake. I was rejected from some prestigious programs because I may have been ‘too broken’. Never underestimate the power and strength of ‘broken’ people. I am glad that these days, with so much advocacy work by so many amazing people, people of colour are somewhat ‘allowed’ in these spaces [university programs]. Ten years ago, that was not the case. I was an anomaly. And I don’t mean the colour of my skin solely. Getting into academy becomes tricky for people like me, with little access to social, financial, and emotional support and then you add gender and race.

You have spoken quite a bit about people on the fringes. That we need to include them in decision-making. Can you elaborate on this?

I have personal experience to thank my awareness of who is missing from these conversations. I used to be absent from the conversations that decide the ‘what, why, when, where, and how’ of the mental health support provided to people like me. At the time, I felt helpless and angry, and I wanted to do something about those feelings. I knew I needed to get into the system to challenge it.

When I decided to get into psychology, I had terrible grades early in my undergrad. Back then, I had more Ds than I care to share now. People are surprised when I share this part of my history. They don’t believe me.

Poor grades meant I couldn’t get into the first two programs. When I received the acceptance letter from the third program, I felt alive for the first time in many years. I imagined somebody out there looking at my application and thinking, ‘This person has had a plethora of adversity heaped upon them, but they have a lot to offer and are willing to try’. Somebody took my context and learning history into account when making the decision. It mattered so much. I was able to breathe a little easier. It was my second chance. I felt seen, heard, and important enough to keep fighting.

If it weren’t for that third program, I would not have reached where I am today. I would not have been a registered psychologist. I would not be doing a PhD questioning where is the equity in mental health services. And I think about that moment often. What if somebody looking through my application rejected me the third time? What would my life look like now? We need to think, what are some ways we are already excluding people that are key to this conversation? Why are we not bringing them to the table? They need to be at the centre of the table, especially when discussing equity. I embed this philosophy in my therapy room as well. It matters even now.

Sehar Moughal, 2022. Photo by Julie Zhu

You are an ardent advocate of taking the time to understand clients and their context over simply treating ‘symptoms’, aren’t you?

Absolutely. You cannot do therapy without understanding your own and your client’s context, surroundings, and learning histories. If we miss a person’s context in therapy, it can result in more harm than healing. The assumption that our clients’ have similar learning histories and contexts (ignoring our privilege as psychologists) means we miss critical questions that need asking during therapy.

How you incorporate this philosophy into your work?

Together, we (my clients’ and I) explore their historical, situational, and immediate context, their surroundings, and their environment. And that is powerful. Knowing the baggage you have carried for so long and may hold for much longer is scary and empowering at the same time. Scary; because it is unfair, it sucks. Empowering; now you start to see that you are not the problem.

Thinking about and acknowledging my client’s context and my own privilege, the questions I ask myself most frequently are: Would I be able to do XYZ if I was in my client’s context? How would I feel if someone asked me to do this? How would I react if my therapist told me XYZ? For some clients, I am the first person they’ve talked to about what’s happening in their lives, so I’m careful to acknowledge and validate their strength and courage. I tell them straight, ‘This really sucks’. They need to know this. I cannot stress enough the importance of acknowledging what they are going through. I say it loud and repeat it until I feel a shift where they are not blaming themselves. This is when healing begins.

The second way I incorporate this philosophy is through the way I approach ‘the goal’ of my therapy sessions. I never go in to fix anyone, and I communicate this at the onset to my clients. I tell them, ‘You are not broken; our system is’. Healing is a process, so let’s show some compassion for ourselves.

You are challenging the field in which you are located academically. Tell us a bit more about your current research, what you are trying to do, and what drives you to do it.

My doctoral work explores a therapy model for people of Indian/Pakistani ethnicity with family violence trauma. I am moving away from the deficit framework used in therapy and instead looking at ways of moving towards empowerment. For example, I am against using the traditional measures and self-reports that spit out a number at you and render the person seeking therapy as a data point. A blip. It is not okay. It is archaic and devoid of an individual’s learning history and context.

I am starting to see this shift in our field, but it is as slow as cold molasses. It isn’t easy shifting things, but my own experiences drive my work. Some nights, I want to give up and leave all this work behind, but then I remember my darkest nights, and what once was a source of great pain now gives me the strength to make it better for others.

Sehar Moughal, 2022. Photo by Julie Zhu

Support looks different for different communities. You have mentioned that you are part of the gurudwara and mosque communities. What does support look like there?

There’s a dominant discourse that our communities are not engaging with mental health services. We are portrayed as people who are not connected. I think what’s missing from this perspective is the acknowledgement and understanding that there is support in the communities to which we belong. We forget about the Mosques, the Gurudwaras, the temples, and people’s extended families. It’s easier to talk to their family, sometimes extended families, than to a professional in a setting that is scary for a lot of us.

So, we must move away from why our communities need to be more engaged to what we can do to make this more integrative. Acknowledge that there are many different ways of knowing and doing. We must ask, how can we work with the things already happening in the communities? So instead of saying, let’s figure out something new, we need to say what strengths already exist in the communities, and how can we keep reinforcing them? How can we keep funding these things to create change?

What is most rewarding to you in your line of work?

I know this will sound cheesy, but it is true: my clients’ smiles. Precious. We talk about so much pain and suffering in our sessions, and one smile speaks volumes.

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