Hearing Voices

This is a moving article from Karen Sinnott in The Journal via @JeminaNapier in which she talks about the experience of mental health care as a Deaf person in Ireland.

When you start to work with Deaf people with psychosis, as I did in 1996, you learn very quickly that 'deaf people with psychosis often hear voices', and it takes a long time (well - it took me a long time) to ask what does that mean and how do you know? 

Diagnosing psychiatric disorder is hard. It is exponentially harder with a Deaf patient - even if you are a Deaf clinician - because the definition of schizophrenia (for example) is based upon statistical analyses of symptoms described at interview by hearing patients to hearing researchers, and so the diagnostic criteria come from a fundamentally hearing phenomenology of psychosis. A clinician will ask "do you hear voices" and the patient will say yes (or no). For hearing clinicians and patients what they each mean by the English word "voice" likely has considerable overlap, and - arguably - that answer suffices.

For a Deaf person, in a signed clinical interview, you do not have that shared vocabulary. Signing clinicians, or interpreters, have to make an interpreting decision about how to ask that question in BSL/ISL. Do you sign voice with a mouth-like handshape, or a V-hand? Where do you sign it? At the throat? Near the ear? In a neutral space (if there is one)? Is your sign more akin to talk as opposed to speak? Given time and care, you need to ask a series of many specific questions about the language of the 'voice', the modality, the location, the patient's confidence in their own description and so on, and then base the diagnosis on that. If you are interviewing via an interpreter, that whole process becomes all the more complicated, and potentially also opaque. My friend, and genius, Jo Atkinson has researched this and published on it, for example here.

But to me it leads to more fundamental questions about the nature of communication and interaction. Is it sufficient to assume that the person means the same thing as you when you say "voice"? We naturally do this in conversation; we use highly familiar catch-all terms that, because we use them all the time, we assume that any pair of us means the same thing by that word. Only much later on in the conversation, if at all, do we realise we have been talking at cross-purposes.

What does your Deaf patient mean when they report 'hearing voices'?

And why, when we are super-cautious about taking as read the patient's claim of being followed at all times, or of being an African prince, are we so wiling to accept at face value their claim to be hearing voices?

NOTE: This post is in no way intended to doubt Karen's own account of her own particular experiences. Rather I thank her for her important and courageous article, and the opportunity it presents to me to raise broader questions.

Jim Cromwell
Sign Language Interpreting: Engaging the Disengaged, Empowering the Disempowered

This is an absolutely fascinating (interpreted) article by Tom Holcomb on StreetLeverage recently, interpreted from his ASL at StreetLeverage – Live 2017.

He clearly identifies the ways in which interpreters' paradigms of message equivalence and interpreting accuracy disempower the deaf person (when ASL is the minority language in the room. I am interested in how these effects change when the language ratio is equal or inverted) -

Often the blame goes to hearing people who have no clue how to properly support deaf people’s participation. In casting the blame on the non-signing hearing participants, we have avoided taking a hard look at the current standard practice of interpreting to see if the deaf people are actually unintentionally disempowered by the interpreters on hand.

He continues...

The current twenty-minute switching standard was based on research regarding interpreters’ mental fatigue. The findings have shown that fatigue causes increased interpreting errors and physical challenges that resulted in hand injury. Yet, there is no research on the impact of these switches on deaf people’s ability to comprehend the interpreted message or their ability to participate effectively in the interpreted session...

The optimal system, for me, is to have both interpreters working simultaneously with the work rotated every time a new speaker has a turn rather than rotating based on the time intervals of 20 minutes. By seeing a different interpreter for every speaker, I find myself much more engaged in the meeting. I also find it easier to participate when the second interpreter is available to interject my message immediately if the first interpreter is busy with the Spoken English to ASL interpretation for the current speaker.

Read the whole article here on Street Leverage. It is excellent.

Jim Cromwell
Language Deprivation

A powerful piece via the Nyle DiMaraco Foundation.

The problem that remains is that nine out of ten deaf children are born to hearing families of whom a negligible proportion can already sign. Unless families embark on BSL training very quickly, the four-to-five year window for the child's language acquisition is already closed. There has to be broader teaching of BSL in primary schools, and geographically and financially accessible BSL courses available to families.

Jim Cromwell
Looking for filming opportunities

While I am a qualified BSL/English interpreter, I am currently not registered with NRCPD because of a career break working in another profession. To re-register I need to do some guided CPD, and film myself interpreting.

I am looking for opportunities to interpret and film. I would need myself and the deaf person on the screen, and the hearing person able to be heard (and ideally on screen also). The video would only be seen by me and my supervisor (another interpreter).

I would be happy to interpret for free, if I am able to film the job. If you would like free interpretation please would you contact me via this page?

Thank you!

Jim Cromwell