Back to Top

Lessons in Difference, by "Diaphora"...

Lessons in Difference, by
Lessons in Difference, by "Diaphora"...
Lessons in Difference, by "Diaphora"...

How does working with a particular client help you think about issues on working with difference? 
(Or - Lessons in difference, by "Diaphora"...)


1. Introduction

Let me make it clear from the outset - this is not a case study.  Rather, this is the exploration how the author's encounters with one particular client, Diaphora (her name has been changed for the sake of anonymity), has been an education and a cause for contemplation.  It is a series of lessons in culture, diversity and difference in the form of one person's life as metaphor.  It is based on interactions with Diaphora and understandings gleaned from conversations with her during a period of her hospitalisation.  In addition there are observations and thoughts arising from statements, diagnostic discussions and comments made by members of the professional medical team working with Diaphora during her stay in hospital. Diaphora's admission and period of medical diagnostic testing serendipitously coincided with the author undertaking studies in the subject Culturally Responsive Practice (PHE5CRP), for which this paper has been written.

The central premise of this paper is that culture and diversity occurs in the embedded infrastructures of one's society, the history of one's heritage and the constructs of relationship and being; from the level of the non-conscious and unrealised to the overt and identified (Campbell, Lende, & Downey, 2013).  Each person carries an experience of culture; each person holds ownership to a heritage of culture; each person expresses the uniqueness of their own cultural being and diversity in the outworking of their own being's uniqueness (Campbell, Lende, & Downey, 2013; Lenga, 2013).  

As such, any person's life in some way or another is a metaphor of diversity and difference.  In this case, that person happens to be Diaphora.

2. About Diaphora and the lessons encountered

2.1 Family of origin background

Diaphora was born in Melbourne during the late fifties.  The first born daughter of recently arrived Greek immigrants within what would eventually be a sibship of three - two girls and one boy.  Her early childhood was typical of many "Greek" girls in her situation - week days at the local state primary school; Greek school every weekend; Greek Orthodox Church with some regularity; the obvious differences in the dates of Easter, Christmas and New Year in the Greek Orthodox calendar; socialising primarily with extended family and other expatriates (with the prospect of marriage to one of the good greek boys in particular); speaking only Greek at home and only English at school.  As Diaphora grew and became influenced more and more by the culture of her school friends and the zeitgeist of the sixties and seventies, she found herself becoming more and more at odds with her Greek heritage (Kuczynski, Navara, & Boiger, 2011).  Added to the usual generational clashes that most teenagers experience were the clashes of her parents' and family's hard held and patriotically defended cultural framework within the rapidly shifting milieux of the sexual and cultural revolutions of the time.

Moving into her early twenties, Diaphora became more and more aware that the family stories of struggle and narratives of re-establishment, acculturation and survival within the "new country" were woven into her psyche, at times causing her great conflict, at other times great comfort (Falicov, 2005).  In the end a sense of identification with the history and language of "her people" - both the familial and the ethnic - proved potent, and she was, in many ways, transnational (Stone, Gomez, Hotzoglou, & Lipnitsky, 2005).  The "good Greek boy" was doing well in his job and, Diaphora recognised a sense of comfort, familiarity, identification and belonging in their similar and shared "stories" (De Fina, 2006).  By default Diaphora and her family had undergone a certain amount of acculturation as they connected with their new life in Australia, however "old world" socialisation had been purposeful and enculturation had been particularly strong, primarily in the parent to child dynamic (Kuczynski, Navara, & Boiger, 2011).  It was easy to do the expected thing and they got married.

2.2 Married life...

The "good Greek boy" turned out to be not so good.  

It wasn't long before Diaphora became the brunt of  his violent verbal and physical outbursts.  In recalling the years that her family had known his family she started to realise that this behaviour of her husbands was likely passed on to him from his own father, who had probably been cursed with the same intergenerational mantle himself.  Diaphora recalled whispered conversations and silent looks full of hidden meaning amongst the adults which had occurred, on occasion, in discussions about his family.  She had not consciously realised anything specific at the time, but she was now being expected to be complicit in keeping the same level of silence in her own marriage.  She was Greek.  She was the woman.  He was her husband.  There was nothing that she could do.

This silence was a mongrel of many types of silence - silence to preserve the public "face" of family and self; silence to hide an intergenerational secret; silence of oppression; silence as power, negation, stoicism, denial and conspiracy (Wajnryb, 2001).  It was complex, potent and disempowering with inherent obligations, in her mind, to protect those beyond herself.  Diaphora was also surprised to find her parents were complicit by means of inaction in their own silence concerning her situation.

As a result, in time, Diaphora came to hate and distrust her once familiar community and, in particular, Greek men.  Her beautiful house, husband's good income and two daughters grew to mean less to her.  She built constructs within her life in which the Greek community in general were conspiring against her and all Greek men in particular were definitely not to be trusted.  This extended to major difficulties with the specialist she encountered on her admission to hospital.  Diaphora feared that he was part of the overall conspiracy, she "absconded" and then became considered a flight risk, resulting in obligatory escorted leave only, close monitoring and suspicion from staff.  The expectation was that she would undoubtably "run" again despite her assurances that she was willing to endeavour to overcome her fears in order to find some form of diagnosis.  

But before we look too far into her admission situation we need to understand a little more of her story leading up to this point.

2.3 Disillusion and delusion

For many years, Diaphora saw her primary role as a buffer of sorts between her husband and her daughters.  She was what protected them from his violence and abuse.  She was their scapegoat and sacrificial lamb.  Mentally and emotionally, the toll on her was huge and as soon as her daughters were independent and living away from home her framework of reference started to fall apart.  She became more and more disillusioned with the aspects of her heritage that kept her bound by their expectations.  Religion, marriage, money - good Greek Orthodox; good Greek girl (Makrenoglou, 2009); good Greek wife; good Greek husband with a good job and good income.

Elements of a delusional construct became great at times and Diaphora, as mentioned earlier, became paranoid and suspicious of anything connected with these facets of her life.  She left her home, her husband, her family, her religion - anything that had, in her mind, any sort of link to her "Greek-ness".

2.4 Rebuilding yourself... finding yourself in a new Weltanshauung?

Diaphora explored.  In her explorations she was determined to allow herself permission to experience and be open to things she had always been closed to.  Obviously, the bastions constructed by her family's cultural framework had not been effective in providing protection and haven - why not allow for the possibility that something quite alternative and juxtaposed to that framework, might?

Diaphora would say that this was a period of her life when much of the person she is today was "found".  It was during this time that she travelled extensively, read a lot of "alternative" literature, lived in communes, experimented with drugs, and explored "new age" spirituality.  There were occasions when she had virtually no money and lived a subsistence, "hand-to-mouth" existence.  She learnt to "read" people and get a feeling for their character from the way they spoke with her and from, what she describes as, a sense of their aura.  She also became more aware of her dreams and how they often "spoke" to her, revealing insight into areas of her life and providing understanding, at times, which she found comforting. Finally, wishing to live near and communicate more closely with her daughters, she returned to Melbourne and has been living in a "temporary accommodation" situation for the last four to five years.

2.5 Cultural clashes of a new kind

It is fair to say that the journey thus far for Diaphora has been difficult in many ways and she has suffered both physically and mentally.  In recent years, as well as being plagued by anxiety and depression, there have been physical issues including somatic sensations, photosensitivity and alopecia.  In addition, Diaphora has experienced a series of repeated dreams in which she is injured, shot or killed.  She calls these her "death dreams".  Most of these dreams are accompanied by some sort of somatically congruent experience.  For example, a recurring dream of being "shot" from an angled height, through her forehead, with the bullet lodging behind her left eye is equated, in her waking life, with a sensation of photosensitivity and pain in that eye.  In another example, dreams of her being strangled manifest in a cough-like tic, or alternatively, perhaps the cough-like tic is manifest in dreams of her being strangled. In either case, the tic and the dreams are exacerbated by anxiety.

As a result of some of the more physically obvious symptoms, Diaphora came to hospital to try and find a diagnosis that defines what she has been experiencing.  One possibility is that she has a form of systemic lupus erythematosus.  What is frustrating for Diaphora, however, is that the western diagnostic medical and psychiatric model has its own cultural construct which does not readily allow for some of the more "unusual" symptoms she describes.  As stated by McGoldrick and Ashton (2003) "those of us in mental health have been specifically trained by the official diagnostic manual (DSM) to define problems as if they exist in some universal vacuum, without reference to culture" (p. 254).

Her dreams, photosensitivity, and somatic sensations are often dismissed as forms of psychosis, delusional and psychogenic in origin, and have not been investigated as possible interpretations of actual physiologically based disorders being manifest and understood from within her "different" framework.  Her choice to remain in low cost, "temporary housing" for a number years is readily interpreted from within a western capitalist class value and work ethic construct and seen as inability on her behalf to function successfully within our society.  Her belief in "alternative" and "new age" spiritual interpretations, including her belief in auras and spiritual interconnectedness of all people allowing her insight into the way others think about and interact with her (a different kind of "gut feeling", perhaps), was seen as a psychopathological delusional construct (Allen, Naka, & Ishizu, 2004).  Even her delight at playing with Lego blocks was seen as evidence by some of the medical staff as indicative of something not being quite right since "Lego is for children".  It took a little bit of "online education" to convince them that it was not so strange, after all, for an adult to work (i.e. "play") with Lego (Cooperman, 2010).  Nerdy?  Maybe.  But not necessarily indicative of mental illness.

Concluding comments

Diaphora's story illustrates and highlights many aspects of culture, diversity and difference.  

The adopted and adapted aspects of the broader societal culture in which she grew up, was often at odds with the "Greek-ness" of her family and heritage, and although she was in it, she was aware that she was not of it - she was different and the difference was somewhat alienating.  When at school, she did not feel Australian.  When at home she did not always want to be Greek.

The inherited values of her family's culture, ingrained and set by heritage and history, contained a matrix of comfort, belonging, identity and being, but, in time, proved inadequate when they allowed for an infrastructure that refused to redress oppressive and violent behaviours.  The pain and upheaval it caused was so great as to cause ongoing suspicion and a generalised rejection of - a splitting from - any association with her cultural heritage.  Particularly the patriarchal aspects.   

The exploration of and understandings derived from her encounters with alternative cultures, whilst healing and beneficial to her sense of self, proved problematic within culture of the prevailing societal medical framework.  There was no space for her internal and embodied experiences of her illness.

With continued consideration, Diaphora's lessons in difference, as illustrated in her life story thus far, continue to inform and unfold new understandings.




Allen, M., Naka, K., & Ishizu, H. (2004). Attacked by the gods or by mental illness? Hybridizing mental and spiritual health in Okinawa. Mental Health, Religion & Culture, 7(2), 83-107. doi: 10.1080/1367467031000101019


Campbell, G., Lende, D. H., & Downey, G. (2013, May 24). Neuroanthropology: What is it and why should you care? [Audio blog post]. Retrieved June 3, 2013, from


Cooperman, H. (2010, June). Hillel Cooperman: Legos for grownups [Video blog post]. Retrieved April, 2013, from hillel_cooperman_legos_for_grownups.html


De Fina, A. (2006). Chapter 13: Group identity, narrative and self-representations. In A. De Fina, D. Schiffrin, & M. Bamberg (Eds.), Discourse and identity (pp. 351-375). Cambridge: Cambridge University Press.


Falicov, C. J. (2005). Emotional transnationalism and family identities. Family Process, 44(4), 399-406. doi: 10.1111/j.1545-5300.2005.00068.x


Kuczynski, L., Navara, G. S., & Boiger, M. (2011). Chapter 9 - The social relational perspective on family acculturation. In S. S. Chuang & R. P. Moreno (Eds.), Immigrant children: Change, adaptation, and cultural transformation (pp. 171-191). Lanham, MD: Lexington Books.


Lenga, H. (2013, June 8). Culturally responsive practice: Attachment, trauma and culture. What does culture mean? Lecture presented at Master of Art Therapy and Master of Counselling in La Trobe University Health Sciences, City Campus, Melbourne, Australia.


Makrenoglou, A. (2009). Food, Gender, Generation and Ethnicity: Being a ‘good’ Greek Girl? Retrieved June 8, 2013, from conferencepapers09/papers/Makenoglou,%20Anna.pdf


McGoldrick, M., & Ashton, D. (2003). Chapter 11. Culture: A challenge to concepts of normality. In F. Walsh (Ed.), Normal family processes: Growing diversity and complexity (pp. 249-272). New York: Guilford Press.


Stone, E., Gomez, E., Hotzoglou, D., & Lipnitsky, J. Y. (2005). Transnationalism as a motif in family stories. Family Process, 44(4), 381-398. doi: 10.1111/j. 1545-5300.2005.00067.x


Wajnryb, R. (2001). Silence: How tragedy shapes talk. Crows Nest, N.S.W.: Allen & Unwin.