Episode 9. Ashleigh Wallach talks about the d/Deaf and Hard of Hearing experience, and what you need to know.

Anita:

Hey, Aileen.

Aileen:

Hey, Anita. How are you?

Anita:

Yeah, I'm good. I really enjoyed talking to Ashleigh Wallach about the D/deaf and hard of hearing experience and what we need to be thinking about as psychologists.

Aileen:

I am really glad that you did this because this is an area where I know very little. And listening to you, it really gave me an idea on how to have conversations in areas where I might make mistakes, and the way that you approach it with grace, especially when you are talking about, "Oh, this is how, how I came up with the idea of doing the transcript" and how instead of falling into complete shame, you just took it on board and gave that possibility of, we might not get it right and this is what we do, instead of not trying at all. So I think that this was a very brave conversation to have.

Anita:

Thanks, Aileen. I feel like when we talked about starting this podcast, that's very much what we wanted it to be about, really. It can feel like there's a polarity between either we're perfect and we're totally right on, and we know all of the words, and we are super diversity competent, or we just totally avoid it and dismiss it. Either you get it totally right or you're just wrong and you're cancelled, which means that it just becomes so difficult to talk about any of it.

Aileen:

I guess that when you were talking about including transcripts for the podcasts and how you approached that really gave me a permission to come to terms with what I actually have available around me, what I can do. But it, it, it keeps coming back to an individual problem with an individual support, when in reality it's a system problem and it's a system that needs support. Because even if you want to make this podcast accessible, other than the transcript, I don't know what else we could do.

Anita:

Yeah, we'd have to engage an Auslan interpreter, and I guess it would then have to be a video, so we'd have to make it available on a different kind of platform. It is a really new area for me as well, and I couldn't find other podcasts on this topic. So I felt like it was really important, and so I wanted to include the whole conversation.

Aileen:

It's a really good listen too. Thank you so much, Anita.

Anita:

Thanks so much for joining me today, Ashleigh. Can you tell me a little bit about yourself?

Ashleigh:

Hi, Anita. Thank you so much for having me on board. I am Ashleigh Wallach. I am a psychologist, general psychologist, and my expertise in the, in the field is to work with d/Deaf and Hard of Hearing people. So that's the whole spectrum from speaking, hearing with hearing devices, right through to deaf, no hearing, use sign language to communicate, and so the, the whole gamut in between.

So it's sort of something I fell into, having a hearing loss myself from birth. I wear hearing aids and then so as I went through my education and, learnt, learned about psychology, went through my degree, it just sort of naturally became something I was interested in because, you know, there's just not much out there for the deaf population.

Anita:

Yeah, I think when you go through a psychology education and you're not seeing things that speak to your own experience, then that can be a bit of a strange experience. Was that your experience of studying psychology?

Ashleigh

Oh, look, we're going back a while, but I guess the main thing I got from studying psychology was this sense of, I guess, just the gap in our awareness and knowledge around the impacts of deafness over a lifetime, and that's without speaking to, you know, acquired deafness later in life and the impacts of that. And it was like this light bulb moment in the middle of a 101 class of like, "Well, what do deaf people do when they go see a psychologist? You know, what, how do they communicate? What's the process there?" And it just sort of got me thinking. And yeah, you're right. Like the education itself, you know, as you know, with psychology education, at least when I went through, it was very general and broad, and English heavy, and text heavy, and, you know, and spoke to that general, the typical trauma that someone might experience and so the impacts of that. But for a d/Deaf person, that can look very different depending on the type of family they grow up in, the type of education they receive, and the level of deafness that they have. So it's a very nuanced, complex area that wasn't even touched on when I was in, when I was studying.

Anita:

Yeah. I don't think it was covered in my training, so I'm really pretty ignorant in this area, Ashleigh, so really interested in everything you've got to say. The only time I think that I've heard about deafness or hearing loss and the impact was when I was working in the Northern Territory for a period, 'cos there's a lot of hearing loss up there, which really impacts on people's ability to fully participate in general life, education, a lot of problems in the justice system, and so on, for people because of hearing loss. And so that was something I really hadn't been aware of until then. Because of my ignorance, I don't know a lot about the different terms, and you were saying, Ashleigh, that you're hard of hearing yourself.

Ashleigh:

Yes, that's right. So it's an interesting one where as you grow up and, you know, from the get-go when I was younger, it was always “hearing impaired”. And then so as you sort of come into the D/deaf and Hard of Hearing world and the services that are currently around, there, there is a lot of negative connotation with the word hearing impaired, and hearing loss, and failing the hearing test, and so, you know, from the get-go in the medical system you're in deficit, right? Yeah. And the Deaf community, you know, don't like that, of course, because for them in their deaf culture and deaf community spaces, being Deaf is a point of pride. And, you know, the culture and the joy they share in being together and communicating in sign language and going to Deaf events and supporting each other in all of their endeavors, that being Deaf is not something that is a bad thing. And there would even be Deaf parents who if their child was Deaf, it's not a bad thing. It's like, "Well, that's, they're part of our world, they're part of our culture, they're going to be fine," because, you know, the language is there, the foundation is there, the support is there. The terms that, term hearing impaired that I grew up with, I quickly learned, oh, actually that's derogatory from the get go, or, you know, implies a deficit. So the shift to “Hard of Hearing” came when I was in my 20s. So you've got the term “Hard of Hearing”, which is commonly associated with people who speak and hear, and use hearing devices. And then you've got capital D deaf, which is someone who identifies with the Deaf community, Deaf culture, and uses sign language to communicate. And then you've got “little D deaf”, which is someone who is deaf but doesn't maybe associate or identify with the Deaf community, and they're predominantly in the hearing world only. And so you've got these different terms depending on, on what someone's experience has been or is in their daily life.

Anita:

I have so many questions after you say that. One is the sense of shifting identity, I guess, for you. Like, I guess when you were growing up, you sort of would think of yourself as maybe a hearing impaired person. Were you in a mainstream setting?

Ashleigh:

Yeah. So growing up hearing impaired, I was very much in the hearing world. I was in a hearing family. There was no one else in my immediate community who also had a hearing loss of any degree or wore hearing devices. And so I was very alone in that experience. But then it was also something that my family didn't really focus on. It was like, as you see hearing now, you and I are talking, I can pass as hearing, right? And so that a lot of, of my experience growing up in the hearing settings, school, community, sports, that whole gamut- I could pass as hearing, and so it wasn't really a thing. But as you know, a young girl wearing hearing aids, you know, wears their hair down so you don't really see, and, and it became a point of, you know, whether I had confidence or not when someone knew I was hearing impaired or not. And so, you know, someone might say, "Oh, you don't seem deaf or you don't seem like you're hearing impaired," and it's like, "Oh, okay, cool," like I'm, you know, flying under the radar here. But then it does impede on your sense of identity and self-confidence, because when it comes to actually asking for what I needed, that means revealing that I have a need, and then asking for that access. So for example, going into a psychology lecture and the lecturer has a really soft voice or a high voice or mumbles, and I would need a note taker. And so having to go to disability services, liaison officers there and saying, "Can I please have a note taker?" Like it was, it's something that I had to learn and grow into, that idea of, yes, I have a need, and that is okay, and there is a way to get this need met. And that's the important thing, not whether it makes me look different. As you know, young people don't want to look different. They want to belong, they want to fit in, they want to, you know, just be like everyone else. And so that shift really happened in my early 20s where I was like, "Okay, I'm hearing impaired, so what?" Like, I need to just own this. And that's a tricky stage for a lot of young people, for sure.

Anita:

So it's when something is seen as a deficit in that way, then it's seen as a good thing that you pass, I guess. And so I'm passing. Nobody even knows that I'm hearing impaired, so that's a good thing. But then on the other hand, then you have this sort of isolation about, oh, well there's this aspect of me that people don't necessarily know about, and that I'm having to struggle with quietly. And then when you're asking for equal access, like to be able to equally access the lecture as other people, then it feels like you're revealing something that's wrong with you, in a sense.

Ashleigh:

Yeah, exactly. Exactly. And it's something that whether, regardless of the level of hearing loss you have, you quickly learn to kind of pick up what you can and try and make sense of what's happening without maybe necessarily all of the words. And so but then when you might not hear something, then you've got to decide, is this something I need to actually know, or can I just leave it and just pretend I'm okay? And then on top of that decision-making around what to ask for and what not to ask for is that fatigue of trying to hear and understand what's going on. Like you and I are here now, I can hear you quite clearly. I'm not using the captions. I'm quite tuned in. But say we met at school pickup time when there are kids running around and there's other mums and parents chatting, and like all of a sudden I'm like really close to you and trying to make sure I can see your face. And, you know, if my kid calls to me from across the yard, I probably wouldn't clock them because, you know, I'm so paying so much attention to what you're saying. And so being selective about where you put your attention, and then the extra load of actually understanding what's being said, yeah, it makes it tricky.

Anita:

And it sounds like a lot of cognitive load. It must be quite exhausting.

Ashleigh:

Yeah, it can be sometimes, yes.

Anita:

And then in social interactions, if people don't realise that you're, you're doing all of those things, making those calculations, then that could create a little bit of awkwardness, I imagine.

Ashleigh:

Yeah, it's quite interesting sometimes. I'll be in a group with friends and hearing friends And someone will say something, but maybe I don't respond, and then it's almost like they remember, like, you need to get her attention first. But it's an awkwardness that, you know, I realised early on that I can make this awkward by going, "Oh, I'm sorry, I didn't hear you," and try and apologise for that. Or just go, "Oh, yeah, no worries, just tell me what you said again," or just kind of making it really not a thing. It's okay that I miss things sometimes, and it doesn't devalue who I am as a person or a friend. It's just a communication blip, and we can overcome that together.

Anita:

And I imagine you sometimes end up doing a bit of educating around you about that.

Ashleigh:

It's the little things like, you know, "Can we turn the background music down?" Or, "Sorry, I'm not hearing you right now because my kids are yelling." Or, like, it's just being open, honest, and transparent about what I am taking in and what I'm not. And being okay with that. You know? And that takes a lot of soul-searching almost, I think, for people to really come to that point of feeling that it's okay to not hear everything all of the time, and there are ways around this. But it also means building that network around you who are supportive and open and caring, and will repeat things for you without making you feel like you're a burden.

And also a very different story for someone who needs sign language to communicate. And so in terms of, you know, just accessing a service, you know, if I was to pivot the topics a bit- you know, to me, having this level of hearing is considered a privilege. I can talk on the phone, I can talk to you. It was easy enough for us to organise this time together to then communicate freely and openly. If I was Deaf and needed a sign language interpreter, that adds a whole layer of complexity to the conversation. So we would have an interpreter in the call. I would be signing to the interpreter, and they would be voicing to you. But then booking the interpreter, is it an interpreter I like working with? I might have a preferred interpreter. You know, so there's those extra layers that d/Deaf people must face. I mean, I'm curious, from a perspective of someone who receives mostly only hearing clients, if a d/Deaf person came to your clinic, do you know what to do?

Anita:

Well, I was just thinking as you were speaking that this is one of the things that's very confronting about learning about something like deafness or another area of ability or diversity really in general. So you kind of think, "Well, what are we doing? What have I done?" Like, or, "What is the impact of my ignorance in this area?" You know, like, are there Deaf people or, or Hard of Hearing people who are not coming to see me because I haven’t really thought about it, because I’m putting the burden on them, I guess, to come and check what's available for them? I think what I would need to have, I think I've worked with interpreters for language differences quite a lot, but I haven't worked with a sign language interpreter So I wouldn't, I would need to do quite a bit of background research. And I wonder what that's like for Deaf people and hard of hearing people. Would they bother? Would they bother coming to see me? Because I guess I'm thinking that, of course, they may wish to see someone like yourself who has that extensive knowledge, but there's only, you know, I don't know how many of there are, people like you. And on the other hand, you also can't specialise in everything. If somebody hasn't experienced a particular mental health issue or a particular trauma or something like that, and they want to see a specialist in that, they need to be able to do that equitably. I wonder what that's like. I'm guessing you've got some thoughts on that.

Ashleigh:

Yeah, I mean, and it's interesting, so you know, your question, would they bother? Because when clients come to see me and I say, you know, "Have you seen a psychologist before? Have you seen a therapist?" And nine times out of 10 they will say, "Yes, I have," but then they'll say they didn't really get much out of it because they didn't click or, but also they say they've spent so much time in their therapy sessions talking about the Deaf experience or, or deafness or Deaf culture, sorting out access, interpreters. A lot of d/Deaf people have found themselves educating the psychologist or the therapist, which, you know, that burden should not be on the client. And I know you agree with me, but it's inevitably what happens because there's just not enough deafness awareness out there in terms of the amount of psychologists and therapists who are deaf aware. That list is growing, but it is still not enough for the population of D/deaf people seeking help in Australia at the moment. There is a list, and I can forward you a link to that to include in the show notes if you like. The biggest concern I do have for the d/Deaf community is their ability to have a choice in who they see, and not feeling like they've only got the very few psychologists who have deafness awareness or sign language ability as their go-to. And especially as you say, there's only so many things I can specialise in. Deafness is just one layer. There's also everything else that can happen in someone's life experience that I might not have specialisation in, like, you know, maybe with an eating disorder, for example, that's not something I feel confident in treating. And so, and then who do I refer them to? You know, it's a very limited pool of people. So in terms of the experience of a deaf person, the, what we know to be really important is that assumed access so you, that they know that they can go to the service and they will have their access need met without feeling like they have to volunteer that information. So having on your intake form preferred method of communication, put Auslan in there. Or if you have administrative staff, training them up, you know, if someone comes in and they select Auslan, don't then call them up to book an appointment, right? 'Cos then that's just discordant to the service.

Anita:

How do you become a Deaf-aware psychologist?

Ashleigh:

Oh, goodness. Yeah, there's no straightforward answer to that because what my journey involved was starting as an admin assistant at an audiology clinic while I was studying and learning Auslan (sign language) at community classes while I was working there. And then I worked for another Deaf service in providing community-based family support to parents and kids, and working in deaf schools. And so it was all of the kind of service-based work that I did that gave me that deafness awareness while I was studying, and then taking the leap and opening up my doors to saying, "I am a D/deaf-aware psychologist," and then working with D/deaf clients for the last six to seven years, adults, and just building my knowledge as I went. Like, I paid money to stay up until one o'clock in the morning last night because there was a presentation run by a UK education provider which had a US specialist presenting. So this is how rare this kind of event is that I saw that was on, it was about adapting mental health interventions for deaf people, and I was like, "Well, I need to see what this is about, see what they say, how are they doing things." And so it's really, there is a shortage of education and awareness based services in Australia. But then also what's exciting about this conversation is that you are interested in learning about how to support this population, whereas a lot of psychologists might just not really want to go down that path because it seems really difficult, it seems really convoluted or complex, or it's getting the mental health professionals interested in learning this in order, but then also having the services there to provide that consultation and awareness there. So I hope this conversation maybe piques interest in some people, but yeah, it can potentially feel a bit too hard basket for a lot of people.

Anita:

Yes. And I wonder how many of the Deaf aware psychologists have had some kind of personal experience of deafness in their family or something like that, that has piqued their interest. And of course, it shouldn't take that to be interested. But yeah, it is hard and I find that sometimes it's like that for with people who speak English as a second or third or fourth language as well. That it can feel a bit like, well, this is really too hard. Getting an interpreter is too hard. And so you do sometimes have to do quite a bit of advocacy or just, you know, explain this is actually an equity issue, this is a human rights issue, like everyone should be able to access health services. This isn't optional, like some sense like, this is like a, something I can decide whether they'd be interested or not in diverse groups, rather than kind of realising that, oh, actually we have an obligation to provide services to people, you know, to learn about accessibility requirements and make our services accessible as possible. And I guess consultation is that other piece - do you find you have many people consulting you?

Ashleigh:

No. This is the first, yeah, for in kind of interest in, in, or having the question asked, how do I make my psychology service accessible to the d/Deaf population? No, I haven't really had that pop up. I'd say if you were to be interested in, uh, that area of deafness awareness, you'd probably do the Google search and find yourself going to somewhere like Deaf Victoria or Deaf Australia or places like that, that have deafness awareness as part of their policies and supports. But then how to apply that to a psychology clinic or psychology service is that nuanced extra that would just take talking to someone who does that or trial and error, which, you know, psychologists don't love doing trial and error. They like to know exactly what to do when. And so if there's a few hurdles there, and it's understandable, but at the same time, I'm really keen to see a shift in this. And Deaf Victoria are in the process of lobbying the Victorian Government to implement a deaf specific mental health service or center, which yeah, I wish them the best of luck and really hope that gets off the ground. And there is something similar in Queensland already. There's a statewide consultation and liaison service, and what I understand of it, is that a D/deaf person who's experiencing mental illness or symptoms can go to this service, and then that service will link them in with another service and provide deafness awareness and set them up there. But then it's not actually somewhere someone can go, and that's where they get the intervention and support going, which is good. Like, you're trying to sort of, you know, get people into the community and getting the access to the supports that are already there. But what we know from the services in the UK and the US is that when you're providing a service that is language concordant, culturally appropriate, you know, made for them, built for them, designed by the Deaf community, the outcomes are greater. And you have people actually accessing them and going to these services. So yeah, there's a lot of work that could be done in Australia, in Victoria, but awareness is the first step, and sometimes it can be confronting 'cause it is like a whole new world, a whole new way of providing psychological intervention. And that's why psychologists get curious when they have a D/deaf person in the room. It's like, "Oh, so tell me about, you know, what this is or what this means. What's, you know, why is it like that?" And, you know, do your research beforehand, and so you can deal with what the D/deaf person's bringing into the room, not their deafness.

Anita:

It made me think a little bit about the role of specialist services for groups that are underserved by mainstream mental health, because yeah, it's that tension in providing specialist services in a way, isn't it? That you want to say that D/deaf people are everyone's business, that D/deaf people should have access to all services, and everybody should be across this. And then at the same time, having a centre where people really have the expertise would be, I imagine, really beneficial. And, also I imagine then you can build up, or you can really build up expertise in that area.

Ashleigh:

Yeah. The exciting thing about something like a D/deaf-specific mental health space would be that you would then have potentially up-and-coming young people seeing that this is some, it's an area that they can work in as a D/deaf person. They get trained and, you know, you're creating more supports by having that foundation.

Anita:

I guess that's the capacity building for the whole workforce in a way; if there was a center like this, you can have internships there and then people can have, you know, that experience of an internship or a full training, and that can be a way of having more Deaf-aware, psychologists as well, and getting more D/deaf people to train as psychologists.

Ashleigh:

Yes. Yes. There's, you know, I can only think of three, four Lived Experience Deaf psychologists, including myself in Australia.

Anita:

Yeah, that's not much.

Ashleigh:

No. I mean, I think there's a couple more, but they're the ones I know of personally. But yeah, they're on the list, and there's even, like, a little checkbox on whether they're Deaf, hard of hearing, have Auslan, use interpreters. You know, so you can see what supports and you would like to link up with. But yeah, it's very minimal and the idea of having a space where someone can just go and get that expertise or that knowledge from other professionals in the area. Then also, you know, research could be really a big part of that. You know, you've got access to the D/deaf population who are experiencing distress, and so it's something that could be really wonderful for the Deaf community, but just needs a service or a government that's willing to put the money in.

Anita:

There’s another tension in what you're saying, is this, you've mentioned the sense of going in as a psychologist with someone whose experience feels quite unfamiliar, like they're deaf or hard of hearing, and being able to sort of try trial and error. But on the other hand, not being a psychologist who makes the client educate them, that you've done some education yourself, you've gone out and done some research and have thought about it and not expecting the client to spend their valuable therapy time educating you. And I think that can make me feel sometimes worried about just being curious because I'm like, "Oh no, I'm getting that person to educate me." That's not fair and I need to find this knowledge somewhere else.

Ashleigh:

I'm really glad you raised that because, say, you listen to the conversation and you feel that tension and you think, "Oh, now I can't ask anything about their deafness." That's not what I mean. That's not what I'm saying. It's more the, I guess the thinking about in the room when you ask the client a question, think about the reason behind the question. Is this coming from a place of, "Ooh, I wanna know what it's like being D/deaf," or is it from a place of, "This will help inform me about their lived experience and the impacts of what they're going through," and then deafness being part of that experience? So, you know, if you're, if someone's talking to you about, say, a fight they had with their friend, and they're both D/deaf signing people- And they're having this fight, or they've had a disagreement, but then you're going into sort of, or you're interested more in, so how much can that person hear or compared to you, or I don't know what kind of question it might be, but whereas if you're like, "Okay, so how would you like to move forward based on your values?" Or more around, like, what the issue is rather than the mechanics of it, if that makes sense.

Anita:

Is it partly in that example, like getting a bit fixated on the deafness aspect of it?

Ashleigh:

Yeah. And potentially blowing it into a bigger part of the issue than it really is, because the argument isn't about their levels of deafness or how they communicate. It's more about there's been a disagreement, so how do you want to try and resolve this together? And that, the underlying understanding that you have around relationships and conflict resolution rather than, oh, so you're Deaf and they're Deaf, and it's probably a poor example, but…

Anita:

It's a fine example. I mean, I wonder if it's a bit of a feeling, of overshadowing sometimes that this one aspect that maybe a psychologist is not very familiar with just is so present in the room that you can't see the person. Like you're just seeing them as a Deaf person and trying, and maybe trying really hard, you know, to think about deafness and what it means to be Deaf and really learn about deafness. But in that process, you're not really seeing them as a person, as a full person, and seeing their experiences a little bit more broadly.

Ashleigh:

Yeah. And then on the other hand, deafness is also still, it should still be a consideration because of the impact that it can have throughout someone's development. So say if they are born deaf, but then their parents don't sign to them, and they focus on oral English development And, but they've got no auditory input, and then they get to five or six, already their language development will be significantly delayed. But if they were implanted, so cochlear implants from zero to six months, they can do it quite early these days, and they focus on that aural pathway, and the child has access and is able to acquire that language, then there's no problem. If the deaf child's born into a Deaf family where sign language is the primary and preferred language, and the deaf child has access to language from the get-go, and won't have any language deprivation. So you ask: What was your experience? Did you go to hearing schools? Did you go to Deaf schools? And so from that kind of basic developmental map, you will have a more of a sense of, okay, what was their daily social, educational, developmental life like. So, ‘cos it's different from a Deaf child going to a Deaf school compared to a Deaf child going to a hearing school, and, you know, the different barriers and stigma, levels of audism they would have experienced throughout their life. Are you familiar with the word audism?

Anita:

No, I was just processing that word, and I thought, "Did she say Autism? I don't think so. That doesn't fit." No. What is audism?

Ashleigh:

Audism is this, I want to say this right, and I'm probably not going to give it justice, but this sense that being hearing is a position of privilege, and is, means that being less than hearing is less than. And so, you know, if, for example, being in a classroom, they've put a movie on, and you say to the teacher, "Hey, uh, can I have some captions?" And the teacher says, "Oh, sorry, I can't get the captions to work. Can you just sit closer to the TV?" That you're placing the burden back on the Hard of Hearing or d/Deaf person, and kind of prioritizing the hearing students in the class. It's not a case of, "Okay, let's change the movie to something that has captions." It's just let's just keep going, and you can just kind of work around it. That's the experience of a lot of D/deaf people, where they come into these spaces, and there's just no accommodation or access considered or provided, or if it is considered, it's dismissed because it's too hard, or can you just adjust? Like, the constant adaptation for the D/deaf person into these hearing spaces erodes self-confidence, self-worth. It's really an ongoing impacts in terms of how they see themselves in the world. And they can internalise that of like, "Oh, I don't want to burden someone," or, "I don't want to ask for something and then they say no," and it's the, this sense of like, "I can't do it because I am D/deaf," and, "That's not for me because I am D/deaf," and that's internalised audism as well.

Anita:

Is that what shows up for people often when you're seeing them in your practice?

Ashleigh:

It shows up in a sense of not wanting to... sort of people pleasing, so, and adapting to their environments. It's, you know, being anxious and not going to social events or, or hearing events or family events because they might be the only D/deaf person in the room, and they call it, there's a term called dinner table syndrome, where you've got a dinner table full of the family, and the D/deaf person is just kinda sitting there, hand on fist, and just, like, eating their dinner, just looking around the table, just picking up snippets, but not really being engaged or included.

Anita:

Sounds very lonely.

Ashleigh:

Yeah, it can be. It can be, for sure. And so- being included, being pulled into and supported to access things like the dinner table or the movie in the classroom or, you know, can just make a big difference for that person for that day.

Anita:

And is this the sense, the idea of D/deaf trauma that you've mentioned?

Ashleigh:

Yes, D/deaf trauma. They, there's a term coined only relatively recently, so I'm going say within the last 10 years. So that idea of, you know, there's the language deprivation side of it, there's the lack of inclusion or sense of exclusion from social spaces. There is a list, can't name them all off the top of my head, I'm sorry, but I can provide you with another link that has that, the deaf trauma elements listed, if that's something that people are interested in exploring further. For sure. Yeah. So there's, it's, it depends on the, as I said before, that variety between being hearing right through to D/deaf, hearing family, D/deaf family, like it really depends on the context of in which you were brought up. And what we do know is that from, you know, the ACEs questionnaire, the Adverse Childhood Experiences, so D/deaf people are more likely to score higher on the ACEs questionnaire. The, they are more likely two to two and a half times more likely to experience a mood or anxiety disorder than the hearing population. They're five times more likely to attempt suicide. They're three times more likely to abuse alcohol. So there is, you know, the common link there being this experience of deafness and then the adverse experiences they have growing up. And language deprivation is nowadays getting a lot more notice because of that potential impact right through into adulthood of not getting that foundational language input between zero to five years of age. Because if you can imagine, say, a D/deaf child sitting in the lounge room at home, parents talking in the background, their hearing sibling next to them, the hearing sibling knows that mom's about to go and go down to the shops and get some milk, but the D/deaf child looks up next minute and goes, "Where's Mom?" Because they haven't heard the conversation. But then if there's no shared language The concepts that the child will develop will be mostly concrete. So when they see a red ball, they see the red ball, but they might not have the word ball to associate with that. And then if you have a very limited level of language around the world around you, then everything that you talk about with your family members is going to be very surface level. Like, are you going to eat, sleep, go to school? You know, very surface. There's no complex conversations around abstract concepts. You know, time sequencing, you know, yesterday we went to the park, and tomorrow we're going to go to the zoo. And, but there's just, you don't get to have those kinds of conversation when the child doesn't have that shared language with you. And so the ongoing impact of that You know, you can imagine.

Anita:

It sounds like a really profound impact on development. I have had deafness come up a little bit in a conversation about neurodiversity as well, so I don't know if you have any thoughts or knowledge about that intersection.

Ashleigh:

Look, I have a peer group that I'm part of, two other hearing psychologists who work in the D/deaf space, and we have talked about this at length, that intersection between deafness and neurodiversity, and just how common it is to see other diagnoses come into play, especially around neurodivergence. And so we have talked about creating a resource or something that can hope to help to show people how things show up in a similar way, but, you know, express caution around diagnosing something like autism for, say, difficulty with social interaction and sensitivities to noise or other signs of autism that might also be explained by something like language deprivation, and that lack of exposure to social nuance as they grow up. And the impacts of the daily traumas, the “little t” traumas that come with, you know, that neglect or lack of inclusion in the day-to-day in the hearing world. So it's, it's a really interesting topic, and one that is still in need of extensive research, for sure.

Anita:

And you’re doing some work around creating D/deaf affirming spaces in psychology. Is that right?

Ashleigh:

I am in the developmental stages, so trying to set up an online program, that is provided in just Auslan at this stage. I am thinking of the hard of hearing who don't use Auslan as well, but that can come later. But the D/deaf community, there's nothing like this out there where they can come and just learn about emotional awareness, what's the difference between a thought and a feeling, you know, how might you help yourself regulate or cope with some big feelings, and then go from reacting strongly to something- And being pulled around by our emotions versus, you know, taking that breath and responding intentionally, doing what's important to you, not because it's easier. You know, challenging those, challenging that any sense of, you know, say the experience of going to a conference and they don't provide a Auslan interpreter. It's this immediate feeling of, "I'm not welcome," and so you wouldn't bother going or you'd shut down or ... Whereas when you think about, okay, what is important to you to go to that conference? Well, okay, you’re going to have to reach out, talk to the people, see if they can get you interpreters. You know, start that conversation. It's uncomfortable, but is it worth it? I get sort of being able to get people from that reacting to this very real and very unfortunate reality that is that they face barriers on a daily basis to, okay, well, what can I do to help push what I need forward, even though that's what I would not prefer to have to do, but is in line with me getting what I want. So I want to help empower the D/deaf community in that way because unfortunately the history for the Deaf, it's just full of oppression and discrimination, that the immediate response is to just not trust, not try, don't jump, don't, you know, go there because you'll get disappointed. There is a collective transgenerational trauma that come from actually having their hands held down because they were not allowed to sign in the classroom. Even though that was how they accessed information. Talking 50, 60 years ago and longer, but that's trickled down, right? Anyway, I'm getting off track here.

Anita:
No, I think it's relevant, and it's interesting. You know, I do have an interest in intergenerational trauma, but it's got this different feel for Deaf people because it's not necessarily passed from parent to child. Yeah. Maybe sometimes it is passed from parent to child- but the knowledge, I guess, is passed through in the community.

Ashleigh:

And there are a lot of deaf, strong Deaf, proud families who, you know, they're Deaf parents, Deaf kids, and it's just been passed and passed. But it is, yeah, it's a collective community experience for sure.

So having the benefit of being a psychologist with some level of lived experience of deafness and the wonders of technology, meaning I can stream this online and anyone in Australia who is d/Deaf can access it, I hope to, you know, fill a little bit of that gap of knowledge and awareness around what they can do to just help them get through, you know, the day-to-day and the tough stuff, regardless of where they live and what level of understanding they have of mental health and coping. Yeah. I just want it to be an extra resource.

Anita:

And if we didn't have a D/deaf or Hard of Hearing psychologist, there might not be a noticing that there was that gap. It's another reason why it's so important that it's a diverse group of people that go through the education.

Ashleigh:

Yeah. Yeah, for sure. For sure.

Anita:

Can I ask a very practical question, which is that, can you get Auslan interpreters in private practice funded?

Ashleigh:

Yes. Interesting question. So depending on the service, the, so if it's a hospital-based service or a medical-based service- then the service pr- organizes the interpreter, and it's through a funded service called NABS. In private practice, the, because of the way NDIS has kind of structured things, now it is on the client or their plan manager or support coordinator to arrange the interpreter for the session. So they contact the interpreting service, tell them the time for the appointment, and then it's through their NDIS plan that they arrange that. Most clients prefer that because then they can organize the interpreter that they want, and if they're available as well. And then when we have sessions, I would then check with the interpreter or with the client first, you know, they were happy with the interpreter, happy with how things went, and the communication on the day. Say, "Okay, let's see if we can get the same interpreter, same kind like for the ongoing sessions." So you've got that continuity of care and the interpreter's familiar with what we're working on. But if you haven't worked with an interpreter before, or it's someone new, briefing them before the appointment if you're going to cover something a bit tricky or complex. And then also, you know, if it's a heavy session, providing, you know, a little bit of time afterwards to the interpreter just in case they need a bit of support or a debrief as well. Some interpreters, you know, will say, "No, I'm fine. No, it's all good." And, you know, some will maybe point out something that they struggled with in terms of how the session was run or you can have that opportunity to share that communication around what went well and what didn't, which can be really beneficial to the process as well.

Anita:
A lot of these principles are, are ones you can apply for working with other types of interpreters, like spoken language to spoken language. But I was just thinking while you were speaking that the visual would be different because when you're working with two spoken languages, then often the psychologist and the client are still kind of focused on each other. Whereas, I guess for an Auslan interpreter, you'd, the client would be watching the interpreter and watching back. So just the gaze, I was just thinking about how the gaze would be a little bit different, which is interesting.

Ashleigh:

Yeah. So placement in the room can help with that. So if you have the interpreter sort of next to you And then they're looking, then the client's not having to go next to them, look at them, and then turn to look at you to talk. Because what's really important is that you talk to the client, not to the interpreter. So having the interpreter next to you means that their eye gaze isn't as- there's not much burden on the eye gaze switching, and you can then keep just focusing on the client rather than, you know, if you find the signing distracting.

Anita:

That makes sense because the interpreter's talking to you - using spoken language back to you, so you don't have to turn and look at the interpreter, so yeah. That's really useful.

Sadly, we're out of time. And is there anything that you feel is important to say that we haven't covered?

Ashleigh:

Oh, goodness. We've covered a lot of ground, I think, today. I mean, thank you for your curious and insightful questions. I'm really, just really glad that we've had this opportunity to just start opening the door on this kind of conversation and for the d/Deaf community. I did have a thought just to really kind of highlight, or I don't know if you, what you think of this, but even just this conversation now between two people speaking in English, talking about the Deaf community, it even makes me feel a bit awkward is not quite the word, but I feel the discomfort of having this conversation in a way that now d/Deaf people, if they want to access this conversation, they're going to have to read the transcript. There's no Auslan interpretation. And then already you can sort of see, like, there's another access issue, even just in this podcast, and I just wanted to acknowledge that and just really hit home how access is just such a secondary consideration when it comes to the Deaf population, and it's really, you know, unfortunate. Yeah, it's not an easy one to fix either, like, because if we thought, "Hey, let's have an interpreter in the room here," firstly we'd need two, because we've gone over the hour. Yeah. And we switch 15 minutes each, and then the cost of that as well.

Anita:

Yeah. And look, I'll be honest that I only started doing transcripts when I had I was speaking to a Deaf counsellor who said that, "you don't even have transcripts, why contact me?", was quite frank with me, like, "You haven't thought about d/Deaf people in your podcast." So then I started doing transcripts. So, I mean, yeah, they are all really tricky questions. I guess it's every time you do that bit of engagement, you realise….every time I produce something and I don't do a transcript, how is a D/deaf person going to have any idea? And then there's a secondary issue you're talking about around, I think, around we're not D/deaf, you and I are not, although you're Hard of Hearing. When do you get to speak on behalf of? If you're working a lot with a population, do you get to speak on behalf of, because your lived experience is partially similar to a D/deaf person? Is that something that people feel is okay? But I think one thing I'd say about that is that it's asking for feedback too, and if we do, you can't get it right necessarily, but if we do then have feedback, hopefully we can have some feedback from d/Deaf people who kind of say, "Well, look, actually that, that didn't…you really missed these aspects of D/deaf experience." And then we have to be humble enough, but it's not, hopefully, in a canceling way to say like, "That was shit, you shouldn't have done it," but to be a bit more like, "Oh, okay, well, we didn't realise, so yeah. Let's do it better next time." And I think that's what stops people sometimes from even trying, right?

Ashleigh:

That's exactly right. I don't want to get it wrong. That's right. You know? So I just feel like, 'cos we get, you know, we'll have this moment of anxiety of like, "Oh no, maybe I've not done this whole thing properly," but you’ve got to say- "Well, look, I'm giving it a go, and people can tell me that I've done it wrong, and then I can try again," and that's all we can do, and if we don't do it that way, then we'll never have the conversations, I think. Exactly. Right?

Anita:

Yeah. That's my feeling. But thanks so much, Ashleigh. I do ask people one question if you don't have to run off, which is usually like, what sustains you in the work?

Ashleigh:

It might be a bit cliche, but even just those moments in a session where you're really in tune with each other. And you see the shift in how they're relating to the issue or problem that they're, that we're addressing, and in such a way that is, that makes them lighter. And it's that lightness that I just think is the most beautiful part of therapy, 'cos if we can't make their life feel lighter, then we're in the wrong industry. Yeah, I find that really satisfying and a privilege to be able to witness for my clients.

Anita:

Yeah, that's beautiful. That's a lovely note to end on. Thanks again, Ashley.

Ashleigh:

No worries. Thank you, Anita.