When Silence Speaks: A Reflection on Engaging in Expressive Arts Activities and Thoughts of Suicide

Abstract

Deep, potent silences sometimes underlie thoughts of suicide. This paper presents a personal reflection of silence as a form of expression, and examines how engaging in expressive arts activities may reveal and help in processing feelings of distress and thoughts of suicide. There is an additional layer of hegemony that the use of words adds to discussions of suicidality, which makes these discussions inaccessible to many of the disenfranchised, including people from a refugee background for whom English is not a first language. But, for those struggling with speaking the (English) language in the first place, at what level of language acquisition can they be deemed fit to express and accurately represent their thoughts and ideas about suicide? Does their silence count? And so, by tackling this dilemma, this paper seeks to examine alternative ways of expression that do not heavily rely on words. It explores how, in our undertaking of suicidality studies creatively, we may embody and dignify the ways of the marginalised that have been devalued by a colonialist or interventionist agenda. The paper is an exercise in re-writing their experiences from the critical consciousness of coloniality. It is a disassembling of the control, domination, and exploitation that words can have. It is an attempt to shift the source and profile of knowledge about suicide from those who wield the power and privilege of words to those who live in the margins, shielded by silence.

1. Introduction

I have often reflected on these words that were said by a young man from South Sudan, in Kakuma refugee camp, about his experience of displacement: ‘You know, here in the camp there are many things that are affecting us. When there is no way, you just keep quiet. You cannot think about it, you cannot talk about it, you can just keep quiet’ (Gitau 2018).

A lot can be said through silence. In this paper, I present a personal reflection of engaging in expressive arts activities along with people from a refugee background. This work is not based on interviews carried out with participants, but, rather, on my own participation and reflection on my experience as I sometimes co-led these engagements or was simply a participant. I write from the position of being a migrant woman from East Africa, now living in the unceded land of the Darug First Nations people in Western Sydney, having migrated to study at the University of Sydney. I also write from the position of working with people from refugee backgrounds in Western Sydney and regional New South Wales. I am continually learning, reflecting, and being challenged to work in ways that are respectful and conscious of our varied experiences, and I am committed to decolonising methodologies of working with refugee populations.

I discuss the hegemony of words and the place for silence in the study of suicide. I examine how this silence can be accompanied by, or expressed in, some expressive arts activities that are not language heavy. In this way, I embrace the idea that there are multiple alternative ways of expressing thoughts and ideas about suicide, thus promoting non-oppressive and decolonial interventions.

This concept of a multiplicity of ways to express thoughts and ideas on suicide has marked the emerging field of critical suicide studies in recent years. There has been a shift away from the traditional view of suicide as an individualised, pathological condition resulting from poor mental health, a condition medically treatable, preventable through logical means, and researchable by quantifiable methods (Chandler et al. 2022; White et al. 2016; Hjelmeland et al. 2018; Fitzpatrick 2020; Jaworski and Marsh 2020; Bantjes and Swartz 2019; Lenette 2023). These scholars in the field have critiqued the traditional view as narrow and inadequate, and have argued for a view of suicide that includes the social-cultural determinants and interpretations of suicide in its causes, treatment, and prevention, indeed in its very conceptualisation. In this expanded conceptualisation, suicide is seen to be shaped by culture, history, politics, gender, identity, media, and power, among other factors (Chandler et al. 2022; Bao 2020) including, I would add, language.

Beyond the critique, critical suicide scholars have sought to examine alternative ways of researching suicide. They strive to disrupt the epistemic injustice evident in the representation of suicide in terms of its history, theory, knowledge production, and ethics (Jaworski and Marsh 2020). In their response to the limitations of dominant biomedical quantitative approaches to suicide research, Bantjes and Swartz (2019) examine the practice of analysing first-person narratives of nonfatal suicidal behaviour to make truth claims about the causes, and, in conclusion, emphasise the contextual nature, partiality, and intersubjectivity of these narratives. Fitzpatrick (2020) critiques the standard practice of suicide prevention and education that tends to silence alternative interpretations and expressions of suicide. They emphasise the need for new ways of thinking about suicide literacy that enhance equal participation, embrace multiple perspectives, and empower individuals and communities to understand, express, and respond to their ideas about suicide. My personal reflection on suicidality expressed in silence is a contribution to these new ways of thinking about, and expressing thoughts on, suicide.

The Nobel Prize-winning author Toni Morrison (1931–2019), known for novels exploring the African American experience, confessed that she had spent her entire writing life trying to make sure that the white gaze was not the dominant one in her books, that she did not have to be consumed by, or concerned about, that white gaze (Abimbola 2019). Abimbola (2019) discusses how we must, invariably as authors, grapple with who we are as authors, our position or standpoint, what she refers to as ‘pose’, and who we write for, what she terms ‘gaze’.

I find myself struggling with this dilemma too, the ‘gaze’ for which I write, trying to balance

… between on the one hand, the need to tell it like it is, and on the other hand, an effort to globalise the use of language, to make [my] message intelligible … to sanitise the reality that [I] wish to convey, to hide the dirty linen. [For] when the foreign gaze wins over, as it often does, complexity, nuance and meaning … can be lost.

(Abimbola 2019, p. 4)

This reveals the imbalances of power in the production of knowledge in the global health field, and my goal is to contribute to undoing what those imbalances represent, ‘… a continuity of the colonial project in global health …’ (Abimbola 2019, p. 4). I see a real need to continue looking for strategies to undo these colonial attitudes and practices.

The Power Words Wield

Words have power. They make, create, shape, and form. And recreate. They can consequently unmake, destroy, and render shapeless and formless what they have made. And kill. They do this to experiences, ideas, feelings, sensations, thoughts, and indeed any aspect of human existence. We hear countless accounts of how individuals were made, or unmade, through the words of a teacher, a parent, or another adult of significant influence in their lives. In this regard, I think some words of one teacher in my primary school—in a village in Kenya, then freshly independent from British colonial rule, and still reeling with the colonial legacy—may have formed or unformed me. Or reformed me. I will come back to this experience later, but this marked the time when I began seeing the boundaries between myself and others, forming my own identity, seeing where I ended and others began.

Michel Foucault’s discourse on technologies of power, referring to the techniques used to determine the conduct of individuals, to submit them to certain ends or domination, is indicative of this power that words wield (Arribas-Ayllon and Walkerdine 2017). Foucault’s interest in the influence of the powerful over the accounts of the past, and how this shapes and forms our attitudes and perceptions of historical events, is of particular significance to my reflection in this paper. And not only of past accounts, but present and future as well. How does language construct ontologies today? Knowledge is informed by social constructs and expressed through discourse in relation to certain groups or peoples. Day (2024) illustrates how this may occur within mental health practice, giving an example of discrimination through discursive constructure using language subjugation:

A mental health professional assesses risk by asking a suicidal service user if they intend to ‘do something silly’. Whilst attempting to soften their language, the professional in turn dismisses the client’s pain and struggle of a very real intent to die—diminishing their experience and potential willingness to name their own, now expunged, suicidality.

(Day 2024, p. 31)

When these kinds of practices are repeated and normalised, ‘regimes of practice’ (Foucault 1991) are formed, and these influence common behaviours and attitudes toward people living with distress and thoughts of suicide. I find Foucault’s concern with the analysis of discourse, especially with regard to the ontological position of those who hold power in society (Day 2024), very important as I reflect on this topic.

In a similar vein, Bourdieu (1989, p. 23) talks of symbolic power in the social space, which is used to preserve, transform, and conserve current classifications of individuals, groups, and institutions. This symbolic power, of necessity, is based on the possession of symbolic capital, ‘The power to impose upon other minds.’ We may say that words or language are this symbolic capital, and, as Bourdieu (1989, p. 23) further argues, ‘Symbolic capital is a credit; it is the power granted to those who have obtained sufficient recognition to be in a position to impose recognition’. And so, those with this capital have the power to form or unform groups, to speak on behalf of, to be an ‘incarnation’ of, ‘the collective’.

Language, and particularly verbal language, has the power to make reality and experiences, and, further, influence identity, status, class, goals, and quality of life (Barnes 2015; Jiang 2002). Jiang (2002, p. 56) refers to the ‘Standard Language is Morality’ metaphor that has been pervasive in shaping what is considered ‘good’ or correct and bad or wrong. The English language is particularly notorious in promoting this metaphor, as people from the higher social classes are said to speak the standard, proper English, while the poor speak bad, corrupted English. Related to the Standard Language is Morality metaphor is the ‘English is a Language of Power’(EILP) metaphor, meaning anyone who does not speak English, or speaks it poorly, is significantly deprived:

… the EILP metaphor excludes those who haven’t acquired the language. English, therefore, has become a gatekeeper to social and economic progress and to access to many professional domains; it regulates the international flow of people and influences global relations.

(Jiang 2002, p. 61)

From the perspective of the emancipation movement in South Africa, Kadt (1993) talks of how language empowers and disempowers, and how emancipation greatly depends on this power of language. But she goes on to specify that it is not all languages that have power, but, rather, specific languages in particular societal contexts. The English language particularly exercises a power or mediates an economic or political power that already exists. English is seen as a bearer of civilisation, religion, culture, knowledge, progress, and modernity (Kadt 1993).

Recognising, to some extent, the power that words wield, the mental health field has gradually moved from the use of labels to define individuals towards person-first language that seeks to separate the identity of the individual from the clinical diagnosis or condition, e.g., rather than use the noun ‘mentally ill’ or ‘disabled person’, the person-first language uses ‘person who has a disability’ or ‘individual who has mental illness’. This shift is grounded on the principle of linguistic relativity (or the Sapir–Whorf hypothesis), which holds that language shapes perceptions of the world and greatly influences cognitive processes (Granello and Gibbs 2016). In their study, Granello and Gibbs (2016) found that language and labels had a significant effect on tolerance toward people with mental illness. This move to person-first language is meant to promote respect, dignity, and sensitivity towards people who have been marginalised or stigmatised due to living with distress.

2. The Expressive Arts Activities

Talk and language are both essential components of everyday interaction, but sometimes we express ourselves better without words. It is thus

… absurd to only rely on what we hear to make sense of the world, but there is the need to rely on feeling, observation, understanding, knowledge, empathy, and other non-verbal clues such as eye contacts, gestures, movement, tone, posture, and artefacts.

(Bao 2020, p. 1)

Bao (2020) points to two issues in my experience that have made research in this field rather difficult: one is that it is hard to record data for analysis when participants are speechless, and there are no scientific methods of transcribing silence; another is the Western obsession with words and the non-appreciation of silence as a way of expression, which leads to intolerance with silence.

Expressive arts involve largely non-verbal ways of expressing feelings and perceptions, and include art, music, drama and theatre, imaginative play, dance, and movement. Malchiodi (2020, p. 1) notes that the expressive arts ‘… are action-oriented and tap implicit, embodied experiences of trauma that can defy expression through verbal therapy or logic’. The importance of the non-verbal ways of expression is germane given that studies have shown how trauma tends to manifest non-verbally (Bracken 2003; Van der Kolk 2014) and often destroys language. A person going through an atrocious traumatic event or pain, for example, tends to communicate in grunts, groans, or silence, their ability to use words having been rendered mute (Herman 1997; Levine 2010; Porges 2007; Scarry 1985).

I have selected a few of the expressive activities that I have participated in for the last one-and-a-half years. The greater part of each of these activities is self-directed, with each person having freedom to choose what they want to do with the material provided and quietly engaging in the activity. These activities are outlined below.

2.1. Neurographic Art

This is an art form that invites us to draw freeform lines on paper, allowing the pen to flow spontaneously, while thinking of an issue of concern, stress, or problem. We are provided with paper, permanent markers, felt pens, or sharpies, watercolours, acrylics, pastels, crayons, colouring pencils, and alcohol markers to use for the drawing, and we choose what we want to use. The term neurographic art was coined by a Russian psychologist, Dr Pavel Piscarev, in 2014, to refer to an art form that comprises drawing freeform lines, making patterns and shapes, and colouring them freely and creatively. We connect the lines and shapes we have drawn, making loops, and rounding off the corners. We then add colours of our choice to the sections or shapes of our drawing.

On reflection, the lines and shapes in neurographic art enable connection between the conscious and the unconscious, as the process engages both our aesthetic and emotional intelligence (Vergara 2022). The word neurographic is made of two words: neuro, referring to brain cells and the connections between them and the body, and graphic, referring to the use of pictures, shapes, and patterns to depict the world around us. The art thus connects what is happening in our minds with what is happening in our bodies and what is happening around us.

2.2. Bilateral Drawing with Music

This arts activity involves drawing with both hands while listening to, and following the rhythm of, a piece of music. Bilateral drawing does not aim at creating a specific image or art piece, but, rather, spontaneous drawing using both hands at the same time. We use pencils, felt pens, chalk, or any other materials we choose to draw with. We are invited to choose two pens/pencils/markers of different colours and, starting in the middle of the page, with the two pens next to each other, spiral out from the central point, following the rhythm of the chosen music. After some time, we change the direction of the spirals, slowly making the spirals smaller and smaller back to the centre of the page, still following the rhythm of the music. We then begin crossing each hand to the other side of the page, letting the lines overlap. We do not have to have a pattern to what we draw or create.

This activity is based on the concept of bilateral movement, or using both sides of the body, which assists in sensory integration as it engages cross-hemisphere activity in the brain (Malchiodi 2020; Elbrecht 2018). It helps to quieten the brain or calm the mind, making us feel grounded and centred.

2.3. Soles of Feet Meditation

In this activity, we trace our feet on paper and work inside and outside the outlines of the feet to express how we experience and feel about the world around us (Singh et al. 2003). We are provided with drawing paper, collage material such as magazines, scissors, coloured pencils, crayons, felt pens, pencils, paint, highlighters, pastels, and other colouring supplies, and glue or glue stick. With the materials available, we draw images, shapes, or symbols that represent our experiences and thoughts about distressing situations.

This activity helps to divert attention from an emotionally arousing thought, event, or situation to an emotionally neutral part of the body, in this case the soles of the feet. We are able to stop and focus the mind back on the body, calm down, and make a choice as to how to react to the event, situation, or thought that triggered the emotional response.

2.4. Body Mapping

This arts activity involves creating life-size body images using drawing, painting, or other art-based techniques to visually represent aspects of our lives within our social contexts (De Jager et al. 2016; Gastaldo et al. 2012). We are invited to reflect on how the body feels, where in the body we feel certain emotions (e.g., sadness, joy, frustration, anxiety), and use any of the arts supplies provided to draw symbols or pictures or attach any magazine or clip art pictures to the body map to visually represent our experiences, emotions, and sensations.

Body mapping allows us to share stories and explore ideas in a non-verbal, respectful, and non-judgemental environment. It also provides a better appreciation of complex situations, experiences, and thoughts, including those that are difficult to communicate. Body mapping has been used in different contexts, including as an arts-based research tool which, due to its focus on embodied experience, lends itself to exploration of bodily and psychological feelings and experiences. It has also been used as a way of telling stories whose significance can only be understood in relation to the participant’s overall story and experience. With people from refugee backgrounds, body mapping is used to express individual experiences of displacement, resettlement, and on-going challenges and distress participants face. The activity provides a non-verbal method for expressing ‘experiential states’, such as pain, discomfort, anxiety, and frustration, which may be difficult to verbally articulate (Skop 2016). The activity also helps generate societal narratives or socially shared stories. Through societal narratives, one person’s experiences are transformed into collective experiences (Hyden 1997). The process of collectively sharing narratives is therapeutic in itself, as it involves a cathartic process of witnessing (Kelly and Clifford 1997; Frank 1995) and an increased sense of social connection.

3. Discussion

3.1. How Silence Speaks

There is a ‘still, small voice’ referred to in the Bible, a stillness akin to silence, which seems to ring louder than the stronger noise-producing forces. In this Biblical story, Elijah, a prophet, is instructed by God to go and stand somewhere so that God can speak to him. It is recorded that there was a great and strong wind that tore into the mountains and broke the rocks in pieces, ‘but God was not in the wind’. Then came an earthquake, ‘but God was not in the earthquake’, then came a fire, ‘but God was not in the fire’, and, after these powerful forces of nature, there was ‘a still small voice’, and God was in that still voice, and Elijah heard him (New International Version Bible 1984, 1 Kings 19:11–13). It is interesting to note that Elijah also experienced depression and suicidal thoughts during this event and was desperate to hear God’s voice, and only in silence could he hear God’s redemptive voice.

Silence does not indicate absence or nothingness, and it can be used to access and draw attention to hidden elements in our communication. In an attempt to discuss how ‘silence speaks’, Barnes (2015, p. 13) refers to Cummings’ (1969) poem, ‘Silence’, and notes how the poem presents ‘grammatical pauses in unexpected places which expose the way silences in the form of stops and gaps provide rhythm, sense and meaning to our language and speech …’

Silence is thus a positive, not a negative, and carries meaning even by virtue of being an absence, as saying something by leaving something unsaid. Some things are actually lost in speaking. Zembylas (2004, p. 193) sees respecting silence as ‘a call for respect of the self, otherness, humility, and a sense of wonder’.

When silence is seen as the polar opposite of speech, the dichotomy privileges speech. Acheson (2008) disputes the idea of silence as the polar opposite of speech, which is a Western notion in which speech enjoys primacy while silence is seen as a void, a lack, or a background in which speech occurs. Cultural differences regarding how silence is understood are quite telling, e.g., in some Eastern cultures, silence is as important as speaking, as it provides opportunity to reflect on the value of what is being said. As Acheson (2008) notes, the conception of silence is so varied across cultures that there is as much potential for intercultural misunderstandings of silence as there is in speech. How often I have been asked to ‘explain my silence’!

The concept of silence as an embodied phenomenon resonates with the idea of silence being positive, carrying meaning, having potent power. Acheson (2008) presents silence as gesture, as embodied, and, rather than being a background to expressed thought, an expression in and of itself. Acheson (2008, pp. 536, 537) thus uses a number of terms for silence, including ‘the conspicuous and meaningful absence of a linguistic sign’, ‘strategically used omissions’, ‘the deliberately unspoken’, and, sometimes, ‘the imposed absence of speech and theft of voice’, a silencing. Silence, like speech, thus requires human agency, e.g., when we talk of the ‘biting of the tongue’, taking a deep breath and silently counting to 10, or a silence that ‘we must train our bodies to produce—to listen intensely or extensively … silence that defies cultural norms and/or power structures, such as refusing to speak a colonial language or to participate in oppressive structures’ (Acheson 2008, p. 537).

The embodied nature of silence is evident in the way we feel it in our bodies, the way it produces emotional and physical symptoms in our bodies. And this happens both when we encounter silence and when we are responsible for producing it. Sometimes silence makes us ultra-conscious of time passing. When I am quiet, or there is no noise around me, I am more aware of my body, my breathing, my heart beating. The fact that silence is experienced or heard by the deaf differently from the way they hear the absence of sound is proof of the existence of silence as a positive and intersubjective, embodied phenomenon (Acheson 2008). This calls for us to acknowledge that there are some experiences, concepts, skills, sensations, relationships, and perceptions that defy articulation and that spoken language is limited in its expression of. For these, silence becomes the preferred and more precise tool, and expressive arts a possible alternative.

In her treatise on how the expressive arts transform trauma, Jones (2018) notes that

Art becomes the transition site between the ‘felt’ and the ‘told’, the body and the world, where the subconscious becomes conscious, and the subjective becomes objective—both visible and audible. Art becomes the culturally mediated ‘voice’ of change, both literally and figuratively.

(Jones 2018, p. 46)

Through the expressive arts, even in silence, we can reach into parts of ourselves we did not have access to, and express experiences we did not have language for, rendering a deeper articulation of our realities.

3.2. Resisting and Decolonising

Though words hold power, an overt power that no one can deny, there is a potent power in silence, a defiance against capturing meaning and value only in words. Silence has often been used as a form of resistance against dominance and oppression (Dimitrijević 2021; Houston and Kramarae 1991; Wagner 2012; Ngũgĩ wa Thiong’o 1986; Gatwiri and Mũmbi 2016). Mahatma Gandhi, the anti-colonial Indian nationalist and political ethicist who ‘fought’ for India’s independence from British rule, is said to have observed silence every Monday as a form of non-violent resistance. Gatwiri and Mũmbi (2016) explore the ways in which Kenyan women use silence to resist patriarchal dominance and oppression; they discuss the opportunities that silence presents in empowering women living in these situations. Ngũgĩ wa Thiong’o (1986) advocates for linguistic decolonisation as part of the process of challenging the cultural and epistemic legacies of colonialism.

Even when it is not deliberately used as a tool to resist subjugation, silence has the capacity to portray a sense of choice and control over what is said and left unsaid. Even when it is not a refusal, but an inability to speak a particular language, silence still makes a statement on its own, declaring ever so delicately but powerfully, ‘I am here! Though you do not hear me, I exist. And I am no less than you because you can be heard’. As Barnes (2015, p. 25) argues, ‘Even in its most resistant form, silence often draws attention to itself as a defence’.

Some intriguing examples of using silence as a form of protest or resistance, quoted by Acheson (2008), include how some people who are deaf choose to remain silent, even though they are not mute, and speak with their hands only. For them,

… this silence is a response to the stigmatization they feel from the hearing world, which tends to regard their speech as deficient in some way—that is, less than fully human, or less than equally intelligent … Some, like those who oppose cochlear implants in favor of remaining deaf, use their silence to protest the hegemony of spoken language over signed.

(Acheson 2008, p. 549)

Another example is of a woman from the Warramunga tribe of Australia who refused to speak for 24 years (women were supposed to abstain from speaking for two years while mourning close male relatives). This woman used silence to enact her identity, protest her victimisation, and resist societal imposition:

… the duration of silence not only altered the meaning of the silence, from acquiescence to resistance, but also gained strength through its very length. The silence waited, hovering, gathering power like a storm brewing, and was no less moving while it lasted than when it finally broke.

(Acheson 2008, p. 547)

The English language is particularly prone to resistance because of its association with colonialism. As part of the colonial legacy, countries ‘previously’ colonised by the British have retained English as the dominant language, in most cases as the official lingua franca. As mentioned earlier, I grew up in a village in Kenya, a few years after the country ‘gained its independence’ from British rule. Growing up, I encountered English as this hegemonic force that elevated those who spoke it and mercilessly trod down those who did not. If we dared speak our mother tongue in school, we were met with the severest punishment! English became this hard-faced, cruel master that wielded a heavy rod, a master that we both feared and revered, one that we longed to liberate ourselves from. Because of its association with colonialism, English has sometimes been rejected in certain contexts. Ngũgĩ wa Thiong’o (1986), in Decolonising the Mind, specifically discusses the use of English to dominate and continue perpetuating colonialism. He asks,

How did we arrive at this acceptance of ‘the fatalistic logic of the unassailable position of English in our literature’, in our culture and in our politics? What was the route from the Berlin of 1884 … to what is still the prevailing and dominant logic a hundred years later? How did we, as African writers, come to be so feeble towards the claims of our languages on us and so aggressive in our claims on other languages, particularly the languages of our colonization?

(Ngũgĩ wa Thiong’o 1986, p. 9)

Ngũgĩ wa Thiong’o (1986) eventually vows that this book, Decolonising the Mind, was his farewell to the English language as the original language of his writings; he has consequently continued to write in his mother tongue, Gĩkũyũ, and have his books translated later into English and other languages. Kadt (1993), in discussing the emancipation movement in South Africa, acknowledges that her familiarity with English as a first language has previously made her ignorant of the fact that, when one speaks English, they are inevitably exercising power, which may frustrate one’s best efforts to exercise justice and fairness.

Foucault’s discourse on the mechanisms of power and domination, referred to earlier, is very relevant to our discussion on the need to dismantle the power in language and to acknowledge the potential in silence. Foucault believes that resistance is the way to go about changing these structures and mechanisms. He sees struggle and resistance leading to new social practices and even new forms of subjectivity (Pickett 1996). According to Foucault, resistance is linked to the practice of self-creation and entails ‘refusing what we are’ defined as, since the individual is the product of power, and so resisting entails ‘de-individualising’ and creating something entirely different (Pickett 1996, p. 464). It involves ‘re-writing’ our experiences ‘from the perspective and critical consciousness of coloniality’ (Mignolo 2007).

And what are the implications of this notion of silence as resistance to research on mental health, particularly in relation to suicide? In my expressive arts group, through our silent art activities and quiet expression of our distress, we may be quietly protesting the domination of words, especially words in English, to describe our condition. We may be silently, gently, and subtly saying ‘no’ to the various ways we have been defined and directed by those who hold linguistic power over us. We may be responding to distress in our own terms, and our own time, as the activities are unhurried and, in the most part, self-directed. We would thus not be depending on others to ‘give us voice’. Indeed, Zembylas (2004), in reclaiming the importance of silence, takes issue with the idea of ‘giving voice’ or helping the marginalised ‘reclaim their voice’, arguing that

… the tendency to push some groups to reclaim their voices is not necessarily liberating to them or an indication of ‘good’ ethics on the part of those who take this initiative. Developing the capacity to ‘hear’ the meanings of different silences is fundamental.

(Zembylas 2004, p. 209)

Rather than trying to give voice to the experiences of the suffering and the marginalised, we need to learn to hear their silences and the meanings they may attach to these silences.

I find a similarity between the experiences of First Nations people in the U.S, Canada, and Australia, and those of people from refugee backgrounds, especially in terms of the disenfranchisement suffered through the years. In discussing suicide among indigenous communities in the U.S., Trout et al. (2018) argue for the advancement of decolonial and community-based approaches, along with best practices in research. These approaches are cognisant of suicide as a complex and socially negotiated problem that is related to the history of colonial violence that the indigenous people have suffered, and the importance of promoting the sovereignty and self-determination of indigenous communities. In their research, seeking to explore the perceptions and views of Aboriginal participants in relation to discussing suicide, Heard et al. (2022) conducted focus groups in three communities in New South Wales, Australia, and found that silence about suicide and the impact of this silence, a sense of being powerless to act, as well as shame, fear, mistrust, and negative experiences of mental health care, were among the chief factors affecting discussions about suicide. This invariably leads to a feeling of isolation for those bereaved as a result of suicide, of feeling stuck and unsupported, leading to a vicious cycle of being unable to ‘break the silence’. The participants reported fear of being removed from the community if they discussed suicide, and a mistrust of mental health facilities due to previous experiences of poor follow-up and engagement in support, as well as receiving culturally inappropriate care, and, in some instances, witnessing racism. This fear and mistrust in discussing suicide thus seems closely related to the history of injustice and subjugation experienced by indigenous Australians.

In discussing decolonising efforts within global health and feminist studies, Gumbonzvanda et al. (2021, p. 169) call for a reclaiming of a praxis developed within historically oppressed countries that has been ‘lost through erasures of knowledge production’. They further note the epistemic violence that permeates the global health field ‘that can occur when external experts speak, uncritically, on behalf of those from historically marginalised backgrounds’. And I ask, how can we disrupt this power that words have and leverage the content in the potent silences of marginalised communities?

From my reflection, a transformative paradigm in mental health, which moves from ‘over-medicalised and reductionist biomedical model’ that currently dominates the mental health field, is called for (Whitaker et al. 2021, p. 1). This kind of approach would be respectful to the rights of the marginalised, including indigenous populations and people from refugee backgrounds, promoting self-determination and seeking to address the power imbalances that have been entrenched by colonising practices described earlier in this paper. As Whitaker et al. (2021) discuss in their critique, the biomedical model tends to promote dualities such as patient vs clinician, mentally ill vs mentally well, client vs service provider, etc. These labels pathologise people living in distress and are not sensitive to the social determinants of the distress. The biomedical model thus functions as the framework of the powerful, those who can label and classify, thus assigning position and declaring the fate of those in distress. A critical focus in research praxis highlights these power disparities and how they are perpetuated, and seeks to dismantle them while embracing diversity and promoting justice. Day (2024, p. 32) aptly draws a significant parallel between ‘The stronghold of the medical model and the chokehold of a service user’ in the mental health system, and emphasises the need for resistance

… demonstrated in the liberating practice of service users re-identifying as survivors, forming movements of protest, holding services and trusts accountable, demanding changes in practice, and co-development of research.

(Day 2024, p. 40)

This resistance may of necessity be a silent one, not involving words. When words fail, or are inaccessible, too powerful and unreachable, when they are simply inadequate, those in distress could have access to the expressive arts.

4. Conclusions

This paper has discussed the hegemony of words and the place for silence in the study of suicide, based on a personal reflection on participating in expressive arts activities. It has revealed the imbalances of power in the production of knowledge in the global health field, including knowledge about suicide, and has sought to contribute to the undoing of the colonial attitudes and practices that make these imbalances possible. The paper has examined how silence speaks, and how it may be expressed in expressive arts activities that are not language heavy.

Central to the argument in this paper is the assertion that there are multiple alternative ways of expressing thoughts and ideas about suicide, and there is a need to promote non-oppressive and decolonial interventions. Such alternative ways of expression include the expressive arts, largely involving non-verbal ways of expressing feelings and perceptions. These mostly non-verbal activities are especially relevant given the ways people in distress or experiencing trauma may be unable to effectively communicate with words.

The discussion of silence as resistance is particularly critical because, through silent art activities and the quiet expression of their distress, people may be quietly protesting the domination of words, especially words in English, to describe their condition. Silence as resistance thus presents opportunities for a transformative paradigm in suicide studies that is respectful to the rights of the marginalised, promotes self-determination, and seeks to dismantle the power imbalances that have been entrenched by colonising practices.