{Article accepted} Communication about well-being and distress: Epistemic and ethical considerations

One direction in which the AHRC-funded Researching Multilingually projects took me (and others) was the exploration of ‘the languaging of wellbeing and distress’, a meeting point between clinical psychology and applied linguistics, interdisciplinary work led by Ross White now at Liverpool University. Interdisciplinary work, especially as it is transformed from multi-disciplinary work, is not easy in my experience, and this (just accepted) article was no exception, taking several years to reach this point:

White, R., Fay, R., Chiumento, A., Giurgi-Oncu, C., & Phipps, A. (forthcoming). Communication about well-being and distress: Epistemic and ethical considerations. Transcultural Psychiatry.


Communication about wellbeing and distress involves multiple stakeholders – including experts by experience (EBE), researchers, clinical practitioners, interpreters, and translators. It can also involve a variety of discourses and languages. Each of the stakeholders may employ diverging epistemologies to understand and/or explain experiences. These may link to differing sources of authority, and be articulated using particular linguistic resources. If the stakeholders, intentionally or unintentionally, fail to recognise the validity of other stakeholders’ ways of conceptualising and verbalising their experience of wellbeing and distress, epistemic injustice can arise.

Language lies at the heart of the epistemic injustice risks involved in the languaging of wellbeing and distress. Its problematic presence can be seen in:

  1. the interface between divergent discourses on wellbeing and distress (e.g. biomedical versus spiritual); and
  2. communications involving multiple linguistic resources, which can be subdivided into multi-language communications involving a) translation of assessment measures and b) interpreted interactions.

Some of the multi-language challenges of communication can be addressed by translators and/or interpreters as, for example, they strive for conceptual equivalence. We argue, however, that all stakeholders have an important role as epistemic brokers in the languaging of possible epistemological differences – thus, fully equitable communication requires fully effective epistemic brokering. In turn, effective epistemic brokering requires all stakeholders to be reflexively and critically aware of the epistemic injustice risks inherent in multi-language communication.

The article concludes with a set of prompts to help raise stakeholder awareness and reflexivity when engaging in communication about wellbeing and distress.

Keywords: Epistemology, interpretation, translation, multi-language, distress, wellbeing, global mental health, reflective practice, reflexivity, epistemic injustice


Given my professional-academic ‘homes’ in TESOL and Intercultural Communication, and more broadly my affiliation with critical applied linguistics, I would never have expected to be contributing to Transcultural Psychiatry – a fully peer reviewed international journal that publishes original research and review articles on cultural psychiatry and mental health. Cultural psychiatry here refers to a concern with “the social and cultural determinants of psychopathology and psychosocial treatments of the range of mental and behavioural problems in individuals, families and communities”.

It is a challenging (in both positive and negative senses) working interdisciplinarily and I am delighted that we now have a product to celebrate this strand of collaboration.

The observant amongst you will note some common DNA (re epistemic injustice) in this Transcultural Psychiatry article and collaborative work involving Zhuomin Huang, Ross White and myself, e.g.

Huang, Z. M., Fay, R., & White, R. (2017). Mindfulness and the ethics of intercultural knowledge-work. Language and Intercultural Communication17(1), pp.45-57. Available here.

As a trio we are currently working on the reviewer comments for a resubmission of an article for Language, Culture and Society with the revised title “Guarding against epistemic injustice: transknowledging with a critical intercultural ethic”.


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