Deep listening: working with Indigenous mental distressDeep listening: working with Indigenous mental distress
All In The Mind
'How do I get them to talk?' Hinted-at events, listening to the silence, roundabout stories. Mental health and other professionals inexperienced at working with Indigenous clients struggle with the limits of their cultural awareness, with language barriers and with the historical legacies of mistrust and misunderstanding. Cultural competency is more than sharing a joke. So what is it? And how can psychologists, doctors and others acquire it?
30:13•22 Dec 2007
Deep Listening and Indigenous Mental Distress: Hearing the Story Beneath the Pain
Episode Overview
- Standard Western diagnostic tools may miss distress in Indigenous clients because they ignore historical and social "noise".
- Deep listening involves stillness, reflection, hearing both words and silence, and following stories with concrete action.
- Trust grows when professionals share a little of who they are, work with families and communities, and keep their promises.
- Cultural competence is an ongoing journey, not a two-day course, and demands understanding history as well as current realities.
- Effective work with Indigenous clients requires accepting different communication styles, including silence and avoiding direct eye contact.
“"Indigenous people are sick of not being listened to. It's disrespectful to the ultimate."”
What insights can experts and survivors share about addiction? This episode of All In The Mind zooms in on "deep listening" and how it shapes work with Indigenous people experiencing mental distress. The conversation centres on cultural competence, and how non-Indigenous professionals can easily miss what’s really going on. Psychologist Dennis McDermott explains that standard Western tools, like the Edinburgh postnatal depression scale, can fail completely: "The noise in the background was so strong...
it was difficult to pick out a clear signal." That "noise" includes 200 years of colonisation, the stolen generations, ongoing racism and individual trauma layered on top. You’ll hear from local elder Rob Lowe, who warmly situates people on Peekarong country, and psychiatric nurse Deborah Parkinson, the only mental health worker embedded in her regional Aboriginal community.
Deborah describes working not just with individuals but entire families, often in crisis, and stresses the importance of "asking people to tell their story" and giving that story time. A key theme is the Indigenous concept of deep listening. Drawing on ideas such as Dadirri and ngara, Dennis describes it as a still, reflective way of hearing "the silence" as well as the words, and finishing listening with action.
It’s framed as everyday respect shown through behaviour rather than "pious words". The episode also looks at mistrust of psychology as part of a "colonial arm" that has helped label people, remove children and define Indigenous behaviour as a problem to be punished. Senior lecturer Wendy Nolan argues that ignorance breeds fear and racism, and that only genuine education and relationship-building can shift that.
Psychiatrist Caroline Byrne adds the clinical "musts": know the specific community, take off the white coat, be comfortable with silence, and always follow through. If you’re curious about what meaningful, culturally aware mental health care could look like, this thoughtful discussion might get you questioning how you listen and whose stories you truly hear.
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