OpenUCT :: Browsing by Author "Swartz, Sally"

Browsing by Author "Swartz, Sally"

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Open Access
A case study exploration of the therapeutic phenomena of projective identification, transference and countertransference: a brief therapy with a patient with psychotic anxiety
(1996) Abrahams, Deborah L; Miller, Sheila; Swartz, Sally
This dissertation reviews the concepts of projective identification, transference and countertransference from an Object Relations theoretical perspective. The developmental mother-infant relationship is explored as a model for understanding the therapist-patient interaction in both its normal and pathological forms. Projective identification is used to illuminate the workings of transference and countertransference. W.R. Bion's conception of the mother-therapist as 'Container' and infant-patient as 'Contained' is presented as pivotal to understanding that interaction. Failures in projective identification - and therefore in symbolic functioning - are explored, with particular focus given to psychotic and psychosomatic manifestations in patients. The relevance of transference and countertransference phenomena to brief psychotherapy is also considered. These concepts are then applied to a specific therapeutic case. The patient was seen as an in-and outpatient over a 5 month period 1-3 times per week. The patient's history and a brief formulation are presented, followed by a discussion of how the above-mentioned theoretical issues manifested in the therapy. The patient operated on the border between psychosis and neurosis and communicated in primitive pre-verbal and powerful symbolic ways. Case illustrations focus on the interplay between her psyche and soma, the impact of the hospital setting as well as particular transference and countertransference difficulties incurred.
Open Access
Assessment of children for brief psychodynamic psychotherapy : training implications
(1991) Levy, Lisa-Ann; Swartz, Sally
The aim of this study is to develop a framework for the assessment of children for short-term psychodynamic psychotherapy, with a particular emphasis on the training of child therapists. For this purpose the literature on brief child psychotherapy is reviewed, and selection criteria mentioned in the literature are collated and summarized. These criteria are then applied to 5 cases seen by trainees or newly qualified clinicians in order to assess their usefulness in a training setting. Potential sources of difficulty for inexperienced clinicians in the assessment for and process of this specialized form of child psychotherapy are considered, and guidelines as to how this approach could be usefully employed in a training institute are suggested. On the basis of the literature and case discussions, a format for the assessment of children for brief psychotherapy is devised in order to assist the trainee.
Open Access
"The baby will grow" : a poststructuralist and psychodynamic analysis of a community psychology intervention
(1999) Long, Carol; Swartz, Sally
Progressive South African psychologists have recognised the need for community approaches in South Africa which maximise access to psychological intervention and which value politically aware psychological practice. Few extended analyses of such interventions exist in the literature, and community psychology has been critiqued for its lack of theory. This study aims to provide an extended analysis of a community intervention conducted with a group of Primary Health Care Workers. The intervention was motivated by their request for psychological skills in order to enable them to work more effectively with their clients. Interactive workshop sessions were thus conducted by two facilitators (including the author) under supervision over a period of one year. The aim of such workshops was to instil a psychological way of thinking. This consequently implied an emphasis on the emotional world of Primary Health Care Workers. This study provides a post-structuralist and psychoanalytic analysis of the process of intervention in order to offer potential suggestions for future community work and to explore how the interface between psychoanalysis and post-structuralism may offer possibilities for more theoretically grounded community work. Particular emphasis is placed on power relations, discourse and language, and psychoanalytic understandings of relationship in order to explore the intervention as well as the implications of articulation of post-structuralism and psychoanalysis in community work. It is suggested that psychoanalysis is best utilised in community settings when it explicitly recognises socio-political influences and includes these in the object-worlds of ourselves and our clients, and when recognition of power and difference are foregrounded. A further aim involved subjecting a Foucaultian discourse analytic method (e.g. Hollway, 1989) to a practical intervention in which there are multiple texts and in which the clinician becomes the discourse analyst. Whilst this method is no doubt controversial, it offers the potential to extend the use of post-structuralist methodology to the analysis of practical therapeutic encounters beyond the typical methods of analysing written or transcribed texts. Implications of this analysis thus hold bearing on future intervention as well as on future methods of researching psychological practice.
Open Access
Battered and bruised : a case study illustrating the complex nature of a woman's separation from her physically abusive husband
(2002) Lewis, Graeme; Swartz, Sally
This research study employed the single case-study method with the aim of illustrating the complex nature of a woman's separation from her physically abusive husband. An alternative framework for analysis is proposed, which incorporates literature stemming from psychoanalytic and feminist origins into a unified understanding of the battering and escape process. Instead of focussing on society and context, the proposed model initially takes into account the effect of the battered woman's impoverished developmental history in relation to her paradoxical attachment to her abuser. Thereafter, the impact of such an upbringing is kept in mind when considering the broader factors that such a woman encounters within society and her context as she negotiates her separation and escape process. Material was gathered over an eleven-month treatment period that highlighted ambivalence on the part of a 37-year-old woman to truly separate and prosecute her abusive partner. It was shown in this study how it is possible to make sense of this behaviour by utilising the psychoanalytic concept of splitting, as well as by taking account of the developmental hurdle of separation-individuation. The impact of socialised, patriarchal religious values about a woman's role in relationships was also taken into account and shown to reinforce her powerful psychological defences and attachment to her abusive partner. In addition, inefficiency on the part of the police and the courts were shown to exacerbate her sense of helplessness, and frequent courtroom postponements served as a vehicle for ongoing harassment. Within this context, her ongoing exposure to violence, harassment and verbal abuse served to isolate and tap her already limited resources, which further hindered her ability to manage herself and the complex process of severing her ties to her abusive partner.
Open Access
Behavioural and emotional problems in a Guguletu school: a pilot study
(1991) Walaza, Nomfundo; Swartz, Sally
This paper investigates teachers' perceptions of the prevalence of common emotional and behavioural problems in a black primary school in Cape Town. The rationale in undertaking this study is that there is little epidemiological data pertaining to the incidence and types of particular psychiatric disorders in African children. Also, there were concerns from the staff and students of the Child Guidance Clinic of the University of Cape Town that the facilities and services offered at the clinic are only accessible to a small sector of the community. It is thus hoped that the findings from this study would shape direction for future clinical intervention. A selected review of the relevant literature is given. The needs of the teachers are assessed by finding out the prevalence of emotional and behavioural problems, how they manifest and how teachers perceive them. This is geared towards establishing a hierarchy of priorities for common problems. The analysis is divided into two sections; general pattern of problems and teachers' explanation of problems. Findings reveal that although the problems presented by the teachers in this study are similar to those found in developed or First World countries, teachers use different categories from those normally found in basic psychological or psychiatric texts. Categories are based on the teachers' explanations of a particular behaviour.
Open Access
Charting domains of silence - a description of a process of feminist training addressing the rape of men in prison
(2002) Woodin, Nicola; Swartz, Sally
The rape of adult males is a subject in need of attention. The rape of men within South African prisons particularly, has been inadequately researched and documented. Investigation is necessary in order to challenge myths which serve to maintain a 'cycle of silence' regarding the male rape, to guide preventative measures, and inform appropriate services. A training programme within Pollsmoor Prison, is described. The initiative addressed the rape of men in prison, upon request of a group of inmates and warders named 'Friends Against Abuse'. This record is a self-reflexive account of a facilitator's experiences of the research and training. It describes a process of reflection and action, its style consistent with the feminist values that informed the work. The methodological blend of Participatory Action Research, Experiential Training, and contributions from psychodynamic thinking, are elaborated. Discussion explores professional and personal challenges to women working within this domain. It raises questions regarding the impact of a feminist agenda on such work and considers issues of sustainability and the impact of similar interventions. Strategies to ensure effective implementation, monitoring and evaluation are suggested, as well as mechanisms to guarantee integrity, such as 'debriefings' and supervision.
Open Access
Colonialism and the production of psychiatric knowledge in the Cape, 1891-1920
(1996) Swartz, Sally; Louw, Johann
This dissertation describes the evolution of psychiatric practice in the Cape during period 1891-1920, following the appointment of the colony's first Inspector of Asylums. It was a time during which legal reform and social and economic change brought about significant shifts in management of the Cape insane population. The dissertation describes conditions of increasingly strict segregation of patients according to racial categorisation and gender. It argues that this period was pivotal in establishing psychiatric practices closely related to those in Britain. Particular attention is given to the history of Val ken berg Asylum. which opened in 1891, and was the colony's first whites-only asylum. The dissertation describes those features of colonialism rendered visible through Cape psychiatric practice, and explores their implications for the management of the Cape insane. It argues that Cape psychiatry mirrored and contributed to the racist and sexist attitudes upon which exploitation of the colonised population was predicated, though the production of racist knowledge about the colonised population. The dissertation uses management of the insane in the Cape as an example through which to explore the complex ways in which the 'mother' country was made present in colonial practice through the creation of structures which not only insisted on a hierarchy of knowledge and power flowing from coloniser to colonised but also constructed the indigenous as susceptible to rule. The dissertaion argues that texts have primacy as the medium through which knowledge is formulated, circulated and sustained. Discourse analysis of a wide variety of texts provide a reading of the institutional and discursive practices associated with Cape colonial psychiatry. Doctors, around whose activities psychiatric practice was constellated, are the dominant voice in theses texts. However, the subaltern voices of the insane can be distinguished in the contradictions, and silences of the case records, analysis of which is a central focus of the study. Case records are a largely neglected resource in histories of insanity, psychiatry, and asylums. This dissertation formulate and illustrates a method of reading case records which attempts to address the theoretical and methodological problems which have, in the past, contributed to their neglect as a resource.
Open Access
Community-clinical psychological consultation with teachers in an "African" lower primary school : discourses and future directions
(1989) Wood, Rosemary Jane; Swartz, Sally; Swartz, Leslie
Following the action research tradition, a series of four workshops was conducted with 14 - 20 teachers at Songeze Lower Primary School in Guguletu. The workshops were in response to a preceding 'fact-finding' study as to the teachers' perceptions and attributions regarding common emotional and behavioural problems of pupils at their school. This pilot study arose from debate about the relevance of psychological practice in the South African context and in an attempt to identify feasible means of extending the services of the University of Cape Town's Child Guidance Clinic to "oppressed communities" in the Cape Peninsula. It was hypothesized that workshops would be a resource-efficient means of triadic, community - clinical consultation. This workshop series was negotiated with the teachers and comprised: 'Problem Identification and Assessment', 'Discipline', 'Listening Skills' and 'Referral Resources and Group Consultation'. During each workshop, didactic input was supported with hand-outs while large group discussion and problem solving was also stimulated. The last three workshops were quantitatively evaluated by the teachers and in a fifth meeting their qualitative feedback was elicited. An important variable in the above study involved its having been conducted by two researchers, one being "black" and the author being "white". Issues of language barriers, credibility, trust and differing perceptions and expectations between researchers and the participant teachers complicated the workshop process. The teachers' differential responses to the researchers, based on their 'colour', resulted in each experiencing and interpreting their role and relevance differently. It was found that the teachers' most pressing needs concern basic teaching skills and that clinical psychologists have a relatively minor contribution to make via simple, directive input along behaviour modification principles. Workshops were not found to be an optimal mode of intervention. It is suggested that inter-disciplinary team consultation, with clinical psychology interns playing a role in psychological and psychometric assessment and providing workshops on topics such as Discipline may be a more appropriate means of extending the Child Guidance Clinic's services to schools in the Guguletu community. A strong recommendation is made that the study of an "African" language be included in the Clinical Psychology training program. A further suggestion of exploring the need for, and feasibility of, interns conducting teacher support groups is also forwarded.
Open Access
The constellation of the archetypal feminine : a psychic process essential to psychodynamic psychotherapy
(1994) Blow, Tracy Jacqueline; Swartz, Sally; Anderson, Rod
The aim of this study is to explore and demonstrate the necessity for a psychodynamic psychotherapy which embodies and thus evokes the qualities of the Archetypal Feminine. C.G. Jung's concept of the coniunctio, or union of psychic opposites, forms the central theoretical premise on which the study is based. It is with the constellation of the coniunctio that psychic tranformation is achieved. The re-evocation and hence constellation of the archetypal feminine is viewed here as essential for the attainment of psychic integration, in view of the denigration and splitting off of psychic feminine aspects so evident in the histories of most cultures. The role of the feminine in personality development is described by way of an analysis of the archetype of the Feminine, and a documentation of early infant object relations as posited by such Analytical Psychotherapists as Michael Fordham and Mara Sidoli. These early infantile experiences can potentially be re-evoked in the therapeutic transference, particularly when a regressed psychic state is facilitated. This is well documented by analytical psychotherapists, and it is posited here that in order for this process to occur, a therapeutic approach which reveres and hence evokes the Feminine in all her manifestations is critical. This theoretical proposition is examined by way of an analysis of a series of dreams. The dreams were recorded by the dreamer while in a psychodynamically-oriented psychotherapy. The dreams occurred over a seven month period, and were presented in written form to the researcher with accompanying associations. Without gaining any further insights from the dreamer, the researcher analysed the dream series by utilising the associations provided, and amplifying archetypal material. In this way, the need for a therapeutic approach which facilitates the spontaneous emergence of feminine symbolism is demonstrated, and hence the gradual constellation of the coniunctio is shown. The implications for psychotherapy which emerge from this analysis involve the need for an approach to psychic healing which allows for the facilitation of the constellation of the archetypal feminine. Such an approach would provide a sense of secure therapeutic boundaries which would evoke the qualities of the containing vessel. Within this holding environment, a state of regression would occur in which the patient could re-experience infantile levels of relating, levels at which original damage occurred. With an awareness of the dynamics of such early relating, and the potential for their re-evocation,the therapist would facilitate healing and psychic transformation. Myth and fairytale would provide a rich source of reference for the interpretation of dream symbols, and for understanding the myth being lived out by each patient.
Open Access
The construction of shame in feminist reflexive practice and its manifestations in a research relationship
(2010) Womersley, Gail; Swartz, Sally
Despite the psychically toxic nature of shame, and the way in which it manifests so acutely within intersubjective spaces, it has historically been under-researched and under-theorised. However, a burgeoning of literature in recent years has brought an increasing awareness of shame as a pathogenic force. An investigation of this noxious affect is especially pertinent in the context of qualitative feminist research in South Africa, marked by a myriad of class, gender and race differentials between researcher and researched. I therefore consider the significant effect of shame on a specific dialogue which unfolded between myself and a research participant in the course of interviewing rape survivors in Cape Town. The interview is examined through the dual analytic resources of psychodynamic theory and reflexive research practice, with a view to gaining a deeper understanding of the implications of this noxious affect for feminist reflexive research. The analysis reveals the ubiquitous manifestations of shame within the intersubjective space, traceable through the three markers of the affect; namely the content of the narrative, the form or structure of the interaction as well as my own emotional memory of the event. The analysis tracks the shame which arose in such a research context, demonstrating how shame neither belongs exclusively to the self or the other, but is unavoidably generated, exacerbated and maintained within the relational, intersubjective field. A particular exploration of its manifestations on the micro-level of the research relationship through the analytic resource of psychodynamic understanding, highlights the necessity of feminist reflexive practice considering shame. What is highlighted is a need to reflexively locate the emotion within our racialised, gendered and institutionalised research relationships, and to wrestle with the implications this has for meaning-making and embodied subjectivity. Such a consideration would arguably provide invaluable insights for feminist reflexive research and practise as it pays critical attention to positionality, reflexivity, the production of knowledge and the power relations that are inherent in research processes.
Open Access
Dancing the Other in South Africa
(2016) Samuel, Gerard M; Swartz, Sally; Freire, Ida Mara
At the centre of discourse of Dance in South Africa is the notion of Other. The form and approach in Contemporary Dance in South Africa in the 21st century has been shaped by cultural forces such as apartheid and colonialism. This thesis sets out a phenomenological study of Othering in Dance in South Africa through a hermeneutical unpacking of 'Older dancing'. Its critical question grapples with the notion of age as a new marker of alterity in Dance and asks: How does dancing the Other bring new ways of seeing bodies? The lived experiences of four categories in Older dancing: dancers, choreographers, directors and dance critics, in and outside of South Africa since the 2000s, will be analysed. My own position in each of the categories above has allowed me to participate in Contemporary Dance and the performing arts field in South Africa for over 45 years. A partial history of Contemporary Dance in South Africa is explicated in order to provide paradigmatic frames for this study. The philosophical enquiry of this thesis has foregrounded Dance Studies as a discrete research field in order to highlight dance and the body itself, and to reassert an enviable position of dancing bodies as research instruments and knowledge producers. A hermeneutical narrative analysis was deployed following twelve interviews that were conducted over 4 years (2012-2014). Seven South African and five non-South African 'voices' were analysed and coded against four primary lines of enquiry in Experience: notions of cultural inscription and dancing bodies as blank slates; questions of (in)visibility and frailty of older persons, wisdom and (in)dependent older dancers and the ontologies of marginalisation for Older dancing within concert theatre Dance. This suggested a thesis of wider Body-space reading and continuum for Dance that could be useful in understanding epistemology of prejudice. Recommendations that flow from this study will relate to Dance Studies in South Africa that is already moving away from its anthropological roots in tribal dances, experimentations with multicultural dance, towards unpacking intersectionality, public art and the contested label African dance. It provides Body-space as a further theoretical tool with which to observe dancing and bodies as states of becoming that will be of interest to Dance Studies, Performance Theory and Cultural Studies.
Open Access
A description of the process of working intersubjectively with an insecurely attached young adolescent : a case study
(2010) Short, Sotirios; Swartz, Sally
The dissertation presents clinical case material from a psychodynamic therapy with a 12 year-old boy. He presents with minor conduct disturbance, difficulty in affective expression and withdrawal in the context of a dysfunctional family system. The case study research addresses the following aims. It uses information collected from initial interviews with the family and subsequent therapy and feedback sessions to explore the patient’s attachment patterns. It explores the links between the patient’s attachment style and his access to and expression of affect.
Open Access
Different stories : multicultural issues in the training of clinical psychologists
(1995) Ahrends, Ilse; Swartz, Sally
Despite an ever-growing body of international literature on multicultural counselling or psychotherapy, comparatively little has been written on multicultural counselling in South Africa, or the need to train South African clinical psychologists to work in a multicultural milieu. My own experience of the training course in clinical psychology at the University of Cape Town was that there had been very little formal or informal discussion of multicultural issues in counselling. Considering South Africa's multicultural population, I wondered whether we had been sufficiently equipped to work with a culturally, racially and socio-economically diverse clientele. Seventeen clinical psychology interns at the University of Cape Town were interviewed to find out their perceptions of this aspect of the course. A qualitative, ethnomethodological approach to the study was taken. A semi-structured interview schedule was used so that the interns' responses could be explored further. Analysis of the data was guided by social constructionist and discourse theory. The interns felt that it had been difficult to talk about multicultural issues during the training. Their reasons for this are discussed in the light of a politically motivated preference for talk about similarities rather than differences between people. Recommendations are made for an awareness component in the training to increase sensitivity among interns to their own biases and prejudices, and to their cultural heritage; and for a multicultural perspective to all training in counselling and psychotherapy.
Open Access
Divorce in the Muslim community of the Western Cape : a demographic study of 600 divorce records at the Muslim Judicial Council and National Ulama Council between 1994 and 1999
(2002) Toefy, Mogamat Yoesrie; Swartz, Sally
This thesis examines marital discord and dissolution within the Muslim community in the Western Cape. The writer contends that the rising incidence of divorce in a community may indicate underlying social upheaval especially within its family unit. Marriage and divorce reveal individual characteristics, faulty norms and disfuntionality that may be generalised to greater societal trends within a community. The aim of this study is to identify the main reasons and contributing factors that lead to divorce. Such data will assist in planning and supporting proactive communal programmes to reduce the high divorce rate in the community.
Open Access
An ethnographic and socio-semantic analysis of lexis among working-class Afrikaans-speaking coloured adolescent and young adult males in the Cape Peninsula, 1963-1990
(1991) Stone, Gerald Leslie; Swartz, Sally
The study is an investigation into the distinctive, predominantly Afrikaans lexis of adolescent and young adult working-class coloured males in the Cape Peninsula, acquired in social anthropological, psychosocial and sociolinguistic research between 1963 and 1991 (the period of lexical usage is limited to the preceding year). Issues raised by the investigative method, ethnographic participant observation, in regard to subjective data, are also explored. The lexis reflects a lexicogrammatical code of a regional dialect used by all generations in their speech community. Youths construed by speakers as enacting respectability use the lexis of parents or switch to varying degrees into middle-class ("standard") Afrikaans or English. The distinctive lexis of working-class adolescent and young adult male age-sets is thus confined to those construed by speakers as enacting disreputability, delinquency or both. In folk myth and lexicogrammatical code, working-class speakers distinguish four working-class communal identities and corresponding lexicons within the working-class dialect: the respectable, disreputable, delinquent and outcast, constituting a religio-political hierarchy construed in terms of cosmically and socially ordained intracommunal stratification, social status, peer-group association and valence and development of identity. For reasons of space· this study is confined to the disreputable lexicon, which, together with the delinquent lexicon, is termed ou roeker tale (old smoker terms), created and maintained by adolescents and young adults only, although both are used to a lesser extent by many older speakers. The data are organized broadly in terms of communal identity and lexicogrammatical code, and are presented in three parts. The first is an ethnography of folk constructions of communication, language, dialects, communal identities and lexicogrammatical codes, drawing on an exegesis of the socio-semantics of lexis. The second is an ethnography of the communal identities, communal lexicons and their lexicogrammatical codes themselves between 1963 and 1990, focussing on ·working-class male disreputability. The third part is a semantic, grammatical and etymological lexicon of disreputable lexis in ou roeker tale, numbering 2,211 items. Halliday's (1976) formulations of antilanguage are applied to the data and criticized. The major instances of overlexicalization are presented and interpreted. The study concludes that the concept of antilanguage is heuristically valuable but simplistic, one-sided and limited insofar as it pertains to dialect. Its fundamental codal rule of static antagonism is reformulated in terms of ambivalence, creativity and development in communal identity. Issues of methodology, theory and further research are raised in summary.
Open Access
Evaluating the role of Kinesiology, as an adjunct therapy, in the management of patients with Crohn's disease
(2002) Jogee, Rasheda; Swartz, Sally; Bokhorst, Frank; Winter, Trevor
This randomized controlled experimental study was designed to determine whether Kinesiology, as an adjunct to medical therapy, would improve the management of patients with Crohn's disease. One hundred and fifty consecutive Crohn's disease patients, attending the Gastrointestinal Clinic at Groote Schuur Hospital, were randomly assigned to a Kinesiology (n=50) and a Control Group (n=50). In order to assess the effect of physical contact, a third group who received Massage (n=50), was also included. All participants attended their monthly hospital visits and continued taking their prescribed medication.
Open Access
Examining illness narratives in chronic fatigue and immune deficiency syndrome : a mindbody perspective
(2001) Gray, Jeniffer; Swartz, Sally
A semi-structured interview was used to obtain illness narrative data from 10 Chronic Fatigue and Immune Deficiency Syndrom (CFIDS) patients. A qualitative narrative analysis was completed and the findings were discussed in relation to the patients' subjective understanding of the illness process. This was related to current CFIDS research findings, and more especially to the four theoretical paradigms that underpin this research - namely, Medical Illness Model, Lifeworld Illness Model, Mindbody Medicine, and Psychodynamic Theory. Each one of these illness theories highlighted an aspect of the healing influence on CFIDS patients' illness course and meaning. The analysis confirms the importance of all these healing influences. Thus it was concluded that the medical treatment, arising from the Cartesian dualistic understanding of mind and body, proved inadequate on its own as an effective intervention to bring release from CFIDS symptoms and enable the patients to engage a new meaningful life-process. The four paradigms together represent the mindbody reality and indicate the importance of patients receiving interventions at all levels of their lived experience. This intervention approach was shown to be most effective. It is therefore suggested that the Health System work towards such collaborative, integrated health care for chronically ill sufferers.
Open Access
The Expansion and elaboration of the category personality disorders in South Africa 1948-1982
(2009) Laurenson, Helen; Swartz, Sally
This archival study tracks the expansion and elaboration of the category personality disorders in South Africa from 1948 to 1982. Valkenberg Hospital patient files, official documents and professional publications are triangulated with interviews with clinicians. Previous findings that the diagnosis was applied primarily to white, and to a lesser extent coloured, patients in both the early and late 20th century are confirmed. The thesis argues that the expansion and elaboration of the category personality disorders occurred in interactional fashion both from the top down (via the state and the psy-professions) and from the bottom up (in interactions between clinicians and patients). It was linked to the professionalization of the psy-professions articulating with the state's need to manage the dangerous individual in the context of fears about white degeneration.
Open Access
The exploration of elective Caesarian sections as a choice around childbirth
(2011) Lappeman, Maura; Swartz, Sally
A growing number of women in the private health sector are choosing to have elective caesareans in South Africa. This dissertation explores the motivations influencing women who choose an elective caesarean section (CS) for non-health reasons. Qualitative research describing factors influencing pregnant women’s decisions in South Africa is limited and inconclusive (Chadwick, 2007). Thus, most of the literature that was examined was internationally based .The literature review highlights how technology has given us more options and better care when it comes to pregnancy and childbirth. With the medicalisation of childbirth, however, obstetricians have more power and control in a woman’s life and therefore might directly influence the choices she makes. This study considered 10 South African women’s narratives of their decision-making process in deciding to have an elective CS. On average, it had been approximately 2 years from the time when the women had the elective caesarean section. As the aim of the study was to hear how the women positioned themselves in their stories, the researcher’s interventions were limited to a minimum through semi-structured interviews. The data was transcribed and the use of narrative analysis was employed to evaluate the data. This dissertation interrogated the word ‘elective’ in the context of a medicalised childbirth. The narrative structure highlighted how the obstetrician was a crucial decision maker for the women by either the language they used which conjured up images of fear or by simply portraying the elective CS as a rescuer for the pregnant women from her own ‘unruly’ body. All the women had chosen to place their trust in their obstetrician and the medical technology involved in childbirth. The choice of how they would deliver was handed over to the doctor from their first appointment. Elective CS are becoming an accepted cultural norm within the private health sector in South Africa. Women ultimately choosing CS see their bodies as a vessel for a healthy baby and that how the baby enters the world is less significant. Through the exploration, these 10 women’s doctors emphasized vaginal birth’s complications and underplayed its benefits. On the other hand, the best elements of CS are communicated and advocated and the worst underemphasised. Elective CS rate will continue to increase as long as women see it as their obstetrician’s choice in having a healthy baby.
Open Access
An exploratory study : the family's experience of the initial interview at the Child Guidance Clinic
(2005) Naicker, Allengary; Swartz, Sally
This project was an evaluation of the initial interview as experienced by a sample of six families who utilised the services of the CGC in 2003. Families were given a semi-structured interview schedule which focussed on a number of common experiences of the assessment interview. A thematic analysis was employed to understand this qualitative enquiry into the family's perception of a service sometimes criticised as traditional, elitist and contradictory to the proposal that a broader, more community based intervention be proffered.

Browsing by Author "Swartz, Sally"

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