Mental Suffering – Interpretations and A Counselling Framework: A Mixed Methods Study in Hong Kong

Abstract

<p><b>Aims and objectives:</b> There were four aims of this study. First, to explore a cohort of Hong Kong Chinese residents’ interpretations of the general meaning of mental suffering (MS). Second, to explore the same cohort of Hong Kong Chinese residents’ interpretations of the meaning of their MS experiences. Third, to explore whether (and what) Buddhist concepts were reflected in the same cohort of Hong Kong Chinese residents’ interpretations of MS. Fourth, to derive an MS counselling framework (MSCF) with Buddhist concepts. </p> <p><b>Methods:</b> This study adopted mixed methods research in the collection, analysis, and interpretation of data. I developed and administered a questionnaire comprising five questions to the 52 participants in Phase 1. I requested that they give written responses to the questionnaire questions and send back their written responses to me. Two methods were used to analyse the written data obtained, i.e., thematic analysis (to identify various themes from the written data and then qualitatively analyse those themes) and content analysis (to quantify the written data into countable variables, enabling quantitative analysis of those variables with SPSS). After Phase 1, I invited 15 participants to join Phase 2 as the written responses of these participants contained special themes or unclear contents. Seven participants were finally willing or able to attend the face-to-face interviews in Phase 2. These seven interviewees were again asked the same five questions with additional in-depth follow-up questions. In Phase 2, the verbal data were transcribed and analysed qualitatively with interpretative phenomenological analysis to analyse how interviewees interpreted the meaning of MS and their own MS experiences, and how I interpreted their interpretations.</p> <p><b>Findings:</b> IBM SPSS Statistics Version 26 was used to generate various significant, meaningful quantitative results in Phase 1. Participants’ ages were perfectly correlated with MS experiences related to meaning, esteem, mental illness, growth, abuse, trauma, work, friendship, and safety, indicating that participants of older age more frequently mentioned these nine themes in their life. On the other hand, participants of younger age more frequently mentioned the other seven themes in this study, including love, loss, family, study, relationship, disaster, and sickness. There were also interesting results related to specific reactions to MS. First, male participants more commonly experienced decreased capability, negative sensations, and negative physical symptoms during their MS experiences. Second, participants with higher educational backgrounds experienced more neutral feelings, neutral thinking, negative thinking, and negative behaviour during their MS experiences. Third, participants whose MS experiences were related to the family experienced more positive thinking, positive feelings, neutral feelings, and positive behaviour during their MS experiences. Fourth, MS experiences of safety, abuse, friendship, trauma, esteem, and study were closely related, and these experiences were more likely to lead to neutral behaviour and mental illness during MS experiences. Fifth, MS experiences related to work, growth, sickness, or disaster were more likely to lead to positive physical symptoms, neutral physical symptoms, positive sensations, neutral sensations, increased capability, and changed capability during the MS experiences.</p> <p>This study has also found many meaningful qualitative results that have been discussed in detail in the thesis. Echoing various perspectives of the terms or concepts related to MS that are mentioned in the literature, except for the anthropological perspective, this study showed that the responses given by participants and interviewees reflected elements or concepts related to the perspectives of Western psychology, mental health or mental illness, Western religion (Catholic or Protestant churches), and Eastern religion (Hinduism or Buddhism) in their interpretations of MS in general and of their MS experiences. Because counselling approaches commonly used in Hong Kong usually reflect perspectives of Western psychology, mental health or mental illness, or Western religion, the fourth aim of this study was to try to derive an MS counselling framework with Buddhist concepts, as Buddhism is the second largest in the religious population in Hong Kong.</p> <p>Based on the Buddhist concepts reflected in participants’ responses, I derived an MS counselling framework (MSCF), its protocol, and features. I compared each feature of the MSCF with various conventional counselling approaches and their techniques to determine similarities. To maintain the necessary ethical principles and rigorous professional standards, I tested the approach and strategies of the MSCF and found that the MSCF applied adequately to the two hypothetical illustrative examples. </p> <p><b>Conclusions:</b> This study has produced four novel contributions to current knowledge. The first contribution is an understanding of how a cohort of Hong Kong Chinese residents interprets the general meaning of MS. The second is how the same cohort of participants interpret the meaning of their MS experiences. The third is an understanding of the Buddhist concepts reflected in the interpretations of the meaning of MS. Finally, this study contributed the novel MSCF and its protocol.</p>