Communication about Distress and Well-being: Epistemic and ethical considerations

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.