Czerniawski dissertation by ICSW

The Institute for Clinical Social Work

Speed Kills: The Experience of High-Risk Road Practices in Jamaica

A Dissertation Submitted to the Faculty of the Institute for Clinical Social Work in Partial Fulfillment for the Degree of Doctor of Philosophy

By Catherine E. Czerniawski

Chicago, Illinois February 19, 2022

Abstract

This phenomenological study explores the lived experiences of eight Jamaican citizens, who have either directly or indirectly experienced a road traffic accident, and their subjective perspectives on road safety practices in Jamaica. As with many developing nations, Jamaica is a country besieged with a high number of road traffic accidents resulting in death and injury. It is a public health crisis that only continues to escalate despite programmatic efforts for change. Systemic neglect and chronic unprocessed trauma define daily life for most Jamaicans and inform the perceptions and attitudes that Jamaican citizens have towards road safety practices, identity, and the value of life. Through the psychoanalytic lens of postcolonial theory and trauma theory, the research data presents a deeper understanding of the psychosocial factors influencing high-risk road practices including pervasive poverty, governmental neglect, performative masculinity, and relational disconnect, making evident how unsafe road practices serve as an adaptive defense necessary to bolster the value of life for many.

iii

For my husband, parents, and maternal grandmother.

Acknowledgements

This dissertation study would not have been possible without the support of many. Thank you, Dr. Ida Roldan, for believing in my vision; Dr. Allan Sholom for the thoughtful political dialogues and inspiring perspectives; and thank you to Dr. Jaqueline Vincson for serving as a trusted reader to this project. I would like to extend special gratitude to my committee member, professor, and consultant, Dr. Karen Daiter, one of my biggest supporters and inspirations since I began at ICSW. Your generosity in time, guidance, and clinical wisdom has made a forever imprint on me. I would also like to extend my sincerest gratitude to Dr. Jennifer Tolleson, my Chair, supervisor, and clinical consultant. Your dedication to my educational journey has been immeasurable. Thank you for believing in me during the times when I did not believe in myself or thought earning a Ph.D. would be possible. I also wish to express my deepest gratitude to the eight Jamaican citizens who agreed to participate in this study. Without you, none of this would have been possible. I am humbled that you entrusted me with your stories and unique perspectives. Your words underscore your love for your families, fellow citizens, and country; Jamaica. CEC

Table of Contents Page

Abstract.............................................................................................................................iii Acknowledgements……………………………………………………………………....v List of Abbreviations.........................................................................................................x Chapter I. Introduction…………………………………………………………………………....1 General Statement of Purpose Significance of the Study for Clinical Social Work Statement of the Problem and Specific Objectives to Be Achieved Theoretical Framework Research Question to Be Explored Theoretical and Operational Definitions of Major Concepts Statement of Assumptions Epistemological Foundation of Project Foregrounding Origin of a Study

Table of Contents--Continued Chapter

Page

II. Literature Review…………………………………………………………...19 Introduction Jamaica’s Colonial History Colonization’s Impact on Infrastructure and World Positioning Road Death Crisis in Developing Countries: The Scope of The Problem Jamaica’s Programmatic Responses and Statistics: The Depth of the Problem The Human Factor: Impact of Gender and Culture on High-Risk Behaviors Responsibility and Societal Impact: The Costs of the Problem The Impact of Gender, Cultural, and Personality Factors on Unsafe Road Practices Psychoanalysis and Colonization Psychoanalysis, Postcolonial Theory, and Subjectivity The Symbol of the Automobile, the Body, and Psychoanalytic Theory of Accidents Trauma: Psychoanalytic Theory Trauma: Mourning and Melancholia Trauma and Its Effects: Jamaica’s Present-Day Culture of Violence Melancholia and the Abject Summary

vii

Table of Contents--Continued Chapter

Page

III. Methodology……………………………………..………….…...................85 Introduction Methodology Ethical Considerations Issues of Trustworthiness Potential Limitations

IV. Findings…………………………………………………….…………….103 Introduction Description of Research Participants Introduction to Qualitative Categories Disparity and Those at Risk Environmental Influences on the Value of Life Trauma Jamaican Perspectives on Mental Health Empowerment versus Helplessness: A Voice for Change

V. Discussion……………………………………………...……………………175 Introduction Trauma as an Organizing Frame Conclusion

viii

Table of Contents--Continued

Chapter

Page Clinical Implications Study Limitations Recommendations for Future Research Personal Experience During the Research Process

Appendices A. Consent Form...............................................................................................199 B. Pre-Screening Email Introductory Script.................................................207 C. Confirmation of Participation and Final Review of Informed Consent 210 D. Semi-Structured Interview Guide..............................................................213 References……………………………………………………..……...………..218

List of Abbreviations

RTA

Road Traffic Accident

RSU

Road Safety Unit

WHO

World Health Organization

PTSD

Posttraumatic Stress Disorder

Chapter I

Introduction

General Statement of Purpose This interpretative phenomenological study (Smith, Flowers, and Larkin, 2009) aimed to develop a psychoanalytically informed, in-depth understanding of the subjective meanings of road safety practices in Jamaica while illuminating the lived experience of a small sample of Jamaican citizens. The participants of this research project consisted of eight adult Jamaicans who were directly or indirectly impacted by loss or injury due to unsafe road practices. Examined were the psychological and cultural links between Jamaica's colonial history and contemporary attitudes towards road safety. Through intensive, semi-structured interviews, the objective was to qualitatively contribute to an understanding of sociocultural values ascribed to unsafe road practices with respect to collective trauma, perceptions on the value of life, and an absence of normative death anxiety. Additional interest was identifying clinical implications for risk prevention strategies addressing road traffic accident (RTA) fatalities and injury in postcolonial Jamaica. This study is not generalizable but instead seeks to make meaning in a collaborative process between researcher and subjects.

Significance of the Study for Clinical Social Work Understanding the lived experience of others is a fundamental value in the field of social work. It is how we make meaning of different phenomena and the subjective experiences that, ultimately, contribute to the development and implementation of practical behavioral and mental health interventions and services. This contribution is evident on both a macro and micro level. The core person-in-environment perspective is exemplified in this study, thus inviting a more in-depth comprehension of internal psychological frameworks of individual experience within the external context of the Jamaican culture and community. The history of social work is rooted in providing services to the underprivileged and underserved, which is no different in Caribbean nations. Maxwell (1994) outlines poor housing, unemployment, and violence as classic areas of social work provisions in the impoverished third-world Caribbean. Additional social issues include high rates of drug use, domestic violence, child abuse, and the HIV/AIDS epidemic. Although state-funded social work services are in place, Maxwell noted that such programs have historically been inadequately funded or staffed with enough trained personnel. At the time, he argued the following: The focus of training needs to be less oriented to direct service (micro practice) to allow more attention for developing capabilities in organization, planning, policy development, and advocacy. Social work will not realize its potential as a profession to impact social problems in the West Indies until full recognition is given to the need to invest to a much greater extent in macro practice. (p. 28)

3 While the development of efficacious social work organizations and community action is imperative for prevention and change, the micro-level must remain of equal value. Each individual has his or her own unique clinical needs. Providing mental health services on a smaller group and individual level allows for a deeper understanding of feelings and behaviors that may promote change in the self and within families, all of which impact a community's emotional health and functioning. Since gaining her independence, mental health services in Jamaica have undergone a structural shift, transitioning from the British colonial model of institutionalization to community-focused treatment. Emphasis is placed on decreasing mental health stigma and developing psychiatric and therapeutic treatment models that recognize the residue of colonization on the internal and external structures passed down through generations of the colonized (Hickling, 2020). Literature conveys a need for increased clinical social work services in Jamaica to address cultural issues and respond to the chronic level of community violence and crime. There are 57 per 100,000 homicides in Jamaica, ranking it the second highest country for homicides globally (Pariona, January 9, 2020). As a result of rampant incidents of violence, many citizens are struggling with symptoms of grief, depression, anxiety, and Posttraumatic Stress Disorder (PTSD). Although mental health services are available, a disproportionate amount of Jamaica's GDP is spent attending to the country's violence, limiting the necessary funds for mental health treatment (Bourne, P., et al., 2015). While this research project is not a study on trauma, the literature underscores a correlation between road traffic accidents and their impact on clinically significant mental health diagnoses (Smith, et al., 2007). The high rate of RTA deaths in Jamaica,

4 similar to the high rates of violence, generated my assumption that this tragic public health crisis psychologically impacts many people. On a macro level, Jamaica's government implemented the Road Safety Unit (RSU) in 1994, addressing road safety practices with educational-based programmatic endeavors. However, the continued high number of RTA fatality statistics indicate that educational programs are not alone sufficient for change. Rather, a lack of clinical resources may leave people ill-equipped to understand the disavowal of safety measures or provide the necessary tools to process and cope with this epidemic's psychological impact. Therefore, further examination aims to assist the field of clinical social work in understanding the psychology behind unsafe road practices in Jamaica and inform preventative strategies, resources, and interventions on a micro level, encouraging potential attitude and behavioral shifts, perhaps minimizing sociocultural normalization.

Statement of the Problem and Specific Objectives to Be Achieved If asked to share one's associations with the island of Jamaica, they may describe a Caribbean paradise, with turquoise waters and silky white beaches. They might also identify the island as the birthplace of Reggae music or affiliate it with Rastafarian culture and the universal ideals of "one love" and "respect." While much of the above is true, Jamaica is a complex country, both in terms of its beauty and spirit and its legacy of violence and poverty. Jamaica only achieved her Independence from England on August 6, 1962. For sixty years, Jamaica has strived, with much success, to internationally promote herself through music, sports, academics, and the tourist industry. As a result, Jamaica is an attractive destination with international heroes, but its infrastructure

5 remains that of an underdeveloped country with a culture still coming to terms with its postcolonial identity, both socially and politically. Like many developing nations, Jamaica is afflicted with high incidents of RTA's. While developed countries have made strides towards decreasing accidents resulting in injury and death, this remains globally disproportionate in developing countries, including the Caribbean. The World Health Organization (WHO) projected that "by 2030, the fifth most common reason for loss of health will be an injury generated within the road transport system" (ISO Focus, 2009). Jamaica is one such Caribbean nation that identifies RTA fatalities and injuries as a public health crisis. According to Jamaica's RSU, between 2001 and 2014, road traffic fatalities fluctuated in the 300-person death range, with 80% being male. Unfortunately, those numbers have continued to rise, surpassing the 400 mark in 2019 and 2020. Jamaica ranks 136th in population out of 195 countries and ranks 131st for road traffic deaths. Although a 131st ranking places Jamaica in the "low" category for road traffic deaths at 8.15 per 100,000 people, the country is ranked 59th in overall life expectancy (World Health Rankings, 2020). Nevertheless, RTA's remain a visible part of Jamaica's safety noncompliance, resulting in preventable injuries and fatalities. The highest number of deaths is attributed to pedestrians, followed by pedal cyclists, motorcyclists, pillion passengers, then leading to passengers of public rides, such as taxis, and other modes of automobile transportation, with the lowest fatalities attributed to the actual drivers of the vehicles (Burrowes, D., Road Safety Unit, 2017). Jamaica has responded to the RTA health crisis by implementing heightened, countrywide campaigns on safety education and legal enforcement strategies. In fact, in 2017,

6 Jamaica was identified as one of the countries with "best practice" seat belt laws, meaning that seat belt usage is mandatory for all occupants (WHO, 2018). Nonetheless, statistics reveal that approximately 435 people died in 2019, increasing from 389 in 2018. This rising number suggests that despite forecasts for improvement, this strategy is not adequately addressing this cultural dynamic. The road safety practices not being consistently exercised include, but are not limited to, wearing helmets while riding motorbikes and seat belts while in a moving vehicle, both of which are legally enforced. In a newsletter dated 2015, Kenute Hare, the director of Jamaica’s RSU, implored road users to take road safety seriously, stating that The majority of our road crashes are related to bad driving practices . . . drivers must change their behavior and think of other road users. Road fatalities are not just statistics, these deaths cause a great deal of suffering for the people who have lost a loved one or who are left with a permanent injury. It has a big impact in our lives. (Ministry of Transport, Works & Housing Road Safety Unit) More recently, Mr. Hare further emphasized the psychosocial nature of the problem, particularly with motorcycle riders. More psycho-social interventions are needed. If you talk to some of these motorcyclists, they place no value on life. They don’t care. It’s hard to tackle that kind of mindset. They have no love for themselves. We will achieve more if we create a more orderly society. (Lewis, November 19, 2019, para 17) The above commentary, and the limited research on this research topic, supports the argument for why an understanding of the attitudes and values ascribed to high-risk road

7 practices and mortality, as well as the identification of clinical implications for RTA prevention strategies, mental health treatment, and sociocultural change, is necessary. Unfortunately, RTA fatalities and injuries are not an uncommon phenomenon in developing countries, resulting from eroding infrastructure that struggles to keep up with the increased use of motor transportation. Resources are needed to prevent criminal activity and health crises, such as HIV/AIDS, while governments strain to reinforce the implementation of road traffic laws and vehicle standards. Therefore, the financial burden that this preventable public health crisis creates only serves to drain resources designated to assist citizens in other vital areas of growth and prevention. As with many crises of socioeconomically disadvantaged countries, this epidemic does not garner mainstream media attention because their experience is not considered an "acute crisis that generates an emotional response from developed countries. Per Mathews (September, 2009), "events that happen to the world's poorest people in countries that are off the Western 'radar' may simply be ignored by the media because they do not contain enough of the positive triggers discussed" (p. 27). This can lead those residing outside of Jamaica to have a negative perception of certain behavior choices and, ultimately, an entire group of people due to a lack of understanding of the psychological links between cultural attitudes and, in this instance, low utilization of road safety practices. While the literature addresses government, socioeconomic, and gender issues that contribute to this public health crisis, effective methods for addressing this issue are limited without understanding the lived experiences of Jamaican citizens. Literature consists of mainly quantitative studies, revealing a critical need to address the crisis of

8 RTA's in developing countries, precisely because of the aforementioned economic strain on country resources. In an article examining the economic burden of physical trauma in Jamaica by Plummer et al. (2010), in their injured sample, "Motor vehicle accidents occurred in 22.4% of cases, including motorcycle accidents, motor car drivers and passengers" (p. 27). Such physical traumas result in immediate and often long-term medical intervention. For example, in 2006, it was estimated that 33.4 million USD was spent on hospital care to treat road traffic accident injuries, which is 20% of the overall health budget (Plummer et al., 2014). This sequence takes an economic toll on hospitals and government resources, as many of these patients are often left unable to work after sustaining severe medical traumas, further placing an economic burden on communities. Thus, one may speculate that, if provided, mental health interventions addressing the psychological impact of trauma sustained from RTA's would be financially hindered by the cost burden as well. Another set of literature outlines road safety prevention campaigns that have been in development in Jamaica since the early 1990s. However, Kenute Hare, the director of Jamaica's RSU, acknowledged that it takes At least three generations to change a culture, so we are sowing the seeds now with our children. We intend to have them be the catalysts of change because we recognize that the adults have not been doing a good job — they are killing themselves and children on the road. (Jamaican Observer, December 30, 2019) If prevention campaigns are only moderately successful in decreasing RTA fatalities, how do Jamaican citizens understand this crisis afflicting their country, and what do they identify as effective prevention? More specifically, how do Jamaicans understand

9 actively engaging in unsafe road practices, and does the lack of exercising safety precautions represent a cultural issue or an individual sense of agency? Articles on high-risk behaviors in Jamaica are devoted primarily to safe sex practices and the prevention of HIV/AIDS and other sexually transmitted diseases. Maharaj, et al. (2009) analyzed past literature on the prevalence of health risk behaviors among adolescents in the English-speaking Caribbean. Their review sampled articles from 19802005, locating 95 relevant papers, finding that "as of the year 2000, the major causes of mortality among 15–24-year-olds are homicide, accidents, and suicide, followed by AIDS" (p. 2). They discuss additional health risk factors, such as obesity, but there is no mention of health risks specifically related to RTA's, nor unsafe road practices in the summation of their literature. Perhaps this is due to the study focusing on adolescents between the ages of 10-19 years old, below the legal driving age in Jamaica at 18 years of age. Therefore, information regarding attitudes and behaviors affiliated with these health risk categories may be helpful in understanding high-risk road practices. Despite literature in developing nations examining the significant correlation of PTSD symptoms with survivors of car accidents, there is a gap as to how chronic exposure to RTA fatalities and injuries psychologically affects Jamaican citizens. Social media appears to offer theoretical queries concerning coping strategies and potential desensitization to trauma exposure, as instances of death and carnage are frequently posted through photographs and videos, routinely circulated in communities. This practice has gained attention in the local media due to the secondary trauma inflicted upon the deceased's loved ones, whether the death is caused by suicide, violence, or RTA's. As a result, loved ones have begun pleading for people to cease this practice. Jean

10 Davy, a parent who lost her only child due to a car accident, spoke to the public about this issue at a National Road Safety Council (NRSC) mid-year press briefing. "Before taking your smartphones to record the death of someone on their last breath at a crash scene to place them on social media, I am asking that you please consider that person's family. Imagine their pain" (The Gleaner, 7/13/18). Ms. Davy exemplifies a suffering parent whose child has become a statistic to this public health crisis. Her plea highlights a subsequent phenomenon related to understanding coping strategies embedded in a culture with past and present chronic violence or an absence of normative anxiety regarding death and injury.

Theoretical Framework Theoretically, this study seeks to make meaning psychoanalytically. Psychoanalysis values the unique, subjective experience of the individual, as it seeks to offer a deeper understanding of the human experience and behavior through unconscious phenomenon. Psychoanalysis locates the individual in the context of her surroundings, recognizing that we are intricately linked to our social histories, cultural beliefs, and current dilemmas. Better understanding Jamaica's history and the collective trauma experienced by the mostly post-slavery and colonialized population will help to clarify the psychosocial dynamics embedded in this public health crisis. Postcolonial theory explores the dehumanization of the colonized subject, both psychologically and physically, and how the legacy of violence during colonization is lodged in the unconscious development of self-identity and ways of understanding oneself in the world (Hook, 2012). Postcolonial theory is relevant and applicable for understanding the psychological and cultural

11 contexts underlining high-risk behaviors, an absence of normative death anxiety, a reenactment of trauma, and the value of life in the Jamaican people. As is further discussed in the literature review, it is of critical importance to also acknowledge the postcolonial threads that run through the foundation of psychoanalysis. Specifically, how psychoanalytic ideas of the psyche were informed through the marginalization of the colonized, identifying the colonized as "primitive" and emotionally undeveloped (Brickman, 2018). Although I am utilizing postcolonial theory as a tool for understanding my research objectives, psychoanalysis offers a broad range of theoretical stances in which to interpret qualitative data and construct meaning. A qualitative approach to this topic allows audiences to benefit from enriched knowledge on the lived experience of the RTA public health crisis, providing an understanding that may assist stakeholders to invest in social work services in their communities for the psychological well-being of their citizens. A more in-depth perspective on attitudes and behaviors towards road safety practices may also help inform programmatic changes from a clinical perspective. This view will encourage the development of new strategies towards addressing this crisis and hopefully contribute to the expansion of clinical services on a micro-level, aiming to create a decrease in medical and psychosocial trauma. Finally, this qualitative study underscores the beauty of differing cultures, as each culture has a historical foundation that informs unique ways of living. It is anticipated that this study will promote an awareness of these differences and encourage knowledge based on decreased assumptions and judgments.

12 Research Question to Be Explored The question structuring this research is: How do Jamaican citizens subjectively make meaning of road safety practices in Jamaica? By utilizing a psychoanalytic theoretical lens of inquiry focusing on postcolonial and trauma theory, the intention was to develop greater comprehension of the following: How do Jamaica’s postcolonial history and current environmental traumas shape the values, perceptions, and attitudes that Jamaican citizens have towards general safety and, specifically, road safety practices? Do socio-political, cultural, and gender factors impact the perception and use of road safety practices? Do Jamaican values and attitudes on mortality impact the choice to engage in or not engage in the usage of road safety practices, and what does this reveal about normative death anxiety? How does exposure to injury or loss through road traffic accidents, either directly or indirectly, affect safe behavior practices? How do Jamaican values and attitudes about road safety practices inform opportunities for intervention and preventative services?

Theoretical and Operational Definitions of Major Concepts For the purposes of this study, terms are defined as follows: Road traffic accident (RTA) fatalities and injuries: The occurrence of death or physical injury as a result of a road traffic accident.

13 Developing countries: Countries with low income per capita and slower economic, industrial, and social development. High-Risk Behaviors: Actions that place one at greater risk of harm and may result in psychological trauma, and/or physical injury or death. Trauma: Exposure to a life-threatening event, either directly or indirectly, that results in psychological disturbance and/or physical injury. Unsafe Road Practices: This includes but is not limited to: not wearing a helmet while on a moving motorcycle, not wearing a seat belt while in a moving vehicle, riding in a moving vehicle at excessive speeds, not obeying the rules of the road, using alcohol or drugs while operating a vehicle. Post-colonialism: A theoretical approach that is concerned with the lasting impact of colonization; the occupation and economic exploitation of the people and territory of another country.

Statement of Assumptions The following list of assumptions are derived from the researcher’s values, biases, and experiences in Jamaica, in addition to the literature: 1.

I assume that premature road traffic accident fatalities and injuries have a meaningful psychological impact on the individual, family, and communities.

2. I assume the people in Jamaica are living in a postcolonial context and that this context shapes the subjective experience of individuals, families, communities, and cultures.

Epistemological Foundation of Project This study is located within a hermeneutic paradigm of inquiry. Hermeneutics focuses on interpreting the meaning of human interactions and behaviors, allowing for a greater understanding of the uniquely subjective experience. It is of a constructivist interpretation, as meaning is uncovered through in-depth reflections and analysis of multiple interviews. "Dilthey believed that every "lived experience" occurs within a historical, social reality. He further believed that these lived experiences may be outside the immediate awareness of the individual but could be brought to consciousness" (Ponterotto, 2005, p. 129). Thus, in-depth, semi-structured questions allow for the subjective, lived experience of a small sample of Jamaican citizens to inform the reality within the specific context of Jamaican culture. The constructivist position includes "the individual's experience and perceptions, the social environment, and the interaction between the individual and the researcher" (Ponterotto, 2005, p. 130). The above allows for multiple realities, not a universal or singular truth, thus providing a greater scope for understanding. Furthermore, listening to and observing the participants and their narratives through a psychoanalytic framework invites a richer experience of being actively present during each encounter and permits greater depth in which to make meaning. Finally, my rhetorical structure cannot be depersonalized due to my epistemological and axiological stance. As a result of my subjective and interactive experience, my findings and position in this study are presented in the first person.

15 Foregrounding The participant's position to the researcher is critical, as my values and lived experience cannot be separated from the study. This study is an interpretative project in which I will discover and make meaning collaboratively with the participating subjects. Thus, it is necessary to outline my inherent biases, many of which evolve from my upbringing as a white, educated person of privilege from a developed, Western country. As a result of this position, I believe that the rules of the road are effective and that engaging in unsafe practices will increase one's odds for injury or death. I also believe that, if possible, it is the responsibility of those in the home environment and community to instill this value at an early age prior to one's ability to operate a vehicle. Despite identifying my own biases, I do not believe it is fair to impose my beliefs on the practices of other cultures. Rather, I desire to understand the reason for differing cultural norms, behaviors, and expectations. In an effort at transparency, although I was raised in a position of privilege, I have always been intrigued by lived experiences that diverge from my own, especially those of people from different cultures and socioeconomic backgrounds. My parents are from vastly different ethnic and cultural backgrounds. From a young age, I was sensitive to the variances of their social histories, recognizing the implicit and explicit tensions occasionally generated from their dissimilar backgrounds. My curiosities and interests diverted me from the specific lane where my environment was grooming me to direct myself. I not only wanted to hear the personal stories of others, but I wanted to work in different communities, providing services to those who are marginalized. My social work career has been rooted in these desires, as has my personal life. My closest friends are

16 from different ethnicities, and my husband is from Jamaica. Thus, my motivation for this study feels natural and true to my values. This is where my passion lies.

Origin of a Study Jamaica is a country dear to my heart. My love affair with Jamaica began in my youth when Jamaica became a fantasy destination for reasons unknown. Although I had visited various Caribbean countries, Jamaica remained an untouched isle of which I felt inexplicably linked with little to no exposure other than my reggae albums. I was ignorant of the culture but entranced with an assigned ideal of beauty, escape, and irie (good) vibes. In 2012, my fantasy became a reality, and Jamaica has since become like a second home. Not only do I return every year, but in 2017, I married a man from Westmoreland, Jamaica. During my travels, I have been exposed to the beauty, bountiful riches, and lushness of the island, as well as the gritty and impoverished reality of life where daily survival brushes up against trauma and violence in a postcolonial country. Jamaica relies heavily on tourism for economic survival, but behind the luxury resorts, many communities lack resources, including basic needs such as running water. Outdated infrastructure has contributed to hazardous road conditions, which, compounded with high-risk behaviors, has led to an epidemic of road-related deaths and injuries. I have encountered this trauma on multiple visits to Jamaica in unexpected ways. I have frequently witnessed locals engaged in discussions about family members, friends, or neighbors who were killed or severely injured in road-related accidents. When seated at a local bar, I was shown a video posted on Facebook that a bartender and multiple

17 Jamaicans were watching on the phone. It was a video of a mortally wounded man crawling on the road. He had just been in a road traffic accident and was missing a leg, severed mid-thigh and bleeding out, all while a crowd gathered around, imploring him to remain still. The crowd ranged in age, from children to adults. I have since seen many such videos. Although my initial horror has somewhat subsided, which I hypothesize is from becoming slightly desensitized to the gore, I remain left with feelings of profound sadness, confusion, and tinges of anxiety, while my local friends appear unaffected. Such injuries and deaths are a routine part of their lives. On another afternoon, I was in a car that began to slow down as it approached a police road stop. The driver and the front-seat passenger, elementary school teachers, immediately fastened their seat belts. I was unaware that they were off. Upon inquiry about the stop, I learned it was routine to enforce that drivers obeyed the speed limit and buckle up. Once we passed through, the driver and passenger promptly took off their seat belts. Asking why they chose not to wear them, they laughed, casually remarking that "nobody really" wears them and indicated discomfort. I was surprised that these two educated adults, entrusted with educating others, were not inclined to exercise this simple safety precaution while silently noting my judgment. This experience provoked discomfort, as it conflicted with my perception of basic safety precautions to prevent injury or death. Issues of road safety have since become unavoidable when visiting the island. Billboards campaigning for safe driving and preventative actions jump out to greet me as I exit the airport. I have witnessed a cultural disavowal of the risks associated with unsafe driving practices resulting in many locals failing to heed safety precautions. This, in

18 conjunction with my exposure to multiple stories of road traffic injuries and deaths, and what I viewed as public safety campaigns advertised on multiple billboards, promoted my interest in understanding this issue from within the Jamaican culture. Additionally, my life has changed since my first visit to the island. Once married, I became more conscious of the fragility of life. Love has increased my vulnerability and anxiety about issues of mortality. The thought of losing time with my partner because of injury or death led to hyper-vigilance around prevention, including my mandate that he obey the law by wearing his seatbelt. What is a natural preventative measure for me was not for him. As a result of life changes and heightened awareness, I no longer dive into this cultural emersion with a blissful sense of freedom and adventure. Previously, being crammed into a semi-broken taxi with six other adults, winding up a steep terrain towards areas unknown, gratified my desire to be miles away from the confines of my everyday life. That has changed. Now, when cruising blind curves at excessive speeds, I experience intrusive ruminations that this ride might cause my death. If not that particular journey, then once I move to the island. If not my death, then the death of a loved one, resulting in a surge of profound fear. I've realized that the videos of carnage and death shown to me by the locals had not desensitized me. Instead, this information triggered my anxiety and awakened an intense sense of wonder. At that moment, my desire to study and understand this cultural phenomenon of high-risk road practices in Jamaica became realized.

Chapter II

Literature Review Introduction Before delving into psychoanalytic theory, it is necessary to account for Jamaica's history of colonization. This overview contextualizes the research question at hand and is essential in offering a perspective for long-standing and present-day socio-political and cultural influences that continue to impact the people of Jamaica. As with all countries, communities, and cultures, social, political, and psychological constructs are rooted in historical experience and create a pattern of being. For this study, such information is critical for understanding the subjective experience of the research sample, with a focus on how Jamaica's cultural enactment of materialism, masculinity, and violence might intersect with individual perspectives and values regarding unsafe road practices and the RTA crisis in their country. Following an overview of Jamaica's colonial history will be an illustration of RTA's as a global crisis and one that disproportionately affects developing countries. Pertinent data and statistics illuminate the human impact on both a macro-level, focusing on the larger country of Jamaica and its communities, and on a micro-level, examining the consequences affecting individuals and families. This information sets the stage for a psychoanalytic inquiry into the lived experience of this phenomenon.

20 Postcolonial and trauma theories are the psychoanalytic frameworks utilized for this project, providing an inroad for understanding attitudes and beliefs towards road safety practices and the value of life for a small sample of Jamaican citizens in the Caribbean. First, it is meaningful to acknowledge psychoanalysis' colonial underpinnings and how psychoanalysis' colonial history has influenced psychoanalytic terminology and ideas about the psyche, particularly regarding the "primitive" unconscious (Brickman, 2018). This theoretical critique permits an analysis of the subject matter and data without disregarding its relevancy to the hurtful history of colonization and marginalization of the "other." It will also be helpful to apply psychoanalysis to theories of motoring, referring to the act of traveling by car or motorcycle, and consider the symbolic meaning of motoring and the unconscious processes that inform behavioral motivations and influence identity. Postcolonial theory will highlight the unconscious interpersonal experience of the colonized and the embedded impact of slavery on the self in terms of identification and subjectivity in relation to experiences of racism and dehumanization. Unconscious processes, such as internalization and melancholia, will also be discussed as means for understanding behaviors potentially motivated by unconscious anxiety. Finally, trauma theory will offer a lens for appraising the historical impact of colonization. This is executed through a discourse on epigenetic trauma and how trauma sequelae inform repetition and behavioral actions, ultimately, to better discerning the meaning of road safety practices in the face of a highly visual and visceral crisis in Jamaica.

21 Jamaica’s Colonial History Understanding the social-political fabric of Jamaica and the psyche of its people requires an examination of her colonial history. Prior to Columbus' sail across the ocean in search of new land, the Spanish identified Christianity as the gateway for the salvation of the soul. Colonization was a means for expanding Spain's territory and power and a means for extolling the virtues of Christianity (Brickman, 2018). Christopher Columbus was the first European to land upon Jamaica in 1494 when traversing the seas in search of gold. Although discovering no gold, Columbus was awed by the land's beauty, describing it as "the fairest island that the eyes have beheld" (Mordecai & Mordecai, 2001, p. 1). When Columbus first encountered the Amerindian people of the Caribbean, he touted them as "uncorrupted, loving people," welcoming, generous, with no possessiveness of material items or property. Despite a warm and nonthreatening welcome, this perspective shifted to an identification of "lack" regarding the absence of possessions that Europeans identified as important in giving structure and meaning to their culture. Thus, the narrative became altered to one of difference for future dehumanizing of this 'otherness.' The shock of intercultural contact - the exhilaration of encounter and the terror of difference - would be tamed and the impulse for acquisition fed, by assimilating this "lack" to familiar categories of inferior otherness: savage and barbarian, wild and noble, heathen and infidel, all of which would later converge in the figure of the primitive, laying the basis of theories that would be constructed to locate these peoples in relation to their European discoverers. (Brickman, 2018, p. 23) By the time Columbus made his discovery, Europe had already established a slave trade with Africa and perceived Africans to be uncivilized beings destined for slavery.

22 They believed blackness equated to "darkness, dirt, and the stains of sin, and the color came to be the unifying sign under which all the elements of Africa were subsumed: Africa was called the dark continent" (Brickman, 2018, p. 27), and slavery rationalized to be a means of improving the life position and conditions of savages. As Brickman stated, "Savagery was associated with slavery as though to suggest that the institution of slavery was not a historically imposed condition but had arisen out of the dark and savage nature of Africa itself" (p. 29). Therefore, when the Spanish landed upon the West Indies, this ideology of ingrained assumptions about "dark" people secured the imposition of Christianity on the indigenous people, for this was necessary to salvage their souls from innate barbarism. However, Waytz & Schroeder (2014) address the process of dehumanization not as a desire to salvage the other, but a process in which the "other" is perceived as subhuman or lacking the capacity for "conscious experience and rational thought" (p. 252). Slavery is one example of what Waytz & Schroeder refer to as dehumanization due to commission. Dehumanization by commission stems from active desires to distinguish oneself and one’s own group from outgroups, stigmatized groups, subjugated groups, or disliked targets, or from an active desire to justify and license harm toward others. Although these active motives may not be salient at the moment that dehumanization occurs, dehumanization in intergroup contexts or in the context of aggression often (but not always) stems ultimately from active causes . . . rooted in one of two processes: (1) the active processes of suppressing or denying consideration of others’ minds; or (2) a passive failure to consider others’ minds. (p. 252)

23 This psychological phenomenon allows one's defenses to perceive another human as inferior and engage in "moral exclusion" (Opotow, 1990) so that aggression may be directed towards a subjugated group without conscious attachment to violent dehumanization. Animalistic dehumanization (Halslam, 2006) "involves denial of cognitive capacity, civility, and refinement" (Waytz & Schroeder, 2014, p. 255), further denigrating the subjugated as possessing animal and savage capacities. The dehumanization by commission process is exemplified in Brickman's (2018) description of the Spanish colonizer's perceptions of Africans and is explicitly and implicitly embedded in racism, both past, and present. Thus, despite being met with the kindness of the Arawak, the indigenous people of Jamaica, violence, barbarianism, and oppression were the tactics used for colonization, and the Spanish took claim of Jamaica through brute force and bloodshed. Eventually, the Spanish eliminated the entire Arawak population in a manner which Shim (2018) described as "characteristic of the genocide methods used by the conquistadores" (p. 3), which left only the Spanish and their black slaves, the Maroons, to occupy the land. The Spanish maintained control until 1655, when the British seized Jamaica, eventually gaining formal and complete occupation of the island in 1670. Having lost its indigenous people, Jamaica was morphing into an island of the British ruling class, or Planter class, and their enslaved, officially becoming a British colony in 1707 (Shim, 2018). Sugar was the major export, making Jamaica the "star in the British imperial crown" (Mordecai & Mordecai, 2001, p. 9) and the world's most significant producer of sugar at that time. The enslaved, primarily from West Africa, were shipped to the island and sold to the plantation owners as the labor force. This process of

24 exploitation and dehumanization further eradicated the indigenous culture of the people, inevitably altering Jamaica's psychological and social structure. Mordecai & Mordecai (2001) provide a detailed chronology of Jamaica's colonial period highlighting how quickly enslaved black people outnumbered the white plantation owners. By 1764, they found the estimated population of Jamaica to be "166,454 people, of which 140,454" were enslaved. By the 1800s, "there were about 15,000 whites, a ratio of 1:20" colonizers to slaves (p. 10). Despite representing the majority, the enslaved were powerless, without rights, and in a position of dependence, deeply grounding their subjectivity and identification to one of inferiority. Allies of English abolitionists in Jamaica established their own churches and taught some enslaved people to read and write (Mordecai & Mordecai, 2001). One might speculate that the development of these skills activated and strengthened a sense of agency, resulting in increased expressions of unrest and dissension. The slaves began fighting for their rights, mobilizing and rebelling against the unethical plight of slavery. These rebellions were violent and are a source of pride in Jamaica's history, perhaps further exploring how modern-day violence unconsciously aligns with an internalization of the aggressor against postcolonial oppression. In 1808, the slave trade was abolished in the British empire, but not officially recognized throughout the empire until 1833. At that time, a bill was written stipulating that although the enslaved were free, they were required to provide a whole week of unpaid labor. This labor was also labeled an "apprenticeship" to their former masters, who would, in exchange, provide basic provisions, such as shelter and food. This bill went into effect in 1834 and intended to last for a period of twelve years. However, in

25 most instances, the formerly enslaved people were not provided with adequate provisions as agreed (Mordecai & Mordecai, 2001). Consequently, they abandoned these "apprenticeships," and left the plantations to farm with the Maroons who had escaped to lands in the blue mountains. As a result, the twelve-year bill was officially abolished in four years, and complete emancipation from slavery was granted on August 1, 1838. Despite the people of Jamaica achieving their freedom from slavery, they were left poor and with few resources, while the old, abolished systems of colonization were insidiously integrated into the contemporary social fabric of Jamaica. The British directly governed the country, and consistent with colonization they aimed to benefit from Jamaica financially. The Planter class, or upper-class whites, remained at the top of the hierarchical structure, and race divisions became pronounced within the African Jamaican community (Shim, 2018). A "brown" class emerged in the mid-1800s due to master and slave relations and was perceived as superior to their "black" countrymen. Jamaicans who were identified as "brown" were given opportunities for "civil service" posts and were representative of the middle class, receiving more financial resources and education opportunities (Mordecai & Mordecai, 2001). By the 1930s and 1940s, Jamaicans began to express unrest regarding inequality as the middle class attempted to find its voice, thus beginning the development of Jamaica's new political parties. On November 20, 1944, the colonial government was altered to include adult suffrage, and by November 11, 1957, Jamaica shifted further towards selfgovernance but remained under British rule. As a result of the increased mobilization of Jamaica's middle class, the British government recognized what the British prime minister described as the "winds of change" (Shim, 2018, p. 33), referencing political

26 shifts of anti-colonialism spreading across colonized countries. Thus, Britton released Jamaica from their occupation, and Jamaica achieved her independence on August 6, 1962. When Jamaica achieved her independence, the structure of colonial rule was already stitched across the land and etched in the psyche of the people. Despite self-assertion being a primary factor in Jamaicans achieving their independence, years of oppression, a perception of inferiority, and corruption of cultural identity led to an emotionally splintered community and complicated self-identification (Shim, 2018). Jamaicans express pride in her achievement of independence, but political corruption and a significant economic decline have continued to shackle the development of healthy selfactualization. As a result, social order is chaotic, evidenced by high statists of violence and lawlessness, which remains an ongoing battle today.

Colonization’s Impact on Infrastructure and World Positioning Colonization benefits the colonizer. In Jamaica, the aim was to bring wealth and goods back to the British people. For this to occur, Shim meticulously (2018) outlines how the development of sound infrastructure was necessary to maintain the production and transportation of goods. In the mid-1800s, the Crown Colonial System brought this infrastructure to Jamaica through the building of roads and rails and telecommunication, electricity, and water systems. Jamaica also inherited British social institutions consisting of military, law enforcement, healthcare, educational systems, and religious teachings. In part, the latter institutions were implemented to stem acts of unrest and aggressive revolts from the Jamaican people.

27 Colonization forever alters the culture and the original systems of community functioning and operational life. Colonial social systems were viewed as “gifts” to the Jamaican people, offering exposure to new ideologies and infrastructure, thus justifying the colonizer’s achievement of wealth as a natural benefit of the colonization process. School texts and religious teachings canonized the superiority of the British and their value systems while slowly eradicating Jamaicans’ identification with their African heritage (Shim, 2018). This is the process of diffusionism, when changes occur in a community due to an outside force. It is an elitist perspective positing the belief that European ingenuity and inventions are superior to local culture, rationalizing colonized oppression as a beneficial process while dismissing established ways of life (Blaut, 1993). Subsequently, the Europeans became historically coded as the primary source of culture, placing the white man as superior to neo-natives or the “other.” Objectively, colonization was the genesis of an engrained moral corruption, not altruism (Cesaire, 1955). The colonizer safely hid behind the intellectual theorizing of religions, philosophers, sociologists, and ultimately, psychoanalysts, each establishing a tolerance for barbaric savagery towards those of different races and cultures through a perversion of what was deemed to be primitive. As Césaire (1955) clarifies, it is the process of colonization that has served to destroy, or “de-civilize” the already civilized local habitants. Césaire challenges the notion of primitivity by illuminating the once historically thriving and civilized Africa, where the people had a system of production and community that did not require salvation. Europe’s process of de-civilization began with the destruction of African societies, corrupting their capabilities to concretize the colonizer’s power and economic advancement.

28 Eurocentric diffusionism is problematic in that “outside” communities such as Africa are perceived as inferior to European intellect and spirituality. Thus, “outside” communities are identified as irrational, less intelligent, and uncivilized, further perpetuating the indoctrination of colonialism as a benefit or gift from European civilization to non-European communities. This conjecture then influenced the foundation of future intellectual pursuits and theoretical developments, viewing marginalized humans as scientifically inferior to their European counterparts. Blaut (1993) found that At the most general level, intellectuals were shaping theories of social evolution which were in essence demonstrations that the postulates of diffusionism are natural law… A great range of theories in both camps [diffusionist and evolutionists] were constructs aimed to assist in colonial activity, and to develop and strengthen the doctrine that European colonialism is scientifically natural, a matter of the inevitable working out of social laws of human progress. (p. 24) The lasting legacy of European diffusionism is evident in the development of theoretical stances, such as evolutional theory and psychoanalysis (Brickman, 2018), and is historicized in texts written from the perspectives of Western experiences and values. Such texts are not only located in the educational system of colonized countries (Shim, 2018) but perpetuate the myth that said countries are without history prior to colonization. It is a political process that continues today, aimed at maintaining certain ideology and historical perspectives so that a particular group may control political power.

29 In Howard Zinn’s (1980) seminal work, A People’s History of the United States, he dissects the educational texts of the United States, born from the elite, as a means to maintain a societal hierarchy and produce a specific idea of national identity and patriotism by concealing the narratives and experiences of the oppressed. Additionally, a recent study examining American history textbooks in differing regions of the United States discovered the customization of historical data based on dominating political beliefs in the assessed areas (Goldstein, 2020). One may speculate that such actions will continue to affect the values and ideology of future generations by constructing beliefs with this paradigm. The process of modern diffusionism commenced with more affluent countries stepping in to assist with the decolonization process. Assistance was not purely altruistic but political, as exemplified by the United States’ financial assistance of Jamaica in the 1950s in an effort to prevent the spread of communism from Cuba (Blaut, 1993). Thus, modern diffusionism ultimately became a new take on old colonial patterns, seizing the vulnerability of developing countries to establish reliance on wealthier and more powerful countries. “Vulnerability includes notions of marginalization which recognize the socio-cultural and politico-economic circumstances of many individuals and groups in developing countries” (Pratte, 1998, p. 55). In conjunction with ongoing political corruption and poverty, modern diffusionism left Jamaica unable to capitalize on all of her capabilities. The residue of colonization has impeded systemic and societal achievements, while current political structures continue to oppress, reinforcing the embedded mental slavery from that time. Perhaps it is this very residue of relentless

30 oppression that produces unconscious enactments of protest in the form of unsafe road practices.

Road Death Crisis in Developing Countries: The Scope of The Problem The World Health Organization’s Global Status Report on Road Safety (WHO, 2018) finds that globally, RTA’s account for approximately 1.35 million fatalities, making it the eighth leading cause of death worldwide, surpassing HIV/AIDS, Tuberculosis, and diarrheal diseases. They also identified RTA’s as the leading global killer of children and young adults aged 5-29 years, with recent estimates that these numbers will rise to 3.6 million by 2030. As a result, the United Nations General Assembly established a “Decade of Action for Road Safety” from 2011-2020 to reduce the number of RTA fatalities globally. They developed a five-pillar approach to attack this issue, including road safety management, infrastructure, safe vehicles, road user behavior, and post-crash response (Global Alliance of NGOs for Road Safety, 2020). Despite many countries implementing these strategies to reduce this public health issue, data underscores that little worldwide progress has been made towards reducing road traffic fatalities in low-income countries since 2013. In developing countries with low economic and industrial development, it is critical to recognize how disproportionate RTA fatalities are when considering the number of deaths in low-income countries, given their population and the number of motorized vehicles in use. According to the WHO, 93 % of all fatal road-traffic accidents occur in low- and middle-income countries, which are home to 85 % of the world’s people, who

31 nevertheless own only 60 % of all vehicles. The statistic shows that the risk of dying in a traffic accident is three times higher in low-income countries than in high-income countries. (Dombrowski, 2019, para. 2) Specifically, the WHO (2018) identifies African nations as having the highest RTA fatalities at 26.6 per 100,000 people, followed by South Asia at 20.7 deaths per 100,000. In contrast, Europe and the Americas have the lowest RTA fatalities per capita at 15.6 and 9.3 per 100,000. Additionally, these continents and the Western Pacific are the only nations to experience a decrease in road deaths since 2013. The World Life Expectancy (2017) online health rankings provide more granular data for comparison. They reveal that Jamaica, a country with 2.9 million people, averages 9.7 deaths per 100,000 people compared to the United Kingdom with 2.58 road accident deaths per 100,000. This data spotlights the discrepancy in the number of RTA fatalities between Jamaica as a developing nation and the very developed and more densely populated United Kingdom. Globally, “pedestrians and cyclists represent 26% of all deaths, while those using motorized two- and three-wheelers comprise another 28%. Car occupants make up 29% of all deaths, and the remaining 17% are unidentified road users” (WHO, 2018, p. 6). In developing countries, the mode of transportation is correlated with low-income levels, as many citizens cannot afford car ownership. In Jamaica, pedestrians, cyclists, and motorcyclists are identified as the most vulnerable road users, and transport by foot, buses, and taxis remain the most economical means of travel. While one may not immediately associate taxis and buses as high risk, in poorer countries, these vehicles are densely packed with passengers to secure the most money for the driver and are often not adequately maintained or up to standard legal requirements. One study quoted a Nigerian

32 commuter describing these buses as “flying coffins,” “moving morgues,” and “death traps” (Nantulya & Reich, 2002, para. 5) due to the number of people and multivariate risks for road traffic accidents. When utilizing a motorized vehicle, five critical behavioral risk factors are identified as contributing to RTA’s and fatalities. These five behavioral risk factors include speeding, drunk driving, failing to use motorcycle helmets, and not using a seat belt or child restraint (WHO, 2018). Emphasis is placed on the necessity of implementing and enforcing key legislation strategies on preventing said risk factors, noting that globally “123 countries, representing nearly six billion people, have laws that meet best practice for at least one of the five key behavioral risk factors” (WHO, 2018, p. 7). Although legislation for road safety in Jamaica does exist, substandard legal enforcement of the laws remains an obstacle to making roads safer and decreasing the number of RTArelated deaths and injuries (Jamaica Observer, February 13, 2018). The WHO (2018) outlines statistics on death and trauma in each key area, providing best practice risk prevention strategies, further addressing the needed enforcement of road traffic safety laws. For example, head injuries are the leading cause of death for two- and three-wheeled motor vehicles users. Thus, the correct use of helmets for drivers and passengers is critical to reducing deaths by as much as 42% and head trauma by 69%. While front and rear occupant seat belt usage can reduce death or injury for drivers by 45–50% and occupants by 25%. The use of backseat child restraints additionally can prevent approximately 60% of child deaths. These statistics not only represent the percentage of human lives that can be saved, but the implementation of road safety

33 measures would also alleviate the significant economic burden that injuries and the loss of life place on the families, communities, and entire countries.

Jamaica’s Programmatic Responses and Statistics: The Depth of The Problem Jamaica has identified that RTA’s are a public health crisis, which has guided the implementation of legislative and campaign strategies focused on prevention. In 1994, under the Ministry of Transport and Mining, Jamaica developed the Road Safety Unit (RSU). Their mission statement is as follows: Promote and foster an orderly and disciplined traffic culture that is conducive to the development of a safe traffic environment, through the conceptualization, design and dissemination of a sustained programme of public information, education in schools, legislation, accident information and research. (Burrowes, Road Safety Unit, 2017) Jamaica’s RSU strives to achieve its mission by gathering vital research and data on RTA’s and fatalities to advocate for ongoing legislation, measure the success of programing, and further an understanding of the psycho-social behaviors contributing to this phenomenon. In 2012, the RSU established the “Under 300” campaign with the aim of not exceeding 300 road traffic fatalities annually (Burrowes, Road Safety Unit, 2017). Distressingly, this campaign has not achieved its goal since its commencement, with current data revealing that RTA fatalities continue to exceed 400 per year. Taking a closer examination of the 2018 data, motorcyclists, pedestrians, passengers in private motor vehicles, and drivers of private motor vehicles accounted for 80% of RTA fatalities, with motorcyclists and pedestrians accounting for the highest number.

34 Additionally, male deaths outnumber female road deaths, a consistent trend noted in the literature. Males also overwhelmingly represent the majority of drivers in study samples. In 2018, the RSU found that 332 out of the 389 fatalities were male, and males accounted for all 99 motorcycle deaths. Westmoreland Parish, where Negril, a famous tourist town and job producer for Jamaican citizens, had the highest fatalities at 50. Further statistics reveal child RTA fatalities increased by 11%, with the highest number occurring with passengers of a motorized vehicle, and elderly road fatalities increased by 12%, with their highest number occurring as pedestrians (Burrowes, Road Safety Unit, 2017). Programmatic undertaking by the RSU emphasize efforts to provide safety measures and tips for their riders, vulnerable passengers, and pedestrians. Information is disseminated through educational books in primary schools for children aged 6-12 years old, hoping to create a foundation of knowledge and awareness at an early stage of development. In addition to weekly outreach programs in the community, the RSU has taken its educational efforts on the road, attempting to reach more vulnerable populations. The RSU has also developed several safety awareness campaigns that include designating June as Road Safety Month, providing education on the risks of drinking and driving, and developing a national helmet awareness day (Burrowes, Road Safety Unit, 2017). In 1993, the non-for-profit National Road Safety Council (NRSC) was established in Jamaica. Their mission statement is “To reduce the incidence of road collisions by devising strategies, recommending programmes and developing and implementing a sustained road safety campaign in order to influence road user behaviour, prevent death and injury and thus lower the cost to society” (nationalroadsafetycouncil.org.jm). The

35 NRSC’s website provides many valuable tips showcasing a human perspective to this epidemic. Included are testimonials from accident survivors who share painful stories of injuries and life-altering consequences with the intention of emotionally appealing to drivers and positively influencing their decision to exercise safe driving practices. Videos capturing real moments of crash impact are also featured. Although I, the researcher, benefit from online avenues for disseminating information, many Jamaicans do not have access to a computer or the internet, thus limiting the population whom such informational forums might positively influence. Therefore, it remains critical that information is promulgated by family and community members, as well as programmatic ground outreach. Road safety laws and their enforcement are essential components to reducing RTA’s and fatalities. “To achieve maximum compliance with legislation, it is generally accepted that propaganda and publicity campaigns are of little value if unaccompanied by highly visible and consistent enforcement of the law” (Crandon, et al., 2006, p. 2). In May 2018, the Jamaican Senate approved the new Road Traffic Act outlining the country’s rules for road safety, with a goal for implementation in 2020. The Road Traffic Act addresses penalties for not obeying traffic signs and speed limits, directives to obtain licenses for various motorized vehicles, and restrictions on licenses and causes for revocation (Burrowes, Road Safety Unit, 2017). For example, the Road Traffic Act specifically addresses motorcycle drivers stating that “Reckless driving is defined as operating the motorcycle ‘at a speed or in a manner which is dangerous to the public, having regard to the nature, condition and use of the road and the amount of traffic at that time (Section 27-1)” (Cawich, et al., 2010, p. 57).

36 The new Road Traffic Act also stipulates that operating a motorized vehicle while under the influence of alcohol, texting while driving, or not wearing seat belts or a helmet violates legally mandated safe road practices. Since the new Road Traffic Act passed, a study evaluating the use of seatbelts in Kingston, Jamaica, compared to a previous study conducted when the front and rear passenger seat belt usage was not mandatory, found that implementation of seat belt usage increased. However, it noted a gender discrepancy in that female driver and passenger usage was higher than male drivers and passengers (Crandon, et al., 2006). A study examining helmet usage identified several reasons for helmet non-compliance, including “the cost of the helmet, ignorance, a cultural disposition towards lawlessness, fatalism, insufficient educational campaigns, and recreational drug use” (Crandon, et al., 2009, p. 5). They also established additional factors: discomfort when wearing a helmet, inconvenience, and no expectation of an accident. Offenses for abusing road safety and regulations are punishable via a demerit system on one’s license and significantly increased fines and the possibility of jail. Laws are enforced by license registration centers and the Parish police. The police have access to breathalyzers to screen for driving while under the influence of alcohol and frequently use road stops to check for seat belts, helmets, and child restraint usage, as noncompliance remains a significant factor. Regrettably, despite hopeful efforts implemented by Jamaica’s legislative and programmatic strategies, RTA fatalities and injuries continue to plague the people of Jamaica. A psychoanalytic examination of this phenomenon will assist in understanding the subjective attitudes and values informing road safety practices, emphasizing the relevancy of this study.

Responsibility and Societal Impact: The Costs of The Problem The literature addresses the public health issue of RTA injuries and fatalities in terms of responsibility, emphasizing the government’s role in remedying this issue. The Association of Caribbean States (2017) shifted its disaster management focus away from reducing the effects of natural disasters, such as hurricanes or earthquakes, to study RTA fatalities as a man-made disaster. Highlighted is the necessity of a political commitment in order for there to be a reduction of RTA fatalities. Shim (2018) focuses squarely on political and governmental corruption issues for the lack of progress made towards developing and maintaining/repairing infrastructure, including roads and rail lines. Although the neglect and disrepair of Jamaica’s roadways pose a legitimate hazard, the literature brings attention to human error in not exercising safety precautions as compounding the number of fatalities and injuries. Thus, the responsibility is socio-political, relying on both governmental policy and enforcement and the behavior modification of Jamaican citizens to obey road safety practices and laws. Of consideration is the argument that a lack of investment in the communities by Jamaican leaders translates to a lack of desire to invest in oneself. This curiosity will be further explored through theoretical analysis if identified in the lived experience of this study’s participants. Similar to natural disasters, high RTA injury and death statistics place a devastating economic burden on already impoverished countries. Jose Luis Irigoyen, a World Bank traffic safety officer, labeled it a “poverty-inducing problem” (Hundley & McCarey, 2014).

38 More than 90% of injury deaths occur in low- and middle-income countries, where preventive efforts are often nonexistent, and health-care systems are least prepared to meet the challenge. As such, injuries clearly contribute to the vicious cycle of poverty and the economic and social costs have an impact on individuals, communities and societies (Gosselin, et al., 2009, p. 246). This economic burden extends beyond medical treatment for acute physical trauma, as many injured require long-term medical care and recovery services. Additional stress is placed on the families of those wounded and on entire communities due to the injured being unable to contribute to the family financially. A World Bank Study (2018, January 9) found, “The greatest share of mortality and long-term disability from road traffic crashes happen amongst the working-age population (between 15 and 64 years old)” (para. 6), which is especially difficult for families who have multiple victims. The Cost of Care Project (2017) conducted a study in 2014 examining the financial impact of direct medical costs, including the investigation of accidents and hospital treatment, with indirect medical costs, such as a loss in productivity and ongoing treatment for permanent disabilities. Specifically, “For road traffic crashes the estimated direct medical cost was J$1.4 billion and the indirect productivity cost was J$1.8 billion making a total (direct and indirect) medical cost of RTC J$3.2 billion dollars” (Cost of Care Project, 2017, p. 19). This impacts the overall GDP and depletes an already economically disadvantaged nation, subsequently affecting opportunities for upward mobility of the Jamaican people and negatively shaping one’s self-identity and worth.

39 The Human Factor: Impact of Gender and Cultural on High-Risk Behaviors Although the literature recognizes RTA's as multifactorial, studies consistently identify human behavior as the major source of the high number of road injuries and fatalities. Quantitative research studies are the dominant methodology for examining how human behavior and culture may impact unsafe road practices. Overall, demographics find that young adult males with poor economic status are at higher risk for engaging in unsafe driving behaviors, which results in higher numbers of RTA's and fatalities (WHO, 2018). However, statistics only illustrate a greater need for a qualitative exploration of this phenomenon to make sense of the psychological motivations contributing to this crisis. Therefore, this section will examine relevant psychological and cultural factors in Jamaica, including the addition of applicable international studies, to further ground this research project. Jamaica's national motto is 'out of many, one people,' in recognition of the island's multi-racial, multi-cultural, and multi-religious people. This motto also aims to bring together people of different classes and political views. Jamaica is very much a country that exudes a culture of warmth and hospitality, welcoming people by enacting their motto. Even so, Jamaica is of a split identity, as she is also one of many Caribbean islands besieged by a culture of historic and present violence. A common Jamaican saying, "See me and come live with me are two different things," (Jamaican Observer, August 02, 2015, para. 1) underscores the vastly different experience of people struggling to live together in Jamaica as one, in comparison with the ideal experience that awaits visitors. In reality, Jamaica continues to grapple with a harsh divide between social

40 classes and subsequent power differentials, resulting in unacceptable levels of poverty, aggression, and violence. Poverty is an intrinsic factor in understanding Jamaican culture, as colonial history paved the foundation for extreme divisions. Such extensive inequalities between poor, uneducated Jamaicans and those with greater opportunity remain a defining aspect of the Jamaican lived experience. However, despite limited financial resources, Jamaica has been described as a "bling" culture, which places significant value on material possessions. This way of life is exemplified in advertisements, music videos, and television programs that promote expensive and "flashy" cars, clothing, and jewelry, as well as "flashy" men and women (Brodie-Walker, 2013, p. 209). In one Gleaner article, a Jamaican citizen discussed bling culture, emphasizing its importance versus societal changes that might benefit all Jamaicans, stating, "Whether Jamaica has adequate buses on the road which you can set your watch by is totally irrelevant to the average Jamaican. He wants his own ride, not just for convenience but to show that he has 'arrived'" (Boyne, June 24, 2012, para. 2). Per Dr. Lucien Jones, speaking of Jamaican culture, The minds of those who are held captive by the philosophy of materialism must be transformed. They see their salvation in more money, increasing possessions and the ability to indulge in whatever their appetites demand . . . they measure the value of life by the amount of money that has been accumulated, (and) the possessions they have acquired (Boyne, Sunday, May 14, 2017, para. 8).

41 Thus, in Jamaica, money or the illusion of money shores up one's identity by achieving a sense of respect and individual self-worth, substituting for lack in a socioeconomically depressed environment. A culture of hyper-masculinity also dominates Jamaica. This, too, is popularized through musical lyrics and videos that depict women as sexual objects and promote violence against those who identify as homosexual. Gender and masculinity are social constructs developed around culture and societal norms. In each culture, there is hegemonic masculinity (Connell & Messerschmidt, 2005), or "a normative male ideal in a society which supports the gender hierarchy and subordinates' marginal masculinities and men who do not comply with it" (Groes-Green, 2009, p. 292). Gender is, therefore, performative rather than fixed or naturalized (Butler, 1995). For most young men in the Caribbean, the success and strength of their manhood to a large degree depends on how well they can perform “normative, straightjacket or dominant masculinity” to obfuscate any form of tenderness or effeminacy. Their hyper masculinity is an apparatus or sum total of collective surveillance and regulation of what is supposed to be male.” (Crichlow, 2014, p. 31) Young men in poverty must enact their cultural masculinity as a disavowal of loss in an effort to compensate for their lived reality of societal and power deficits. Butler (1995) posits that one's masculine gender identity is based on repudiation or misidentification with the feminine and a sense of dependency. She argues that gender identity is formed around a melancholic loss that has not yet been mourned, an interesting theoretical consideration when contemplating enactments of masculinity in Jamaica. A discourse on melancholia will be further explored in the context of an unresolved mourning of colonial

42 history and a racial 'ideal,' in terms of how this affects identification, subjectivity and perhaps has an implication on unsafe road practices in Jamaica. Braly, et al. (2017) further builds upon masculinity as an enactment by highlighting the "precarious manhood paradigm" and the assertion that masculinity is often perceived by many men "as a commodity to be earned and maintained through behaviors" (p. 1). If masculinity becomes threatened, expressions of aggression, which have been socialized as an "acceptable" form of emotional expression, serve to stabilize and reassert one's masculine identity. Whereas Walker & Butland (2000) describe such enactments as "protest masculinities" (p. 11) when masculinity is expressed through aggressive actions as a result of being unable to achieve manhood through more traditional routes such as economic or educational opportunities. The above concepts apply to some Jamaican men, as many will enact masculinity through violence and aggression. Echoing colonialism, there is a defensive position of violence against the "other," or violence against women and homosexuality in Jamaica. The literature has found this to be true in other socioeconomically disadvantaged communities. In a study on issues of class, violence, and sexual performance with young Mozambique men, masculine authority was earned by their sexual performance and physical violence towards women, rather than be identified as a subordinate male due to poverty. Specifically, it was revealed that massive unemployment caused by neo-liberal reforms have led to a growing number of young men basing their authority vis-a-vis women on bodily powers, understood as abilities and physique of the male body, rather than on economic powers and social status poor young men react to a situation of unemployment by enacting

43 masculinities that are subordinate vis-a-vis middle class peers, but which find expression through violence or sexual performance vis-a-vis female partners. (GroesGreen, 2009, p. 286) This study's findings reinforce that poverty and a subordinate social class lead to increased male aggression and violence against women to substitute for lack of economic status. Second, to violence, most of the literature on high-risk behaviors in Jamaica focuses on unsafe sex practices and the HIV/AIDS crisis in the Caribbean. In contemporary Jamaican society, male sexual prowess is primary to achieving power status, whereas women may also achieve status by engaging in sexual relationships with men who identify as powerful (Haynes-Robinson, 2013). This socio-cultural perception negatively impacts successful messaging about safe sex practices and subsequent healthy changes in safe sex practices. As a result, unprotected heterosexual intercourse remains the primary means for contracting HIV in Jamaica. Again, the enactment of heteronormative masculinity and cultural myths can be partially linked to high-risk sexual practices. Thus, the use of bodily powers, either through violence or sex, aligns with the colonial process of objectifying the other. It becomes a means to achieve a sense of status and control primarily for men who have experienced diminished masculinity. This literature invites an examination of how the body might be understood psychoanalytically and how gender informs unsafe road practices, despite the potential for adverse long-term consequences.

44 The Impact of Gender, Cultural, and Personality Factors on Unsafe Road Practices As previously discussed, statistical data reveals that men represent the highest number of RTA's and fatalities in the Caribbean and the world. Nevertheless, the literature has primarily focused on positivist research models providing statistical data on the effects of male driving behaviors, with the assumption, there are "natural" gender differences in driving behaviors between males and females. This ignores the class dimension and socio-cultural variables in road use (Walker, Linley, et al., 2000, p. 6). For example, revisiting protest masculinities, Walker, et al. (2000) examined an Australian study on "working-class" men of lower-income. They found that the practices of road use allowed the building of masculine identity, and thus a sense of dignity and self-worth, in a context where the culturally approved source of masculine dignity - holding down a job and being a breadwinner-is no longer generally available, because of high youth unemployment. (p. 11) Thus, a devaluing of the self is formed through socio-political and economic factors that become embedded in the unconscious, potentially contributing to high-risk road practices. In order to further understand this phenomenon of driving culture and gender, Redshaw (2006) conducted a study exploring the culture of young people driving in Jamaica by examining how social contexts, focusing on family and peers, influenced performances of gender through driving. Her findings indicate that young men viewed risky driving as acceptable as an avenue for demonstrating and mastering power. The fact that men were ‘stupid’ in cars was not a problem for the men in the group, nor was the fact that they tended to speed or lose control. Somehow the crashes and

45 ‘stupidity’ men were involved in were excused because men were seen as having a stronger affinity with cars. This affinity was part of how they engaged with cars and was demonstrated in their driving style, thus was regarded as part of being male. (Redshaw, 2006, p. 6) Thus, high-risk road practices were understood as a normative part of being male, and that social messaging and gender increased the likelihood for driver risks. As a result of this type of data, it is recommended that safety policies and educational approaches incorporate gender, ethnic, and class dimensions for understanding road traffic accidents and developing appropriate interventions (Walker & Linley et al., 2000). There appears to be an absence of studies examining the reason for the statistical discrepancy between male and female drivers and road safety practices within the literature. Walker & Linley, et al., 2000 suggested that Girls are a key part of the social field in which boys learn masculine conduct and a key audience for masculine display. Girls as passengers have an interest in learning how to deal with reckless drivers, and the gender dimension of that interaction is crucial. Expanding girls’ gender repertoires may be a crucial move in the safety education of boys. (p. 25) Young women are also recognized as participants of Jamaica's "bike back culture," where pillion passengers, usually females, are scantily clad to maximize body exposure, without protective garments or helmets (Cawich, 2009, p. 5). Pillion practices violate pillion passenger laws outlined in the Road Traffic Act and further contribute to RTA's by acting as a distraction (Cawich, 2010). Thus, pillion culture in Jamaica appears to correspond with gendered road practices aimed at achieving status through the body, and

46 in this case, sexuality. Therefore, the subjective experience of female participants would further enhance an understanding of unsafe road practices in Jamaica, reinforcing the critical need to hear their voices as citizens who can inform new safety programmatic measures and campaigns. While there is literature on road traffic culture, there is less on how cultural differences correlate with risky road traffic practices and fatalism. Imperative is the consideration of variance risk perception between cultures, as what I perceive as a highrisk road practice, such as not wearing a seat belt while riding in a car, maybe a routine way of life for others, despite statistics directly linking such behavior choices to an increased chance of fatality. Nordfjaern, & Simsekogulu et al. (2012) conducted a study examining road traffic culture between Turkey and Norway, highlighting a cultural contrast in road practices. Most importantly, regarding fatalism, people in low-and-middle-income countries often focus on destiny and religion related to accident causation, while they consider individual behavior and driving under the influence of alcohol as less relevant. In this way, fatalism could result in a more passive attitude to taking precautions, and less willingness to drive in accordance with traffic regulations. (p. 205) Perhaps, a passive attitude in exercising road safety precautions in Jamaica is an expression of helplessness or futility imbedded in the colonized psyche. Similar to the above study, driving under the influence of alcohol and marijuana is another contributing factor to RTA’s in Jamaica (WHO, 2018). Dr. Lucian Jones, the vice-chairman of Jamaica’s National Road Safety Counsel, expressed his concern about unsafe road practices and substance use stating,

47 the basic problem we have on the road, which is indiscipline. It's a mindset which we are definitely trying to change. So, it's one other issue, apart from just driving recklessly on the road. It's a major concern for us that people don't understand the problems which are associated with drug use (Gilpin, J-A, The Gleaner, Monday, January 16, 2017). The article provided data finding that one in six males and one in seventeen females in Jamaica claim to drive under the influence of a substance. Conceivably, fatalistic beliefs in Jamaica may correlate with attitudes regarding substance use as a non-factor in unsafe road practices. Turkey's citizens are also determined as having a risk of greater exposure to "natural hazards," which correlated with an increased willingness for general risk-taking behavior (Nordfjaern, & Simsekogulu, et al., 2012). This factor is found to be consistent in countries of lower-income. In parallel, Jamaican citizens experience high incidents of trauma through community violence and natural disasters, such as hurricanes, perhaps contributing to fatalistic beliefs in Jamaica. There is, however, a gap in the literature on Jamaica's fatalistic beliefs, making this an area requiring further inquiry. Time perspective is another significant predictor of high-risk road practices where 'present-oriented' individuals are more likely to engage in high-risk driving behaviors versus those identified as 'future-oriented.' Zimbardo et al. (1997) define time perspective as: a general psychological construct permeating much human motivation and decision making. It can be thought of as a unique cognitive style of processing information and acting based on learned, preferred focus on one or another dimension of the temporal

48 environment, past, present, and future. When that perspective becomes chronic - the person typically uses only a narrow or biased temporal frame for dealing with the world - it then functions as a personality trait. (p. 1020) Those who are present-oriented were more often found to be males exhibiting a greater predilection for impulsive and libidinous behaviors, including substance use and gratification in sensation-seeking activities. Additionally, those who reside in the 'present' temporal frame demonstrate an inflated sense of confidence in their driving capabilities, all hurdling towards an increased possibility for RTA's (Zimbardo et al., 2007). Attitudes and dispositional factors are also directly linked to unsafe driving behaviors. A study examining Ethiopian drivers (Hassen et al., 2011) found that many drivers with negative attitudes towards road safety practices believed that safety laws were "arbitrary, unjust, and unuseful or designed for a purpose other than road safety" (p. 14). Therefore, this mindset, linked with behavioral risk factors, increased the likelihood of these individuals being involved in an RTA. Another study (Mallia, et al., 2015) discovered that personality traits and attitudes towards road safety are linked to aberrant driving behaviors and crash involvement. Specifically, more anxious and hostile personalities affected the likelihood of aberrant driving behaviors. Whereas positive attitudes in older, professional drivers towards road safety and altruistic personality traits in drivers correlated with fewer driving errors. Interestingly, the findings on the attitudes of professional drivers are in contrast with the "professional" driving of taxi drivers in Jamaica, who are often referred to as "taxi germs," due to their history of reckless driving habits (Global Voices, November 19, 2019). Despite this concern, many Jamaicans must either share the road with taxi drivers

49 or rely on them for daily transportation to school or work, which are integral for upward mobility and the development of a positive self-identification. While the above data addresses the impact of personality on the safety performance of professional drivers, little is understood about how these personality variables are linked to socio-cultural realities, nor how the attitudes of Jamaican drivers or passengers may inform their road safety practices. Additionally, the majority of the literature focuses on younger male drivers, identifying a gap in knowledge on how these factors might psychologically impact the lived experience, behaviors, and values of older drivers. Consequently, in keeping with the postcolonial focus of this study, little is understood about how these personality variables are linked to socio-cultural realities.

Psychoanalysis and Colonization Psychoanalysis is a theoretical discipline and technique in which scholars argue that certain psychoanalytic terminology, tropes, and fundamental assumptions promote colonialist ideas (Blaut, 1993; Brickman, 2018; Frosh, 2013). Frosh (2013) contends that colonialist ideas are at the foundation of Freud’s conception of phantasy, psychic and unconscious life and have sustained colonial culture regarding identifying pathology and essentializing the idea of the “other.” This can be understood through a history of being cost-prohibitive for many and serving the upper-class elite as well as assigning alienating diagnoses that do not adequately if at all, appertain the subject’s experience of racism and its impacts on the psyche. Theoretically, psychoanalysis reveals an analytic means of separating oneself from the other; civilized; versus uncivilized. While contemporary psychoanalytic scholars, especially African Americans, and Hispanics, are promoting

50 change by challenging this practice and perception of race in psychoanalysis (Basio Wingrad, 2014 PEP Video; Gherovici, Christian, Plotkin, 2019). Khanna (2003) explicitly labels psychoanalysis as a colonial discipline and bases her critique on the theory’s superior positioning of the Western man versus the colonized subject, who is the “other,” primitive, feminine, or homosexual. With a theory of diffusionism, Blaut (1993) also acknowledges how intellectual theories of social evolution were rooted in colonial ideologies, while Brickman (2018) further unpacks the influence of such theoretical disciplines on Freud’s development of psychoanalysis. She underscores a racial bias in psychoanalysis deep within its texts and how the sociopolitical influence of colonization ushered in a conceptualization and categorization of people as either human or inferior beings. As Brickman (2018) notes, Freud conceived his theory of psychoanalysis during the Victorian era in Vienna, Austria, in an atmosphere politically charged with antisemitism. As a Jewish man, Freud was a member of the oppressed, a group regarded as “black” (Altman, 2004). Thus, psychoanalysis, developed and practiced by the majority Jewish, was perceived as an ethnic discipline, or what Frosh (2005) labeled a “Jewish Science.” Per Tolleson (2009), “This racialization of psychoanalysis, the ongoing anti-Semitic assaults against it, the repudiation of its emphasis on desire and death, and the socialist and communist affiliations of so many of its early practitioners placed psychoanalysis, in its beginnings, firmly in the social margins” (p. 192). Freud strove to garner the scientific legitimization of psychoanalysis, attempting to reposition his status and Judaism in European society to one of intellect and civility. After many leaders in the field fled the Nazi regime for America, psychoanalysis began to develop theoretical stances informed

51 by Western societal structure and values (Altman, 2004; Tolleson, 2009). However, this process of theoretical conception ambivalently served as a displacement of the marginalization of Jews on to the “primitive other” (Frosh, 2013). Ultimately, Freud’s aim was not to create a race-based theory but one that is universal. This is where psychoanalysis’s ambivalence is seen, as race became a part of the repressed past that one must, repudiate and then re-incorporate for the person to become whole and civilized (Brickman, 2018). Demonstrating his separation from cultural anthropology into modernist theorizing, “Freud claimed primitivity to be a universal feature of the psyche of all humankind, rather than a characteristic of savages only.” (Brickman, 2003, p. 52). Freud incorporated debunked anthropological evolutionary scales into the foundation of his theorizing, asserting that “primitivity” preserved the earliest stage of development. “Primitive peoples were those who had existed at the threshold of the transition from animal to human, and the term became prominent in accounts that arranged cultures within a hierarchical developmental scheme, from most primitive to most advanced and developed” (Brickman, 2018, p. 18). Therefore, savages, infants, and neurotics all shared a similar “primitive” psyche, the first state of mind. The second state included the barbarians, considered more civilized as they worshiped religion, which Freud compared to Oedipal children who worshiped their parents. The third, or “civilized,” state of mind, is when religion is not necessary for survival, and for Freud, it represented when children successfully resolved their Oedipal crisis. As Brickman (2018) notes, psychopathology equates to a regression down the evolutionary scale, a regression that correlates with darker skin.

52 Freud established the Oedipal complex as a universalizing constituent, although this was only applicable to those in the West. Khanna (2003) argues that Freud’s conceptualization of otherness began with a theory of lack and the mystery surrounding a woman’s genitals: specifically, her lack of penis. Freud referred to the mystery of a woman’s sexuality as the “dark continent,” equating women with the mystery of Africa, primitive and distant lands unknown. With penis envy, the woman owns a sense of shame, feeling inferior to man, further exemplifying how psychoanalytic theory, language, and color schema have marginalized groups as inferior, reinforcing the “Ideal” of Western white males and permeating the psyche. However, Hook (2012) cautions against overly critiquing psychoanalysis and its historically problematic ideological values as universal, arguing that, One problem arises when critiques of this sort become totalizing, is that opportunities for genuinely culturally nuanced forms of psychoanalysis - which themselves offer opportunities for the critical refinement of psychoanalytic thought - are lost. In this respect we might say that the psychoanalytic theorization of the postcolonial - and of racism in particular - is as of yet an unfinished project. (p. 99) Instead, this perspective supports that psychoanalysis be used as a means for engaging cultural and political applications to theorizing. Cushman (1995), in his studies on the intersection between psychotherapy and culture, valuing the social world, by locating social interaction and human subjectivity within the space between people and within history and culture, by acknowledging the interweaving of the individual and the society, by recognizing ongoing relatedness and involvement of human life, by valuing the polyvocality of our psychological terrain

53 and the multiculturalism of our planet’s terrain, psychotherapy practices could demonstrate a morality that would challenge the dominant moral understandings and political arrangements of our era. (p. 299) Essentially, Cushman is positing that the practice of psychotherapy and its theoretical frames are modifiable to move beyond a situated belief system about what it means to be human or “Ideal.” Rather, cultural considerations when critiquing and applying theoretical approaches can highlight interpretative and formulaic biases, as with the development of psychoanalysis, thus allowing for a richer understanding of various human perspectives of being and a celebration of the multitude of differences without pathology. In order to achieve this, one must be aware of and continue to challenge embedded beliefs that structure one’s experience.

Psychoanalysis, Postcolonial Theory, and Subjectivity Postcolonialism is a theory of social construction founded on the premise of hierarchal differences. It encompasses a broad range of theoretical discourse anchored in political, moral, and psychological realms emphasizing power differentials between individuals based on various attributes. It is the process of shaping realities through unconscious assumptions about individuals and groups by extolling specific value systems and beliefs to aspects they cannot control. Social construction situates one’s perception of reality in political and historical contexts, reinforcing that perceptions of difference and oppression are born from social systems. Per Cushman (1995), Culture infuses individuals through the social practices of the everyday world, shaping and forming the most fundamental ways how humans conceive of the world and their

54 place within it, how they see others, how they engage in a framework of mutual obligations and responsibilities, where they are located in a hierarchical structure of local power relations, and how they use all of this to determine their own behavior and make choices. (p. 17) Thus, it is often informed by the needs and desires of those dominant in society and assumes prevailing social values that represent their consensus. As a result, an Ideal is essentialized, and the Ideal becomes regarded as a fact of the social world rather than a fictitious construct informing the world on how specific people are to be viewed and treated (Gergen, 2009). Racism exemplifies a culturally constructed and sustained threat against the developing ego and self of those identified as different. Despite postcolonial theory’s ambivalent relationship with psychology, Frosh (2013) argues that these disciplines need each other. Specifically, “the failures of connection between the two disciplines impoverishes both . . . it results in a theory of the subject that is either asocial, or that neglects the agent possibilities for resistance and change” (p. 142). Postcolonial theory allows psychoanalysis to go beyond unconscious, internal forces and to consider the subject as social and affected by the immersion of one’s environment. It creates an opportunity for considering how the human subject is not self-contained but is permeated by forces that it cannot necessarily understand or control. This means that whilst psychoanalysis has tended to concentrate on ‘internal’ forces, it provides an opportunity to consider the social ‘saturation’ of the subject; or, put another way, it gives leverage to theories that deal with the formation of the human as a social subject. (Frosh, 2013)

55 The external world, or “social,” is requisite when examining the colonized psyche, as both the external situation of oppression and an internal conflict with black and white identifications rob the colonized of internal freedom to contradict the social norms that oppress them (Davids, 1996). The result is a compromised development of subjectivity and a denigration of the self. Identity formation occurs from the interactions between the individual and his engagement with the environment (Butler, 1997; Fanon, 1952; Freud, 1925; Mitchell, & Black; Oliver, 2004). For the colonized in Jamaica, their African identities were stripped, and their degenerate social position informed their new identity. Oliver (2004) accentuates how dehumanizing and reducing the subject to a commodity reinforces an identity that a white colonial past has already predetermined. She writes that “meaning as predetermined is at the heart of colonial logic, which maintains that the black man is determined in advance by history as subhuman and ripe for subservience, that he is subject to manifest destiny, that is white destiny” (p. 14), positioning the colonized as inferior. Fanon (1952) definitively illustrated this position, writing “there is but one destiny for the black man. And it is white” (p. xiv). Thus, the European colonizer constructed the black man and the inferiority complex from which he suffers. Fanon’s (1952) discourse on colonial racism underscores its penetration and alteration of the black man’s colonized psyche, leading to the development of an inferiority complex. When the black man is confronted with the white man and must contend with his “otherness” in the face of “the Other,” he unconsciously absorbs a belief about his inferiority.

56 The black man knows he is black, but because of an ethical shift, he realizes (the collective unconscious) that one is black as a result of being wicked, spineless, evil, and instinctual. In the collective unconscious black = ugliness, sin, darkness, and immorality. (p. 169) Consequently, the recognition of inferiority for the colonized leads to an internal split where the identification with one’s blackness, or badness, must be disavowed. Layton (2006) refers to this construct as the “normative unconscious,” which are: The psychological consequences of living in a culture in which many norms serve the dominant ideological purpose of maintaining a power status quo” (p. 239), as “no social location exists without reference to all others, and all create their own identities by taking up some cognitive and affective position toward dominant cultural ideals. (p. 241) Therefore, the self becomes submerged in a neurotic position of alienation and dissociation for psychic survival, as the conscious awareness of this conflict would be too painful for the ego to manage. This idea will be elaborated on further in the section on trauma. A fundamental aspect of subjectivity is the ability to make meaning. For the colonized, this ability was dismantled, even concerning one’s own body (Oliver, 2004). Fanon (1952) describes how “the negro symbolizes the biological” (p. 144), representing the sexual instinct and evoking an external response of fear from the white man. Fanon believed that such values attacked the body schema, evolving into a historical, epidural racial schema where the skin is penetrated by the “injection” of the white man’s punishing super ego. He posits that an inferiority complex develops through

57 internalization and epidermalization and the self becomes imprisoned in black skin, reinforcing an internalized hatred of the self. The white man’s values are caustic agents that cause pain that can no longer be decided into neat categories of the physical, emotional, and psychological. The caustic agent burns through the skin to the psyche itself, which shrinks back, obliterates itself, and becomes somaticized as hysterical symptoms lodged in the muscles. The circular - or perhaps dialectical - movement between skin, emotions, psyche . . . undermines any “black and white” distinctions between mind and body. (Oliver, 2004, p. 49) Thus, the argument that the body of the colonized is no longer of one’s creation and perception is amplified. The colonized has become occupied, a phobic object reduced to the color of his skin, with white defined as good and black as evil, ultimately colonizing both the body and the psyche (Oliver, 2004). White’s (2002) analysis expands upon the idea of racial self-hatred and its insidious effect on black identity formation and the barriers neutralizing a desire for autonomous functioning. The self has become an object absorbing hateful, racist projections, which become re-externalized through expressions of hostility and destructive impulses experienced as hating but often directed towards the self. Fanon found the anger of oppression stored in the muscles of the colonized, with this tension discharged as aggression towards the self (Oliver, 2004). Whereas Freud (1905) believed tension results from stored up energy, or a dammed libido, where there is a release of this psychic energy from an unconscious idea to a conscious expression of affect. From this selfawareness, the expression of affect is laden with anger and aggression turned towards the

58 self. It is disguised by identifying with the aggressor, in this case, the colonizer’s negative perception of the oppressed as bad. As a result, one may experience an unconscious disregard for safety, well-being, and value. Today, many Jamaicans enact behaviors reminiscent of slave culture, including violent, aggressive, and dismissive behavior towards others and, at times, the self. While the colonized endured unspeakable violence, they also reproduced violence as a defensive measure during several famous slave revolts. The history of these revolts is a source of pride and cultural lore in Jamaica, as they represent unity, determination, and a belief in justice. In Wretched of the Earth (1961), Fanon argues that the oppressed must engage in violence, specifically, a violent revolution, to break free from the psychological imprisonment of colonial racism. In many Jamaican communities, this justice continues to be enacted when citizens take the law into their own hands. While violent behavior is rebuked, it has also served as a source of control, a defense in which the self-attempts to defy trauma, demands respect, and shores up one’s identity. Therefore, Jamaica appears entrenched in conflictual ideas regarding identity and an internalized identification with the aggressor and actions of self-preservation versus criminality. These ideas are further explored in the section on trauma.

The Symbol of The Automobile, The Body, and The Psychoanalytic Theory of Accidents Embedded beliefs about self-value become enacted in attitudes towards the self and symbols within one's culture. Holmes (2006) posits that experiences of racism and

59 classism result in a "success neurosis" or the need to defend against the achievement and maintenance of success. Oedipal strivings, or "forbidden wishes," must be disavowed, while "societal opposing forces may also be internalized into one's super ego, leading one to punish oneself for any pursuit of success, as well as to anticipate punishment from real and opposing forces" (p. 219). In modern society, white, capitalistic structures are reified as moral standards and insidiously preserve colonial social structures. Those suffering from societal marginalization may continue to negotiate the internal trauma of racism as they encounter obstacles to success and freedom. In contemporary Jamaica, current poverty and the residue of a colonial past reinforce this sense of inferiority (Shim, 2018). The limitations for opportunity are not disguised, but forbidden wishes are reduced to a hunger for the symbolic status of achievement. From the time of its invention, the automobile has been a symbol of ingenuity, power, freedom, and social status. In cinema, movies have romanticized man's relationship with the car, with the automobile at times serving as a central character. The automobile personifies a 'cool' factor, as does the motorcycle. There is that youthful fantasy of cruising down the boulevards with careless abandon. We develop attachments and identifications with our cars, which is evident in the personalization often ascribed to one's car or motorcycle. Through my experiences in Jamaica and stories shared by a Jamaican contact, it appears that one such cultural symbol of money, power, and freedom is the motorcycle, or even greater yet, the automobile. Grumet (1989) penned an article illustrating the ways of which the automobile is interwoven through cultural and emotional life, utilizing the language of motorization to communicate emotional states.

60 In psychiatry, we talk of impulses as “drives” and might describe a highly energetic person as “driven.” Similarly, an intense or active person may be described as accelerated, “in the driver’s seat,” or living life “in the fast lane.” Depressed or unsuccessful persons may complain of being “at a standstill,” “stalled,” “immobilized,” . . . or just “spinning my wheels. (p. 19) He further underscores the psychological enticement or identification one can make with ownership of various model names that represent aggression, power, freedom, and elitism, such as mustang, jaguar, trailblazer, and escape, among others. Through these attachments and identifications, the vehicle can become an object of "narcissistic ego," where ego investment and boundaries may blur between the physical body and the automobile's body (p. 21). Where one experiences lack, perhaps one's mode of transportation acts as a symbolic substitute, bolstering the ego. The automobile also delineates those with economic means versus those without, paralleling people who can move through society with social freedoms versus those subject to discrimination. Grumet (1989) references the idea of territoriality as a driving impulse for road eroticism or aggression. If one's automobile or motorcycle is intruded upon, does this present as a narcissistic injury or, as Grumet hypothesized, awaken an instinctive need to "defend one's "home?" Grumet underscored this as "especially pronounced in young male drivers and those from lower socioeconomic classes in that the vehicle may be all they possess" (p. 28). In Jamaica, the motorbike is often-time the individual's only possession and, as suggested previously, serves as a source of status and freedom. Conversely, the motorcycle can also be disposable. Per a periodical interview with Luchen Jones, vice-

61 chairman of NRSC, “for some of the bikers, the bike is not that important to them. When they are seized by the police, owners might not return for them. And, police report that they are seen riding a new bike in a short space of time” (Jamaica Star, Aug 21, 2017, para. 6). In this regard, the bike may represent an extension of the devalued self that can be damaged, seized, or discarded and indicates perhaps an avoidant attachment style often associated with those who have experienced trauma (Ainsworth & Bell, 1970). Psychoanalytic literature on the theory of accidents has sought to explore how unconscious motivations contribute to understanding the cause of accidents. In The Psychopathology of Everyday Life, Freud (1901) challenged whether serious accidents resulted from self-injury or suicidal fantasies. He wrote of "an impulse to self-punishment which is constantly on the watch and which normally finds expression in self-reproach or contributes to the formation of a symptom takes ingenious advantage of an external situation until the desired injurious effect is brought about" (p. 179). Based on this premise, one might posit that Jamaican citizens who choose not to exercise safety precautions are unconsciously leveraging their environment and accident culture as a potential expression of masochistic and self-injurious impulses in an effort to gain control over these injustices. In addition to previous considerations, this is yet another perspective to explain this phenomenon, although it remains critical not to pathologize that which is unknown. Dorpat (1978) cautions against psychoanalytic assumptions of mislabeling accidents as expressions of self-destructive impulses or an unconscious death wish and notes that psychoanalytic studies historically miscategorized accidents in this manner. Dorpat challenges the semantics of "accidents," differentiating accidents versus action.

62 "Accidents are happenings; they are not, by definition, human actions. Unlike actions, accidents are not consciously or unconsciously intentional, and they are not intrinsically meaningful" (p. 273). Therefore, not all behaviors resulting in accidents should be assessed as motivated by self-destructive purposes. Notwithstanding, victims or survivors of accidents often reason that unconscious, self-destructive motivations are the cause. This occurs to defend against overwhelming feelings of helplessness while grasping for a sense of control. Additionally, Dorpat's (1978) micro-study of multi-situational accident victims revealed that despite being aware of a possible threat posed by the situation, each member of her sample failed to exercise safety precautions to decrease the risk of danger, nor did they experience a sensation of fear prior to the accident. Dorpat described "normal and expectable reaction to danger situations involves the following: the recognition and appraisal of the signs of danger; an affective fear response; and finally, the mobilization of adaptive responses designed to minimize the danger" (p. 280). She assessed the lack of the above responses to be a result of a vertical ego split, allowing omnipotent fantasies of control, invulnerability, and power as means to deny the danger. Dorpat's interpretation rested on the belief that the idealized object was omnipotent. Thus, mourning the loss of the idealized is critical for the subject to mend the split and develop the capacity for self-preservation actions. The phenomenon of not exercising precautions in dangerous situations needs to be better understood and is further analyzed in this study. This is necessary to make inroads in distinguishing whether RTA's in Jamaica are, in fact, accidents or unconscious actions, or both.

63 Psychoanalytic studies have also explored psychological motivations linked to automobile accidents by focusing on character types. Tabachnick (1976) references the historical work of Dunbar (1943) and Alexander (1949) and their consideration of the "action-oriented" individual as Persons who had multiple accidents as people who were quick, decisive, active, impulsive, independent and adventurous. They made up their minds quickly and moved towards immediate rather than long-range goals. Their interest was social rather than intellectual and they were casual in regard to emotions. Their reactions to illness were bravado, fatalism, or a play for secondary gains. (Tabachnick, 1976, p. 51) In a study of male driving victims of single-occupancy car crashes, Tabachnick identified subjects as falling into either a depressed group or one that was action-oriented. During his interviews with the depressed group, the subjects presented with key symptoms, including a feeling of emptiness, a desire for withdrawal from life activities, self-hatred, and higher use of alcohol. Thus, Tabachnick hypothesized the possibility of subjects being partially suicidal or "courting death" when driving. Whereas the actionoriented group accounted for 80% of the subject sample. Common characteristics of this group were independence and disinterest in interpersonal relationships, or defense against needs and dependence on others, as well as poor adaptation to transitional, adult responsibilities and the possible anger over impending object loss. Additionally, the subjects preferred to engage in activities alone, demonstrating impulsivity and behaviors centered around physical activity.

64 Ultimately, Tabachnick (1976) posits that there is little difference between the depressed group and the accident type, as both groups eventually become passive, which he describes as a "death trend" opposed to Freud's "death instinct." Specifically, "a death trend is a phenomenological construct that both the depressive and action-oriented type succumbs to, as contrasted with Freud's death instinct which is a motivational force" (p. 61). In both groups, Tabachnick underscores how the automobile serves as an instrument for a withdrawal from the external world. He posits that driving indulges one's narcissism, especially in single occupancy situations when the indulgence of escape and freedom are self-focused. He also views the internal security of the car as a womb, which starkly contrasts the raw exposure and unrestricted freedom of riding a motorcycle. Perhaps this contrast highlights an inability to fully accept internal security, which may contribute to risk-taking behaviors that jeopardize these internal objects and the self. Michael Balint (1959) analyzes levels of thrill-seeking activities, including "games of chance, either offered openly as such or slightly camouflaged as games of skill, the chances being usually heavily loaded against the player and the prizes offered hardly worth the stake" (p. 20). In Jamaica, for example, a recent trend involves local bikers engaging in high-risk road practices that include riding with their eyes shut or without headlights. This behavior is linked to "bike-riding gang" initiations, in which "males have found an outlet where they can be men among men" (Masters, March 7, 2018, para. 3), representing an enactment of cultural masculinity in the face of loss and power deficits (Butler, 1995), and a conscious decision to push the boundaries of safety, despite the risk of severe injury or death.

65 Baliant (1959) further posits that many who choose to engage in thrill-seeking behaviors are individuals who perceive the world as untrusting, where there is an inequality between a person and a dominant environment, paralleling the experience of societal inequalities, both internal and external, of the oppressed other. Therefore, thrillseeking behaviors, such as aggressive and unsafe motoring, are an attempt to escape from an ambivalent and conflictual internal world and ultimately deny a painful reality. Thus, the vehicle represents both a conflicting sense of security and risk, as such thrills offer an avenue for managing internal aggression and anxiety, with the need to bolster an ego that is not yet fully mature (Baliant, 1959). Grumet (1989) explores the euphoria of speed but also queries whether the "motoring experience may also awaken other phylogenetically ancient impulses, replaying less pleasant struggles from the evolutionary past: needs for power, control, dominance successful defense of territory and opposition to those who challenge us" (p. 22). Similar to Balint (1959), he argues that the external action of motoring is a coping strategy to escape dangerous internal processes. In courting danger through counter-phobic adventures of speed and recklessness, he is able to keep repressed deeper fears of weakness, inadequacy, femininity, vulnerability, or longings to be passive, to sleep, or to die, by acting out his conflicts on the roadway and thereby keeping access to consciousness limited. (Grumet, 1989, p. 23) However, one might also consider that aggressive motoring is not only representative of "fleeing" internal dangers. Instead, aggressive motoring may also serve as an unconscious desire to eradicate the internalized colonial other through the obliteration of

66 legal parameters and the destruction of the Western ideals that are represented in material items such as the automobile.

Trauma: Psychoanalytic Theory In this section, trauma theory is utilized as a frame to comprehend the psychological impact of both acute and chronic trauma on the phenomenon of RTA culture in Jamaica and the disuse of road safety practices. As illustrated in the literature, the trauma of colonization is a historical experience embedded in the psyche and replayed in contemporary Jamaican life. The road traffic accident crisis is a literal vehicle for trauma, but one that presents an opportunity for prevention through a sense of individual agency and action. This invites a query as to why one consciously chooses or unconsciously engages in an action that has an increased risk of psychological trauma through injury or death. What is the perception of mortality and the value of life in Jamaica, and how do historical and contemporary events influence the psyche's ability to process and cope with trauma? Although ample literature on trauma theory is available for understanding its correlation with unsafe behaviors, it has not been applied to the specific inquiries of this research project. Trauma is a concept that has been widely and loosely used throughout the world and in the psychoanalytic community. As a result, it becomes at risk of losing value and substance, thus impacting an accurate understanding of and ability to treat trauma effectively. This is not a recent concern, as Anna Freud (1967) lamented the abuse of the term, recognizing the need for psychoanalysis to narrow its use for effective interpretation and analysis. For example, in the United States, many people express

67 feeling 'traumatized' by the current political scene and racial injustice, while others feel 'traumatized' after committing an erroneous social media blunder, or there are those who describe experiencing trauma after witnessing or surviving a near-death event. Psychoanalysis more generally understands trauma as when one's ego functions become paralyzed as a result of a sudden, unexpected and overwhelming event that cannot be integrated or mentalized (Krystal, 1978), with a clear separation between the traumatic situation and the subsequent traumatic responses (Freud, 1920; Furst, 1967; Krystal, 1978). Psychoanalytic trauma is not a gradual process, but a disarming subjectively experienced "situation" that results in psychic disorganization and a sense of helplessness (Freud, 1926; Krystal, 1985). The traumatic event may be acute and sudden or chronic and historical, but the psychic impact of the affective experience is always subjective. In Freud's development of psychoanalytic theory, he cemented trauma and its sequelae as critical psychological phenomena. Freud's ideas on trauma shifted somewhat during his early theorizations, vacillating between emphasis on external traumatic "situations" or internal stimuli. During his work with Brueur on The Studies on Hysteria (1993-95), Freud asserted that neurotic symptoms were a result of repressed memories or "reminiscences" of traumatic events that were too painful for the mind to access (Krystal, 1978; Van Der Kolk & Van Der Hart, 1991). Freud then took a slight theoretical detour with his theory of infantile seduction, positing that his patient's neurotic symptoms were actually compounded by earlier repressed experiences of childhood sexual abuse. Despite eventually acquiescing that not all children are sexually abused, Freud remained steadfast in his overriding belief that trauma and its complexities could not be understood solely

68 based on internal or external factors but must be analyzed together in order to grasp the subjective experience of trauma and its consequences (Furst, 1967). Freud began to focus on two theories of trauma, the "unbearable situation" and "unacceptable impulses" (Krystal, 1978, p. 85), as avenues for understanding psychic reality and affective responses to traumas. When traumatic 'situations' overwhelm the ego, he found that the defensive response was a repression of the stimuli and their affect. This process resulted in the conversion of unconscious affects into neurotic behaviors known as trauma neuroses. Freud (1917) further pursued this concept with the stimulus barrier, describing the ego as coated in a type of defensive shield to protect against a "multitude" of "intense" and overwhelming stimuli (Krystal, 1985, p. 137). Once this barrier is penetrated, the ego becomes incapacitated and powerless to process the stimuli, thus rendering the subject unable to cope effectively with the traumatic event. Often with trauma, one's ability to cope can be informed by the response in the surrounding environment and the exposure to past traumatic events. This study invites the opportunity to better understand how Jamaicans perceive trauma and explore coping processes with regard to how past and present culture and environmental factors influence the types of defenses utilized to navigate trauma or potentially recreate it. As indicated, trauma can be both acute and chronic. For Freud (1926), acute trauma occurs when a person encounters a live traumatic event for which he is unprepared, such as witnessing a sudden and tragic road accident, resulting in the aforementioned intense experience of helplessness and disequilibrium of the psyche (Krystal, 1978). During the acute encounter, Freud identified two types of anxiety responses: automatic and signal. When danger is unanticipated, the stimuli generate an automatic, unconscious response.

69 Whereas signal anxiety occurs with conscious awareness of the dangerous situation, enacting defenses to protect oneself from the traumatic event. However, Krystal (1978) found: While it is possible for the traumatic event to be averted, the individual will nevertheless, be significantly affected by the state of the strain. Ego strain not only leaves the individual with symptoms, but because of the ego changes and residual rigidities, it diminishes the freedom of choices for future protection of trauma and may thereby constitute a predisposition to traumatization. (p. 88) Exposure to dangerous and threatening stimuli may cause long-term erosion of one's ability to successfully employ a range of defenses, leaving one vulnerable to future traumatic situations. This underscores the necessity for understanding the Jamaican perception and experience of unsafe road practices when the likelihood of trauma exposure is a routine way of life. As such, one must consider whether road traffic accidents even register as traumatic experiences. The sequelae of trauma result from an inability to tolerate the affective response generated by the traumatic situation, potentially creating affective disturbances throughout the lifespan. These sequelae are informed by how a person can adapt, cope, and make meaning of the traumatic experience, often resulting in disturbances that interfere with an individual's present-day cognitive, relational, and perceptive capabilities (Krystal, 1985). A significant differentiation is between infantile trauma and the sequelae of trauma in adults. Infants, in their immaturity, experience trauma somatically due to their inability to distinguish affect states. Krystal (1985) outlines the developmental path towards achieving affect utilization as "differentiation, verbalization, and desomatization"

70 (p. 134), which may become stunted when a primary parent is inadequately attuned to the infant's primordial needs. With this said, one must not lose sight of how cultures vary in child-rearing practices. A primary parent is not always available in Jamaica, which does not constitute trauma. However, the summation of infantile and collective traumatic experiences and characterological patterns are what contributes to adult capabilities for cognitive and perceptive affects of experiences to become conscious. Krystal (1985) coined the term "catastrophic trauma" to describe an adult response to an unavoidable danger, shifting from signal anxiety to a sense of helplessness so overwhelming that the outcome is a complete psychological surrendering, potentially resulting in psychic death. He describes it as a shift from numbing to when All known mental functions are progressively constricted, including evaluation of one’s self and environment, conation, judgement, associations, scanning, symbolization, abstraction, integration, and the rest. According to this conception, psychic trauma results from a certain perception, evaluation, and affective reaction to a given danger of inner and outer origin. (p. 136) This process is a passive, defensive response to an intolerable subjective experience of trauma and unbearable anxiety, inviting exploration of whether engaging in unsafe road practices in Jamaica represents a passive, psychic surrendering when continual trauma is a reminder of inevitable death. Or, does vulnerability and unbearable anxiety from chronic exposure to dangerous stimuli result in a detachment or dissociation from normative death anxiety, which acts as a signal for threatening situations? Conversely, aggressive road practices may represent an effort to control one's internal and external world to disavow fears of annihilation and anticipatory anxiety. Death is

71 inevitable for us all. However, when the odds increase of having one's life cut short due to being immersed in an environment relentlessly impacted by chronic violence, there becomes a conscious resignation to death. In Tolleson's (1996) study on the psychic role of violent gang life on Chicago's male inner-city youth, she found that chronic exposure to deadly violence resulted in unsafe behaviors that challenged death as an adaptive coping defense for managing anticipatory anxiety. Specifically, chronic exposure to deadly violence resulted in a "counterphobic leap" into danger due to the youth's belief that they would die young (p. 190). Baliant (1959) posits that the environment may actually encourage aggressive behaviors by celebrating the individual's subsequent destruction. Not only is the individual allowed to give free rein to his aggressiveness, but—and this is equally important—he is rewarded for it, his aggressiveness is accepted and approved of by his environment even though it is broken up and destroyed in the process. The less anxiety and inhibition the individual feels, the more aggressive or destructive he can be; the more efficient is his performance, the higher is the prize awarded. (p. 20) Therefore, one may argue that unsafe road practices in Jamaica are not a passive surrendering to trauma, but an aggressive means of achieving the omnipotence necessary for managing the vulnerability of life and the terror of death. Prior to Freud, Janet (1907) had already begun to pave the way to understanding trauma by recognizing how an acute, traumatic event could trigger a dissociative, subjective experience. He examined the memory system, which allows for integrating

72 new experiences and the ability to understand the experience through meaning make schemas. With acute trauma, Janet found that: Under extreme conditions, existing meaning schemes may be entirely unable to accommodate frightening experiences, which causes the “memory” of these experiences to be stored differently, and not be available for retrieval under ordinary conditions: it becomes dissociated from conscious awareness and voluntary control. When that occurs, fragments of these unintegrated experiences may later manifest recollections or behavioral enactments. (Van Der Kolk & Van Der Hart, 1991, p. 427) Janet posited that acute traumatic experiences became embedded in the psyche and the body but may not become linked to existing mental processes. As a result, the experience is unarticulated, which Van Der Kolk (1987) labeled "speechless terror," or may further result in the numbing of affect, dissociation, and withdrawal. Again, in understanding the Jamaican experience of trauma, this research project will examine whether overt, unsafe road practices, in some instances, behaviorally represent an enactment of what cannot be consciously processed and verbalized. Additionally, do aggressively unsafe road practices generate the experience of feeling alive when one's internal world feels devalued and deadened? Although responses to acute traumatic situations vary, Freud (1939) highlighted the complicated dynamic between the ego's need to disavow conscious awareness of the traumatic stimuli while also engaging in the process of repetition compulsion in an effort to master the traumatic experience. Attempts at mastery are an effort to reformulate the traumatic experience and develop a sense of security and invincibility through

73 omnipotent control. Mastery serves as an avenue for recuperation, as do various effects of trauma that might appear incongruent with present-day situations. Appreciably, these effects offer a link to understanding the traumatic historical experience. Freud argued this type of recuperation to be a critical process for a splintered ego to heal and negotiate a safe way of coping with the external environment. While in Inhibitions, Symptoms, and Anxiety, Freud (1926) revisited the idea of repressed memories and conceived that what cannot be recalled is ultimately repeated in the present, which may lead to self-injurious behaviors or suicide such as both overt and passive unsafe road practices. Balint (1959) suggests that continual repetition of past traumas, or trauma neurosis, through the engagement of thrill-seeking behaviors is a sustained effort to conquer oneself. Thus, omnipotence defends against a conscious awareness of internal and external trauma. Conceivably, unsafe road practices in Jamaica may be assessed as thrillseeking behaviors that represent an unconscious attempt at mastery, which is necessary to cope with unmet needs and repress fears of alienation and annihilation. Internal conflicts, such as internalized racism or identification with the aggressor, in collision with presentday environmental traumas, may also generate behaviors with a greater opportunity for fatalities and physical injury. Chronic trauma is especially relevant to this research project, as Jamaica is a country that has been literally and figuratively shackled by both historical and present-day trauma. Chronic traumatic situations are created by man, enveloping the individual with repetitive, ongoing exposure to dangerous and life-threatening situations, with the Holocaust representing one of the most analyzed examples in psychoanalytic literature (Bettelheim, 1943; DeWind, 1968; Hart, 1994). The experience of slavery and

74 colonization exemplify a culmination of acute traumatic situations, expanding into years of chronic, inescapable environmental trauma. With chronic trauma, the objective is to survive by developing the ability to psychologically accommodate dangerous conditions (Bettelheim, 1943; DeWind, 1968). Moreover, these accommodations may have long-term implications for changes with regard to identity, defenses, and personality, eventually becoming familiar and a 'normalized' way of life (Freud, A. 1967) and are often irreversible ego defenses (Grubrich-Simitis, 1981). As a result, individuals with chronic trauma exposure can present with overstimulation in response to aggressive impulses or little reaction to imposing threats (Freud, A. 1967, Grubrich-Simitis, 1981). This has been evident during my visits to Jamaica when people might casually discuss violence and witnessing death while presenting an affective response similar to discussing a benign topic. As with the unfathomable atrocities of the Holocaust, a multitude of traumas ensued during colonization, with death and physical suffering the most visible and inescapable measures (De Wind, 1968). Daily, the colonized were forced to confront death, endure physical depletion and emotional humiliation. The experiences of chronic trauma are often somatically encoded, which leads to a greater likelihood of behavioral enactment of the traumatic event. Therefore, once a situation familiar to the original trauma is experienced or triggered, a re-enactment is likely to follow (Van Der Kolk & Van Der Hart, 1991). Continual exposure to trauma may also evoke defenses that impoverish the cognitive perception capabilities necessary to prevent disruptive affective responses. Krystal (1985) noted that "A particularly effective "stimulus barrier" in individuals who do not respond

75 emotionally to threatening situations may be due to a case of developing affective blocking (or "numbness"), which makes them "cold," aloof, or unempathetic" (p. 152). This passive response may be correlated with difficulties in relationships and expressions of empathy, perhaps also negating the emotional experience of grief associated with chronic loss. Additionally, it may result in a perception that one does not regard how his behaviors, such as unsafe road practices, may have severe and deadly consequences for others. As touched upon in the section on colonization and psychoanalysis, the trauma of colonization embedded itself in the psyche of the colonized subject, altering one's identity and demoralizing the self. In instances of the Holocaust and colonization, identifying with the aggressor became an active ego adaption and defense (Freud, A., 1936; Bettelheim, 1943). This defense differed from the passive "catastrophic" trauma, or what Stern (1953) described as a "catenoid reaction" (Krystal, 1985, p. 135). Blum (1987) highlights how identification with the aggressor acts as "an anxiety-relieving protective function, restoring to the ego a sense of power and mastery” (p. 616)—again, arguing that the reality of the traumatic situation becomes modified to allow for possible recovery. Furthermore, Blum posits that "the mobilization of the person's own internal aggression and punitive tendencies is also very important. Pointing to the angry attacker, traumatized patients may defend against awareness of their rage" (p. 615). Thus, identifying with the aggressor provides an outlet for unconscious aggression. Temporality is also an intrinsic component of chronic, sustained trauma. DeWind (1968) emphasized how the enslaved live in a fragmented world where the only reality can be in the here and now. He cites this as the need to live in the "immediate place and

76 time" as "no tomorrow exists." In reference to the Holocaust, DeWind delineates that upon a prisoner's release, chronic trauma exposure restricts one to remaining in the present tense, as the idea of future and death are intertwined. Whereas, Grubrich-Simitis (1981) stated, "After years of sheer survival from one day to the next, the future could no longer be conceived of as an extended time to be filled meaningfully. Time was frequently experienced as standing still" (p. 424). The issue of time not only impacts survivors of chronic trauma but has an intergenerational effect as well, which will be further addressed in this literature review.

Trauma and Its Effects: Jamaica’s Present Day Culture of Violence In present-day Jamaica, violence remains a way of life in many communities. As a country, Jamaica is ranked the second for highest homicide rates world-wide, with 57 out of every 100,000 people murdered annually (Pariona, January 9, 2020). This is a remarkable statistic considering the country's small size, which inhabits just under 3 million people. The chronic exposure to systemic violence for many reinforces the fragility of life and yields a bleak outlook on future possibilities. Per Cohen (1985), "Existing wishes are destroyed and the capacity to destruct wishes impaired. Traumatized individuals can neither exist as they were nor imagine going on, in some cases, die" (p. 169). The frequency, duration, and intensity of sustained trauma and an arrested fantasy life conditions one to live in the here and now. Perhaps, this correlates with the aforementioned 'present-oriented' individuals who engage in high-risk driving behaviors (Zimbardo et al., 1997) or speaks to the use of action-oriented defenses for the ego to contend with a chronic trauma history (Krystal, 1985).

77 When examining childhood trauma, the focus is frequently placed on the child's environment for coping w trauma and recovery with specific attention on the role of parenting and attunement (Tronnick, 2007; Wallin, 2007; Winnicott, 1969). Still, it is imperative to reiterate that practitioners and researchers do not pathologize behaviors from differing cultures by assuming a Western lens. In Jamaica, a household may function differently depending on the needs. Essentially, one cannot assume that upbringing and parental patterns are neglectful if necessary to provide for their families (Thomas, 2011). For example, it is often common for one parent to leave Jamaica for Canada or the US to provide for their families back home. Children are also often sent to live with different family members to receive certain provisions and care. Therefore, this study will not assume a bias toward ideas of attachment as trauma. Therefore, this study will not assume a bias towards ideas of attachment as trauma. Additionally, I do not want to pathologize different cultures where people are perceived as violent. Rather, as Thomas (2011) emphasizes, the focus resides with Jamaica’s structural violence and its effects. In a study of Jamaican adolescents exposed to chronic violence in both urban and rural communities, Bailey (2011) found that those in lower-income communities experience early and chronic exposure to violence, which the youth described as "shootings, machete attacks, rocks, etc. . . . stabbing, chopping" as a part of routine life (p. 168). Unfortunately, in Jamaica, many such incidents occur not only in the community but in the school environment, negating that location which is often viewed as a safe refuge. Jamaican youth attempt to be identified as "bad and tough" to cope with the violence and earn respect from their peers. However, many adolescents reported attitudes of either

78 "stoicism" or "depression," questioning the value of life, and experiencing desensitization as a way to cope with chronic trauma exposure (Bailey, 2011, p. 169). An additional study examining the relationship between Jamaican masculinity and violence (James & Davis, 1995) found that chronic exposure to community violence was "linked to a ubiquitous sense of pessimism and hopelessness among both urban and rural youth" (p. 97). In keeping with Bailey's (2011) findings, aggression is utilized to achieve respect and self-confidence, especially from peers. Seeking identification as the "bad man" creates an avenue for establishing a sense of power and dominance amongst chronic trauma and mimics the criminal "dons" in the community who have perversely come to symbolize money and power. Further findings underscore attitudes of police mistrust concerning their ability to stem violence and legally maintain order. Thus, this study reinforces the impact of chronic trauma on attitudes, masculine identification, and the engagement of coping strategies that may cause additional risk of injury or harm. In one sense, chronic environmental trauma becomes "not experienced as events in life but as life-defining" (Bollas, 1987, p. 111). Finally, in Becker's (1973) formative book, The Denial of Death, he writes of "heroism" and the unconscious need to justify the value of one's life, all to deny the fear of death. He presents denial as a response to universal terror in a world in which the social is filled with symbols and measures. Balint (1959) also described the heroic positioning in the face of danger. Rather than shying away from potential or impending death, there is a "turning towards the approaching danger, facing it in order to watch it, keeping away from objects that offer false security, standing upright on his own" (p. 38). In a dangerous world not only of physical threats to mortality but also of inequality and

79 internalized racism, this defensive process allows one to disavow the pain of unimagined wishes and the shame of internalized inferiority and unmet needs. Thus, the theme of heroism is relevant to this research study about understanding how behavior, such as unsafe road practices, in the face of chronic exposure to violence and loss, may, in fact, be adaptive.

Trauma: Mourning and Melancholia The concept of trauma and mourning is significant to this research project with regard to alienation and identity, particularly when considering the loss of one’s culture and homeland. Hart (1994) describes the experience of forced exile from the homeland as an example of bereavement affecting life on multiple levels, including culturally, familial, and personally, noting the loss of an expected pattern of life and the freedom to dream of future possibilities. The additional experience of bereavement in these circumstances is one of loss within a situation of pervasive loss, and in a context where both external and internal resources are severely depleted, so that the sense of self is already threatened, and in a state of increased vulnerability to further trauma. (p. 228) Compounding the experience of loss was the inability to openly acknowledge or outwardly grieve, as this was prohibited due to the severity of the consequences. As a result, this generated further alienation and led to a denial of the emotional response with defenses such as psychic numbing and dissociation. Davis (2007) further recognizes the psychic magnitude of the “loss of a secure base or nation and a perceived motherland” (p. 180). She suggests “that for descendants of slaves

80 born in the Caribbean, the literal and symbolic motherland concept was a psychological protector from the historical abuses of slavery” (p. 186). In many respects, the loss of one’s homeland parallels a loss of self, resulting in a split identity between an old identity and a newly assigned one, reinforcing alienation and limiting the opportunity for healing. Additionally, the inability to grieve these traumatic losses and experiences during imprisonment often resulted in the displacement of mourning onto the children and future generations (Hart, 1994). In Freud’s Mourning and Melancholia (1917), he theorizes that melancholia is the inability to successfully mourn a lost object. As a result, the object is absorbed by the ego and becomes a narcissistic identification. Freud posited that lost objects may not only represent loved ones but could represent the loss of country, as “mourning is regularly the reaction to the loss of a loved person, or to the loss of some abstraction which has taken the place of one, such as one’s country, liberty, an ideal, and so on” (p. 243). The ego development becomes structured around these lost objects, and these objects contain “the history of those object choices” (Freud, 1925, p. 29). The conflictual relationship with internalized objects may ignite hatred and sadistic feelings, which complicates matters as the object has been internalized. As a result, the melancholic person often experiences a low sense of self-regard and may behave in a manner that unleashes and projects a hatred towards the self, even suicide. While Freud pathologized melancholia, Eng & Han (2000) presented an argument for depathologization with regard to racism and group identifications. Their writing is relevant to this literature review as they argue that racial melancholia should be conceptualized as a “conflict” rather than “damage.” They do not view melancholia as an

81 individual pathology but a social conflict that requires “communal” mourning that is “intergenerationally shared” (p. 693). The hope is that communal mourning will assist in identity and psyche reparation, making the ego whole. However, if there is no room to complete this on a social and political level, reactions through violence and reenactments continue, as it is hard to align the lost object with good objects when confronted w a constant traumatic social world. As discussed previously, the inability to adequately grieve the multiple losses sustained from colonization, both intrapsychically and externally, is often passed forward intergenerationally. Chronic traumas can form a collective experience, impacting the psyches of subsequent generations, especially when continuing to brush up against the residue of past trauma in contemporary life. Gordon’s (2011) paper further explores the intergenerational transmission of unmourned trauma with second-generation holocaust survivors. Specifically, he argued there is “an inherited failure to mourn and consequently the unawareness of time passing, the lack of self-agency, and the absence of a personal narrative” (p. 365) and connects this paralyzed state in time as the basis for the repetition of past traumas in contemporary life. A lack of narrative or memories is passed down to future generations who enact the memories without the history (Gordon, 2011; Eng & Han, 2000). Therefore, the achievement of mourning through Klein’s (1940) depressive position allows for acknowledging past trauma, the mourning of colonial history and a racial ‘ideal,’ and recognizing one’s separateness from those experiences for future generations.

82 Melancholia and The Abject

Finally, melancholia and the abject are relevant to this research project to further understand the connection between the psyche and the body, as the literal corpus bears the consequences of internal motivations. Oliver (2007) presents a discourse on ‘social melancholia’ by applying Kristeva’s (1998) position that the self may be left in a psychic space of depression, isolation, and emptiness after internalizing the maternal abject love object. Social melancholia addresses the loss of a lovable self as an object or “not the loss of a loved other but the loss of a loved self that causes melancholy; and it is not the incorporation of the loved other but the incorporation of the denigrated self that leads to self-abnegation” (p. 89). Essentially, the internalization of abject racism and oppression replicates the depressive psychic space, and a further alienation Oliver argues is the colonization of psychic space. Kristeva’s (1982) theory of abjection centralizes the symbolic importance of the body and the ego and the ultimate anxiety: death. The abject beckons unconscious fantasies of repulsion and anxiety that assist in forming early experiences of negative subjectivity and identity development (Hook, 2012). As described during the introduction of this research project, it is common for many Jamaican citizens to share and post videos of accident scenes and the dead or dying. Janet (1907) also posited that dissociated experiences cannot be verbalized but are acted out through the lived experience in a postcolonial world of ongoing inequality. Perhaps, the draw to witnessing death, destruction, and maimed body parts strewn across Jamaica’s roadways, is to come face-to-face with one’s fears and anxieties of internalized degradation and oppression. The process of witnessing may also serve as a psychic purge of sorts, a catharsis, as what was once always ‘of me’ then becomes ‘not me’ (Chisholm, 1992). Unconsciously courting death through unsafe

83 road practices allows the ego to attempt to control, confront, or expel the abject from the body, thus establishing a sense of boundaries around the self. Another consideration of the abject is whether accidents are fetishized. In Malater's (2007) analysis of Cronenberg's 1998 movie Crash, he explores the perversion of emerging oneself in a place of collective trauma. In Jamaica, this is everyday violence, including deadly road traffic accidents. He states that: Perversion on the social level is based on a collective will to reinforce the disavowed of the traumatic through the creation of a social fantasy in which the presence of traumatic rupture is erased. Just as trauma is disavowed, so too are the traumatized disavowed; they can turn to only to others similarly shunned, forming connections that are caught between conflicting wishes to both enact and deny forbidden mourning. (p. 894) It seems the perversion or the lure of psychic trauma repetition allows for a disavowal of vulnerability and the horrors of death while visiting a crash site may also allow one to symbolically connect with unconscious trauma that cannot be verbalized. Witnessing from outside the immediate trauma is a means to regain control and walk the boundary line between reality and fantasy, or self and disavowed otherness. The act of witnessing, the expulsion of the abject, and the use of bodily powers to achieve an internal sense of safety and control will be considered when exploring the lived experience of unsafe road practices in Jamaica.

84 Summary This chapter presented an in-depth review of literature relevant to understanding the meaning of road safety practices in Jamaica. A historical overview of Jamaica's colonial history and current statistical data on Jamaica's RTAs underscores the motivation for this project. While broad, this literature review incorporated an examination of multiple components of comprehension on a topic that has not been qualitatively investigated. Ideas on psychoanalysis and its relationship with colonization and socio-political and cultural constructs in Jamaica provide avenues for locating subjectivity and identity in both a historical and contemporary context. A psychoanalytic examination of motoring collides with social positioning and the illusion of status, reinforcing unconscious conflicts with internalized racism and an inferiority complex. At the same time, trauma theory offered a frame for discerning the various affective experiences and subsequent sequelae of trauma. Highlighted are the impact of intergenerational trauma and the role of mourning in the reparative process. In all, this research project aims to further understand how the participants experience and comprehend road safety practices, especially regarding identity, behavioral motivations, and mortality.

Chapter III

Methodology Introduction This qualitative research study utilizes an Interpretative Phenomenology Analysis (IPA) (Smith, Flowers, and Larkin, 2009), grounded in a hermeneutic epistemology. This project aims to develop an in-depth understanding of the subjective meanings of road safety practices in Jamaica while illuminating the lived experience of a small sample of Jamaican citizens. Research on psychological and socio-cultural factors that influence attitudes towards safety practices is well suited to a qualitative study. A naturalistic approach to qualitative research is one of the many orientations that has the “ability to transform the world” (Creswell, 2013, p. 44). Creswell cites Denzin and Lincoln (2011) when he defines qualitative research in part as: a situated activity that locates the observer in the world. Qualitative research consists of a set of interpretive, material practices that make the world visible. These practices transform the world. Qualitative researchers study things in their natural settings, attempting to make sense of, or interpret, phenomena in terms of the meanings people bring to them. (p. 44)

86 In order to comprehend the complexity and nuances of meanings ascribed to different cultures and ideas, qualitative research presents a richer uncovering of such unique phenomena, which a quantitative study would be unable to capture adequately. The literature review highlights that research on the crisis of RTA’s in developing countries consists primarily of quantitative studies, which focus on statistics supporting the argument that RTA injuries and fatalities constitute a public health crisis. These quantitative studies provide useful data specifics on the types of accidents resulting in death, concrete prevention measures, as well as subsequent ramifications on community resources. While the argument for ongoing and strengthened safety policy and a need for behavioral change may be evident, the absence of research seeking to explore the psychological and cultural attitudes towards road safety practices leaves one to speculate why many Jamaican citizens are not heading or implementing safety practices outlined in country-wide road safety campaigns and laws. Thus, a qualitative study offers an opportunity to address this underdeveloped research with greater depth. This qualitative research project also sought to give voice to those who are historically marginalized. By presenting the personal story of this phenomenon in developing countries, a voice is given to the Jamaican experience. In this same vein, qualitative research is mindful of the potential power differentials between the researcher and subject. This differential is especially relevant in this research project as this researcher is Caucasian and from the United States, underscoring an acute power differential between resources and opportunity. However, qualitative research strives to “empower individuals to share their stories, hear their voices, and minimize the power relationships that often exist between a researcher and the participants in the study" (Creswell, 2013, p. 40). This

87 researcher's goal was to use the value of empowerment as a fundamental element woven throughout this research project.

Methodology This study imparts an Interpretive Phenomenological Analysis (IPA) methodology. Per Smith, Larkin, Thompson (2009), “IPA synthesizes ideas from phenomenology and hermeneutics resulting in a method which is descriptive because it is concerned with how things appear and letting things speak for themselves and interpretative because it recognizes there is no such thing as an uninterpreted phenomenon” (p. 8). Van Manen (2007) finds the reflective power of this method as a passionate study driven by the fascination of understanding the human experience with the world. To engage in such a practice, he eloquently states: Not unlike the poet, the phenomenologist directs the gaze toward the regions where meaning originates, wells up, percolates through the porous membranes of past sedimentations - and then infuses us, permeates us, infects us, touches us, stirs us, exercises a formative affect. (p. 11) This appreciation for the unique beauty of the subject and his position in the world is entirely appropriate when stepping into a different culture. This study attempted to virtually amerce itself within the culture of Jamaica in a quest for a greater understanding of the lived essence of the discussed phenomenon. IPA aims to give a voice to and make sense of ones lived experience by allowing the participants’ narratives to reveal deeper meanings, as “human beings are sense-making creatures, and therefore the accounts which participants provide will reflect their attempts

88 to make sense of their experience” (Smith, Larkin, Thompson, 2009, p. 4). IPA is more concerned about common processes than the cause and is rooted in the philosophical notion of “being” (Heidegger, 1962). Larkin and Thompson (2012) describe its idiographic origins in that meaning is derived from a “person-in-context” level, focusing on the particular details of a specific participant rather than on generalizations. IPA is a dynamic methodology where the researcher assumes an active role that cannot be reduced to mere objective interpretations. Due to the culture-specific focus of this study, IPA gives voice to the participants in a manner allowing the person-in-context to be best represented. Per Smith and Osborne (2007), IPA is “a two-stage interpretation process, or a double hermeneutic” (p. 53). This process essentially posits that the researcher is intrinsically intertwined with meaning-making, a process that coincides with the participant’s attempts at making meaning of his/her world. A hermeneutic epistemology lends itself to research that is “interpretative and concentrated on historical meanings of experience and their developmental and cumulative effects on individual and social levels” (Laverty, 2003, p. 15). Hermeneutics is a collaborative process between the subject and researcher in which local and internal meanings are interpreted. Unlike empirical studies, hermeneutics does not seek to discover truth about the studied phenomenon. Rather, it is grounded in the philosophy that there is no universal truth to be known, which is critical to differentiate from the subjective “truth” rooted in one’s unique, individual experience. There are differing philosophies on how to approach the interpretative process. Husserl introduced the theory of transcendental phenomenology, in which the essence of an experience was discovered by suspending or “transcending” one’s assumptions.

89 Whereas Heidegger argued that transcending one’s assumptions is futile, as a person cannot be separated from his world. Such strong emphasis on the worldly and embodied nature of our existence suggests that phenomenology is a situated enterprise. This position is often called hermeneutic phenomenology, to emphasize that, while phenomenology might be descriptive in its inclination, it can only ever be interpretive in its implementation. (Larkin and Thompson, 2012, p. 102) Gadamer (1975) further explicates that truth is never fully realized as experiences are subjective, and interpretation is ever unfolding, or “essential to an experience is that it cannot be exhausted in what can be said of it or grasped at its meaning” (p. 61). He found understanding as a process concurrent with the actual event in which one is attempting to find meaning. The researcher is situated in the moment of meaning-making and cannot separate or bracket one’s history, preconceived values, and social location. Thus, foregrounding becomes critical to recognize the inevitability of researcher bias and its existence in the interpretative process. Gadamer states that when listening, we are not neutral and must not “forget all our fore-meanings concerning the content and our own ideas” (p. 281) so that it is the subject’s truth that becomes revealed. Finally, IPA methodology has been particularly relevant to studies on public health, as it has been a valuable tool to delve into the inner world of medical patients (Hong and Dos Santos, 2017). Although this study did not strictly focus on participants who have been physically injured in an RTA, the participants were all impacted, if not directly, then indirectly, by simply being community members. The mere fact that RTA’s have essentially become an epidemic in developing countries places this study under the

90 umbrella of public health. As such, the objective of developing a deeper understanding of the lived experience of the participants provides insights beneficial for enhancing preventative programs.

Research sample. The sample size for an IPA study may vary, but Smith, Flowers, and Larkin (2009) write that the idiographic approach of IPA and the detailed case-by-case analysis that it requires is best suited for small samples. A small sample was conducive for this research project, as it is an international study. Although no longer conducted overseas due to COVID-19, time and economic factors remained important variables that impacted the number of participants this researcher was able to interview. The proposed goal was to achieve a sample size of six to eight participants. Ultimately, eight Jamaicans, five males and three females were selected and agreed to participate in this study. The age of the participants ranged from the mid-20s through the young 50s, with a median age of 33.25. Smith, Flowers, and Larkin (2009) emphasize the necessity of achieving a purposeful, homogenous sample, while Creswell (2013) describes this element as "essential" when studying the lived experience of a particular phenomenon. For this study, the Jamaican culture and phenomenon of exposure to RTA's serve as the homogenous element, while purposeful sampling provided the opportunity for a sample with diverse perspectives and experiences. Thus, all participants were Jamaican citizens and from the island, a necessary parameter to capture the lived experience of the Jamaican culture authentically. Creswell (2009) underscores the importance of purposeful identification of interviewees and the location for interviews as well. He writes that qualitative research

91 promotes new knowledge to be unpacked in a natural setting, situating the data in context. Although the COVID-19 pandemic restricted the possibility of conducting this study in the natural setting of the participants' home country of Jamaica, this deviation did not decrease the opportunity for rich layers of data. The goal was for both participant and researcher to be ensconced by culture with limited artificial intrusions. Through this researcher's familiarity with the island and by hearing the local sounds and obtaining vivid descriptions of the participant environments at the time of the interviews, this researcher believes that conducting the study via distance still yielded impactful results. In order to make sense of and interpret the narratives of the participants, they had to be able to articulate their lived experiences descriptively and authentically. Therefore, participants unable to grasp the concept of unsafe road practices or who struggled with communication were excluded from this study. It was expected that participants would at times speak in Patois, the national dialect of Jamaica, which this research welcomed. However, due to my limited ability to speak Patois, participants were required to have the capacity to share their stories and translate their use of Patois into English. Thus, potential participants unable to converse with this researcher in English were also excluded. Despite the literature revealing that many Jamaican RTA deaths are pedestrians (WHO, 2018), this study focuses on the lack of exercising safety precautions when operating a moving vehicle, car, or motorbike, which excluded those who are strictly passengers or pedestrians. Therefore, initial inclusion criteria required that participants be at least 18-years-old and hold, or have held, a motorcycle or automobile driver's license. Research and statistics also indicate that the majority of RTA fatalities occur in men

92 between the ages of eighteen and thirty (WHO, 2018). However, this research sample was open to both men and women, as women are also emotionally and physically impacted by this phenomenon. The hope was that female participants might offer an additional perspective invaluable to the study, exploring the possibility of gender differences in motivation for unsafe road practices. Additionally, the age of participants was not limited to the range with the highest accident rates in order to expand the sample pool and gain various perspectives. Finally, inclusion criteria required that participants also know, directly or indirectly, of at least one person who has been injured or killed from an RTA when riding a motorcycle or vehicle, or the participant has been injured herself. Individuals who have actively engaged in road safety programming or campaigning for any community organization or government program were excluded from this study. A benefit to conducting this study virtually was the ability to sample participants from across the island, providing the opportunity to speak with those who live in rural and urban communities. Thus, sampling was not limited to one specific Parish. Initially, this research was to be conducted in the centrally located Parish of Westmoreland, which is the location of the Seven Mile Beach in Negril, a popular location for tourists. Of consideration was that with most tourist zones across the island, the government is conscious that these locations are safe, as many tourists are active pedestrians and make use of local transportation. Tourist zones, such as Negril, also attract locals from other Parishes who commute to or have relocated there for employment opportunities, resulting in a high concentration of motorcycle riders and taxis that transport both locals and tourists in the region. Finally, Westmoreland is the Parish where this researcher has

93 family through marriage, which created a greater likelihood of securing participants from this community. As a result, the Parish of Westmoreland did serve as a base for locating participants, but by not restricting the research to one location, a broader and diverse range of perspectives was achieved. This research project utilized a snowball sampling method in conjunction with purposeful sampling. Creswell (2013) refers to this type of strategy as chain sampling. Essentially, this method is when, based on knowledge of the topic and community members, a selected participant identifies and refers additional potential participants with the belief that they will provide rich data on the research topic (Smith, Flowers, & Larkin, 2009). This type of sampling proved to be invaluable, as trust established with one participant opened the door to three others. This researcher was also aware that having a partner from the community may assist in developing trust and conveying a sense of cultural awareness despite being from outside the culture studied. This was confirmed to be an advantage, as four of the participants were casual contacts of this researcher's husband, who met the participation criteria and were open and eager to speak with me. A potential weakness of snowball sampling is the opportunity for the confidentiality of participant identities to be compromised, as community members or participants who make referrals have a greater likelihood of knowing whether someone chose to participate in this study. This is a variable beyond this researcher's control, so clear boundaries regarding confidentiality were established once a referral was provided and a participant was selected. For example, all referring participants were made aware that dialogues between the researcher and participant are confidential, whether or not the referral agrees to participate in the study. Information gathered during the interviews

94 would not be shared with anyone other than the participant providing the data and the research committee, regardless of the relationship between participants. Notwithstanding, this researcher acknowledged the research participants right to share information about their involvement with other family, friends, and community members. This was not an issue that negatively impacted this study. Finally, this was a voluntary study, and participants were informed that they might withdraw from the study at any time. As with any research project, the risks that may impact participant motivation for joining the study were considered. These risks included any personal relationship this researcher may have with an individual making referrals. One possibility was that potential participants might agree to join the study to please or not disappoint the referring individual. This researcher assessed this risk when discussing voluntary participation in an effort to avoid this conflict. An additional risk with any study is that participants may be inclined to volunteer due to the financial incentive provided at the end of each interview. This researcher was aware that this motivation might increase participant interest because of pervasive poverty in Jamaica. Therefore, with careful consideration, forty dollars per interview was chosen as an appropriate incentive, based on financial implications in Jamaica and the significant value of their time and unique perspectives. All participant rights, requirements, and potential conflicts were outlined in the consent form provided, reviewed, and signed, primarily through verbal consent, before the initial interview. Verbal consent was necessary as several participants did not have access to a printer to sign manually. (Appendix A)

95 Research design. This IPA (Smith, Flowers, and Larkin, 2009) study utilized face-to-face, semistructured questions, in which all interviews were audio-recorded and subsequently transcribed by a professional transcription service. Each participant was interviewed twice for 60-90 minutes. Due to the international nature of this study, interviews were conducted over the phone from the United States to Jamaica. The expensive cost of obtaining cellular data service for many participants essentially prohibited the opportunity for face-to-face communication via video. The inability to observe facial cues and, at times, poor cellular service provided the occasional moment of interruption or cross-talking during interviews. Cross-talking was acknowledged to minimize any miscommunication or concerns regarding social or cultural etiquette, and requests for clarification were made when necessary. Despite the loss of non-verbal communication, the opportunity for balancing moments of reverie during interviews with acute attention to verbal intonation and emotional expression provided thick data. The research project commenced with the data collection phase once the proposal and research design were approved by the Internal Review Board (IRB). After IRB approval, initial screening was conducted on the phone via the application WhatsApp, and a script detailing the project goals and participant/researcher expectations was read and emailed to each potential participant for review. (Appendix B) Prior to the first interview, each potential participant was asked to clarify their understanding of the project, motivations for participation, and to provide basic demographics relevant to the study. Informed consent was reviewed a final time (Appendix C). Again, due to the majority of participants not having access to a printer, this researcher contacted the IRB chair and

96 was approved to obtain verbal consent and then sign the consent and date it on behalf of the participants unable to provide signature. Research questions aimed to initially explore the broader purpose of the study, followed by sub-questions that generated a more specific inquiry (Creswell, 2013). Semistructured questions allow gathering thick data by utilizing a more conversational approach to the question-and-answer process. (Appendix D) Therefore, it was critical for rapport and trust between researcher and participant to be developed throughout this interactive process. Smith (2009) believes that the “Interviewing process allows the researcher and the participant to engage in a dialogue whereby initial questions are modified in light of the participants’ responses, and the investigator is able to enquire after any other interesting areas which arise” (p. 57). Thus, this questioning style gleaned additional insights and queries to enrich the data. Analysis of the data immediately after each first interview provided an opportunity for member checking. This step invited the participants to review the researcher’s understanding and interpretation of what they had said so that they may voice any concerns and to ensure that they felt the data accurately represented their responses. It also allowed this researcher to ask clarifying questions and any additional questions developed post-interview. Memoing and reflective journaling provided ongoing opportunities for critical thinking and also assisted in developing follow-up questions prior to the second interview (Creswell, 2009). Finally, all data is confidential. Because Jamaica often feels like a small community, aliases did not feel adequate to prevent the possibility of subject identification. Instead, gender and specific client data were obscured, such as employment, parish, and family

97 details. After the data-gathering phase, participant contact information and transcripts are placed in secure, locked files on both the computer and in a file cabinet for five years, after which data will be destroyed and deleted (Alase, 2016).

Data collection. Potential research participants were initially contacted by secure telephone messaging utilizing WhatsApp technology. At the time of initial contact, participants' email addresses were gathered, and they were sent a script with a brief introduction of the research project, followed by informed consent. The introductory script included the research project's affiliation with ICSW, the study's goal, the type of participation sought, basic tenets of informed consent, and what the participants could expect in exchange for their time (Appendix B). The follow-up script invited participants to share their understanding of the purpose of the study, key definitions, why they are interested in the study, and an understanding of informed consent to the best of their ability. When necessary, potential participants were encouraged to ask clarifying questions as well. Participants also provided general demographic data as part of the initial screening assessment. This data included age, gender, whether they have had experience or exposure to a road accident(s), type of transportation utilized, number of years holding a valid license to operate an automobile or motorcycle, as well as a general understanding of operational definitions of road accidents and safety practices. Again, this data was necessary to assess qualified research candidates (Appendix D).

98 Once participants were identified, informed consent was reviewed over the phone at the time of the first interview. The interviews began after the participants agreed and verbally consented to participate in the study (Appendix A). This researcher requested that participants select a safe, comfortable location for their interview that had few distractions, good cellular service, and promoted confidentiality. There were a few occasions when interviews were interrupted by the weather elements, dropped cellular service, local music, or a young child in the home. However, those moments provided opportunities for casual discourse that furthered understanding of the participants' environmental context and strengthened feelings of comfort and trust. A benefit to interviewing via the phone was the economic savings with regard to location and expense of transportation for both this researcher and participants. Nonetheless, this researcher did incur the expense of the international calls, concluding that it would be more economical to conduct a future study in person if using a methodology requiring a more significant number of participants and interviews. As discussed previously, semi-structured, in-depth, face-to-face, individual interviews were held for 60-90 minutes with 8 Jamaican citizens who met the inclusion criteria. Participants were provided with a cash incentive of forty dollars per interview in exchange for the generosity of their time, which they received via MoneyGram after the interviews. Following each interview, participant responses were transcribed through a secure transcription service. Transcript data was then analyzed for emergent themes and the development of additional questions that may be useful for clarifying data.

99 Data analysis. Data was analyzed through an interpretative lens, following the guidelines of qualitative IPA research as outlined by Smith, Flowers, and Larkin (2009). After accumulating the data, Pietkiewicz and Smith (2014) recommend listening to the audio recordings and reading each transcript several times, creating an opportunity to "step into the participants' shoes" through total data emersion (p. 11). During and after the interviews, memos and reflections were reviewed to illuminate additional perspectives to attain "rich, detailed, and reflexive" narratives. Specifically, Smith, Flowers, and Larkin (2009) write that the analysis of data utilizing an IPA methodology "involves flexible thinking, processes of reduction, expansion, revision, creativity, and innovation. As such, analysis is open to change and it is only 'fixed' through the act of writing up" (p. 81). They further outline the aim of interpreting qualitative data as developing "an organized, detailed, plausible, and transparent account of the meaning of the data" (p. 104). The engagement in the above approaches in data analysis serves to capture the essence of the lived experience and provide more profound levels of understanding. Following the outline provided by Smith, Flowers, and Larkin (2009), each transcript was coded line by line. Emergent themes were identified, and once revealed, each theme was placed into distinct data clusters, establishing connections and patterns. Due to IPA's commitment to the idiographic process, each case was fully examined before moving on to the next case (Smith, Flowers, and Larkin, 2009). This process served to respect each participant's narrative, providing the opportunity to approach the next case with a mindful openness to a new analytical experience.

100 Finally, the data was interpreted by applying postcolonial and trauma theories. Pietkiewicz and Smith (2014) advise that "The researcher should be careful, however, when applying theories developed in one setting (e.g., western culture) to explain phenomena from a different one" (p. 11). Thus, this researcher continuously assessed theoretical relevancy and strove to identify the appropriateness of data in context.

Ethical Considerations Ethical considerations are of concern with any research project that utilizes human participants. Therefore, a primary objective is to protect the human subject from ethical hazards that may lead to the emotional compromise of the participants. It is critical that boundaries regarding confidentiality are enforced and an awareness of cultural variables that may present ethical challenges. For this study, ethical considerations of culture include sensitivity to differing viewpoints and social norms and an awareness of the privileged power position that this researcher holds and unconscious assumptions that this may create for the participants. This research study invited participants to share their personal stories and experiences with RTA's, which required a degree of vulnerability. There was a risk that revisiting such experiences may lead to feelings of emotional discomfort or distress. Thus, participants monitored for any shifts in emotional functioning, and this researcher was ready to provide immediate support if emotional distress became evident. As highlighted in the consent, if a participant felt unable to continue with the interview for various reasons, including emotional discomfort, they could choose to skip a question or elect to stop the interview and cease participation. In preparation, a therapeutic resource was

101 identified in the community for additional participant support if any emotional distress were to continue beyond the scope of the interview. Fortunately, this resource was not necessary.

Issues of Trustworthiness This research project conveys trustworthiness through this study's credibility, dependability, and transferability. In qualitative research, credibility is of the same vein that validity is in quantitative research. Specific to IPA, various therapeutic techniques were drawn upon to assist in portraying the essence of the participants' lived experiences as accurately as possible. These techniques include reinforcing the safety of the research 'space' so that participants feel comfortable speaking freely and honestly. Participants were also asked clarifying questions throughout the interviews to ensure an accurate understanding of the data provided. Finally, this researcher acknowledged the participant's expertise on the subject matter and encouraged them to impart cultural education when necessary. Creswell (2013) discusses the ways interpretative approaches to qualitative research lend themselves toward validations. He references Angen's (2000) writings on two specific types of validation: ethical and substantive. Ethical validation means that all research agendas must question their underlying moral assumptions, their political and ethical implications, and the equitable treatment of diverse voices. Our research should . . . raise new possibilities, open up new questions, and stimulate new dialogue. Our research must have a transformative value leading to action and change. (p. 248)

102

Conversely, substantive validation takes into account the researcher's understanding of the topic being studied and self-reflection (Creswell, 2013). Bloomberg and Volpe (2012) underscore the necessity of ongoing self-reflection as one of the various forms of ensuring research credibility. Of significance is the bias that each researcher brings to her study. In order to prevent biases from intruding on the participant data, ongoing reflection was recorded in the form of memoing and journaling. This process allows the researcher to identify when bias issues may have impacted the lens through which the participant data is understood. For example, this researcher took into account her Western values and education when listening to the views of others from their differing world perspective and Jamaican background. Bloomberg and Volpe (2012) also highlight the importance of a lengthy engagement in the field being studied. Therefore, an in-depth understanding and appreciation of Jamaican culture were necessary for this research project when gathering and interpreting the participant data. This researcher has a moderate history of exposure to rural and urban Jamaican life through relationships with in-laws and locals. However, in terms of ethical validation (Creswell, 2013), this researcher is respectful that exposure is vastly different from residing in or being raised in Jamaica. Therefore, "prolonged involvement in the field facilitates a more in-depth understanding of the phenomenon under study" (Bloomberg and Volpe, 2012, p. 113). There must not only be an appreciation for cultural differences, but comfort with the national Jamaican dialect, Patois, was also critical so that credibility may be captured.

103 Multiple methods of gathering data assist in ensuring credibility. This study utilized member checking to allow this researcher to account for the intrusion of biases and the accuracy of participant portrayal, as well as enriching the credibility of the findings. Dependability is assessed through detailed explanations of the data collection and analysis processes. As Bloomberg and Volpe (2012) note, these detailed accounts are to qualitative research what statistics are to quantitative research. This process was assisted by valuable feedback and discussions with research committee members. Lastly, issues of transferability relate to the clarity of the study so that it may be replicated during future research, whether it be in Jamaica or a new region or country impacted by the topic studied. Transferability is obtained when the researcher can provide "thick" descriptions of the data. Such descriptions are necessary in qualitative work, especially when conveying another person's lived experience, as the reader must feel connected to the time and place of the material. Bloomberg and Volpe (2012) eloquently describe this process as creating a "shared" or "vicarious" experience. For this particular study, the reader must be able to feel the nuances of the Jamaican culture and identify that as the foundation of understanding the participant narrative. Ultimately, the success of transferability is gaged by the ability to generalize the process to any culture, setting, or community.

Potential Limitations This research project is an international study where distance limitations can become an obstacle when conducting research abroad. As highlighted, the issue of travel can create time constraints and additional expenses that an international study requires.

104 However, the COVID-19 pandemic eliminated these potential barriers by forcing a redirection of the study’s location. The shift in location from in-person to virtual increased the likelihood of available and consistent research participants, as there were no time or transportation constraints, but technology resources may also have ruled-out participants who might have previously joined the project in person. Nonetheless, this study required participants who were willing to discuss a topic that could trigger painful feelings, which could potentially impact the number of participants open to engaging in the study. In closing, it is essential to revisit that this researcher is a Caucasian female from a different country and culture, which had the potential to pose limitations based on participant assumptions about this researcher and conscious and unconscious Western biases that I may bring to the study. When appropriate, awareness, sensitivity, and direct acknowledgment or exploration of these differences were crucial actions in ensuring the success of this study.

105

Chapter IV

Findings Introduction This interpretative phenomenological research project aims to develop an in-depth understanding of the subjective meanings of road safety practices in Jamaica by interviewing eight Jamaican participants: five males and three females with a median age of 33.25. The narratives of their lived experience were obtained through sixteen interviews, two per subject, providing over eighteen hours of recorded data, and the analysis of this data has generated the findings outlined in this chapter. Again, this study does not seek to discover truth but instead offers an interpretative lens to glean knowledge about the research questions posited in this project. For the purpose of confidentiality, the participants gender identities and names are concealed. Although Jamaica is the third largest of the Caribbean islands, it can often feel very small with relationships and familiarity spanning multiple Parish. Therefore, identifying details, including the specific Parish in which the participants reside and notable facts about family members and friends, have also been altered to protect participant privacy. Scheduling the interviews was initially a challenging process. Once connected with participants who met the study qualifications, they were provided with several

106 options for scheduling at their convenience. After receiving confirmation of participation, the first three participants did not respond to the scheduling options despite gentle followup requests. It was recommended by this researcher’s husband, a Jamaican, that the participants be given one time and date for interviews with no additional options. Directly assigning interview calls without account for participant convenience felt unnatural and overly assertive, but it was successful, resulting in immediate responses and confirmation of interview dates. This strategy was applied to all future scheduling. However, the data will reveal that the process of assigning interviews is paradoxical, as a segment of Jamaica’s culture is resistant to authority and laws, which is especially evident regarding high-risk road practices and the desire for control over one’s behavior choices.

Description of Research Participants The research sample for this study consisted of eight Jamaicans, including five males and three females. There are some connective factors among participants. All participants reside among two neighboring parishes with both urban and rural communities. Three are independently employed in the taxi business, either via motorcycle or car, and a fourth participant is engaged in farming. Another participant works in the healthcare industry, while the remaining three are employed in the private sector. The participants’ formal education varied, with six ceasing education after high school and three extending their education into University. As will be discussed, participants identified a lack of education almost unanimously as a critical factor contributing to high-risk road practices, especially among Jamaican youth.

107 In terms of road usage, three of the participants ride motorcycles for either work or personal use, while the remaining five drive personal cars for commuting to work, as a tool of employment, and for personal use. All subjects agreed that road safety practices are necessary and shared the personal precautions they implement when driving or riding as a passenger. Each participant has known of or witnessed a road traffic accident (RTA) that resulted in death or severe injury. Five participants described having been in traffic accidents, one that resulted in moderate injury and another in severe injury requiring the ongoing need for medical monitoring. Several participant reports of exposure to RTA’s during the interview process were significant. Specifically, one participant witnessed an RTA on the day of the second interview, while two others observed RTA’s the day prior to their second interviews. A fourth participant witnessed a motorcycle RTA resulting in death shortly after completing the interview process. These incidents are separate from the RTA exposure that qualified the participants for the study, spotlighting the prevalence and normalization of this crisis Finally, two participants provided related data through WhatsApp messaging, separate from their interviews, underscoring participant engagement with the material. In one instance, a participant shared a recorded conversation with an agitated friend who recounted his experience of just being in an RTA while riding in a taxi. After completing both interviews, another participant sent this researcher photographs of a deadly motorcycle accident. One photograph was of a young man lying on the road, unnaturally contorted, dead, and resting in his blood. The research findings of this study will reveal that such tragic RTA’s are routine, if not a daily part of life in Jamaica.

108 Introduction to Qualitative Categories Analysis of the research data revealed two overarching themes: Jamaica, a culture of sustained neglect and poverty, and culture of unprocessed trauma. Jamaica remains an island with significant disparity and oppression (Shim, 2018). Of course, there are areas with people and opportunities for great wealth, but the opportunity for upward mobility and breaking the cycle of poverty remains a rigid divide between classes. Upon reviewing each participants’ interviews, discussions on road safety continually circled back to themes of inequity and chronic trauma, thus creating tension between expressions of Jamaican pride and feelings of hopelessness in an oppressive culture. “Pride” and “respect” were keywords threaded through each interview. These are common descriptors of the people in Jamaica and a part of their regular vernacular. These terms grant even the most impoverished people momentary acknowledgment of their value as humans and the shared experience of being Jamaicans. However, the societal trend towards achieving image and status by showcasing material goods, such as a car, and high-risk behaviors to demonstrate power and obtain respect, has directly impacted the attitudes and values in Jamaican culture. In this effort to achieve an identity of which to be proud, or momentary status and recognition, the value of life has become secondary. This cultural shift has become imprinted on the psyche of many, especially the “younger set,” and is directly relevant to incidents of unsafe road practices and the high number of RTA’s in Jamaica. Under the umbrella of the two leading themes are several categories and subthemes. The findings presented in the sub-themes may overlap at times but will ultimately weave together a cohesive story illustrating the cultural and psychological impact of chronic,

109 sustained oppression and trauma. Conversely, this study underscores how unsafe road practices perpetuate the cycle of trauma, the devaluing of self, and feelings of oppression for the Jamaican people. Essentially, high-risk road practices mirror significant cultural areas of concern, including issues of safety and violence, trust, identity, education, poverty, and toxic masculinity.

Theme One: Road safety: Attitudes and perspectives.

Subthemes:

1. Mixed beliefs 2. Jamaicans are the best drivers: Attitudes and gender 3. Trust: Protect yourself for survival 4. Keeping others safe: Responsibility and modeling

Theme Two: Image, status, and out racing poverty: The importance of being seen.

Subthemes:

1. Heroes and leaders 2. The hype 3. Poverty

110

Theme Three: Disparity and those at risk. Subthemes:

1. Young, uneducated, and a present tense mentality 2. Defiance and mental slavery 3. Bribes and vulnerability

Theme Four: Environmental influences and the value of life. Subthemes:

1. Safety starts at home 2. Love is transformative 3. A generation in need

Theme Five: Trauma in the everyday.

Subthemes:

1. Trauma is routine: Desensitization and normalization 2. Social media and re-traumatization 3. Unprocessed trauma and grief

111 Theme Six: Perspectives on mental health.

Theme Seven: Hope: Ideas for Change.

Road Safety: Attitudes and Perspectives

At the onset of the initial interviews, each participant was asked the same question: When you hear the term road safety, what are the first thoughts or images that come to mind? Consistent messaging was that road safety is about people at both the individual (micro) and community (macro) levels. Three participants shared the following statements, “When I think about road safety, I think about people.” “You cannot just think about yourself alone. You have to think about other people that are using the road also.” “The first thoughts and images that come to mind is just people being a lot more considerate and just following the road rules, not speeding, things like that.” These perspectives are ones of inclusion, indicating concern for self and others. However, while these responses represent the values of this study’s participants, the findings will illustrate how their beliefs are incongruent with their description of current feelings of disappointment and hopelessness at the shifting attitudes and values of some Jamaican citizens.

112 Mixed beliefs. Without exception, participants shared the perspective that road safety practices are not only essential but paramount. "Immediately, I think about seat belts, driving at the correct speed limits, obeying the signs, road courtesy." Being cognizant of accidents is a primary factor when using the road, underscoring the prevalence of accident culture in Jamaica. "When you do hear road safety, the first thing that comes to your mind, you think about... Is there going to be any accidents?" As a result, all participants described their consistent efforts to engage in road safety practices to avoid the possibility of sustaining an injury in an accident. Of the participants who drive cars, the majority stated "always" wearing their seat belts. "I can't even start my car without my seat belt…it feels strange" They also stressed the value of this practice, "I've seen instances where the seat belt would have saved lives. Instances where persons are thrown from the car, I'm like, okay, if you were wearing your seat belt, you would not have been thrown from the car." "It does save lives, because if you pull up in a jam, you slam on the brakes, it holds back your whole entire body from slamming in the dashboard." Whereas the focus was on the critical necessity of riding with a helmet and wearing the right gear for motorcycle riders. I stop by the bike stand and I speak to the guys who run the bike taxi in a group. I talk to them. I call them up. I talk to them. I said, "Listen guys. You need to wear a helmet. One for your passengers. Wear shoes. Don't wear no sandals. Those are not safe. You lose your toes. You break your hands. You mash your head and lose your eyes, and lose your tooth, your lips, and yourself.”

113 Despite positive opinions on the benefit of engaging in road safety practices, participants discussed skepticism held by many Jamaican people regarding safety requirements. Seat belts were discovered as creating the most controversy. For example, one participant referenced how seat belts are commonly referred to as “hanging ropes,” are uncomfortable, and are met with disapproval, while other participants shared stories of how seat belts and airbags can cause injury and possibly death. So, for the seat belt, it's mixed feelings. Some people feel it's uncomfortable, and some people feel that if you meet in a motor vehicle accident, it can hurt you as much as it can save you. I think you are safer with it than without. But I've seen people died in motor vehicle accident while we're in it, where it was the seat belt that trapped them. Sometimes they are pinned, and the seatbelt pull them down and they couldn't get out of the vehicle in time to get to the hospital.

Because most accidents that I think they've [Jamaicans] actually been a part of, is where somebody's spinning down because of the seat belt. So that's what most of them have to say about that. I think a lot of people don't believe in airbags and seat belts. A lot of people say the airbags kill you faster, because most of the time, you meet in an accident and it just come up and hit you in the face, and you're dead.

Most of the time, when I put it [seatbelt] on, they [drivers] just look at me and they shake their heads. A lot of them say it's better not to wear it than wear it.

114 Although the above quotes illustrate conflicting messages about the benefit of seat belts, the need to wear appropriate motorcycle gear, such as helmets and closed-toe shoes, is met with minor controversy. Participants who ride motorcycles value these practices, but the reality is that many Jamaican motorcyclists are less likely to utilize safety practices. One participant denied the cost of equipment as an issue but pointed towards an attitude, while another emphasized the bike as a means of being seen. They're [bike helmets] not really that expensive, but a lot of people just don't care. A lot of people, they see their friends doing it and they see the older people doing it, riding without helmets and stuff. A lot of the younger generation just came up and did the same thing. A lot of people, I'm not going to say a lot of people. We, as Jamaicans, we tend to just do with what we have. And if we have a bike and we don't have a helmet, and we just got on some slippers or whatever, and we need to go somewhere, we're just going to go. None of us are perfect. But a lot of times, you find that we have these things, we can afford these things, but yet we don't take the precautions to actually, get them or wear them.

A lot of Jamaicans, I see the cars trying to do a lot, but they're [motorcyclists] not trying to do a lot. A lot of them are just, yeah, for one, they're not wearing helmets. Two, they're riding bikes in shorts. They're riding bikes in slippers. They want to be seen. They want to be seen on the bike, in the slippers, clean, wearing some nice brands, wearing some nice clothes.

115 In connecting real-life tragedy to the lack of exercising basic safety precautions, one participant who works in a hospital setting estimated that the percentage is “80/20” of accident victims brought to the hospital who did not wear helmets or seat belts, noting that men without helmets represent the majority of the victims. Therefore, messaging on road safety is either not adequately conveyed, or dominant cultural beliefs and the desire to identify with a particular image overshadow the value of safety measures and ultimately, the value of life.

Jamaicans are the best drivers: Attitudes and gender. Many participants spoke of the Jamaican attitude that they are superior drivers as a motivation for not utilizing road safety practices. Notably, this defiance also serves as a denial of risk. A narcissistic defense creates an illusion of control where one’s vulnerability may be experienced as invincibility. Jamaicans don’t like helmets and seat belts. They feel uncomfortable, they say... I don't need no seat belt, I'm not going to get in no accident, man. Most Jamaicans feel like they're the best drivers in the world and they're never going to get into an accident, so they don't need seat belts.

As a passenger, you could just offend a driver just by putting on your seat belt. The minute you put on a seat belt, he's like, what, you think I cannot drive, man? I'm like, “yo, bro, I'm just used to having my seat belt on. It's no offense to your driving. You can drive.”

116

In some cases, all right, a person looks at an accident and like, "How did that happen?" Because even I do it, I'm like, "How in the world did this person end up here?" When you see an accident scene, you're like, "What?" The calculations are so off. And then, when I hear somebody saying, "That could have never happened to me." This person is not a driver, this person cannot drive, because if they can drive then they would not have done this or that, you understand? Despite the posturing of superior driving, attitudes, and ego interfere with exercising basic road safety practices. Regardless, many Jamaicans will not heed the advice or respond to tragedy by changing their behaviors. What they [Jamaicans] think is that everyone thinks they're the best rider or they think nothing is going to happen until it actually happens. It might change the person who making the accident, but the rest are still going to go faster. I've seen a situation where not only one situation, many at times where someone died from a motorcycle accident. On the funeral day, another friend died from speeding and acting crazy on a bike.

A lot of people are in hurry and it's like their mentality, they think that nothing is going to happen. And the world is going to be smooth until they actually pull up in this accident or the situation, they're like, "Shit." Excuse my language, they're like, "Wow." And start panicking, when it's already gone bad.

We have a saying down here [Jamaica], we have drivers, but a lot of people on the road, they just steer. They're not drivers, they're just steerers. A driver will see

117 something on the road and know that that is going to cause an accident and actually slow down or intervene. You know what I'm saying? . . . but a lot of people are just steerers. They just know to steer the vehicle, but they're not drivers. They're on the road, but they're not thinking. Gender is a variable when considering attitude, image, and the importance of road safety practices. With the exception of one male participant, women were identified as safer drivers, primarily due to being mothers and obeying the speed limit. Implied was a nurturing quality that translates to women taking fewer risks. Because a male will come into your car, as a woman, and he will say, "Oh my god. I am driving with a woman driver. That's so good." Because a woman driver doesn't try to overtake anywhere and tries to take fifteen minutes to reach there than five minutes to reach there. So, they are more competent.

Women, I believe are a bit more safe, because, oh, it's maybe it's just the natural nurturing aspect of a woman. We are less risky when it comes down to certain things because of the safety aspect of it. Even most of the women with children, they can be a little more safe. However, most participants perceive male attitudes regarding driving superiority and the subsequent resistance to safety measures as an issue of concern. This attitude aligns with the Jamaican image that men are tough, and thus, utilizing road safety practices may interfere with this portrayal. Per one participant, "Every Jamaican feel like they're "bad bwoy", they're a "shotta.” You know? It's in our culture. That's been embedded from the culture, like I'm a "bad bwoy." This attitude of being a superior driver, or "the best,"

118 again, is a narcissistic defense against acknowledging vulnerability in the face of daily RTA tragedies and of one's social position. It may also serve as a manic defense against the traumatic awareness of death. Male attitudes were also described as contributing to aggressive driving. Specifically, female participants spoke of awareness and personal experience of female drivers being bullied by male drivers. Sometimes the male driver try to dominate you as a female driver. The male taxi drivers out run the female. They believe that because they are a man, they should get that passenger. Sometimes I would have to say, "Oh my god." Men have this thing to say, "Woman don't know how to drive." But woman know how to drive, men don't know how to drive. Because they drive reckless. Men are more reckless. You have to be careful about them.

Oftentimes, the culture in Jamaica is that women, they always say women don't know how to drive and women aren't courteous on the road. But a lot of times they (men) bully the women on the road. So, some woman now starts being defensive in their driving, because they are bullied on the road.

They'll [men] scream at you, "Get off a di road, yuh cyah drive," or "Yuh buy yuh license." They talk down to you on the road as a woman, or they'll make comments. Like you'll be in a taxi and somebody does something that seem way off or a mistake, and then him say, "Ah bet ah wah ooman." You know, stuff like that. They're kind of sexist when it comes to driving.

119

Sexism is a part of Jamaican culture, as is increased violence towards women (Serju, 2021). The above attitudes illustrate how Jamaican male aggression is also reflected in aspects of unsafe road practices.

Trust: Protect yourself for survival. Trust and survival are pressing concerns for the Jamaican people in multiple areas of life, including road safety. Threaded throughout the interviews, the message was that one could not depend on others nor trust them to make decisions in one's best interest. Defensive driving, a positive driving capability, is employed to avoid accidents when using the road. Several participants discussed the importance of taking measures to protect themselves at all times. Sometimes you don't have to see what's coming, so you have to always try to protect yourself. Don't wait for someone to protect you.

I don't fear hitting in someone's vehicle, but I fear someone hitting in my vehicle. Because I know unless it's some mechanical error, then I won't be hitting anyone's vehicle because I'm always seeing the road.

Going on the road daily is a gamble, because things happen even persons who do the best practices on the road, things can happen. And that is what you call an accident. I drive like I'm the only person with a sense. And when I say with sense, I mean with a proper knowledge of how road is supposed to be used. Right? So, I drive but I drive

120 for me and another person. Right? I just pretend that the other person does not know what they're doing, or they're just a first-time driver, or whatever. Three participants spoke unequivocally about asking taxi drivers to stop and let them out when feeling unsafe on the road. Based on earlier statements of Jamaican selfproclamations of being the “best” drivers, this practice reinforces the necessity of selfreliance. If I'm riding with you, you cannot drive without your seatbelt as in, if you're the driver and I'm the passenger, you have to put on your seatbelt, and I won't allow you to drive reckless with me. So, if I'm taking a taxi, I've done this numerous times, and the taxi is being all lawless and reckless, I just ask them to stop. I just take an early leave because I value my life. I don't want to die. So, stop and take another taxi.

If I'm traveling in a taxi and it's going fast, and I tell the driver to slow down. I need him to slow down. I tell him to stop and I get out. If I tell him to slow down and he didn't slow, I'm stuck in the car and I'm getting off. But I'm not going to let him kill me or anything. So that's it for me. One participant even encouraged this researcher to exit a taxi when feeling unsafe during future visits to the island. At the same time, another participant asked and was surprised to learn that this researcher had a prior experience feeling unsafe in a Jamaican taxi. This participant is in the business and does not view taxis as a primary cause for RTA’s, unlike two participants who were more direct in their criticism of taxi drivers, indicating that they regard customers as currency. A lot of people like taxi, bus operators, they think of passengers as money. They think

121 of them as just money, so when they're driving, they drive reckless. If you value a life and you value yours, you wouldn't be driving like that. This perspective alludes to the value of money over human life, thus reinforcing the need to be vigilant. Additionally, this discussion established a correlation between hypervigilance, chronic stress, and exposure to trauma.

Keeping others safe: Responsibility and modeling. Participants who drive spoke of the responsibility of enforcing and modeling safe road practices for their passengers. Emphasis was placed on an awareness of the fragility of life and a personal mission to positively impact the community through safety, which serves as an avenue of empowerment and control in the face of high-risk road practices in Jamaica. It’s a personal decision that I make that I should be safe and that the other persons in my vehicle. I'm responsible for them. So, whatever it is that I do, if I'm going to wear my seatbelt, for my safety, then why not have them wear their seat belt for their safety?

Once you are traveling in a car, it starts from the driver. From the driver put on his seatbelt automatically, the passengers are going to, everyone in the vehicle automatically going to feel for the seat belt, once the driver. So, I think it start with the driver.

122

Responsibility and acute awareness of protecting the lives of passengers was especially evident among taxi drivers/riders. One taxi driver makes a conscious choice to take fewer safety risks, such as riding at high speeds when using the road alone. “When I’m riding myself alone, I would ride a certain way. When I’m riding with someone else, your life is in my control, so I have to make sure I take you safely to your destination.” Another participant reiterated the grave responsibility of protecting another life when in a position to do so. You have to learn how you're supposed to operate on the road. As a taxi driver, it is even more demanding on us more than the person. Because we're carrying the life of people. Those people are in our hands. We’re responsible for the life of those people that we are carrying. A sense of pride and purpose was conveyed when discussing their jobs in the taxi business, fostering a valued sense of self, which is critical for recognizing the value in others. Two participants confidently shared road safety perspectives, speaking pointedly about their knowledge of “the road code” and their desire to benefit others in the community through teaching moments. Just today I was driving then this young kid, he did a wheelie, and he was standing on the bike. Standing up. I'm like, wow. And I drove down to him as his bike down, and I said that's cool and all, but you can wear your helmet. And he said, yeah, you right. You just hope that one day somebody just listens, you know what I mean? As will become further evident in the findings, the lived experience of teaching moments in many participants' personal lives provided moments of feeling cared for,

123 valued, and nurtured. When such models are lacking, external validation becomes necessary for managing possible unconscious anxiety and fear of not being lovable.

Image, status, and out racing poverty: The importance of being seen.

Image and status are paramount in Jamaican culture. For many, the image created by one's exterior presentation provides a temporary escape from the reality of poverty and oppression. The reward is the achievement of respect and power among peers and in the community. High-risk road practices and the danger of losing life and limb serve as an avenue for attaining recognition from others but also appear to shore up one's internal sense of worth in an environment where lives can at times feel of little value.

Heroes and leaders. One way to achieve value and power is through role positioning or securing one's place in the hierarchy of a social group. Participants' emphasized how the desire for hero status and leadership results in high-risk road practices. In Jamaica, the motorcycle is a tool used for convenience and is also used for self-expression and generating attention. Riding the bike fast and engaging in stunts provides a moment of being distinguished from one's peers. You have these young people, they think they’ll be famous. Jamaican motorbike riders, as soon as they see a large group of people, they want to show their true colors

124 and that's the time when the motorbike is going to show you that true color of it. That's when it's going to put you down.

A lot of people, their attitude is once they get a bike, they want to see how far they can get it to go. For some, it’s personal glory, some it’s peer pressure, and some they just want to show they can do the thing. They can make it go and come back. It’s like it’s some image, to get the bike going fast. You get eyes on you. One factor influencing these beliefs are the limited opportunities for advancement in Jamaica. Thus, the chance to achieve power and respect through high-risk behaviors is a way to make a name for oneself, even if that name is known only among a small community or group of peers. Advancing oneself as a leader and claiming that spot is to be reified, admired, or a source of envy for that period. In Jamaica here, no one wants to follow the leader. Everyone wants to be a leader. And to be a leader and to be a leader in that sense, it's caused a lot of things because, as what I told you before, everyone won't be in the same position of life. So that is one of the things that cause road accidents here and stuff like that. A person who'd say he is a leader, and you have this group of people following and at the same time, someone is there thinking how to get you out to be that leader. When you're the leader you're everything. Becoming the leader is a temporary status with the possibility of critical sacrifices, as status can be extinguished instantly through death. It comes in place where everyone wants to be a star. I should say . . . sorry about a star. Everyone want to be a hero. But to be a hero, it's not really required because most

125 heroes die. If you had a friend of yours, he died from a motorbike accident, as in he was doing a stunt, or he was doing something reckless, I think in yourself, you want to take heed on that to know you don't want to make that same mistake. But, here, what I get to understand with Jamaican people, they think because I made that mistake, my friend or my brother or my cousin, they're going to think they can correct it. They cannot because I already passed away. The above statement conveys a denial of death’s permanency, perhaps to avoid the pain of loss, but the need for attention and conscious hunger for status eclipses the risk. The opportunity for correction does not revive the life lost but provides a distorted method for mastery. This type of mastery may simultaneously achieve two purposes; enactment of the trauma assists in managing grief while also simulating absolute control over one’s destiny in an environment laden with trauma and neglect.

The hype. “Hype” is a term that conveys an action or attitude of the Jamaican people and was used by almost all of the participants. Expressions of hype appear to be a direct conduit to personal worth and values, again, in which the vehicle becomes a tool to gain attention through high-risk road practices. We Jamaican people, you know how we hype. We're very prideful people. We like the glitter. We like the gold. People risk their lives just to shine. Just want to be in the limelight. Just to be feeling like they’re rich or living a lavish lifestyle. You know, everybody wants that. Yeah, because most of us are so poor. But, when they get a chance or the opportunity, they going to take full advantage no matter if they risking their lives.

126 Another participant further emphasized the cultural relevance of hype while disapproving of the risks taken to achieve it. Interestingly, this participant is female, financially independent, college-educated, has an established career, and despite enjoying being seen, the implication was that this type of external validation is not necessary. Persons like to look good in Jamaica. I think it's probably a Caribbean thing, we just have a thing about looking good. So, I just equate that to the hype, or they want to be seen. Then you know, you use that kind of an unnecessary mood and attitude. Persons need to see that you're coming or know that you're coming in you just need to create some attention getting mechanisms. You just do what you feel like you need to do and crash turn your car at the stoplight, but a lot of times I just don't see it necessary for that behavior to be displayed. Hype was also identified as prominent in the younger generation, or “younger set,” a group described as lacking guidance, education, and those who gain attention by engaging in hype culture. It [hype] impacts road safety a lot. Because with hype, a lot of people especially the younger generation, hyping among their selves and trying hold the car right now. They are trying to impress each other. Who can do the thing better? Who can go faster? Who can ride better? Who can drive better, all this stuff. There are competing, the hype thing to go and race, like, "Yo, I beat this guy. I wouldn't let him [win] . . . but not realizing the danger that they can cause on the road. Thus, engaging in the hype through high-risk road practices is an avenue for the younger generation to assert a need to be visible in a world of social media and constant images of excess, regardless of the possibility of tragic consequences.

127 Poverty. In addition to ‘hype,’ poverty was also a recurrent theme when asked to share motivations for unsafe road practices. Participants reflected on the impact of poverty on self-worth and the correlation with high-risk road practices. Sometimes I have to wonder. Why do we behave like that? Because we are so poor? Why we behave this way? It's something I've thought about before. I say sometimes, sometimes I say it. It's because we're poverty, we're so poor. They [Jamaicans seeking attention] have tried to escape from the poverty life that we have. They believe that they should be like that person. So, they will try it and to come up with money and stuff like that to look like that or have that because, they wish to have that. Makes you feel like somebody. Somebody will look at them. Poverty is inescapable in Jamaica. A moment in the former quote, “we’re poverty,” captures the blurred line between how the external environment of chronic lack merges into an internalized sense of devaluation. Poverty is no longer ‘out there,’ it becomes owned as a part of the self, which impacts one’s cultural identity and the lens through which one views themselves in the world. The vicious cycle of poverty also leads to desperation and illegal behaviors. Several participants brought up “scamming,” an ongoing issue in Jamaica where people conduct scams over the phone to score money illegally. Scamming is called “free money” because one does not have to work to get it. This lack of work ethic and responsibility results in an “easy come, easy go” attitude towards material items, such as motorbikes.

128 Unfortunately, this attitude may also translate to a lack of respect towards others and a decreased value of life. It’s all about the poverty. Nobody wants to be broke. And if it is that you would have gone to a place where you would have worked hard for whatever it is that you have, you feel a little bit of pride. But somebody, some pride is expressed differently than others. Some persons are very careful with whatever it is that they would have earned by their sweat and tears, while other persons have this "get rich or die trying" mentality. They want to think that victim broke out of poverty. They would have gotten that little break, and they would say "okay, I'm going to buy a car. When you would have bought that car, some of them want to show everybody that they bought a car. So, the hype comes in after you would have stepped up a notch. The hunger for money to achieve respect and self-value has become a dominating part of the culture rather than caring for thy neighbor, highlighting a shift in values. Overall, as a people, we just need to see the importance of doing something, and not necessarily try to only do it because you've going to make money or you're going to get rich from it or be recognized for it. And I think this is human behavior in general. Most times they just do things because they are either going to get money from it or there's some recognition to it. They're not doing it for the greater good. So that concept of doing it for the greater good must be something that everybody gets onboard with.

129 You can tell the difference between a person that values a life and a person that values vanity. Vanity plays a lot, in a lot of things, because nowadays you find that people prefer vanity than people. They'll kill, they'll fight, they'll do a lot of things just to get what they want. Okay, because they're driving a car that costs a lot, they believe the road is theirs. They don't care about nobody else that is on the road. They're driving a fast car. They do what they want to do. Finally, poverty ignites envy in a culture of limited opportunities for economic advancement, contributing to the aggression and violence seen throughout the island. One participant spoke of inequality and how oppression can impact one’s feelings of safety. Whereas another participant was critical, identifying some as having a victim mentality rather than attempting to better their lives and be productive members of society. Most of the Jamaicans that I know, they have this dog-eat-dog mentality. Everybody wants to get rich and they don't want to work. They don't want to work. The persons who work, they're seen as the enemy. A person like me is susceptible to killing and robbing because I go to work and I have a car and I'm have a nice house, but they don't know that I went to school. That's how it is in Jamaica. It's seen as though some persons are at the bottom and some are at the top, right? Not everybody has the same chance or opportunity. Education here is very expensive.

Definitely [there’s envy]. Because other persons who see themselves as poor, because to me, being poor is a mentality. They don't see it that way or it's in their mentality. They see themselves as poor and they're like, "Oh, look at them over

130 there." They don't realize that you will maximize on your opportunity to make yourself what you are. Everybody has the same 24 hours in a day. I know persons who are deemed from the ghetto and poor, and they're successful. Why aren't the others successful? It's because they sit around and they watch other persons and that's how the killings and the robbing come in because they don't want to work. They see you as better than them. In summary, the findings in this section underscore how issues of disparity, lack, and a need to be seen, directly influence attitudes towards the value of life and fuel high-risk road behaviors.

Disparity and Those at Risk Young, uneducated, and a present tense mentality. Continuing with the theme of disparity, when asked about contributing factors to the high number of RTA’s in Jamaica, multiple participants spoke about the poor education of many drivers, focusing on Jamaicans who are unable to read. Specifically, Jamaicans must read and understand the “road code,” a book encompassing the rules and legal requirements necessary for obtaining a driver’s license. Each participant expressed knowledge of Jamaica’s road code and many revealed concerns with corruption in Jamaica’s system that allows drivers to acquire licenses illegally. Participants referenced the ability to cheat the system, using money as a primary tool to access the road.

I say Non-educated. Because a lot of us, we use money to get through in our country, as in to get our license. So, second on that, after they get the license, they don’t know the road code.

131 The average persons in Jamaica cannot read, as in are illiterate. Yes, they have a driver’s license, because anything can be bought. So, they cannot read. Also, they don’t know what the road signs are. How can somebody not be able to read and they’re driving? I mean, that’s a major part of being able to drive. You have to be able to read the signs.

I’m just trying to give you a background of the characteristics of the individuals who are actually driving. So, I wouldn’t want to say they’re illiterate, they’re not illiterate, but they didn’t go through the whole process of driving for their license. So, when they should have read the book [road code] and know exactly and sit the test and know how to do certain things with their cars, specific things that they should have known in their road code book. When they see the signs, they don’t know what to do. Because they never really studied the book, they don’t really know what it is that the sign means.

The majority of participants also identified youth as the main contributors to RTA’s. Those who fall under this umbrella are primarily males between their teenage and early 20s and were described as lacking purpose and respect. When discussing this group, there was a sense of hopelessness with little optimism for future change. One participant spoke of the “younger set” in the past tense, noting that “For most of them, life’s gone away,” sharing the view of lives without futures, detached from dreams and aspirations. They don’t obey, the younger set. They don’t care. They’re just reckless. The problem is, what I said to you before, they don’t know nothing about road safety.

132 And, I told them, it’s a younger set around 16, 20. They don’t work. They don’t work and go to school. They cannot read. They know nothing. They go to the store. They buy the motorcycle. They do nothing. They ride around and cause havoc. They never learn about road safety, nothing like that. So, you know we’re going to have trouble, because you cannot read, you’re going to do stupid stuff on the street, and cause life [death], and that’s what happened most of the days.

A lack of maturity was also used to explain the youth behavior, hoping that age and experience would lead to a shift in behaviors. All right for the younger generation. They haven't that experience, they don't really understand the road. For them they think nothing is going to happen and peer pressure. Say for example, my friend and I were racing down the street, I beat him. People would be thrilled, generally you're best rider all list of. So, it's like praise getting praised. They would say like, "Yo, mi ride away from dem boyz.” Which means in English, it means, I ride away and leave the rest of guys. For example, the other person who's telling the story with and all his friends would be like, "For real, you're a big rider. You're the best rider and all this stuff. You bike fast and all this stuff." So, it's just to come back to getting praised.

I think it's that they think that they're younger and experienced, and they don't think that they can go fast. I think after a time, like with age, they gradually realize that, whether you go fast or you go slow, you're going to reach where you're at, your destination in the end. So, no need to go fast. And maybe they

133 have a couple of broken bones by then, and they're like, "Okay." Probably they get kids and stuff, and they think that they have something to live for and you got to be more careful. So, it just change with older, with ages.

However, a couple of participants suggested a present tense mentality among those who engage in high-risk road practices, revealing thrill-seeking behaviors. (Balint, 1959) "They're not thinking about losing life. They're thinking about what they're going to do is going to happen and everything will be okay." In comparison, another participant asserted that the concept of living for the moment could become distorted. A lot, I don't believe, think about tomorrow. It's like YOLO [you only live once]. Yeah, that YOLO attitude, and well, when you really looked at it, the Bible says, "tomorrow will provide for itself." So, today the Bible says that, in a sense, but they take it to a different level, or maybe that's just their enjoyment. That's just their attitude, their entertainment, that is just what they see living in. The Bible goes back to say when you're investing you invest in two and three areas, because you don't know what will happen tomorrow, you understand? I'm just paraphrasing but, most of the time, I just think that it is the now. They just think about the now. Present tense mentality and thrill-seeking were not a universal perspective among participants, as one participant challenged this idea. "I don't think it's live for today, I don't think it's peer pressure. Because when you're in an accident, you're crying for another day." Despite this argument, the findings indicate that being in an accident or witnessing an accident does not invariably decrease high-risk road practices.

134

What I find fascinating is that a lot of people don't learn from other people accident. Lots of people learn from their accident, but other people don't really learn from other people accident... So, a lot of people do care, but I think the younger generation just don't understand the road. Not much. They come up seeing people going fast and they just think it's the norm, to go fast. Because I think it's so difficult for police to stop when they're going fast. They realize that the police won't stop them because it's hard. I think they just naturally go fast because of that.

Because here in Jamaica, I'm going to tell you how I see this world. You have a lot of people who're very educated, but with their education, they're still backwarded. Here in Jamaica, we use the word dunce. A lot of them is very educated and they're just dunce in what they're educated with. A lot of them, they are illiterate with their dunceness because if you have the mind and the concept of learning, you would listen keenly to what someone said to you.

Defiance and mental slavery. Participants were asked to discuss their understanding of why certain people choose to engage in unsafe road practices. It was hard for one participant to put into words, "I believe when you're unruly, then you're unruly. It's not like you didn't dress up the right way, but you're just unruly. You just believe you should just do anything that you feel

135 like you should do. Because you don't believe that you abide by the rules." Others reiterated the defiance of rules, and one correlated it with cultural attitudes. Jamaican people do not cooperate in nothing that they do. I would say out of 100, you'll find 80% of them do not cooperate because they said they're not living under anyone. Everyone wants to be their own boss.

And this is the thing where you need to understand Jamaica, as what I told you from day one, Jamaican people are always thinking that everything will always be okay because they're undefeated. Because you people in your country, as in, for instance, the US, the United States, Canada, people from the States, they've grown up in a certain rule where they live by their rule. And when they come to Jamaica here, where Jamaica is a third-world country, they think they don't have to live by a rule.

The need to be one’s boss or perceive their people as undefeated can be correlated with Jamaica’s history of slavery and colonization. Two participants used the phrase “mental slavery” to explain their views on the Jamaican mindset, identifying the weakness of the psyche as creating a susceptibility to engaging in high-risk behaviors. To break from the mental slavery, you have to try to have your mind of own and that's where the problem is. Because it's not everyone have that mindset. The impact is on the younger people because what really happens. For my generation what is coming up, their mindset is not strong like ours. Or even like yours. Their mindset is more fragile so they're easy to hurt as in like, go mental and stuff like

136 that. Yeah. But because our mindset was much, being a few years older than them, you had more things. As in more experience.

Because it's a mindset. When someone enslaved your mind, they can manipulate your feelings because your mind controls the body. That's why I love how I try to change myself because you can't change no one, all you can do is advise them. You can give someone the right idea, the right advice and when they look into it they realize what you did said to them, it was the best thing you ever do. Because mental slavery is something where it already plays with your mind and as well. I told you, if your mind is not that strong you can do stupid things.

Whereas another participant was more direct, associating Jamaica’s history of slavery with aggressive behaviors and defiance of laws. So, the slaves that were brought here were a little bit more aggressive and they would have been fighters. So that tradition or that socialization, I guess, would have left some residues of that, I believe. This is me personally, believing that there is some residue and of course being tough, in a sense, is one of those things. So, the aggression and being tough is something that I believe that would have been a result of the people that came here. And always having to defend themselves, and I guess this is one of the things that causes the aggression towards authority in some spaces.

137 Yes, I think it's [anger] ingrained. It's a black thing. Females in Jamaica too, sometimes are aggressive. It's a black thing, I believe. This resilience, the thing that, "I need to fight for my own, this is mine and I need to get it it's because mine," that's coming from slavery as well. Remember they wanted us apart, and you would have to fight for your food and your this and your that. It just came down, the ideology that, "I have to get this from some persons are set apart and you're up there and I'm the down here and I have to fight for what I want.

[On the influence of colonialism on Jamaican attitudes and aggression towards authority] It is possible, it's definitely something that I would not have ruled out because it is from those things that we are socialized, even though we would have evolved. A lot would have grown a lot away from certain things, there's certain things that still stayed. And then that pride from fighting and being victorious and then independent and all of that. And so again, that pride from independence . . . as I say it may not be a 50% as it relates to the impact, but there is some level of . . . I would not rule it out entirely, there is something.

They're [dangerous drivers] just lawless. They have a lawless culture. Anything that is like an enforcement, they'll try to go against it. So, if the law were to be, don't wear any helmets, they will be wearing it. That's how Jamaicans are. I would say it goes back again from slavery, they don't like anybody being over them, dictating. They don't like it. They like to be free.

138 The lingering imprint of slavery on the psyche and cultural attitudes and a people unprepared for independence underscores how one’s identification as prideful serves as an obstacle towards achievement and change. I think right now, mentally, we are more enslaved than even then. We're more slaves now than back then and when we claim that we were getting our own independence was one of the worst things that ever happened to Jamaica. We would be better off if the British were still in control. Because we're our own worst enemy. You know? Sometimes, you can't be left to run your own show. Sometimes someone else has to, you know? And sometimes, because of your own pride, you won't accept that. And it's not doing no good for you or your people.

The thing is that the people thought they was ready, but they didn't envision our government being like this. Of course, we wanted independence, to say we're running our own show. We're Jamaicans, we shouldn't take no orders from anybody. What I'm saying is this, I think the people, we're prideful peoples to be able to say, we're Jamaica, we're not under no one. I think a lot of people, they like that. But then there's another set of people saying, look, man, I don't care about all that, Jamaica is going to be Jamaica whether we're ran by ourselves or ran by another country.

Ultimately, Jamaicans continue to struggle with present-day oppression and disparity, which intrudes upon an ability to come to terms with their colonial history. Thus, their psyche contends with an inferiority complex passed down through generations, triggering

139 intolerable feelings of lack and dependency. As a result, many Jamaicans are susceptible to manipulation to disavow the colonial other and achieve a sense of personal value through external means, including high-risk behaviors and unsafe road practices.

Bribes and vulnerability. With disparity, many people are left vulnerable to achieving a need such as getting a driver’s license through corrupt means, which has a direct impact on road safety. As a result, poverty and the power of money have created a systemic culture of bribery in Jamaica. When people are poor you can use anything to bribe them. And people are subject to being bribed because they never had much.

It's my country [Jamaica] and I'm not going to be biased. Our country, I realize even when you're well-paid, they're not satisfied. So, they will pay the bribe and try to pass it along. And when they pass it along, you don't know how many lives you leave in danger out here [on the road].

I blame a lot of the accidents on the authorities. For instance, the examiners that should be examining you to get your license. I blame a lot of the accidents on them. I blame a lot of the accidents on the examiners that are supposed to examine these cars, these vehicles, to make sure that they're safe to be on the road. Instead of just thinking of taking a dollar, and not thinking about what it can actually do, like the vehicle is not fit on the road.

140

First of all, Jamaica is a place where as beautiful as it is, it's a dark side when it comes to people taking shortcuts. So, there's a lot of drivers on the road that never even really trained to drive. They paid their way towards their license. So, there is the corrupt system where if you have money, you can buy the way to have your car on the road or just be able to drive it period.

Due to a lack of means, including education and community resources, not just for young people but for anyone who cannot pass the driver’s test, paying bribes to obtain a license becomes a reinforced societal method of achievement. Another participant also expressed frustration at a system that abuses people who try to obtain their license legally. Specifically, it was stated that those who issue licenses would purposefully fail people in order to receive a side payment for giving a passing result. Routine corruption gives rise to a passive community acceptance of lawlessness and cultural unrest in response to inequality. The defiance of laws and a lack of respect for others can be directly linked to this cultural issue and a feeling of powerlessness to break from this systemic oppression. It [corruption] becomes embedded in people's DNA. It gets passed down the generations and generations. So, until they [Jamaicans] see something brighter, someone shows them a different way, I think that we're going to continue to be ignorant towards expanding our mind frame and seeing what life is really worth. But if people just quick to bribe, then they're not really looking at the future and what's best for the country overall. It's like every man for himself mentality and

141 until we try to move as one, as a group, come together with a plan and let them know that we not for it anymore, it's going to continue to be the same.

Stability and trust, the antithesis of corruption and lawlessness, generate a level of emotional security necessary to proceed in the world with an “open mind” to life’s possibilities. Therefore, one’s immediate environment plays a critical role in developing internal and external value systems, leaving many Jamaicans at risk.

Environmental Influences on the Value of Life Safety starts at home. The majority of participants referenced either growing up in a loving home or experiencing support from elders in the community as influential to their values and how they proceed in the world. Highlighted is the importance of having positive figures who take an interest, provide attention, and make time to teach and impart guidance as a significant factor impacting the decision to prioritize safety for oneself and others.

My dad taught me how to drive, and not just steering a vehicle. He actually put in the put passenger seat and showed me first how this road thing goes. Give you a lot more confidence as a new driver out there, especially when you have your old man show you the ropes. You finally get around that steering wheel, you want to show dad that, look man, I could even be better driver than you. He said boy, you got it. You got it, boy.

142 It starts from family, down to friends and the community. But it definitely starts in the home. For some people, they aren’t as fortunate as I am, to learn [how to drive] from people who are responsible. So, for me, I learned from people who actually drive safe. Not everyone that I learned from drive safe, but majority. And then, being with my girlfriend for so long allowed me to be even more safe in cars. So, I think that's where I become more aware. And when you practice something over time, it just become a habit.

I grow up in a stable home. I grow up with my mommy and my daddy. I grow up with my brothers. And what really happened, I grow in a Christian home.

As evidenced in the above quotes, these relational experiences create an internalized sense of value, confidence, and pride, which influences life choices, including road safety practices.

All right. For me the way I was brought up, I'm so self-control and centered where I don't need to impress anyone. I motivate myself and I don't need anyone to hype me up or giving praises and stuff. I know what's wrong from right. I know how my actions can affect someone and I wouldn't want to put myself in a situation where affect someone. So, I think that's the difference between me and the fact that I was taught road safety from a younger age.

It starts from home. It's who I am, who I want to be [a safe driver]. I choose who I want to be.

143 Another participant referenced that neglect and lack of guidance in the home contribute to high-risk behaviors motivated by the need for attention and relevance. “Family help to build character. If that’s missing, they find toughness and get messages from elsewhere.” Stability in the home or from a mentor figure in the community strengthens the internal framework to defend against the need for external validation to shore up one’s sense of self.

Love is transformative. A few participants directly referenced the importance of feeling loved as critical not only for achieving a healthy sense of self and identity but also for learning to respect and care for the lives of others. As previously noted, a consequence of an absence of love is the development of an image of toughness as a defense against vulnerability and unconscious beliefs of being unlovable. A lot of these dudes that don’t have no parents, they grew-up on the streets. They have parents but their parents are kids they damn self. A lot of early pregnancies happen here. So, the kids lack attention. When you lack attention your whole life from your parents, you grow up doing weird things just to get attention, risky things. Yeah, I believe a lot of people you see doing high-risk things, they just lack attention. They probably never got none from their parents, so on and so forth. That's what's missing, a lot of parents and a lot of dads is missing out of homes. You know the usual.

When you grow rough, you’re a lot more like a daredevil, in my opinion. You grew up a certain way, you don’t value yourself as much as having someone that

144 was in your corner, pampering you, or spoiling you or telling you how much you’re loved. The soft side is really hard to even crack open again because you never had that. There’re literally people that’s growing with no love. So, you might see someone do something risky to substitute that missing energy. They don’t even know how to even feel that. That's why you see some people are rougher than others, because they don't know that feeling of loving anyone or anybody loving them. They see the world in a harsher a darker light. We've felt love before and continue feeling love. And we know what working hard and being successful does and things like that. We value that, some people don't care about stuff like that because it's like because, I bet it all starts with love. Sometimes you really need someone to explain how much they love you, before you can even understand why you should love yourself, you know? When you mean something to someone, it’s like you start seeing your true value. The experience of love can be transformative. According to one participant, their road safety practices strengthened since being in a long-term relationship with a partner who models and emphasizes the importance of safety. Another participant described a positive shift in road safety practices once welcoming a child. "Well, before I had my daughter, I used to drive a little fast, but since she was born, I've always worn my seat belt from practicing to going on the road, I don't feel comfortable not wearing my seat belt." In both cases, the experience of being loved and giving love created additional selfimportance, value, and strengthened purpose.

145 Per another participant, there is a deficit in the conveyance of love in Jamaican culture. As a result, the lack of communicating and demonstrating love may negatively impact one's developing sense of self, especially in Jamaican males. Growing up, children don't hear I love you from their parents. It is a culture, and it is shifting these days because some youths now start to tell their Mom, "Mom, I love you." Or saying, "You must tell me that you love me." Or that kind of thing. So, it's from the point of the child in some cases, the child that would have been exposed to other people telling their child that they love them. Or watching videos and wondering why their parents don't say I love you, but the parents were not brought up that way either, so it's not something that they can express. It's just a cultural thing that you've got to be strong, and whatever comes your way, overall, we're a strong people, but I believe that because of that same thing, we are suffering because persons aren't open to sharing their feelings. So, it could be a cultural thing that we're slowly learning to address.

Right. They don't know their feelings at all. Conflict resolution is poor starting from there. I don't think they were trained properly so they just go. Then it goes far beyond what meets the eye, because then how they treat boys when they're boys, the same attention that girls get, the love and hugs and kisses and, "Oh, you're my little princess, my little baby." In Jamaica, we don't have that kind of thing going for boys, "You're a man, you're not a crier," stuff like that. Boys, they're hardened when they're young, so they just go with this punishment quality. I think that's a part of it as well.

146 Jamaican men are conditioned to disavow their emotions and have been culturally prohibited from emotional expression. Jamaican women also contribute to maintaining this cultural expectation, despite recognizing the negative psychological and societal impact that this gender structure creates.

I don't think our men, I don't think they genuinely feel loved and wanted. I just think they're seen as banks, so they're just cracking under the pressure. I think about it all the time. Even with my own marriage, I'm like sometimes I'm a little bit too hard. This person has a feeling just like me. They have feelings just like me. Even though we're women, we're expected to just bawl and cry and it's okay. But if we see a man crying, we're like, "Wey yuh ah cry fuh? Yuh a man, suck it up." They think we're hard on them.

Naturally, women are supposed to be more sensitive and nurturing, but I guess to me, it's more of a nurture thing. Nurture versus nature, I think that's how they are grown because they don't get the same level of attention, even going to school and stuff like that. The emphasis that is placed on the girls going to school and learning, they don't do the same for the boys, "He's a boy, let him play," and this and that. It's how they're nurtured. The above quotes underscore some men's emotional and aspirational obstacles in traditional Jamaican culture. Lack in the areas of attention, love, schooling, and overall poverty place male Jamaicans in a vulnerable position to seek out substitutions to fill this void and develop a sense of value and identity. As will be discussed throughout the findings, the use of high-risk behaviors, including unsafe road safety practices and

147 violence, provides an opportunity to enact culturally expected traits of masculinity and an outlet to release repressed rage against systemic oppression.

A generation of sustained neglect. The role of government was a significant area of focus for two of the participants with regard to RTA’s and an overall feeling of manipulation and neglect at the hands of elected leaders. Essentially, the experience of neglect is feeling unloved or devalued. Although it is not the Jamaican government’s responsibility to convey love, a few participants focused on the governmental failure to meet basic needs. One participant spoke of people being left behind by the government. As a result, the experience is of feeling powerless in a system that does not best serve the Jamaican people, which one participant again referenced as “mental slavery.” Politics is the biggest gang. They're the one who all of these things [violence, unrest] started from. Because they come in with their guns and their this and their that where none of that should be in place. When it was slavery, you know this is like in slavery it's like how you see it's running right now because when people talk sometimes they say, "Oh you know we're still living in slavery not because a chain is not on our feet, they use a chain on our mind." That's where we are chained, in our mind.

When your mind is clouded and you haven't even been shown a different way of life, so you been, your mind been like that, you've been taught that, and your kids

148 been taught that so you're good with whatever, you just settle for whatever's going on instead of trying to make a change, you understand?

Participants stressed the government as consistently failing to attend to basic needs, such as creating passable roads and providing everyone with the opportunity to have drinking water supplied to their homes. Again, governmental neglect may be interpreted and internalized as a message of value. It starts at the top. As the overseers of the country. At least give us some decent roads. It's really mind boggling if you ask me because with this economy and the space the economy is in, you wonder how we civilians maintain under these conditions because the government is not really doing its part. Or their part, I should say. Because first and foremost they have rules and regulations. Your car has to be a certain standard to be on the road period. But they don't give you a good road, in a lot of towns and cities, a lot of parts of Jamaica, there's no good roads, so if you're going to tell me that I must keep good tires on my car, and make sure that that my car is up to standards, at least give me good roads to drive on. So, it kind of, the pressure's on the civilians, because we got to go out there and travel on these bad roads and damage in our cars, and have to find money to fix them. It’s [corruption] stopping the country from thriving. Because all right when you have bad roads in certain communities, what happens is the locals, they're the ones that's suffering. Their business is suffering, because people are not going to want to travel on a road where you might have your shop, or you

149 might have your bar, or your grocery store. So, your business is going to suffer. It's like headed two steps up and only to fall back down, you know?

Well, it seems as if we're trapped in a cycle. We're voting for the same people that's been running the place. It's two parties, and they've been back and forth running the place for years. And there's no changes. That's Jamaica for you. The politics side. It's never about what's best for the country. So, this government is basically all about what you can do for me lately. It's not a government that's in the interest of their people and their longevity, you know?”

Thus, an impoverished sense of self-worth derived from internalized neglect or a lack of care might directly correlate with community violence and other high-risk behaviors, including unsafe road practices. However, one participant acknowledged the poor roads while also recognizing the driver's responsibility. I think about the roads is, a lot of them need work on, but you have to work with what you have. So, if you have a narrow road, you shouldn't be speeding on it. So, if on the highway, if you're speeding and you have the road, that's a little bit different. But narrow roads, speeding along corners, that's a no-no. And if you're speeding at night, if you're speeding when the road is wet, that doesn't make any sense. Whereas another participant focused on the corruption of the Jamaican police in addition to the government.

150 They [the government] can do a better job. They need to fix the security. Our crime rate is so high. I don't know how you going to do it, but they need to fix. The security, you need to fix the security. What I'm talking about is the police and soldiers I believe that if you just get rid of all those that corrupt ones and get some new ones, who don't know about law corruption. I believe that's how it could be fixed. Get rid of the corrupt police and soldiers.

Overall, there was a sense that years of governmental neglect and impoverished expressions of love have led to a shift in Jamaican culture. As one participant reflected, “I know better than to do certain things in life right now because my generation, I think, was one of the richer generations. Not richer in money, but richer in soul. Yeah, and richer in discipline. Richer in everything.” The majority of participants emphasized a steady shift in Jamaican culture exemplified by decreased respect and care towards others. It really goes back to love and a community thing. We don't see also us all in it together. As I said, it's more of a selfish thing. It's not my relative. It's not me. It's not anybody for me, then it's fine. It really upset me. So, it doesn't affect them unless it's about them. So, it's easy. They don't see the person as their brother or their sister. It's not like that.

To me . . . Jamaicans, it doesn't matter unless it affects me or somebody close to me. That's the mentality. It's not my problem unless it directly affects me, or my child or my husband. That's how it is. People, they don't really care. Based on what I'm seeing, people don't. The compassion is gone. Because how else would it

151 be? How would you describe it then if somebody's in an accident, they're gasping for breath and you have a phone over them videoing their last breath. That’s crazy.

I just know that the Jamaica that I used to know when I was growing up, the loving Jamaica. You couldn't walk fast like the elder, somebody that's older than us, and not say morning, good morning, or good evening. We couldn't get something and not say thanks, my parents or our peers and anybody. We used to respect our teachers, respect everyone. Nowadays, nobody respects nobody.

Perhaps this cultural shift, a product of the vicious cycle of neglect, has led to an increase in high-risk behaviors. For many, compromised care reinforces the message of being unable to rely on others, neighbors, or the government. The chronic and traumatic experience of alienation and devaluation through neglect results in societal agitation. Thus, trauma begets trauma in the form of an aggressive approach toward meeting one’s needs.

Trauma Trauma, a routine part of life. Trauma touches everyone in Jamaica. Every participant has witnessed car accidents, has known somebody injured or killed from RTA’s in the community, and a few have been in accidents themselves. One participant described being in a severe accident as a pedestrian during adolescence due to being hit by a speeding driver, and the accident led

152 to a lengthy hospitalization for a head injury that requires ongoing monitoring. Interestingly, the description of this accident was only casually disclosed halfway through the first interview. RTA’s are routine in Jamaica. For example, a couple of drivers witnessed accidents on the day of their interview. Another participant was in a minor fender bender when stuck in traffic because of another accident just ahead. One participant spoke of taking the “hectic” highway to work and described seeing car accidents “almost daily.” This participant works in the emergency sector at a hospital and witnesses injured victims of road traffic accidents daily. On the day of our interview, this participant spoke of a gentleman on a motorcycle who was taken to the hospital with “multiple fractures, bleeding . . . it was terrible.” When death becomes routine, it can lead to cultural normalization and emotional desensitization to cope. There is both the acute exposure to trauma as well as the psychological burden of chronic trauma and continual loss. The following quotes illustrate experiences of routine exposure and normalization. I see with my own eyes guys crash on their bikes and their heads wide open. You get used to it. It's like there we go again. It happens so frequently that it's almost creepy how used to it people get.

It [desensitization] happens to me too, because I work at the hospital. When I see them [RTA victims] I'm not really shocked when an accident comes in. I feel sympathy and empathy for them, but I'm not like, "Oh my God," your first initial reaction that you would have.

153

Another participant reported witnessing the aftermath of RTA’s “every day,” including a couple of days prior to an interview. The victim was a male hit while riding a motorcycle, “He can’t even talk. He’s in intensive care.” A couple of months prior, this participant also observed an accident where “his [victim] feet are chop, chop it off. Cut it off, clean, are chopped with cement on the main road. He on the motorcycle, he come around the turn and he chop one off there. And they chop, cut half his foot.” Such grotesque and horrific visuals are not uncommon. Often when an accident occurs, locals from the community gather around the injured or dead and bear witness to the acute trauma and its aftermath. As mentioned in the literature, this happens throughout the island but is especially common in the town of Negril. Every time you see a crowd, you’re driving and you see a crowd of people. Nine times out of ten, a young man crashed on a bike. That’s how Negril is. And then no one learns their lesson. You would think that okay, people knew somebody else’s mistake there’s a lesson. Nope. They still ride crazy. No helmet, no protection. Nothing. Gathering at the site of an accident has become a routine activity for many, in which the lived experience of bodily injury cannot be unseen. Tragic RTA’s are also posted on social media with victims, vulnerable and exposed to the world in their final moments. Thus, there is no shielding from the horrors of this crisis, compounding the level of trauma inflicted on others. The critical question was to understand the phenomenon of posting accident videos online.

154

Social media and re-traumatization. Each participant spoke disapprovingly of the practice of posting RTA videos on social media. "I think it's ridiculous to fit a full video in because it's someone's life. It could have been your brother, your mother. It could have been your family member. If you can't assist and help, you should just give whoever is there, give them space and don't video." One participant spoke with disgust about the pain and anguish inflicted on the families of the victims. It's something that is sickening, and that's just what we were talking about, about people just not caring about each other. I don't appreciate things like that- If you know me, you know that you shouldn't sent that to my phone. If you do, I'm going to be very disrespectful. Because for me, if my sister or my mom, God forbid, anybody that I love, is there on the ground, like there's an accident, or they're in a car or whatever, and they're still alive, and then you're going to be there, videoing it. You could have just actually helped, by bringing the person to the hospital, doing CPR or whatever. Just help them, and you're there videoing it. Another participant referenced the re-traumatization that such videos can inflict on the victims' families. The following example is related to a victim of violence, but the message remains the same. I've seen that person put up videos about persons who got shot up and killed and it happened to them. A family named X. They were terrified because they found out based on social media and they were terrified, traumatized, had to be hospitalized.

155 And they had been begging and pleading for the person to take it down because it was so gruesome. Yet they did the same thing. Posting traumatic images on social media appears to be a phenomenon woven into the culture for some. Perhaps an act of repetition compulsion is an attempt to gain control over the intolerable fear of vulnerability and the anxiety of death. Thus, the external trauma and the re-exposure place one in a power position and disavows the internal experience. Unfortunately, this act can serve to dehumanize the victims. “If I go on to an accident, why would I want to take the picture? They just don't think. What reaction? What's next after a person who see a person die? The person is more real, something real happened to that person.” In fact, the victim no longer has a sense of agency in their tragedy. Instead, the victim becomes objectified, like an actor in a movie, and the recorder can separate oneself from the horror for a moment. The motives for filming and posting RTA’s speak more to value systems and the normalization of trauma in Jamaica, rather than serving as a tool to cope with trauma. Again, motivation for this practice was identified as the need for attention and recognition; a moment of fame in the face of another’s suffering. People want attention. They'll do anything for likes. Especially on social media, you know? It's just for attention. Just to gain likes. Just to get views. Whatever your internet platform is, you want to get some attention, you know?

I guess social media, they're fanatics. They're so taken up with social media for the likes and stuff, that they're forgetting that this is a person. They prefer to go take out their phones and video when a person needs help. They have to catch the

156 feed before they start helping. Everything is about excitement. It's like a little joke, or because it happens so often, even with killings here, they get used to it, so it's nothing. Additionally, for some, this practice reinforced the belief that Jamaicans are not led by love but care for instant gratification instead of caring for others. I think a lot of people do stuff in Jamaica for the likes. Nobody really does anything for love anymore, it's more for the likes. I think it's a generational change with social need and all this stuff. It's not only Jamaica, it's the whole world. Just the other day, I saw an image, it's like a little male of someone drowning, like actually asking for a hand underneath the water. With his hand up and everyone was up with their phone videoing. So, it's generation change all across the world, where something happened people giggle because they think at the end of the day, they're going to get some likes, and people are going to recognize it, and recognize that date to do this and it probably go on YouTube or something and they make something. I don't know, get some likes or hype from it.

Okay, so when I say people don't care about each other, because if you're going to video somebody that you can actually help, because is not dead, the person still has life, and if you're going to video somebody that is dead, and then you post it, and you're going to video somebody that is there gasping for life when you can actually happen, and then you're going to post it- And you're going to be sharing it and send it to get likes or whatever you want, you know what I'm saying? It's like,

157 come on. Nowadays you find that people are sick. And they're not sick to go to the doctor but they're just sick inside. They're just sick. And I'm sick of them. One participant emphasized the lack of empathy in others. With the societal shift and exposure to neglect and chronic trauma, the need to defend oneself against overwhelming lack and painful stimuli has created a barrier against relating to the experiences of others, including the minimization of tragic RTA’s. In some cases it does help the news, but in other cases it's just somewhat disrespectful for the family, especially when the photos are very gruesome. And I don't know who's even doing it. They just don't have that love, empathy and sympathy towards . . . it's another thing that I see is common. I mean, sympathy is something, but empathy is not.

Sometimes they don't even think why they're doing it. They just do it because they have a phone that can take a picture and they just take a picture and circulate it. Some people just don't look at accidents real serious. However, despite narratives of disgust and condemnation, one participant sent this researcher a picture of a fatal motorcycle crash and another of the bloody and broken body of the young man who was killed. In theory, this act could be understood as the repetition of the traumatic event, although it was experienced more as a show-and-tell of the trauma; a conversion of the unspeakable into an externalized, tangible item. Additionally, sending the photographs was perhaps to invite or push the researcher into the trauma rather than be outside of the lived experience.

158

Compounded trauma. This study cannot explore trauma without acknowledging Jamaica's explosive level of violence. The majority of participants provided examples of how the threat of violence is infused into the culture, and behaviors and responses become fear-based, affecting one's ability to feel safe and underscoring a lack of trust. A primary concern is the normalization of violent retaliation when one takes measures to feel safe and advocate for justice. Specifically, one participant discussed how the intrusion of fear into leadership, or the lack of leadership, emboldens criminal behavior. We don’t have enough leaders. And then the leaders that we do have, they’re so scared to speak out, you know? People are scared to speak about the truth. So, somebody’s in the wrongdoing and scared to speak up because he’s scared of his life. So, you know something ain’t good for the community and being scared to talk about it. Highlighted is a failure in leadership and organizations designed to protect and serve result in citizens who feel afraid to report crimes, as well as a fear of the protectors themselves. “People are not often, they don't feel safe in reporting crime and stuff like that because the police force is seen as corrupt, so that's an issue too.” I don't think anybody likes the police. They're afraid of the police. It's just a vibe, not for me though. I don't have anything against police officers. I know that they're doing their job, and if I'm pulled over or anything, I just comply. It's easier that way and I know my rights, so I won't have them infringe upon them- They

159 just see them as some oppressive thing, I don't know. Police coming and people running and I don't know. Even if you've done nothing you're running. Why? However, the police are not immune to the dangers in the community. They have this saying that they don't like Babylon. They call them [police] Babylon. A single police officer would be walking downtown and somebody mob them, well, a group mobs them or mob him because I mean, just a police officer. And you can die in your community when you're off-duty, depending on the community that you're in because you're a police officer. A police officer is labeled as an informant, so generally, JCF, the police force doesn't generally place a police officer in the community that he's from. So, if the person is from St. James, they'll put them in active duty, say elsewhere, Clarendon or whatever, so they generally move around a lot. Fear based enabling or a desire to protect one’s own has consequences as well. And then often, Jamaicans have this mentality where they shield the persons that do wrong. So, your mothers and your girlfriends and whomever, they're in this community, they know that they do wrong, they know that they're criminals and they don't speak up. And I wouldn't speak up either, because when you speak-up you're labeled as an informer and then you die. With regard to RTA’s, the shock and potential trauma after being in an accident or witnessing an accident is compounded by the fear of possible violent retaliation if one tries to address the person who may be at fault. Per one participant, This guy clipped my tail and me stop because I wanted his vehicle's and whatever and he came out of his vehicle and is showing his hip, obviously because he has a

160 gun. So, I just left it because you're going to lose your life for a little scrape on your car? Yes, he was loud and saying, "You can't drive" because I'm a female and it was night and he was holding his waist as though he had a gun, so I just say you know what, call it a day. It's fine, I just fixed it myself because you can lose your life for that in Jamaica here. People stop for accidents and people shoot them and some of them chase off, some of them shoot up the car, so you have to be very careful. You have to know who and when to actually stop and sometimes when we stop we make deals.

In Jamaica, we don't always report it to the police because not everybody has proper license and stuff like that. So sometimes if you realize that, you stop and the person stop and the person is like a scammer, and they're like they don't have any driver's license and the car not insured and they know they definitely going to jail. Sometimes what we do is just assess the damages, take the money, take the cash and fix it. Sometimes you have to do that because if you report something like that now, you can lose your life. In many aspects, Jamaica’s level of violence has created a fear-based society, which alters the way a community functions and the attitudes, behavior choices, and psyche. In response to sustained trauma, there is either a constant state of hypervigilance or compartmentalization necessary to move forward in life. If for instance I'm driving through my community and for instance I hit a child. I would not stop. I would just drive straight to the police station, because if you stop it's possible that everybody could just come down, mob you and kill you, so

161 you just go straight to the [police]. I don't think there's much the government can do to stop the violence. It's basically about the hearts of the people, because I've seen them do many things like crime stop, all sort of intervention, and people were dying like flies here. Before I had my child, I was contemplating even having her because to have a child in this place, you have to worry. She go to school, somebody going to stab out her eye. Just overwhelming. When asked what can be done about the violence, one participant’s response was bleak. Honestly, I don't have any hope. It might sound odd, but no, I'm just over it. But in theory, yes, there are things that they could do, but I just feel like no matter what happens, these criminals just find a way. It's just at that place here. It's like persons can't be helped. Of course, they can do small things, community outreach, raise better boys to turn into good men, stuff like that. Stricter penalties, like if you do the crime you actually go to jail, and you're not released because you know somebody or you go to jail. A sense of hopelessness in a traumatized society speaks to a segment of the population’s perceptions of the value of life and feelings of community. Sustained neglect from leadership and the police’s struggle to contain the violence reinforce a mentality that there is no safe, caretaking structure. Again, this, along with other societal factors such as poverty and toxic masculinity, correspond with an increased likelihood of high-risk behaviors, including unsafe road practices.

162 Unprocessed trauma and grief. Remarkably, three of the male participants revealed emotional vulnerability when reflecting on personal experiences of loss. Perhaps this interview served as a therapeutic outlet for them in a culture where men do not openly share their feelings. Two of the participants spoke of feeling forever altered by the loss. I'm going to tell you the truth. In my heart, in my soul, I'm riding it [motorcycle] but the person who I used to be, it's not me [after witnessing the death of a loved one on a motorcycle]. Because even in this conversation, saying it to you, I know it's really hard the way I'm telling you. And it's like I'm looking at him right now. His dad would be saying to me, "Please, come and look for me." And I told him I cannot because where he's laid to rest, as soon as I go there, that's the person who I am looking at the time. So, it's like I always break down. Even right now, when we're having this conversation, it's like I was just trying to be strong, but I would like to leave it alone.

I lost a best friend in an accident. That one was hard, really, really hard. It was bad, but with time, I will never forget him. I think for almost a year, I didn't believe. That's how long it took me to, that he was gone. Yeah. It's a tough one. Even though talking about him, it's like it brings back memories and stuff, but it's what it is. I can't do anything about it now that he's gone. Only thing I can do is, hopefully this [study] helps someone. Another participant spoke of a significant family loss, a male relative who died from a hit and run. His response to the loss "Yeah, that's just life, yeah. They're here today and

163 gone tomorrow." The recounting of loss was painful, illuminating unresolved grief. One participant described a story in which the stimuli from the loss were so overwhelming that the psyche coped with the event by manipulating his initial processing of the accident scene. So, I heard something [a crash], but I didn't really take a mind to it. Anyway, after I finish (cooking), I saw some people out there. Before I thought it was a goat that was in the road. Whenever I talk about it, I still say I thought it was a white goat, because I know that a white goat used to be on the road, so I thought it was the goat. And then when I went down there, I saw one of the guys crying right around the road. And I saw his mom in the road. Somebody just hit her and just left her. That was really bad. We actually took her up, we saw the ambulance was passing by, so we flagged it down and asked them if they could bring her up to the hospital. One of the guys that was in the area actually checked her pulse and realized that she wasn't dead. She was just unconscious. So, a stretcher was not in the vehicle, so what we had to do was get a board out of the bin that was there and put her on it. I held her two foot, and they held her sides and whatever, and we put her in. When I was holding her two foots, she was a big lady, I felt her foots were shaking in my hands. They were broken. So, that was really bad. That was a bad situation. Because I knew those people, I knew her well. The woman in the accident did not survive. Unfortunately, as a result of tragedies like these, many Jamaican citizens, and perhaps, whole communities, are left to hold unprocessed trauma without the knowledge of strategies to assist in the managing of symptoms such as Posttraumatic Stress Disorder.

164 I have this experience. I have some time when I am coming and the ambulance. I said, "Oh my God." When I see an ambulance, "Oh my God. Something happened. I wonder what happened now." I used to have a panic attack because It's scary. It's so scary to me on the road. It's so scary. I have son. My son he ride a bike. So, I used to have panic attack whenever I see ambulance, because where we are living it's like a lot of accidents. Like accident, like accident, a lot. I used to have this attack whenever I see this ambulance. I get so much, "I wonder what happened. I wonder what happened now. When asked about how one emotionally heals after witnessing RTA’s, the response was prompt, “Never. No, never. Even when talking to you on the phone right now. I remember about it and road safety, so important.” Another participant who works in the medical community described the lack of support in processing trauma and loss. No, no support (in coping with seeing so many injured in the hospital). No. We see people die every day and it's just nothing. It's like, I don't know the extent. Like we don't value your life. Well not we, but some persons don't value life. If a person dies, it's like, "Oh, well he or she is dead.” There is no real remorse anymore. It's just the norm for a person to die in that way, in an accident, foot gone, hand gone, head gone. It's just the norm.

Sometimes we get upset, because sometimes I'm on my way to work and when I look it's a major accident. Yes, I feel sorry for them but then I'm so upset because I know when I get to work, it's just going to be . . . the workload is going to be

165 heavy and the rush and the anxiety is just sometimes annoying, and it can be prevented sometimes. The awareness and exposure to RTA trauma begin for Jamaicans in childhood. Children cannot process losses due to a lack of knowledge, grief awareness, and professional support. One participant provided examples of how children might experience loss and are left without the tools to process and cope with grief. Say for example the child was in the hospital and younger children are not . . . I don't think they're taught how to deal with grief, because you're a child and you would see this child coming to school, and you were under 10. You are under 10 years of age and this child just goes missing. And you heard that they died, they are not really . . . I don't think a lot of the teachers would have observed how that would have impact the children in their schoolwork. So, situations like those, it doesn't really get much attention for counseling, one day lose people from accidents, road accidents and so forth. Overall, I don't think they get counseling when people die, full stop.

I had two classmates when I was in high school that died, both of them died in a car accident. And the one was thrown from the car and other one was pinned in the car. And one died on the spot, and one died on the way to hospital. And if there are some persons who see like the guidance counselors in the school, they came and they spoke to the class and they, based on the persons who were closer to the people, would have gotten some attention, but not everyone would have gone through that counseling session. So even though, say for example let's use a

166 name, Ronnie, was not close to the person that died. It would still be that the person's not there, they're still going to finish the school year with them, and they would have had interactions regardless. So, I don't know how that child would have dealt with it because they did not get direct counseling, even though they would have spoken to the class in entirety they didn't single out the students, not all of them, just the group of friends. The reality is that children are being exposed to losses as a result of RTA’s at a young age, paving the way for future generations with unresolved grief and a lack of coping skills. Again, children are not only learning about RTA deaths and injuries in school but by witnessing tragedies in the community. Therefore, what are cultural perspectives on mental health services and interventions?

Jamaican Perspectives on Mental Health Overall, most participants spoke favorably of mental health services while noting how cultural and gender elements influence beliefs on mental health. Concerning culture, a need for mental health services was identified, but participants spoke of a lack of value and resources and stigma as barriers. Mental health is underrated here. Not enough psychiatrists. Not enough social workers. Not enough people used to guide you or help you when you have something bother you. It's something that's underrated here. It's something that's taken for granted. I believe it’s something that people don’t even believe works. We're so used to holding onto our problems and dealing with it our way.

167 Right. It's really good, but a lot of people feel as if they don't need therapy. And they can, they are strong enough to go to stuff yourself. But a lot of people, it's 50/50, some will go with the therapist and some would make tragedy difficult. And said no therapy, but therapy too helps. It's not easy to get to. I think it's not practiced enough here in Jamaica. It could be bigger. It could be more developed, and I think it could be, but what happened is that a lot of Jamaicans don't, as I said, don't really go to therapist. They feel they don't need it. So, I think that's not widely on a product, I don't think it's, it could be with practice more if we as a nation take that therapy. We powered with certain situation. One participant was able to connect the need for psychological support to assist in managing symptoms of grief, while another noted how talking about feelings and mental health is not normalized. So, there are lots of things emotionally that are left not dealt with. So, regarding counseling services or social work, regarding loss that would be really beneficial, I believe. And this is something I think would help.

We don't have a culture here for therapy for coping. Like everything is drink tea, and all the child is fine. Drink some tea. You have to be mad, mentally challenged to go to counseling. So, it's not, you don't, if you check it, we don't have a lot of psychiatrists and psychologists and stuff like that. But guidance counselors, we have those in every school. So, like, if you're depressed, we don't normalize stuff like that. They're not big on talking about their feelings and stuff like that here in Jamaica.

168

While one participant disagreed with therapy, believing the process of discussing challenging emotions serves to exacerbate feelings, interrupts the healing journey, and leads to negative coping skills. This view exemplifies a misperception of the benefits of therapy and resistance to re-visiting the pain of past trauma. Because what's not helpful, sometimes when you should be thinking of other things you're having it [painful memory] on your head. You'd be thinking about it on your mind when you should be thinking about healing process. You're going to be thinking about the things what you're not supposed to be thinking. With inner healing you want to just be having a straight mind. You know this, when you have people when they're stressed, they hit hard drugs, they think a lot, they smoke a lot and it might be a simple little thing, where as you turn your back and get back, all is taken care of. In order to find an avenue for coping, one participant spoke of verbally releasing frustrations when witnessing trauma and death at work. "Well, Jamaican culture is that we just cuss and quarrel aloud, not specifically to anybody. We just talk, talk loud I guess, and then somebody will just say, "So it go yah man" or something." At the same time, another participant identified the use of prayer. I don't know about others, because I can only speak for myself, but how I cope with it [an accident)] is just praying it could be worse. When I think about something, I think about the goodness of what happened and the bad of what happened. The only thing I can say is, at least it wasn't all of them. It could have been worse. It could have been an accident of everyone in a bus or a cab died.

169 And a few persons died, two persons died, it's unfortunate but at the same time, that's how I think about it. I know for somebody it hurts in some way, but what you can do is just pray for them and just hope one day that all of us will actually come out of this. Because there's a lot of stuff going on, even now. It's just life, yeah.

A primary cultural deterrent to engaging in mental health services in Jamaica is gender. As previously discussed, the cultural norm for males is to be “tough” and not reveal emotional vulnerability. Here in Jamaica, if you're soft and you cry, you're gay. That's how you're labeled. So, if you're a man and you're in touch with your feelings, you're definitely gay. Women tend to be less aggressive towards people who are gay, but the men here, wow.

So, the men's gender, I think there's stigma there, but the females I think they talk. No, I'm not going to say that. I've had a few guy friends that actually got into some situations, they actually shared it with me, but they didn't really share it with a lot of people, not even their families, so I'm not going to say that. Perhaps with trust and privacy, males may be more likely to be vulnerable. One male participant confirmed the perspective that men will disclose their feelings in private with a trusted person, where it feels safe. Another participant developed the ability to role-play in private to independently manage different interactions and potential feelings of himself and others.

170 Yeah, we do have feelings but the male gender is different. We just feel differently. You all [women] feel differently than we do, because you all are more complex than us. We say we just shake it up and shake it off, and that's that. But most of the time when I really talk about my feelings is when I'm with my girl, because she wants me to share, and it's like she wants to play games, she want this, she want that. She want me to tell her something that nobody else knows. You know what I'm saying? So, most of the time, that's when stuff like that comes out.

But a lot of people . . . they're going to say that we [men] don't want to talk to no shrink. For me, I'm not even sure. I tend to talk to myself and role play, because when I was growing up, I used to role play and think about what the teacher will say. I think about when I'm having a conversation with somebody, what they would actually say and what would I say, so that has actually opened my mind over the years to this, being confident to just get up and say what I want to say, you know? In general, the men demonstrated vulnerability during the interviews in this study. It is evident that this project's confidential and contained aspect provided a safe shelter for emotional intimacy, indicating the potential benefits of the talk therapy process.

Empowerment versus Helplessness: A Voice for Change Despite feelings of helplessness and hopelessness conveyed during this study, there was also evidence of the power of speaking one’s truth with the aim of making a

171 difference. The act of being given a platform, feeling valued, and being heard generated confidence and pride, illuminating the wealth of knowledge that exists and the need for more voices to be shared. I like your topic. It will help to others out there. If they can take sense out of it, it would help. We here in Jamaica we would say if you could take the sense out of it, it would help.

It [participating in the study] kind of felt great, like I brushed my shoulders off a little bit. You're expressing yourself to hopefully a broader base of people now. Maybe this interview will reach somebody here. And who knows what can go from there, it's a start. For some, this project led to increased awareness of road safety. At the same time, another participant spoke of being inspired by the field of social work and expressed a passion for helping others and promoting change in future generations of Jamaicans. In fact, it [research project] opened my eyes. It's like, I realized how crazy I feel with driving even more, like when I'm on the road. So, it helped me to understand the road and how dangerous it is on a daily basis. I in my situation, I think that just by having a conversation about it, I think if it was something that was talked about more regular around the world, like around the nations, like nationwide, it would have an impact on a lot of other individuals.

I have a thing for social development, and for just speaking overall, anything that will aid in making the world in itself a better place in my little area, I am so

172 willing to share. Funny enough, I was thinking about doing a diploma in or something in social work, because I do have a passion for young people and because we are the future, the young people are the future. So as much as possible as we can create some change in their attitudes and perspectives toward specific things or general things, then we'll have better quality of life, the mindset of the population will be a little bit different, you'll be more receptive to certain things… and there'll be a little bit more critical in their thinking and not just be just existing they will see their parts, like our interest. Overall, participants were proud of their participation in this study. Despite discussions of cultural despair, the interviews ended with a sense of hope for change. I feel good about what we've talked about. I feel so good. I like that you act like you were so interested and it was good.

I hope this really, your research I hope it impacts a lot of people and help change how people view the road and road safety. So, thank you for your research.

Ideas for change. Upon being given a platform, participants were eager to share their ideas for change. Many suggestions underscored the need to advocate and invest in one another as a community, presenting a united front. The focus was placed on providing road safety education for the youth, emphasizing the need for schools to take on the responsibility if it is not being provided in the home environment.

173 I think enough protesting doesn’t happen in Jamaica. In some communities it does happen. And what I've noticed is those communities are well off. What happens is when you as a community are willing to come together and stand up for your rights and protest in an aggressive way, in such manner, you're not pushing any violence but you're willing to say, our community is not right, so therefor we don't want anyone passing through here. We're going to block this road

The more information you can get, the earlier you can improvise the road code and safety, especially when the man is young, the better. On the whole, participants shared having different awareness of road safety campaigns. All participants have seen road signs encouraging safety practices, but only two participants spoke directly of specific outreach efforts that they have witnessed in the community. Jamaicans have varying access to resources, so a multi-pronged approach towards education and safety awareness must be ongoing and perhaps enhanced. I know about a few of their [Road Safety Unit] campaigns. I'm not sure about all of them. I think they are not promoted properly. And I think they could do better by using social media, internet, just all the native platforms to make it more aware. Not only social media, tele, and broadcasted on communication, stuff like that. As much as it can on all platform that can get it over here, where young, old, everyone from different age groups can get access to it. In addition, there were recommendations for the government regarding road safety campaigns and stricter penalties for violating road safety laws, including steep fines and prison time. Finally, ideas were introduced for improving the economic status of many by

174 providing opportunities for financial success, such as establishing the marijuana industry for local farmers to generate success, rather than providing contracts to big corporations. Police just do their jobs. Stop being bought around, doing shortcuts, and taking bribes. I think they need to get these roads fixed before they enforce anything. If I was in charge, I would fire all the cops. Only the good ones, I would keep the good ones. Fire all the bad cops and pay them a meaningful salary. And then I would make sure they're staying on the right track and put a serious penalty for anyone that's involved with corruption.

Stricter penalties when your car disobey certain traffic incident, and speaking about fine, maybe the fine should be higher. And if you can't pay the fine, you'll have to pay that some way. Stricter penalties could be one of the factors.

I'll tell you; you'll get in more trouble for not wearing a seat belt as opposed to not wearing a helmet. I've never seen anybody get a ticket for not wearing a helmet. The above recommendations and discussions on ideas for change underscore that there are Jamaican citizens from varying backgrounds who are willing and able to engage in discussions that will benefit themselves and their loved ones and the country they love. The topic of road safety is only one of many where high-risk behaviors may be further explored.

175

Chapter V

Discussion Introduction This research project sought to understand: How do Jamaican citizens subjectively make meaning of road safety practices in Jamaica? Utilizing an IPA methodology (Smith, Flowers, and Larkin, 2009), the narrative data illuminates the subjective experiences of eight Jamaican participants to answer the research question. Through the lens of trauma theory and postcolonial theory, the findings support specific psychoanalytic ideas outlined in the literature review and introduce new areas of inquiry. It remains essential to underscore that these are two of many theoretical perspectives that may be used for data analysis. This researcher chose to anchor her analysis in trauma and postcolonial theories due to their relevancy and intellectual curiosity and the hope that the findings may provide practical, cultural understanding and change strategies.

Trauma as an Organizing Frame The findings reinforce Jamaica as a country entrenched in chronic, collective, and unprocessed trauma. Therefore, this discussion is organized around the perspective that trauma is a structuring psychological framework for the Jamaican people. When discussing road safety practices, the research participants revealed the psycho-social

176 impact of sustained trauma and its legacy on multiple areas of life. Cultural areas of concern, including governmental neglect, pervasive poverty, community violence, and hyper-masculinity, reinforce the reality that Jamaica is not far removed from her colonial history. The Jamaican postcolonial experience is a story that has been told for years through music infused with lyrics about poverty, oppression, violence, sexism, and anger towards the government. During the participant interviews, these themes were revealed to be an essence of the contemporary Jamaican identity and lived experience, providing insight into possible unconscious motivations for high-risk road practices. As illuminated through the participant narratives, Jamaicans live with the ongoing threat of danger through endless and needless community violence. There is a sense of lawlessness and what many describe as a cultural deterioration. Emphasized was a change in values and disregard for life, with younger generations emphasizing the importance of money, instant gratification, and social recognition over potential negative consequences, including injury and death. RTA’s are one type of trauma, but the resistance to road safety practices as a controlled, measurable action of self-preservation in the face of persistent danger and unpredictability suggests that this action must serve a psychological purpose for the people engaging in high-risk behaviors. Therefore, a discussion will be on road safety practices concerning socially constructed motives and adaptive psychoanalytic defenses in the face of unprocessed trauma and how RTA’s continue to perpetuate this cycle.

177 Road traffic accidents (RTA’s): A cultural norm. As discussed in the findings, all participants have been impacted by personal exposure to RTA's. Most described RTA's as standard events, many witnessing them daily. Essentially, they are commonplace, having become externalized as a part of Jamaican culture and identity. If there is a gathering of people by the side of the road, it is likely the aftermath of an accident. "Every time you see a crowd, you're driving, and you see a crowd of people, nine times out of ten, a young man crashed on a bike." Due to Jamaica's small communities, the odds are also probable that one knows the accident victim(s) as well, activating symptoms of intrusive anxiety and Posttraumatic Stress Disorder that a loved one might be injured. One participant described how the sound of an ambulance triggers a physiological response, including a racing heart, in response to the fear that her son, who rides a motorbike, might have been injured or killed in an RTA. Narratives on RTA's and societal attitudes and behaviors were conveyed as a matter of fact but imbued with feelings of frustration, disappointment, reluctant acceptance, and fatigue. However, RTA's in Jamaica register as tragic incidents for the participants of this study. Their routine nature and unavoidable exposure have resulted in a pattern of desensitization and compartmentalization, trauma defenses necessary to minimize the anxiety of death and maintain functioning in an unpredictable environment. RTA exposure and its cultural normalization (or the normalization of death) begins in childhood. One participant spoke of losing classmates as a child due to RTA's, noting the experience of a familiar face never returning to school and the reality that a classmate would not be at graduation. Although guidance counselors were provided if needed, there was no memory of an adult initiating the process of discussing loss or educating or

178 providing room for the grief process. "Overall, I don't think they [children] get counseling when people die, full stop." As a result, children must discover adaptive means of coping with feelings of loss, grief, and the uncertainty of life. The literature on children who experience chronic trauma underscores the potential long-term impact on development, including emotional, behavioral, and cognitive functioning and engendering irreversible ego defenses (Krystal, 1985, Grubrich-Simitis, 1981). Participant reflections on the consequences of community exposure to high levels of violence and aggression correlate with the literature that children with high trauma exposure can grow into adults who struggle with emotional regulation, low self-esteem, and increased symptoms of being withdrawn or aggressive, as well as difficulty developing empathy and engaging in healthy socialization (Roy et al., 2003). Children exposed to chronic trauma also face challenges focusing on school, resulting in decreased rates of completion. All subjects in this study stressed the importance of education and asserted that many youths who engage in unsafe road practices lack education and reading ability. Subjects revealed these youths to have subsequent demotivation and an increased likelihood of engaging in illegal methods to obtain "fast money." Behavioral aggression, a lack of empathy, low self-esteem, and a lack of education were indicated in the findings as contributing to the ongoing cycle of poverty and impacting Jamaican attitudes on the value of life and, therefore, influencing attitudes regarding the importance of road safety practices. When contemplating high-risk road practices, it is a valid postulation that exposure to cumulative trauma may also be attributed to compromised decision making and impulsivity. However, that perspective is too simplistic as it ignores the influence of

179 cultural factors outlined in the findings. As will be featured in the discussion, cultural experiences are embedded in the psyche of postcolonial generations in Jamaica, continuing to inform one's identity and self-worth, values, and subsequent behaviors and coping skills.

Postcolonial Jamaica: Systems of neglect and inequality on Jamaican attitudes and identity. The research findings reveal links between the residue of colonization and contemporary Jamaican attitudes and identities. “Fight,” “defend,” “resilience,” “aggression,” “dictating,” “pride,” and “victorious” were just a few of the keywords used throughout participant narratives. In part, Jamaican identities and defenses are born from a history of ancestral slavery and dehumanization and, however, are maintained through repetitive social structures that reinforce the trauma of deprivation through systemic neglect and unrelenting poverty. A few participants spoke directly of their anger towards what they perceive as a neglectful and corrupt government. In theory, the Jamaican government is the parental structure responsible for nurturing its people, but an inconsistent ability to provide for basic needs reinforces the belief that the government is not a safe, care-taking institution. Additionally, as a government rife with corruption, and one that models lawless behaviors through routine bribery and significant economic disparity, Jamaican leadership perpetuates a devaluation of the self, where trusting authority becomes compromised and old colonial systems, such as exploitation, are upheld.

180 As participants contemplated unsafe road practices and the escalated attitudes of aggression and violence in Jamaica, they could correlate contemporary mental processes to Jamaica’s colonial past. There remains an urge to fight for equality and basic needs and a desire to resist an oppressive authority as the reproduction of colonial systems continues to restrict freedoms and opportunities for individuals to emerge from poverty. Angrily, one participant described how structures of neglect and poverty are painfully preserved when business opportunities, such as contracts for marijuana production, are taken from local farmers and given to wealthy investors who, in turn, pay meager wages to those already working the land. In order to facilitate change, this participant recommended community action and protests to challenge the feeling of powerlessness against a bigger system. Violating the rules of the road through the use of unsafe road practices denotes a physical action of defiance against the perpetuation of systemic oppression and inequality. The subject can exercise a sense of agency and experience momentary control, disregarding whether legally enforced safety measures are life-preserving. The findings reveal that many Jamaicans do not trust road safety regulations, including seat belts, and they are aligned with a distrust of the Jamaican government and reaffirming the perception that the government is a non-caretaking entity. Thus, being the mode of transport, the body and object becomes merged and utilized as an unbridled tool for unconscious acts of protest against contemporary and historical oppression, perhaps a signal of not yet avowing historical trauma. Sustained neglect and poverty are intrapsychic experiences that inform the development of internal and external value systems. It is apparent how a lack of

181 investment in the communities by Jamaican leaders and subsequent economic disparity gives rise to internal devaluation and affects community cohesion. Participants revealed how the residual slave mentality and an uncertain sense of the future impact one’s sense of self-worth and the capacity to think with the future in mind. Aligned with studies examining the psychosocial impact of poverty on various cultures, the experience of shame seems to be at the core of these internalized experiences. Shame diminishes the self and creates a multitude of psychological consequences, including self-loathing, depression, and suicidal behaviors (Walker et al., 2013). As seen in the participants’ reflection on youth, this experience of shame is also intertwined with rage, an internal force defending against intolerable feelings of inferiority and dependency. Participants also spoke of how poverty and systemic oppression further impact both individuals and cultures by limiting the ability to dream, a restriction that also reinforces shame. The findings indicate that fantasies of upward mobility are negated as they represent forbidden wishes (Holmes, 2006). These experiences of shame and rage can also be understood as internal reactions to an inability to fantasize beyond the subject’s current circumstances, a transgenerational phenomenon in postcolonial cultures (Citation). Through this lens, this study found that subjects developed adaptive coping strategies to manage shame, rage, and dehumanization resulting in a response indicative of a sense of lack and an inferiority complex of otherness (Fanon, 1952). In an environment with limited opportunities for strengthening ego development, this type of identification with the aggressor allows the participants to defend against internalized objects of self-loathing and shame stemming from lack. This internalized sense of

182 badness, alienation, and dependency seems to be externalized into acts of community violence and aggression, including high-risk road practices. Participants described a culture in Jamaica where shame due to lack is unavoidable, as the inescapable worlds of wealth, materialism, and an “ideal” are flaunted over social media in Jamaica and other developing countries. Shame is experienced through reinforcement from external factors, including visual exposure to prosperity and nurturing, which is heightened given the current climate of influencers and the dominance of social media. Participants spoke of the persuasive influence of social media on the behavior and attitudes of the younger generation of Jamaicans, activating internal identifications with this idealized “other” and reinforcing the need to defend against feelings of self-loathing and inferiority. Thus, flashy materialism and collecting “likes” become a means for shoring up one’s identity, creating value through the momentary recognition of feeling seen. These are two meaningful findings in this study. The need to be seen to reaffirm the self is a behavioral driving force in Jamaica. The desire to feel valued and important overshadows what might be perceived as ethical and moral boundaries concerning one’s own life and the lives of others. This conflict is evident with the use of high-risk road practices, notwithstanding who is sharing the road. Currently, the trend of posting videos of RTA victims on social media exemplifies a more extreme measure of pushing ethical and moral boundaries in order to achieve status, attention, and “likes,” perhaps representing an identification with the aggressor. Uncovered is a moral impasse between internal needs and external validation versus respect for the sanctity of life and those suffering and dying. It is an act that perhaps disregards the humanity of the other, representing unconscious residue from colonial

183 oppression. Nonetheless, it retraumatizes loved ones and sustains the normalization of RTA’s, which may reinforce an ongoing acceptance of a devalued self. The posting of RTA’s on social media may also be understood as an adaptive defensive process in that media images become a means of splitting the anxiety of death from the reality of the lived experience. Specifically, psychic distance is created between the traumatic incident and the self, and it is a method of desensitization and a disavowal of the psychological horror of gruesome injury and death. The action of filming and viewing these videos objectifies the victims while also providing psychological refuge. Converting the internal experience to film or outside the subject creates a dissociative process rather than acknowledging the trauma of the unbearable anxiety and lived reality. In turn, the media also becomes a tool for communicating the unspeakable, or “speechless terror” (Van Der Kolk,,1987), symbolizing repressed trauma memories absorbed by the body and psyche.

Trauma and adaptive defenses: Omnipotence and grandiosity in the context of high-risk road practices. As illustrated in the findings, participants show how direct and indirect exposure to violence and loss has penetrated daily life in Jamaica. The threat of death is inescapable, resulting in a continual state of hyperarousal and hypervigilance. Consequently, aggressive road practices represent an effort to control one’s internal and external world, necessary defenses to disavow fears of anticipatory anxiety of death and annihilation. Participants spoke of lacking control about whether another person might cause them injury or harm, but they did not signal a conscious or unconscious resignation to death.

184 Rather, they seemed to distance themselves from identifying with the experience of anticipatory anxiety by reinforcing their belief in the importance of road safety practices. However, for the younger generation, engaging in unsafe road practices aligns with defenses against vulnerability and unbearable death anxiety and an effort to strengthen one’s ego functioning through earning recognition and respect no matter the risk. Participants’ omnipotence and grandiosity serve as important defenses in the chronic emotionally and physically unstable and unforgiving environments in which they grew. This study found that these defenses appear rooted in unconscious fantasies that helped them adapt and transform one’s internal sense of self to tolerate threatening internal and external experiences. Essentially, omnipotence and grandiosity create the subjective experience of control and the aggrandizement of self in the face of threatening stimuli. Thus, they are critical defenses when the psyche is continually confronted with profound trauma and an internalized sense of inferiority and otherness due to chronic oppression and lack. In part, defiant road behaviors can be perceived as an omnipotent behavioral act of rage in opposition to a neglectful governing system and enforced safety expectations. Defiance enhances a sense of control and agency, but it is only an illusion of control, one that is necessary in order to transcend the chaos of an unpredictable environment, parallel to a lack of control experienced during colonialism. This study found that omnipotence was evident through high-risk behaviors as actions of thrill-seeking (Balint, 1959). While some participants blamed reckless driving on immaturity and a lack of education, there were clear examples of young Jamaican men making conscious choices to repeat dangerous driving activities previously performed by peers. Young men seem to be especially drawn to such repetition when those actions

185 have already resulted in RTA’s. The conscious aim is to display better road skills, although the act seems to serve as a repetitious attempt at mastery to fortify one’s ego and deny the anxiety of death. The act of thrill-seeking is also counterphobic. The subject engages in unsafe road practices by diving headfirst into the anxiety, converting passivity into action by risking injury or death in an effort at control rather than anxiously anticipating death’s arrival (Tolleson, 1996). However, most participants described an increased awareness of road safety practices after witnessing their loved ones injured in RTA’s, with one stating that he gave up using his motorbike for a period of time. Notwithstanding, there were examples of people who died from RTA’s while on their way to the funeral of a loved one who was killed in an RTA. Overall, the responses revealed the lingering emotional impact of losing loved ones to RTA’s, whereas the behavioral changes appeared temporary. Short-lived modifications in behavior appear to result from cultural and internal pressures to project masculinity while compartmentalizing the vulnerability of unresolved grief and the anxiety of death. High-risk road practices may also be understood as an attempt at heroism. Again, in an environment with experiences of chronic trauma and neglect and limited opportunities for upward mobility, surviving high-risk road behaviors yield psychological and social benefits. The findings highlighted how achieving leadership or hero status through highrisk road practices means that the subject is to become admired; it is a self-validation of one’s own life and value (Becker, 1973). Earning respect is critical in Jamaica due to limits on traditional trajectories in which to do so, and achieving heroic status is

186 sustenance to a depleted internal system fighting for psychic survival and meaning. Ultimately, heroism staves off awareness of vulnerability and feelings of helplessness. Grandiosity was evident when participants spoke in broader terms describing the Jamaican perspective of being “undefeated.” Again, this idealized narrative challenges the history of transgenerational trauma and poverty, representing a split between internalized experiences and lived realities. Grandiosity defends against the transgenerational trauma of colonization and an internalized “other,” repudiating an alignment with an inferiority complex (Fanon 1952) and an identity formation based on a history of dehumanization and a subservient social position (Oliver, 2004). Grandiosity is also exemplified through participant descriptions of cultural and gendered posturing with Jamaican males who proclaim to be the “best” drivers and “superior” drivers to others, especially Jamaican women. In contrast with RTA data, such assertions provide a type of permission or gender and cultural normalization to reject basic road safety practices to deny vulnerability and avert the traumatic awareness of death. However, several participants described male aggression on the road as a variable that increases accident risk, noting how Jamaican men “steer” with bravado and, at times, are dismissive and threatening to female drivers. This data aligns with Balint’s (1959) positioning that the environment, in this case, one of hypermasculinity and sexism, actually promotes and celebrates aggressive and destructive behaviors.

Gender: Hypermasculinity, lack, and their impact on high-risk road practices. As previously discussed, the need to feel seen is a significant finding in this study. Participants emphasized Jamaicans' value on physical presentation as a cultural norm

187 across genders, especially concerning accessories of material value that convey a sense of prestige and importance. External objects, such as cars, motorcycles, and dress, seem to shore up a fragile ego and disavow internal vulnerability, shame, and lack due to poverty. However, as with many developing countries that endure massive economic disparity, these items are not easily attainable, contributing to increased illegal activity such as theft and scamming to get these objects. Thus, the internalization of lack and how one copes with it is a critical factor of analysis that directly applies to the perception and use of road safety practices in Jamaica. Again, this is evident as shame due to lack is defended against through the unconscious activation of omnipotence and grandiosity. Participants also illuminated how defenses against lack have become absorbed into Jamaica's cultural norms and expectations with regard to gender performance. Despite the emphasis placed on external appearance for both Jamaican men and women, hypermasculinity was a remarkable determinate of unsafe road practices in Jamaica. Participants were asked whether they perceived gender as influential on road safety practices and to identify whom they believed to be most at risk of experiencing an RTA. As discussed in the literature review and reinforced in the findings, the answer was overwhelmingly young Jamaican men supporting the annual RTA statistics. Participants underscored the cultural expectation for Jamaican men to be viewed as "tough" and the "bad bwoy." While others explicitly recognized the cultural prohibition against men conveying their feelings. In demonstrating vulnerability, Jamaican men risk being labeled weak, homosexual, and susceptible to violent attacks. Thus, gender and masculinity in Jamaica can be understood as performative (Butler, 2006), with unsafe road practices

188 providing an avenue for expressing bravery, control, and power through intimidation and aggression. The findings support theories that performative gender protects the male ego from limited opportunities to meet traditional hegemonic masculinity in an environment of pervasive poverty (Connell & Messerschmidt, 2005). As found in this study, it was cited to be especially true of men in the Caribbean who enact culturally expected traits of masculinity as an effort to achieve power and assert dominance when they are economically unable to do so (Crichlow, 2014). Thus, aggressive road practices deny vulnerability against the anxiety of death, but they protect the Jamaican male identity by shielding unconscious fears of inferiority and dependency and act as a conduit for releasing repressed rage against systemic oppression. Lastly, participant data uncovered how gender performance shields Jamaican males against feelings of lack in economic poverty and in multiple areas of life, including attention, love, and education. Thus, hyper-masculinity also shelters the male ego from an internal fear of unlovability and annihilation. As one participant stated, "It's just a cultural thing that you've got to be strong, and whatever comes your way. Overall, we're a strong people, but I believe that because of that same thing, we are suffering because persons aren't open to sharing their feelings." These findings were significant in that they highlighted how Jamaican men are raised to repudiate their vulnerability, with women playing a critical role in enabling this cultural phenomenon with their sons and brothers. Therefore, it was remarkable that the male participants became the most affected when discussing the death or loss of loved ones due to unsafe road practices. In the context of the research interview, a contained, confidential, and safe environment that mirrors the

189 therapeutic frame, male participants quickly became vulnerable, temporarily softening defenses and speaking honestly about the emotional pain and their experiences of trauma resulting from tragic losses. Counter to cultural expectations; this data provides potential evidence about the need and desire men have to process unresolved grief and trauma and receive support when one can do so without stigma and community exposure.

Healing trauma through the power of the relational experience. The chronic experience of trauma begets additional incidents of trauma. It is an ongoing sequence, creating a rhythmic accumulation of one traumatic event after the next, generating societal unrest and agitation. Several participants expressed a sense of hopelessness and concern about the increase of violence and “lawlessness” in their communities, describing the negative shift in values and increased disrespect for one another. There is an acute awareness of the fragility of life. One participant voiced initial concern about becoming a parent due to the violence. “Before I had my child, I was contemplating even having her because to have a child in this place [Jamaica], you have to worry. She go to school, somebody going to stab out her eye.” There was a sense of grief, loss, and a longing for an old Jamaica, where people were connected and shared values systems. As a result, participants identified the need to be self-reliant with regard to feelings of safety and quality of life. One may also speculate that anger and distrust of the Jamaican government have further ingrained the need to be self-reliant, resulting in defying governmental rules. This was evident as a few participants described “jungle justice”

190 examples where they take the law into their own hands before legal enforcement becomes involved, again perpetuating the cycle of trauma through violent acts of vengeance. Thus, in the context of a changing Jamaica, a significant finding was the heightened awareness of mortality and the sense of disconnection between people, with participant emphasis on a lack of love and respect for others. The experience of systemic neglect appears to have infected the relational dynamics between people and communities, generating distrust and a sense of desperation to meet one’s needs, regardless of the impact on others. Notably, the lack of experiencing love is a dominant variable affecting the value of life in Jamaica, often based on what a person has and what they can do. Superficial and material items or attaining hero status serve as an effort at managing this void, ultimately generating the perception or feeling of achieving a life of value and protecting against the unconscious terror of being unlovable. The findings also revealed how moments of connection through family and mentorships fortified ego development and generated respect for safety and the sanctity of life. As one participant so poignantly stated, “When you mean something to someone, it’s like you start seeing your true value.” The lived experience of providing teaching moments on road safety was also an example of relatedness that created purpose and value for the subject offering wisdom and guidance, including the opportunity for the recipient to feel nurtured and of value. Conveyed was a sense of pride in making a positive difference in the community by attempting to keep fellow citizens safe and notable confidence in having road safety knowledge. Participation in this study mirrored such relational benefits providing a healthy internalizing opportunity, positive affirmation of the self, as well as confidence and pride that their contributions would positively

191 benefit their country. Additionally, the opportunity to share one’s life stories and experiences and truly feel heard and seen as a unique individual of value and worth is parallel with the therapeutic dynamic.

Conclusion In conclusion, the findings yielded data addressing each research question, illuminating psychosocial factors contributing to the phenomenon of Jamaica’s unsafe road practices and high incidents of RTA’s. Overall, the residue of colonization is not only enacted in contemporary societal structure but is imprinted on the psyche of the Jamaican people, shaping perspectives on the value of life and attitudes toward road safety practices. The internalization of pervasive poverty, unprocessed trauma, and relational disconnect contribute to performative gender roles and cultural norms, all driven by an internal response to lack and the scars of transgenerational trauma. Understanding the relationship between the environment and interpersonal will provide opportunities for developing new road maps to address programmatic interventions necessary for the acknowledgment and healing before behavioral change can be expected.

Policy Implications This research project revealed a concerted need for mental health education and the promotion of clinical social work services in Jamaica. Participants had varying degrees of awareness of mental health services and conflicting views on the usefulness of psychotherapy. Services are available, but access remains unclear. Ideally, mental health education and therapeutic services should be promoted and provided at the community

192 level and perhaps be more pronounced in school settings. Participant data highlighted the need for psychoeducation and support on grief and loss issues for young children to alter the trajectory of chronic, untreated trauma. Home and school-based clinical social work services allow for interventions during early childhood development, offer more consistency and cost-effectiveness due to on-site locations, and introduce mental health benefits in a safe and normalizing manner, all essential areas of public health policy to continue building. Secondly, educators and community stakeholders could benefit from mental health awareness and destigmatization training. The findings concluded that psychotherapy is not a commonly sought out or understood service in many areas of Jamaica. Overall, most participants had a rudimentary knowledge of mental health and the benefits of “talking to someone,” with a couple of participants having more awareness than others, but psychotherapy is not culturally normalized. The hope is that leadership will encourage and model a cultural shift in mental health. Policies must also focus on poverty initiatives. Pervasive poverty was a primary factor for social unrest and agitation, contributing to an increase in lawless behaviors and maintaining an internalized sense of inferiority. Thus, poverty directly impacts mental health and the ability to perceive one’s life beyond immediate circumstances. The government must demonstrate consistency and equality in the communities where it invests its resources to earn the trust of its people. Finally, policies need to be aimed at the highest risk population for RTA’s; young Jamaican males. Recruiting and investing in Jamaican youth as community educators, advocates, and mentors for road traffic safety and general community safety is an avenue

193 for empowerment. As they are of critical importance, these positions should be paid to instill a sense of purpose and value.

Clinical Implications This research project highlighted the beauty and unique complexities of the human subject and our susceptibility to universal and culturally specific vulnerabilities. Overall, it is important to feel valued, heard, and seen. Conducting an international study was a reminder of how important cultural awareness is in feeling understood and underscores the reality that social influence cannot be separated from the process. In order to establish a therapeutic dynamic with meaningful change, cultural competency, awareness, and acknowledgment should always be at the foundation of our work. Altman (1995) referred to this process as a “three-person psychology” in which the therapeutic dyad is joined by culture, ultimately becoming a triad (Bodnar, 2004). Awareness applies to the differing cultural and racial client backgrounds and an awareness of how our own biases unconsciously inform assumptions about the clients with whom we work, influencing interpretations and the transference and countertransference. With regard to ethnocentrism, it cannot be asserted or assumed that psychoanalysis will be easily accessible for clients of differing cultures. Cultures experiencing a tension between generational traumas and modern social stressors often cope by engaging in a dissociative process separating the past from conscious awareness. Thus, therapeutic services must assist in cultural mourning and processing collective, generational trauma. Additionally, conducting an international study that explores colonization while being a Caucasian woman from the United States underscores the need for acknowledgment so

194 that dissociative splits may be addressed in a safe environment. Lastly, the participants in this study responded with a sense of hope and felt purposeful after their interviews. No matter where one is from or where they live, there is a need to be heard and as this study revealed, there is much to be shared.

Study Limitations Conducting an international study presents various limitations. First, there are economic restrictions because of the distance. Despite not incurring travel expenses during this project due to Covid-19 regulations, there was a cumulation of international phone costs that would be prohibitive to larger sample size or additional interviews. Secondly, cost and distance, risk-limiting the amount of time that some researchers can commit to a particular project, and the ability to conduct thorough member checking. Finally, this study limited potential research candidates, as those without a phone or schedule flexibility could not be considered.

Recommendations for Future Research For future studies on the lived experience of unsafe road safety practices in Jamaica, I recommend narrowing the participant criteria to focus on young Jamaican males who ride motorbikes and have limited education. While rich and critically informative data was gathered from the female participants of this study, they also circled back to identifying Jamaican males as most vulnerable and contributing to a negative shift in Jamaican culture. Restricting the sample would allow for a closer examination of the population identified to be most at risk.

195 Additionally, I would inquire about the role of religion and how it may or may not inform coping with trauma, loss, and grief incidents. A few participants briefly referenced religion when sharing feelings of anxiety about possible loss and injury and when attempting to understand those who engage in lawless behavior. In contrast, another participant correlated religion with corrupt, non-caretaking government structures. Therefore, it might reveal how religion and unsafe road practices inform belief systems about the value of life and the anxiety of death. Lastly, it is recommended that this research be available for community stakeholders and academic institutions in Jamaica so they may build upon their studies on the road traffic accident crisis in Jamaica. The hope is that this study contributes to understanding motivations for unsafe road practices and spotlights the concerns identified by the proud and invested participants in this study.

Personal Experience During the Research Process As discussed in the introduction of this study, this research project evolved from my own experiences with unsafe road practices in Jamaica. In addition, I witnessed what I perceived at the time to be an indifferent reaction to death and tragedy. As for many, death and its infinite finality have always been anxiety-inducing for me. As a result, I have become more specialized in working with clients who have experienced grief and loss, perhaps as an avenue toward finding peace for myself within the discomfort of life’s fragility and unpredictability. Two facts were colliding for me. First, I had never experienced personal exposure to tragic loss due to high-risk behaviors. Secondly, I was newly married, and as participants

196 illuminated in this study, love and the creation of my new family introduced an unexpected level of vulnerability, magnifying what is at risk of being lost. The idea of loss due to preventable behaviors within one’s control or experiencing loss and not having control of another’s unsafe choices became an area that I wished to understand further. At the onset of this study, I was asked whether I judged the Jamaican people for not engaging in road safety practices. My initial reaction was to say yes. However, my awareness and understanding of cultural differences and societal norms quickly challenged my instinctive reaction with a list of reasons why that is not a choice that I have to make, but why it is necessary or viewed as a way of life for others. After all, I rode for years as a child, adolescent, and young adult in the backseat of a moving car without wearing a seat belt until studies, then policies, then social enforcement finally made the safe choice for me by engraining the message. I learned from this study that, although uncomfortable, I am privileged to have the anxiety of death. I can experience this anxiety because I have not had to desensitize or disavow my emotional experience because of chronic, intrusive, and traumatic stimuli. Ironically and perhaps, perversely, this research project revealed my envy and awe at the adaptive coping skills of others versus holding a hyper-conscious awareness of the potential consequences of high-risk behaviors. Again, I believe a statement that can only be made from a position of privilege. With this said, I would like to discuss my experience researching another culture. I was honored to receive the trust of the participants of this study, who generously shared their perspectives and personal experiences on this research topic. For that, I am forever

197 humbled. Snowball sampling, beginning with three participants identified by a former local and trusted member of the community, my husband, assisted greatly in establishing rapport. My affiliation and knowledge of the island and smaller communities gave me the credentials to further engender trust, as my love for the island and the people was genuinely conveyed. However, I assumed that the fourth participant, obtained by snowball sampling, was aware of my connection to the island rather than my role as a researcher. At the onset of the second interview, the participant expressed some concern about providing me with confidential data, referencing the scamming activity in Jamaica. Once I realized that the referring participant had not disclosed any additional data on me, an erroneous assumption, I apologized and provided more transparency. I was able to discuss my link to the island and speak of her community. The response was, “You know X [neighborhood]. I didn’t realize. You are family.” I was aware of the power differential during the research process as I listened to deeply personal stories of loss, vulnerability, and resilience. The power differential was not about the researcher-participant dynamic but in the context of my first world position versus the life context of my participants. When discussing the negative shift in the Jamaican culture, one participant referenced the United States as being a negative influence. Everybody just has this mentality [lack of respect], I used to see this in Americans. But now that I'm seeing it with my own people, it's just sickening. But for me, a few years ago, we didn't really have a lot of problems like this. We didn't have people just neglecting each other and not caring about each other. Over time, the culture has

198 changed. We actually adopt most of the Western culture, and when I say Western culture, I mean your kind of culture. One may interpret that statement as an unconscious, defensive effort at evening the playing field or that the repulsion of perceived values of the United States is a projection of one’s own internal sense of shame with identification and acknowledgment of the RTA crisis in Jamaica. Or the above statement may be an expression of passive rage, a momentary reveal that I remain part of the oppressive system despite positive rapport and an engaging interview process. Once the interviews were complete, my sense of deep gratitude was overshadowed by a sense of discomfort and guilt. With permission and generosity, I briefly entered the lives of eight Jamaican citizens. They opened the metaphorical door for me, I gathered an abundance of data, and then I left, leaving the door open to the elements of their personal histories. I felt like a thief: a culture thief. I left with riches to assist in my academic endeavor, and it felt unbalanced. Although, per participant statements, I believe the interview process was rewarding based on the reasons outlined in the discussion. I also believe this experience is a reminder for the field to continue and explore the ethics of doing research with populations who are susceptible to exploitation. It is my hope that this study acts as a tool of empowerment that will provide helpful insight for meaningful change.

199

Appendix A Consent Form

200

Leave box empty - For office use only

DO NOT DELETE BOX

Institute for Clinical Social Work Research Information and Consent for Participation is Social Behavioral Research

I,_____________________________________, acting for myself, agree to take part in the research entitled Speed Kills: The Subjective Experience of High-Risk Road Safety Practices in Jamaica.

This work will be carried out by Katie Czerniawski, LCSW under the supervision of Jennifer Tolleson, PhD.

This work is being conducted under the auspices of the Institute for Clinical Social Work; At St. Augustine College, 1345 W. Argyle St., Chicago, IL 60640; (773)935-6500.

201 Purpose The purpose of this study is to understand the subjective meaning of road safety practices in Jamaica while illuminating the lived experience of a small sample of Jamaican citizens who have been impacted by loss or injury, either directly or indirectly, due to unsafe road practices. This study will examine psychological and cultural links between Jamaica’s colonial history and attitudes towards safety practices with respect to collective trauma. By interviewing everyday Jamaican citizens about their experiences and perceptions, the goal of this study is to qualitatively contribute to a clinical understanding of attitudes and socio-cultural values ascribed to unsafe road practices, as well as to glean information that may contribute to strengthening Jamaica’s risk prevention strategies addressing road traffic fatalities and injuries sustained by road traffic accidents. Additionally, the results of this study may also be useful in providing clinical insight for treatment of people presenting to psychotherapy for road traffic accident related consequences, such as trauma of grief.

Procedures Used in the Study and Duration Each participant will voluntarily participate in two 60-90 minute, semi-structured interview. Financial compensation will be provided in the form of a $40 payment per interview via MoneyGram. This researcher will audio record, transcribe the interviews, and analyze the material. After reviewing the transcriptions, you may be provided with an overview of your responses as understood by this researcher to ensure that you have been accurately represented/understood. Participant transcripts will be transcribed by a professional transcription company who will sign an agreement of confidentiality. The

202 transcription company will never have access to participant’s real names or other identifying information. All transcripts will be secured on this researcher’s computer in password protected files. The data will be stored for five years, after which it will be destroyed.

Benefits A potential benefit from participating in this study is the opportunity for you to share your story and to feel understood and heard. An additional benefit is by sharing your information, you may contribute to educating others on the topic of this study and the knowledge gained from this study may produce a benefit to Jamaican society. Payment is not considered to be a benefit of participation.

Costs The potential cost includes personal time and the use of minutes on individual cellular data plans.

Possible Risks and/or Side Effects There is a risk that you may find discussing your thoughts and/or experiences on road safety practices and road accidents to be distressing. This risk is likely to be minimal and would not be expected to persist for a significant length of time beyond the interview. If this happens, you may skip any questions that you do not want to answer, take a break, or end the interview. You will still be compensated for your participation in interviews that had been initiated.

203

An additional risk is a possible breach in confidentiality due to conducting the interviews via phone or video. This researcher does not anticipate a breach in confidentiality, but whenever utilizing technological resources, the possibility is there and thus, this factor must be acknowledged.

Privacy and Confidentiality Your confidentiality is paramount. Only this researcher, the research committee, and the transcription company will have access to your interview transcripts and computer data files. The only people who will know that you are a research subject are members of the research committee. (The individual who identified you as a potential research participant will not receive confirmation of your participation nor have access to your interview transcript or any other identifying information. In order to protect your confidentiality, an alias will be provided to represent you in the data. All files will be password protected and will be located on password protected computers. Any additional data will be maintained in a lock cabinet that only the researcher has access too. All interview transcripts will be destroyed five years after the results of the study are published.

No information about you, or provided by you during the research, will be disclosed to others without your written permission, except: - if necessary to protect your rights or welfare (for example, if you are injured and need emergency care or when the ICSW Institutional Review Board monitors the research or consent process); or

204 - if required by law, for example, if you indicate plans to harm yourself or others. In the event that you disclose that you have harmed or intend to harm a child or an elderly person the researcher is a mandated reporter obligated to disclose harms like these to the state in which the researcher holds the license of a clinical social worker.

Subject Assurances By signing this consent form and giving your verbal consent, you agree to take part in this study. You have not given up any of your rights or released this institution from responsibility for carelessness.

You may cancel my consent and refuse to continue in this study at any time without penalty or loss of benefits. Your relationship with the staff of ICSW will not be affected in any way, now or in the future, if you refuse to take part, or if you begin the study and then withdraw.

If you have any questions about the research methods, you can contact Katie Czerniawski, LCSW (Principal Researcher) at this phone number 773-733-1610, or Dr. Jennifer Tolleson (Dissertation Chair), at this phone number 312-342-3184.

If you have any questions about your rights as a research subject, you may contact Dr. John Ridings, Chair of Institutional Review Board; the Institute for Clinical Social Work; At St. Augustine College, 1345 W. Argyle St., Chicago, IL 60640; (773)935-6500.; irbchair@icsw.edu.

205

Signatures

For the Participant I have read this consent form and I agree to take part in this study as it is explained in this consent form:

Participant Name (please print): ___________________________________

Participant Signature:__________________________________________ Date: _____________

1. Would you like a summary of the results of this study?

Yes: ____

No: ____

For the Primary Researcher

206

I certify that I have explained the research to _________________________ and believe that they understand and that they have agreed to participate freely. I agree to answer any additional questions when they arise during the research or afterward.

Researcher Name (please print): ___________________________________

Researcher Signature:__________________________________________ Date: _____________

207

Appendix B

Introductory Script

208 Pre-Screening Email Script and Questions

Introductory script:

Hello, my name is Katie Czerniawski, LCSW. I am working on my dissertation for a Ph.D. in clinical social work at The Institute for Clinical Social Work in Chicago, Illinois. Thank you for taking the time to speak with me. I am conducting a research project seeking to learn more about the culture of road traffic accidents and road safety practices in Jamaica. I am aware of the high number of car and motorcycle accidents in Jamaica and the educational campaigns created to decrease such accidents. I want to gather information and learn more directly from Jamaican citizens who have personally experienced this phenomenon. This study will consist of two 60-90 minute interviews with each participant. This will allow me to hear your individual story, perspective, and experiences on the research topic.

During these discussions, I will be asking about your personal lived experience with Road Traffic Accidents. Questions will include if you have experienced a road traffic accident(s), whether directly, with it being you, or indirectly, perhaps a family or community member. I am interested in how this/these experience(s) have impacted your life, whether that be an attitude or behavior change or whether the experience has not been impactful. I am also interested in how you experience road safety laws in Jamaica and the people who enforce them? I am curious where you learned about road safety, if you ever think about it, and/or whether your practices might change depending on the influence of different people or environmental situations.

209 Additionally, I would like to learn more about individual attitudes on injury and death in Jamaica, and whether thoughts about safety, not just with road safety, are a part of everyday living. Finally, I am interested in hearing what aspects of your road traffic experience(s) you feel are important to share, especially if what feels important to you is not necessarily something that I have thought of or asked about directly. Most importantly, this study is non-judgmental and confidential. There are no right or wrong answers, and all thoughts and experiences are important if they are meaningful to you. I want each participant to feel comfortable speaking freely and honestly about this topic to the best of one’s ability.

I am aware that this topic might be challenging and evoke difficult memories, and I am sensitive to that. If that occurs, the interview can be stopped at any time. I will also provide you with a local therapy services resource if you feel emotional distress and need further support. You will also still receive a $40 payment per interview via MoneyGram for your participation.

Does this study interest you? Would you feel comfortable discussing this topic? If so, would you be interested in participating further?

210

Appendix C

Confirmation of Participation and Final Review of Informed Consent

211

“Great, thank you for your interest in participating in this study. Before we proceed, I would like to review what we have discussed thus far and ask you a few questions. This will help ensure that I have provided a clear description of the study.”

Review Questions:

1) In your own words, please share your understanding of the purpose of this study. 2) Please share why this study is of interest to you and why you would like to participate. 3) Please share your understanding of confidentiality and informed consent. 4) Please share what you can expect to gain from participating in the study.

“Thank you for answering the above questions. Do you have any questions for me?” “At this time, I would like to review the basic tenets of informed consent. Please let me know if you have any questions. Informed consent will also be reviewed once again before your interview, and I will ask you to repeat back to me your understanding. This final review will serve as your official verbal consent, which will be documented via a recording of the interview and in the final transcript.”

212 Additional Demographic Questions: 1) How old are you? 2) In which community/Parish do you live? 3) At what age did you obtain your license and where? Is it still current? 4) For what purpose do you ride in motor vehicles? For example, to go to work, for work, to visit someone, or for pleasure? 5) Have you ever been in a road traffic accident, or had a family member or known of a community member who has been in a road traffic accident and was injured or killed as a result?

“Thank you again for that information and consent confirmation. We are ready to begin the interview process.”

213

Appendix D

Semi-Structured Interview Guide

214 1) The Jamaican Understanding and Internalization of Road Safety Practices

a) When you hear "road safety," what are the first thoughts and/or images that come to mind? b) When did you first learn about road safety practices, and where did you learn it? What were you told? c) Do you think the environment and/or source of road safety education make a difference? d) Do you change your road safety practices based on different circumstances, such as where you are or whom you are with? e) Do you think road safety practices are important or feel they are necessary? If so, why? If not, why not? f) What is your perspective on how most Jamaicans feel about road safety practices and rules of the road? Why do you have this opinion?

2) Jamaican Perceptions of Risk for Engaging in Unsafe Road Practices

a) What types of behaviors on the road, if any, do you view as unsafe? Have you witnessed these unsafe practices? b) Who do you view as most at risk for a road traffic accident? Why? c) What are the features/characteristics of people most likely to engage in unsafe road practices? How do they engage in unsafe practices? Why do you think they choose to engage in unsafe road practices?

215 d) Do you believe that gender makes a difference in road safety? If yes, how? If no, why not? e) Someone told me that motorcyclists engage in dangerous stunts and driving to achieve a sense of "fame." Can you tell me more about that?

3) Personal Experience with Road Traffic Accident resulting in injury or death

a) Please share your personal experience with a road traffic accident that resulted in injury or death. b) Do you remember how you felt at that time? Please share. c) How has that experience affected your life emotionally? d) Has that experience changed your behavior choices on road safety practices?

4) Jamaican Perceptions on Mortality

a) My study is examining the phenomenon of unsafe road practices in Jamaica, but what do you view as the biggest threats to Jamaica’s emotional or physical well-being? (family, violence, economic, education, political) b) Do you believe that any of the above variables impact or promote unsafe behavior choices? How so? c) What are Jamaican attitudes towards death and dying?

216 d) Do you believe unsafe behaviors, such as unsafe road practices, speak to the value of life in Jamaica? Does it depend on the circumstances? (age, gender, social) e) Are you aware of the trend of sharing death and dying videos on the internet of people who have been in road traffic accidents? (ex: Facebook) Have you seen these images/videos? What are your thoughts on this practice? Do you perceive it as a coping mechanism?

5) Jamaican Perspectives on Mental Health

a) When I use the terms mental health or psychotherapy, what comes to mind, if anything? b) How do people feel about those suffering from mental health? (stigma) e) How do Jamaicans cope with any challenging emotional experience, such as loss from a road traffic accident, or anxiety/depression? f) Do people have access to social work or mental health services in Jamaica? What might prompt someone to seek mental health services?

6) Enforcement and Responsibility Encouraging Road Safety Practices

a) Do you recall seeing or reading about Jamaica’s road safety campaigns or adverts?

217 b) Do you believe that Jamaica’s police are doing a good job of enforcing road safety laws? If yes, how? If no, why not? c) What does Jamaican society need to increase the use of road safety practices? Why and how do you feel these ideas might make a difference?

g) Thoughts/Questions a) Open ended….

218

References

Ainsworth, M.D., Bell, S.M. (1970). Attachment, exploration, and separation: illustrated by the behavior of one-year-olds in a strange situation. Child Development, 4(1), 4967. Alase, A. (2017). The interpretative phenomenological analysis (IPA): A guide to a good qualitative research approach. International Journal of Education and Literary Studies, 5(2), 9-19. Altman, N. (1995). The analyst in the inner city. Hillsdale, NJ: The Analytic Press. Altman, N. (2004). History repeats itself in the transference - countertransference, Psychoanalytic Dialogues. 14(6), 807-816. Angen, M.J. (2000). Evaluating interpretive inquiry: reviewing the validity debate and Opening the dialogue. Qualitative Health Research, 10(3), 378-395. Association of Caribbean States, (2017). Road traffic accidents - A man-made disaster? George Nicholson, Director of Transport of the ACS1 Bailey, A. (2011). The Jamaican adolescent’s perspective on violence and its effects. West Indian Medicine Journal. 60(2), 165-171. Balint, M. (1959). Thrills and regression. Mansfield Library, London. Becker, Ernest, (1973). The denial of death. NY: The Fee Press.

219 Bettleheim, B. (1943). Individual and mass behavior in extreme situations. Journal of Abnormal and Social Psychology, 38, 417-452. Blaut, J.M. (1993). The colonizer’s model of the world: Geographical diffusionism and Eurocentric history. NY and London: The Guilford Press. Bloomberg, L.D., and Volpe, M. (2012). Completing your qualitative dissertation: A road map from beginning to end. Sage Publications, Inc.: Los Angeles, London, New Delhi, Singapore, Washington DC. Bloomberg Philanthropies (2018, January 9). Road deaths and injuries hold back economic growth in developing countries. The World Bank. https://www.worldbank.org/en/news/press-release/2018/01/09/road-deaths-andinjuries-hold-back-economic-growth-in-developing-countries Blum, H.P. (1987). The role of identification in the resolution of trauma: The Anna Freud memorial lecture. Psychoanalytic Quarterly, 56, 609-627. Bodnar, S. (2004). Remember where you come from: Dissociative process in Multicultural individuals. Psychoanalytic Dialogues, 14(5): 581-603. Bollas, C. (1987). The shadow of the object: Psychoanalysis of the unknown thought. New York: Columbia Press. Bourne, Hudson-Davis, Sharpe-Pryce, Francis, Solan& Lewis (2015). The effects of homicides and economics on human and social biology: A mental health challenge for society. International Journal of Emergency Mental Health and Human Resilience, 17(2), 495-501. Boyne, I. (2017, May 14). The root of corruption, The Gleaner. http://jamaica-gleaner.com/article/focus/20170514/ian-boyne-root-corruption

220 Boyne, I. (2012, June 24). Austerity and Our Bling Culture. The Gleaner. http://jamaica-gleaner.com/gleaner/20120624/focus/focus2.html Braly, Adam M., Parent, Mike C., DeLucia, Patricia, R. (2017, September 7). Do threats to masculinity result in more aggressive driving behavior? Psychology of Men & Masculinity. Advance online publication. http://dx.doi.org/10.1037/men0000135. Brickman, Celia. (2018). Aboriginal populations in the mind: Race and primitivity in psychoanalysis. NY: Columbia University Press. Burrowes, D. (2017). Road Safety Unit. http://mtw.gov.jm/roadsafety/index.php/en/ Butler, Judith (1995). Melancholy gender – refused identification. Psychoanalytic Dialogues, 5(2), 165-180. Césaire, A. (1972). Discourse on colonialism. Trans. by Joan Pinkham. New York and London: Monthly Review Press. Cawich, S.O., Harding, H., Evans, E., Crandon, I., Mitchell, D., Martin, A., & Rose, R. (2009). Strategies for secondary prevention of motorcycle road traffic accident injuries: Time for policy re-evaluation in Jamaica. The Internet Journal of Emergency and Intensive Care Medicine, 12(1). http://ispub.com/IJEICM/12/1/5695. Cawich, S., Harding, H., Evans, N., & Crandon, I. (2010, January). Revisiting current strategies for primary prevention of motorcycle collisions in Jamaica. Journal of Injury and Violence: 2(1), 55-60. Cohen, J. (1985). Trauma and repression. Psychoanalytic Inquiry, 5(1), 163-189. Connell, R.W., & Messerschmidt, J.W. (2005). Hegemonic masculinity. Gender and Society, 19(6): 829-859.

221 Cost of Care Project (2017). http://www.nationalroadsafetycouncil.org.jm/pdf/ CostofCare2017_Final2Jan2018.pdf Crandon, IW., et al. (2006). The prevalence of seatbelt use in Kingston Jamaica: A follow-up observational study 5 years after the introduction of legislation. Journal of West Indian Medicine, 55(5), X-X. Crandon, IW., et al. (2009, August 29). The impact on motorcycle head trauma at a tertiary hospital in Jamaica. BioMed Central, LTD, 1-7. doi: 10.1186/1756-0500-2-172 Creswell, J.W. (2013). Qualitative inquiry and research design: Choosing among five approaches (3rd Ed). Thousand Oaks, CA: Sage Publications. Crichlow, W. (2014). Hyperheterosexualization and hyper masculinity: Challenges for HIV/AIDS intervention in the Caribbean, Trinidad and Tobago. International Journal of Sociology and Anthropology, 6(1), 28-41. Cushman, Philip (1995). Constructing the self, constructing America: A cultural history of psychotherapy. Da Capo Press, A Member of the Perseus Book. Davids, M.F. (1996). Frantz Fanon: The struggle for inner freedom. Free Associations, 6(2), 205-234. Davis (2007). Reflections on race, racism, and psychotherapy. New Directions in Psychotherapy and Relational Psychoanalysis, 1(1), 50-56. Denzin, N.K., & Lincoln, Y.S. (2011). The SAGE handbook of qualitative research. Sage Publications, Inc.: Los Angeles, London, New Delhi, Singapore, Washington, DC.

222 DeWind (1968). The confrontation with death. International Journal of Psycho-Analysis, 49, 302-305. Dombrowski, K. (2019, December 17). Enacting and enforcing laws. D+C: development and cooperation. https://www.dandc.eu/en/article/risk-dying-traffic-accident-threetimes-higher-poor-countries-rich. Dorpat, T.L. (1978). Psychological aspects of accidents. Annual of Psychoanalysis, 6, 273-283. Eng & Han (2000). A dialogue on racial melancholia. Psychoanalytic Dialogues, 10(4), 667-700. Fanon, Frantz. (1961). Wretched of the Earth. NY: Grove Press. Fanon, Frantz. (1967). Black skins, white masks. NY: Grove Press. Forbes, M. (2012, November 23). Music and media shaping behaviors. Marcia Forbes, Media Matters. http://www.marciaforbes.com/content/music-media-shaping behaviors. Freud, A. (1936). The ego and the mechanisms of defense. The Writings of Anna Freud Vol. 2 New York: International University Press, 1966. Freud, A. (1967). Comments on trauma. In S.S. Furst (Ed.), Psychic trauma (235-245). New York and London: Basic Books. Freud, S., & Breuer, J. (1895). Studies on hysteria. In J Strachey (Ed. And Trans.), The standard edition of the complete psychological works of Sigmund Freud, Vol. II. London: Hogarth Press, 1955.

223 Freud, S. (1901). The psychopathology of everyday life: Forgetting, slips of the tongue, bungled actions, superstitions and errors. The standard edition of the complete psychological works of Sigmund Freud, Volume VI, vii-296. Freud, S. (1905). Three essays on the theory of sexuality. The standard edition of the complete psychological works of Sigmund Freud, Volume VII: 123246. Freud, S. (1917). Mourning and melancholia. The standard edition of the complete psychological works of Sigmund Freud, Volume XIV (1914-1916): On the history of the psycho-analytic movement, papers on metapsychology and other works, 237-258. Freud, S. (1919). Introduction to psychanalysis and the war neuroses. In J. Strachey (Ed. And Trans.). The standard edition of the complete psychological works of Sigmund Freud, Vol 17. London: Hogarth Press, 1955. Freud, S. (1920). Beyond the pleasure principle (J. Strachey, Ed. And Trans.). New York and London: W.W. Norton & Co., 1959 Freud, S. (1921). Group psychology and the analysis of the ego (J. Strachey, Ed. And Trans.). New York and London: W.W. Norton & Co., 1959 Freud, S. (1926). Inhibitions, symptoms and anxiety (J. Strachey, Ed. And Trans.). New York and London: W.W. Norton & Co., 1959. Freud, S. (1936). Inhibitions, symptoms and anxiety. Psychoanalytic Quarterly, 5, 415433. Freud, S. (1939). Moses and monotheism (K. Jones, Trans.). New York: Random house, 1967.

224 Frosh, S. (2013). Psychoanalysis, colonialism, racism. Journal of Theoretical and Philosophical Psychology, 33(3), 141-154. Furst (1967). The stimulus barrier and the pathogenicity of trauma. International Journal of Psycho-Analysis, 59, 345-352. Gergen, K. (2009). An invitation to social construction. London: Sage. Gherovici, P. Christian, C. Plotkin, M.B. (2019, November 19). In Jamaica,‘road madness’ leads to increased fatalities - and a call to action. Global Voices. https://globalvoices.org/2019/11/19/in-jamaica-road-madness-leads-to-increased fatalities-and-call-to-action/ The Gleaner (2009, January 5) Jamaica’s crime burden-bleeding health-care system. http://jamaica-gleaner.com/ gleaner/20090105/news/news3.html Global Alliance of NGOs for Road Safety, (2020). https://www.roadsafetyngos.org Global status report on road safety 2018: Summary. Geneva: World Health Organization; 2018 (WHO/NMH/NVI/18.20). License: CC BY-NC-SA 3.0 IGO). Goldstein, D. (2020, January 12). Two states. eight textbooks. two American stories. The New York Times. https://www.nytimes.com/interactive/2020/01/12/us/texas-vscalifornia-history-textbooks.html Gosselin, R., Spiegel, D., Coughlin, R., Zirkle, L. (2009). Injuries: The neglected burden in developing countries. Bulletin of the World Health Organization, 87, 246-246. doi:10.2471/BLT.08.052290 Griffen, D., O’Cass, A. (2010). An exploration of personality and speed limit compliance. Journal of Nonprofit and Public Sector Marketing, 22, 336-353.

225 Groes-Green (2009). Hegemonic and subordinated masculinities: Class, violence and sexual performance among young Mozambican men. Nordic Journal of African Studies, 18(4), 286-304. Grubrich-Simitis, I. (1981). Extreme traumatization as cumulative trauma – Psychoanalytic investigations of the effects of concentration camp experiences on survivors and their children. Psychoanalytic Study of the Child, 36, 415-450. Grumet, G. (1989). Emotional aspects of motoring. Psychoanalytic Review, 76(1), 19-36. Hart (1994). Exile and bereavement. Psychoanalytic Psychotherapy, 8(3), 227-241. Haslam, N. (2006). Dehumanization: An integrative review. Personality and Social Psychology Review, 10, 252-264. Hassen, A., Godesso, A., Abebe, L., Girna, E. (2011). Risky driving behaviors for road traffic accident among drivers in Mekele city, northern Ethiopia. BMC Research Notes, 4, 535. https://www.ncbi.nim.nih.gov/omc/articles/PMC3253774/ Hare, K. (2015). (Ministry of Transport, Works & Housing Road Safety Unit) Hare, K. (2018). Preliminary annual traffic crash report, 2018. Ministry of Transport and Mining. https://www.mtw.gov.jm/roadsafety/images/Reports_And_Statistics/ Annually/2018/Crash_Report_December_31_2018.pdf Heidegger M. (1962) Being and time. Oxford: Blackwell. Hickling, F.W. (2020). Owning our madness: Contributions of Jamaican psychiatry to decolonizing global mental health. Transcult Psychiatry, 57(1), 19-31. doi:10.1177/1363461519893142 Holmes, D.E. (2006). The wrecking effects of race and social class on self and success. Psychoanalytic Quarterly, 75(1), 215-235.

226 Hook, Derek, (2012). A critical psychology of the postcolonial: The mind of apartheid. East Sussex, U.K & NY: Routledge, 2012. Hong, K.H., & Dos Santos, L.M. (2017). A brief discussion and application of Interpretative phenomenological analysis in the field of health science and public health. International Journal of Learning and Development, 7, 123-132. Hundley, T., McCarey, D. (January 14, 2014). Roads kill: Traffic accidents take a heavy toll in poor countries, The Washington Post. Jamaican Observer (2015, August 02). ‘Out of many, one people: Motto or myth?’ http://www.jamaicaobserver.com/editorial/Out-of-many--one-people--Motto-ormyth_19221909 James, C.E., & Davis, A. (1995). Jamaican males’ readings of masculinities and the relationship to violence. Caribbean Review of Gender Studies, 8, 79 - 111. Janet, P., 1907. The major symptoms of hysteria. Hafner, New York. Khanna, R. (2003). Dark continents: Psychoanalysis and colonialism. Drake University Press. Kamugisha, Aaron. Caribbean political thought: Theories of the post-colonial state. Kingston, Jamaica: 2013. Klein, M. (1940). Mourning and its relation to manic-depressive states. International Journal of Psycho-Analysis, 21, 125-153. Kristeva, (1998). Powers of horror: An essay on abjection. Columbia University Press: New York. Krystal 1975). Affect tolerance. Annual of Psychoanalysis, 3, 179-219. Krystal (1978). Trauma and affects, Psychoanalytic Study of the Child, 33, 81-116.

227

Laverty, S.M. (2003). Hermeneutic phenomenology and phenomenology: A comparison of historical and methodological considerations. International of Qualitative Methods, 2(3). Article 3. Retrieved 2019 from http://www.ualberta.ca/-iiqm/backissues/2_3final/pdf/leverty.pdf Layton, L (2006). Racial identities, racial enactments, and normative unconscious processes. Psychoanalytic Quarterly, 75(1), 237-269. Lewis, E. (2019). In Jamaica, ‘road madness’ leads to increased fatalities and call to action. Global Voices. https://globalvoices.org/2019/11/19/in-jamaica-road-madness-leads-to-increasedfatalities-and-call-to-action/ Lubit, R., Rovine, D., Defrancisci, L.; Eth, S., (2013). Impact of trauma on children. Journal of Psychiatric Process, 9(2), 128-138. Malater, E. (2007). David Cronenberg’s benevolent pathology: Technology, trauma, and the perverse social link in Crash. Psychoanalytic Review, 94(6): 887-902. Mallia, L, et al. (2015, March 28). Crash risk and aberrant driving behaviors among bus drivers: The role of personality and attitudes towards traffic safety. Accident Analysis and Prevention, 79, 145-151. Mathews, J. (September, 2009). Media and message: Communicating crises. Humanitarian Exchange. 44, 26-28. Maxwell, J. (1994). Social work and social issues: The Caribbean. Center for International Social Work: Inaugural Conference, 4, 26-28. Retrieved from https://opencommons.uconn.edu/sw_intlconf/4

228 Meyers, J. (2015, October 21). Countries with the most and least world traffic deaths. World Economic Forum. Retrieved from https://www.weforum.org/agenda/2015/10/countries-with-the-most-and-least-roadtraffic-deaths/ Mitchel, S., & Black, M. (1995). Freud and beyond: A history of psychoanalytic thought. Basic Books, New York. Mohammed, F. (2014, February 9). Trouble in paradise: Jamaica’s culture of misogyny. Girl’s Globe. https://www.girlsglobe.org/2014/02/09/trouble-in-paradise-jamaicasculture-of-misogyny/ Moodly R. & Palmer, S. (2014) Race, culture and psychotherapy: Critical perspectives in multicultural practice; and race culture and other multiple constructions: An absent presence in psychotherapy. Taylor & Francis Mordecai, M. & Mordecai, P. (2001). Culture and customs of Jamaica. CT: Greenwood Press. Nantulya & Reich, (2002). The neglected epidemic: road traffic injuries in developing countries. BMJ, 324(7346), 1139-1141. doi: 10.1136/bmj.324.7346.1139 National Road Safety Council (NRSC), http://nationalroadsafetycouncil.org.jm Nordfjaern, T., Simsekogulu O., & Rundmo, T. (2012). A comparison of road traffic culture, risk assessment and speeding predictors between Norway and Turkey. Risk Management, 14(3), 202-221. Oliver, K. (2004). The colonization of psychic space: A psychoanalytic social theory of oppression. University of Minnesota Press: Minneapolis, London.

229 Opotow, S. (1990). Moral exclusion and injustice: An introduction. Journal of Social Issues, 46, 1-20. Pariona, (2020, January 9). World Atlas, Murder rate by country. https://www.worldatlas.com/articles/murder-rates-by-country.html Jamaica has the second highest Pietkiewicz, I. & Smith, J.A. (2014). A practical guide to using interpretative phenomenological analysis in qualitative research psychology, Czasopismo Psychologiczne Psychological Journal, 20(1), 7-14. Pinnock, A. (August 2007). “A ghetto education is basic”: (Jamaican) dancehall masculinities as counter-culture. The Journal of Pan African Studies, 1(9). Plummer, JM., Brown, H., Jones, K., Fearon-Boothe, D., Meeks-Aitken, N., McDonald, AH (2010). Trauma: the burden of a preventable problem. West Indian Medical Journal, 59(1), 26-28. Plummer, JM., Ferron-Boothe, D., Meeks-Aitken, N., McDonald, AH. (2014). Trauma in the developing world: the Jamaican experience. West Indian Medical Journal Jun; 63 (3), 267–270. Ponterotto, (2005). Qualitative research in qualitative psychology: a primer on research paradigms and philosophy of science. Journal of Counseling Psychology, 52(2), 126-136. Redshaw, S. (2006). Dangerous gender performances: ‘Hydraulic masculinity’ as a norm for young male drivers, peer reviewed conference paper, October 2006, 1-10. https://www.researchgate.net/publication/237021004

230 Shim, Jermel. (2018). The long road to progress for Jamaica: The achievements and failures in the post-colonial era. USA: Outskirts Press. Smith, B., Mackenzie-Ross, S., & Scragg, P. (2007). Prevalence of poor psychological morbidity following a minor road traffic accident (RTA): The clinical implications of a prospective longitudinal study, Counselling Psychology Quarterly, 20(2), 149-155. DOI: 10.1080/09515070701403679 Smith, J.A., Flowers, P., & Larkin, M. (2009). Interpretative phenomenological analysis: Theory, method, and research. Los Angeles, CA: Sage Publications. Smith, J. & Osborn, M. (2003) Interpretative phenomenological analysis. In J.A. Smith. (ED.) Qualitative psychology: A practical guide to research methods (pp. 51-80). London: Sage. Surju, Christopher. (2021, January 27). Violence against women: An urgent national problem. The Gleaner. https://jamaica-gleaner.com/article/news/20210127/violenceagainst-women-urgent-national-problem Tabachnick (1976). Death trend and adaptation: A psychoanalytic theory of accident. Journal of American Academy of Psychoanalysis, 4(1), 49-62. Tang, K.H., Dos Santos, L.M. (2017). A brief discussion and application of interpretative phenomenological analysis in the field of health science and public health. International Journal of Learning and Development, 7(3), 123-132. Thomas, Deborah A. (2011). Exceptional violence: Embodied citizenship in transnational Jamaica. Duke University Press. Durham and London.

231 Tolleson, J. (1997). Death and transformation: the reparative power of violence in the lives of black inner city gang members. Smith College Studies in Social Work. 67(3), 415-431. Tolleson, J. (2009). Saving the world one patient at a time: psychoanalysis and social critique. Psychotherapy and Politics International, 7 (3), 190-205. Tronnick, E.D. (2007). The neurobehavioral and social-emotional development of infants and children. W.W. Norton & Company: New York. Van Der Kolk, B.A (2000). Trauma, neuroscience, and the etiology of hysteria: an exploration of the relevance of Breuer and Freud’s 1893 article in light of modern science. Journal of American Academy of Psychoanalysis, 28(2), 237-262. Van Der Kolk, B.A., & Van Der Hart, O. (1991). The intrusive past: the flexibility of memory and the engraving of trauma, American Imago, 48(4), 425-454. Van Manen, M. (2007). Phenomenology of practice: Meaning-giving methods in phenomenological research and writing. Routledge, Taylor & Francis: London and New York. Walker, L., Butland, D., Connell, R.W. (2000). Boys on the road: Masculinities, car culture, and road safety education. The Journal of Men’s Studies, 8(2), Winter, 153-X. https://www.questia.com/read/1G1-59269940/boys-on-the-road-masculinities-carculture Walker, R., Kyomuhendo, G., Chase, E., Choudhry, S., Gubrium, E., Nicola, J., Ming, Y. (2013). Poverty in a global perspective: Is shame a common denominator? Journal of Social Policy, 42(2), 215-233. doi:10.1017/S0047279412000979

232 Waytz, A., & Schroeder, J. (2014). Overlooking others: Dehumanization by omission and commission. TPM, 21(3), September 2014, 251-266 – Special Issue © 2014 Cises. White, K.P. (2002). Surviving hating and being hated: some personal thoughts about racism from a psychoanalytic perspective. Contemporary Psychoanalysis, 38(3), 401-422. Wilson, (2018, November 17). Deadly motorcycles - Culture change in Westmoreland needed to tackle motorcycle-related road fatalities, says road safety, The Gleaner. http://jamaica-gleaner.com/article/lead-stories/20181117/deadlymotorcycles-culture change-westmoreland-needed-tackle Winnicott, D.W. (1969). The use of an object. International Journal of Psycho-Analysis, 50,711-716. World Atlas, Murder rate by country (2020) found via https://www.worldatlas.com/articles/murder-rates-by-country.htmlJamaica has the second highest World life expectancy, (2017). (https://www.worldlifeexpectancy.com/cause-ofdeath/road-traffic-accidents/by-country/) Zimbardo, P., Keough, K., Boyd, J. (1997). Present time perspective as a predictor of risky driving. Science Direct, 23(6), 1007-123. https://doi.org/10.1016/S0191-8869(97)00113-X Zinn, H., (1980). A people’s history of the United States. Harper Perennial: Modern Classics.