The Tai Qi of Photovoice

History

Photovoice is based on the understanding that people are experts on their own lives. It was first tried with village women in Yunnan Province, China. How did it begin? One day, at a public health luncheon, my mother, Virginia Cheng Li, and Mary Ann Burris, an international educator asked by the Ford Foundation to serve as a program officer in China, began sharing ideas. My mother proposed what would later become the Ford Foundation-supported Yunnan Women’s Reproductive Health and Development Program. Later, to buttress the household surveys and focus groups, Mary Ann saw the need for village women’s firsthand voices and views of reproductive health. She recommended giving cameras to the village women so that they could photograph their everyday health and work realities. When I had the good fortune to meet this woman, my passion to integrate grass roots documentary photography with values of community organizing and Dorothy Nyswander’s words to “start where the people are” (Nyswander, 1956), along with some proficiency in Mandarin, gave me the opportunity to join the team.

My colleagues and I offered cameras and training to 62 village women, all farmers, who lived in 62 different villages. The village women were our teachers and colleagues, too. For one full year—taking one roll of film per month—the village women photographed their families and countryside to document their lives. They met summer, fall, winter, and spring to describe their photographs and identify the themes in those images. And “my colleagues” is a vague term, but there is no mistaking the breadth and depth of collective experience—Chinese counterparts also included anthropologists, public health cadres, physicians, community organizers, scholars, a photojournalist—and policy makers, crucially, at the township, county, and provincial level. Because not all the village women were able to read or write, these counterparts wrote down the women’s own words about their photographs. The policy makers had the political will and power to act on the women’s recommendations.

In 1994, Mary Ann and I wrote about this “photo novella” project as a tool for empowerment education. That article described the theoretical underpinnings of this approach: empowerment education, feminist theory, and documentary photography (Wang & Burris, 1994). Promoting what Brazilian educator Paulo Freire (1970) has called “education for critical consciousness”, the approach invites people to document and discuss their life conditions as they see them, and inform policy. Our team edited a book, Visual Voices: 100 Photographs of Village China by the Women of Yunnan Province (Wu et al., 1995), and again used the term photo novella, a term that has commonly described the process of using pictures to tell a story or teach language or literacy. Two years later, we submitted an article about the significance of this strategy for participatory needs assessment to Health Education and Behavior, edited by the late Noreen Clark at the University of Michigan, where I was a young assistant professor. Noreen was my dean and guide, and one night over Chinese food in Ann Arbor, she helped me see that our work was far more than a project; we had created and described a methodology by which community people could reach policy makers. Give this process of inquiry a new name, she urged. Without her advice and encouragement, the Yunnan project involving village women using cameras to reach policy makers would have been a significant yet one-off participatory effort. Instead, a testament to Noreen’s vision, our article, “Photovoice: Concept, Methodology, and Use for Participatory Needs Assessment,” introduced and described photovoice (Wang & Burris, 1997), a methodology for participatory action research. ²

I would like to say what working with the village women meant to me, and therefore what photovoice means to me. Learning from Ruan Chun Lan, Li Can Mei, Tao Li Li, and their 59 comrades who walked for miles over dirt roads to get to our meeting sites meant more to me than I could communicate in my western-accented Mandarin and understand of their Hei Yi, Bai Yi, and varied Yunnanese dialects. These women dig the soil and feed the country. These mothers carry straw on their backs, kneeling beneath the staggering weight of loads five times their size. These craftspeople hand-embroider intricate textiles to adorn backpacks for carrying their babies to the field where they stipple holes in the ground with their fingers and hoe corn. And yet, in the early 1990s when we were just starting the project, a visiting scholar from China at the University of California at Berkeley contended that asking the women to take pictures and tell stories about their lives to reach policy makers “would never work.” When I asked why, he said, “because they are stupid.” His comment stunned me, and as you will see later, challenged me to attempt to view his perspective with fierce compassion rather than judgment.

In my early 20s, the mid-1980s, 15 years before I went to Yunnan, I lived with a Chinese family in Beijing in their two-bedroom apartment. In those days, there were thousands more bicyclists on the roads than vehicles. I rode my black Flying Pigeon bicycle to my job as an assistant to the bureau chief and radio reporter at ABC News. I had dreams—a job in the news media would enable me to contribute to changing the shallow, debased understanding of China.

As a person of Asian descent born in North Carolina and named for that state by my immigrant parents, perceptions of China in the west mattered very much to me. At home now, every month, I make bone soup, staying close to the ingredients and collagen of life. My bone soup nourishes me in the world I both inhabit and do not. I was nearly 60 years old the first time I saw a woman of Asian descent on the cover of a major U.S. news magazine. Why do I bring all this up in relation to the history of photovoice? The point of the methodology is to show people that the map in their mind can be redrawn, and a different portrayal, a different route discovered—to equality, to inclusion, to life chances—to everything that impacts physical, mental, and social health, and to offer a route through grassroots participation to influence policy and programs.

Photovoice is based on the principles that images teach, pictures can influence policy, and people ought to participate in creating the policies that govern their lives. While these principles inspire and guide us, they cannot protect us from tragedy and grief. Shortly after our Yunnan project began, Li Can Mei took a portrait of her young son, sitting at a desk with a tattered book, looking at his mother as she snapped his photograph. One month later, her boy drowned while swimming in Yangzhong Lake. No adults had been nearby to save him. I could never forget the look of warmth and love in her son’s eyes. Li Can Mei called the image “Priceless Photograph.” The depth of Li Can Mei’s loss, her words, and the photograph of her son, empowered the village women to advocate successfully for day care cooperatives.

Tai qi is an ancient internal art. We practice for ourselves, but we also practice with and for a local and global community, in the hope that we can be of service. I believe people who use the photovoice methodology also hope to be of service, sometimes for themselves, and I hope often, even usually, for and with a community as well.

Opening to TAI QI, Opening to Photovoice

People come to tai qi by different paths. I could say that I came to this ancient practice because my qi felt weak, or I was suffering because my spine and bones lacked core strength. What I felt in my body ranged from “it’s hard to get up off the couch” to sadness and grief. My fellow students come to class with a sense of their own imbalance, stupor, or racing mind. Whatever brings us to tai qi, we are each seeking to deepen our body awareness and improve our health. Similarly, people come to photovoice by different paths, yet all in some kind of quest. One person comes with curiosity, a desire to learn, a need or duty. Another is outraged by an injustice, while someone else sees imbalance in society that feels wrong. They all sense a potential for change, perhaps in themselves, in how others see the world, in the fairness and the quality of community.

TAI QI, Photovoice, and the art of listening

Four years ago, I flew from California to Tampa, Florida, to attend a national tai qi workshop. On a cool January afternoon, I checked into my hotel room. I took a walk and saw a white egret strolling on the grass. Later I was assigned to a group of people with whom to practice tai qi for the week. I sat down in a folding chair next to Bonnie, a gray-haired woman who teaches tai qi in Canada, and asked her what she had learned from her four decades of tai qi practice. She said, “Tai qi teaches you how to talk to people.”

Tai qi teaches you how to talk to people? There we were, looking like two older students of this soft martial art, sitting on our folding chairs in a big room with a linoleum floor, but the effect of her words on me were like the moment when I watched that great white egret suddenly spread her wings and take flight. Instead of having spooned examples to me, it was her way of being in the world, and awareness, which got to me. As my Generation Z daughter might say: it got me in the feels. To relate this idea to photovoice, I think of the group discussions in which the photographers themselves, in their own words, unpack the story behind their photographs, and everyone listens. This effort is core to the methodology. Guided by the SHOWeD acronym (Shaffer, 1984), each person describes the photograph that she has taken:

What do you See here?

What’s really Happening here?

How does this relate to Our lives?

Why does this situation exist?

What can we Do about it?

It has been many years since I have participated in these group discussions, but what stays with me is how hard the stories were that people brought up. Hard like the death of a parent, chronic pain that cuts the spine like a knife, bullet holes in the school bus windows. I felt unprepared for the depth of trauma people spoke about. I tried to stick to something I knew I could do, which was listen.

When I was in high school, I came across the words, “There is a way of listening that surpasses all compliments,” and I copied them down in a brown spiral notebook of favorite quotations that I still keep by my desk. I believe listening is the most important, and perhaps most underrated skill, for someone who is facilitating a photovoice project. My vision of photovoice as a process of critical consciousness is that each person will dedicate themself to the practice of learning how to talk with people, which really means learning to listen to people, especially to people with less power than, say, the person who is reading these words.

It is the quality of listening that matters. Photovoice projects mirror the power dynamics within society. The whole process of being listened to, or being ignored, reflects power dynamics and biases that arise from national origin, social class, race, sex, gender orientation, and expression, as well as education, age, languages spoken, health status, veteran status, religion, and ability.

Memory of that visiting scholar from China who called these women “stupid” never left me. Photovoice is designed to meet and challenge such views. Eventually, I was able to listen from my heart to his scathing words, and sense a range of emotions behind them. Now I appreciate his bluntness as a gift of sorts. It challenges me to practice the ancestral wisdom of seeing the beam in one’s own eye before noticing the mote in another’s.

Perhaps “the tai qi of photovoice” can become a code phrase to suggest the practice of self-awareness. Among people who use the methodology, I hope practicing the tai qi of photovoice will support reflection, and invite conversations about power dynamics even if they are sometimes uncomfortable. I hope the tai qi of photovoice will encourage people to practice the art of listening to understand.

“Life is one continuous mistake”

I am a student of tai qi. I make mistakes. This awareness has helped me to admit my humanity. I’m fond of the words attributed to 12th-century zen master Eihei Dogen, “Life is one continuous mistake.” When we carried out our first photovoice project in Yunnan, I was part of a team that created something of value to the world and made mistakes. I still wince at how wasteful I was in the making of reprints. Taking responsibility and owning those mistakes with clear-eyed honesty is part of growing up as a researcher practitioner, as well as a human being.

It is easy to write up a project and leave out one’s embarrassing failures of judgment or action. For example, in years of writing and talking about photovoice, I have often told a story that goes like this:

One woman took nearly a whole roll of film that showed a tiny, distant speck of a person, baby on her back, engulfed in a field of rice. When encouraged to take some pictures from a closer range the next time, she replied that she wanted to show that one woman had to farm this massive piece of land.

I was that well-meaning advisor to the photographer. I stumbled, forgetting the precision with which the person behind the camera communicates, and the essence of people saying exactly what they mean.

I encourage the reader to explore depths of failures as well as the depths of heart in looking at one’s use of the methodology. “Encourage the reader” may be fitting words because the practice of owning the failures and flaws can be humbling. The name of an apt tai qi movement comes to mind: “touch sea bottom.”

Bringing People Together

On a spring day last year, our family adopted a puppy. Weighing less than seven pounds, she came to us at 12 weeks old, a pale coffee-colored whirling dervish of a dog. We named her Sangha, the Sanskrit word for community. Sangha connects my daughter and me with the man on the sidewalk who touches her fur and says, “You made my day. After five wars, it is the only thing that helps,” and tai qi connects people in a church basement each week—skinny people and large people, students and construction workers, and atheists and Buddhists get together to practice moving in unison. The worldwide COVID-19 pandemic changed our practice, and for more than a year, nearly, 1000 people from Australia and Costa Rica to Poland and the United States met weekly on zoom.

The day after Sangha arrived at our home, I joined a few old friends to practice tai qi in person for the first time since the pandemic began. Beneath redwood trees, as we began to grasp bird’s tail and carry tiger to mountain, I watched a friend’s hands and wrists coil and uncoil in the sunlight. I felt so astonished by her grace that my mouth dropped open and I could barely focus on my own movements. My friend lifted my efforts just because I was near her. No matter how diligently I had practiced tai qi in my backyard during the pandemic, connecting to this tai qi sangha brought a level of inspiration I could never achieve alone. Bringing people together, I hope that photovoice will continue to enable people to make connections greater than the sum of the parts.

My international tai qi family is made up of human beings. We practice flexibility, and develop core strength, endurance, and form. We are imperfect. As a group, we mirror the power dynamics, flaws, and biases of human nature. Photovoice interactions and photovoice projects mirror the same qualities, sometimes in beautiful and human ways, and other times sad and human ways.

Outcomes

In the years since I left academia, I have developed another practice, writing from the heart. My writing teacher Natalie Goldberg likes to say: do not get tossed away (Goldberg, 2017). She refers to the many reasons we quit writing practice, which helps me acknowledge my own obstacles. I am tired, that person I love is in crisis, I need to organize this meeting, I want to watch the mourning doves feed their chicks nesting by my window. Filling notebook after notebook takes sustained effort. Recruiting policy makers takes labor and resourcefulness. Social and political power is so unbalanced in society that if organizers do not put effort and commitment toward policy change, well, then—it gets tossed away. With writing practice, I partner with friends, and we companion one another in our writing. With photovoice, the policy change effort can only come about in a similar way, with a policy sangha.

Tai qi is a process that promotes the health of one’s internal organs, body, and spirit. In my worldwide tai qi community, we have a stated aim to promote the well-being of everyone in society. Compassion is the foundation. Photovoice is a methodology designed to promote the well-being of all, especially those who bear the greatest health burdens. The degrading effects of paternalism, pity, or a desire for power over others begin to be counteracted when the work flows from compassion.

Bowing

In tai qi practice, we open with a deep bow, and we close with a bow of respect and appreciation. I bow to Kathleen Roe, Robert Strack, Robin Evans-Agnew, and the guest editorial board of this theme issue for giving me this space to write to you from the heart. The words that follow are my other bow of respect, for I, both am and am not a student of photovoice. I am a student of photovoice in what I learn about my own heart and in what I learn from the people who take photographs, tell stories, and advocate to policy makers. But I have not been able to keep up with what has happened in the print and multi-media world of photovoice over the past 15 years.

In 2006, when I left my position at the University of Michigan—where I was living the dream around photovoice, so to speak—I left more than my physical desk and chair, the window overlooking the medical school and big sky, and Shirley down the hall who helped run our department with a nobility and grace one could count on. I left the structure, support, and those intangibles that contribute to a woman of color getting to feel like a grown up whose competence in her work she hopes will make her worthy of the privilege to write and teach what matters most to her.

To the people who have contacted me asking for help in photovoice projects, human subjects’ protocols, masters or doctoral theses, book chapters, and article reviews—I regret that my health condition often kept me from responding. Had it been in my power, I would have given you the moon. Instead, I came to realize the hard way that too much stress is not good for the immune system, and my body sent me urgent signals to pay attention. I had already survived a serious blood disease after college that left me with suppressed protection from infection. In 2001, I was diagnosed with an aggressive cancer, and I eventually chose to leave my position at the University of Michigan and move west with my family. I wanted to get enough sleep, to read a poem to my then two young children when tucking them into bed, and frankly, to try to stay alive. I do not like sounding melodramatic, but it is the closest I can come to describing what was going on for me, even as I learned also how hard it is to release prematurely what I felt then would be my life work.

I wish I could have companioned you in your photovoice efforts the way I had hoped to. That too is part of ripening as a human being—admitting my flaws and omissions, letting go, and cheering from afar as everyone puts forth their best effort and intention and new ideas. My silence may have seemed to signal I did not care, but I want to encourage you now, to tell you that your effort has meaning, and to thank you for doing what you’re doing.

For over five years I have been engaged in another practice that is also a kind of tai qi. I am a student of grief. My practice is to allow my tears to reflect and inform my experience. I engage in this practice not only because of what is going on in this country where I live, but all over the world—and also because of physical and mental suffering and losses in places and prisons unseen; in streets where people are beaten and murdered; in private and public spaces where people ought to be cared for and instead are humiliated and violated; and in oceans, fields, forests, and glaciers. Biologists estimate that a sixth of all birds, a fifth of all reptiles, a quarter of all mammals are headed toward extinction. For a person who believes in public health as social justice (Beauchamp, 1979), paying attention to what is happening, and to whom, is a heartbreaking call to action.

There is also, ironically, a happy aspect of grief practice, felt to the marrow which I call “gratitude grief.” My gratitude to my teachers, fellow learners, and benefactors is deep so that I can only shake my head. If I spoke of them here and described the whys, there would be no room left in this special theme issue on photovoice for the articles to follow. I am thrilled and honored to companion them here. I simply bow again, and may we bow together for every effort we each offer to the tai qi of photovoice.