From: Chapter 14, Trauma Work with Latin American Women in Canada, in Working With Immigrant Women: Issues and Strategies for Mental Health Professionals (© CAMH 2008)
In Latin America, it is acceptable to be depressed. In fact, there is an endearing term for it: “depre,” as in, “Ai! My depre came upon me again.” Or, “I feel very depre.” Or, “I am with the depre again.” Many may talk to others about their problems; these are “problemitas”—“little problems.” People who sit in the park talking to themselves, however, are known as “loquita”—“a little crazy.”
What is not acceptable in Latin America is to go to a “doctor” to talk about problems. A doctor could include a psychiatrist, a psychologist, a counsellor of any type—even a priest (unless it is for confession). Someone who goes to a doctor is “loco”—“majorly crazy.” This means the person cannot function anywhere, is no longer a real person and may be locked up. Everybody knows someone who is “loca” and “is on drugs forever and acts like a zombie—no longer part of this world.”
Many come to a community mental health clinic because their family doctor, community worker or friend has told them that they need help. Sometimes, their first words are, “I am not crazy, you know.” At other times, they may say, “I think I am going crazy.”
In the Hispanic community, a woman is a family’s strength. When a woman is unwell, the family suffers. In dealing with mental illness, a woman may feel considerable shame and guilt about being unable to fulfill her role in the family. She also has to deal with the stigma of “craziness” if she seeks help, and the subsequent loss of respect from others (Freire, 2002; Rubio, 2004; Viswanathan et al., 2003).
This chapter focuses on refugee women from Latin America who may find it difficult to orient to their new life in Canada. (Chapter 12 also discusses clinical issues related to primarily Spanish-speaking women from Central and South America.) While, with time, they adjust to life in Canada, the stresses of the resettlement process may bring back past memories that had been buried in the subconscious. Refugee women often have had no time to prepare to leave their home country or to say goodbye to family and friends. They may have left many matters unfinished (Rubio, 2004; Viswanathan et al., 2003). In addition, they may have had single or multiple traumatic experiences, which sometimes culminate in a lifetime of upheaval carefully guarded in secrecy for years. Once in a new country, many wounds may re-open, along with the pain of losing a sense of being functionally competent because they are in a new and alien environment. These experiences can unearth past trauma, leading them to seek care and trauma therapy.
Clients are often surprised that neither the trauma nor the trauma response stop upon arrival in Canada. The expectation of safety, which is the reason for leaving their country, betrays them. They are not completely safe. The immigration process still threatens their life here, as do economic problems, unsuitable housing, inability to speak the language and difficulties in getting needed child care so they can study or work. They need to work through many details necessary for everyday life in an environment where the illusion of safety is challenged at every turn.
Trauma therapy works to harmonize the physical, emotional and cognitive aspects of a person’s experience in order to reconstitute a whole person (Ogden & Minton, 2000). In this chapter, I address trauma therapy from my experience as a Latin American mental health clinician and trauma worker. I also discuss techniques that I use in my practice to integrate the context of a client’s cultural experience. I use the terms “Hispanic,” “Spanish” and “Latin American” interchangeably. I also use the terms “client,” “woman” and “refugee woman” interchangeably to refer to women seen in my practice at a mental health clinic.
The chapter discusses:
- the social and cultural context of Latin American refugees and immigrants in Canada
- key concepts in working with Latin American women with mental health concerns
- a case study that follows one client through the therapeutic process
- additional therapeutic techniques
- implications for practice
In Trauma Work with Latin American Women in Canada
Implications for Practice