Immigrant Psychology: Heart, Mind, and Soul

By Joachim O. F. Reimann and Dolores I. Rodríguez-Reimann

Migrations have occurred throughout human history. They are often difficult for both the migrants and their new countries. But immigrants can also bring vitality to their adopted homes. All of us thus need to understand what will help new arrivals succeed and prosper.

This book offers information about mental health and wellness among immigrants. It describes both the stressors they often face and the cultural resilience that helps many overcome such obstacles. It then addresses psychological difficulties some immigrants encounter, available treatments, mental health providers, and how to get help when needed. Such information is often discussed in scientific journals and among healthcare professionals. But this book presents it in a style that is easier to understand by people who need help. In that process, it highlights practical examples and integrates knowledge from research and the authors' clinical experience.

• Language: English
• Publisher: Romo Books
• Release date: Nov 3, 2022
• ISBN: 9781955658089

Book preview

PREFACE

Migrations have occurred throughout human history. As we write these pages, new waves of immigrants and refugees continue to receive worldwide attention. The US military withdrawal from Afghanistan, for example, prompted a mounting exodus to escape Taliban rule. On September 15, 2021, United Nations High Commissioner for Refugees (UNHCR) statistics showed that 2.2 million Afghan refugees were living in neighboring countries. Many of those were women and children. UNHCR further reported that nearly 6 million Afghans had fled their homes and country due to conflict, violence, and persecution. ¹ These numbers rise daily. By November 2021, the Human Rights Watch also warned of widespread famine. ² This may well cause further migrations.

Then on February 24, 2022, Russia invaded Ukraine. The United Nations passed a resolution denouncing Russia’s military action, but it continued. As early as March 9, 2022, the UN estimated that more than 2.2 million people from all parts of the country’s socioeconomic spectrum had already fled Ukraine.³ Those numbers have only increased, and the UN has warned that they could eventually top 10 million. While most refugees have ended up in Poland, others have taken various paths. Some have even reached the United States border by traveling through Mexico (e.g., to Tijuana). They then seek US entry.⁴

Mass migrations are far from unique. In late 2021 thousands of Haitians fleeing their country’s endless poverty, natural disasters, gang violence, and political turmoil began to arrive at the US (Texas) border with Mexico. Not all came directly from Haiti. Some had been in South American countries such as Chile for years. But depressed economies caused by the COVID-19 pandemic, increasing anti-immigrant attitudes, and progressively restrictive governmental policies prompted Haitians to leave those countries as well.⁵

Sometimes migrants are caught up in political circumstances with which they have no direct involvement. For example, in late 2021 a large number of migrants (estimated at 3,000 to 4,000), mostly from Northern Iraq and Afghanistan, massed at the border between Belarus and Poland. There they hoped to enter the European Union (EU). But Poland closed its border to them. According to Al Jazeera⁶ the resulting crisis came about because Belarus government officials were upset by EU sanctions. In retaliation, Belarus prompted a migration to the Polish border to create chaos there.

Not surprisingly, the above-described trends pose challenges for both the migrants and the countries in which they seek shelter. Throughout time migrants have undergone long and dangerous journeys that leave a physical and emotional toll. They need safety, shelter, new homes, and the opportunity to thrive. At the same time, absorbing large numbers of new people, even if legally and morally warranted, can stretch local resources beyond what is viable. This can foster resentment among populations already living in the countries immigrants try to enter. However, an influx of migrants can have benefits. In a March 2022 Time Magazine article Semuels⁷ argued that immigration should not just be tolerated but is essential to a country’s prosperity. Citing US statistics he concluded that a local worker shortage and an aging population will contribute to a shortage of goods and services as well as greater inflation. Immigrants can help ease these problems. But US immigration from all sources dropped from 1.6 million in 2017 to 559,000 in 2021. Semuels thus quoted labor economist Ron Hetrick: If immigration does not improve … I’m not sure we get growth back.

To sum up, the specific groups that migrate change over time. But the trend itself is never-ending. Consequently, it is essential to find more effective ways to address this reality.

In a 2020 article, Seth Schwartz and colleagues⁸ discussed the positive contributions psychologists have made and can make as the world deals with international migration. These include connecting research from mental health, other social sciences, and medicine to find practical solutions. Our work reflects that spirit. As part of these efforts, we believe that professional health information and academic knowledge must be available to, and understandable by people who deliver front-line services, policymakers, and immigrants themselves.

This volume is a stand-alone book. But it is also the second one in a series. Our first book, Immigrant Concepts: Life Paths to Integration, presents an overview of the circumstances that immigrants tend to experience. When these circumstances are understood and effectively navigated, successful adjustment to new countries is very achievable.

Psychological well-being is one foundation on which immigrants build their success. In this volume, you will learn about topics that are important to such well-being. We draw on our professional background in psychological theory, clinical practice, public health, and other research. But we are equally influenced by our personal and family immigration stories. This allows us to provide you with 1) the latest information about psychological health and 2) explain how it connects with immigrants’ common experiences. Examples from our practice help make these connections. In short, this book is authored by immigrants for immigrants and the people who work with them.

Many good books address each of the psychological syndromes and types of treatment we describe. But we hope that providing you with a view that is tailored to specific immigrant experiences will help you and your family (or your clients) find paths to healing and wellness.

The initial pages describe our intention for you the reader. As you look through them, you may recognize yourself or someone you know in their descriptions. If so, you have come to the right place.

We explain psychological difficulties so, if needed, you can make sense of what you or someone you know is experiencing. In some cases, we include clinical examples from our practice (in ways that maintain our clients’ confidentiality). We also discuss proven avenues for treatment and recovery. In addition, we provide information about caring for yourself or helping family members or others who have difficulties.⁹

Studies show that people who get treatment in its various forms and have effective social support enhance their inner strengths over time. Rather than just managing their symptoms, they eventually improve the quality of life for themselves, their loved ones, families, communities, and the greater society.

If you have or suspect you have psychological distress, we want you to know there’s hope. You are not crazy. You may be experiencing depression, anxiety, or other treatable conditions. You don’t have some personal flaw. With the right type of help, you can better handle whatever issues you may be struggling with. If you have a family member, friend, or co-worker who has a mental disorder you may want to know how you can be of help and understand different treatment options. If you are the parent of a minor, you may get some ideas about how to access support for your child and yourself. If you are a professional working with people from immigrant communities who are struggling with unique needs and psychological illnesses, this book can serve as a quick reference; a guide to help you understand the problem and how you can be of assistance in your particular situation.⁹

One final thought before we get started: Psychological illnesses and distress are understood differently in various parts of the world. They are often seen as personal failures and a weakness of character. Individuals with psychological problems may fear that the condition negatively reflects on their family as well as themselves. Not surprisingly, that can scare people and keep them from seeking help.

None of these ideas are true. Mental illness is an illness like any other. It does not mean that your (or your family’s) character is weak and defective. Healthcare providers know that mistaken ideas about people with psychological distress are common. They are thus required to keep the information they get from patients or clients confidential. There are, however, some exceptions that can vary by country or (in the US) by state. People who seek professional treatment should ask about confidentiality, so they are well-informed about this topic.

While this book discusses psychological difficulties, we also need to point out that many people in immigrant groups are not afflicted with them. Consequently, we provide information on how frequently certain difficulties tend to occur. The point is not to label a whole population as having problems. In fact, we discuss various personal and familial strengths some immigrants have which lead them to be more resilient to distress and foster better psychological health outcomes than seen in a country’s native-born population.

DISCLAIMER

The content presented throughout this book is only meant for educational and reference purposes. It should not be seen as a substitute for professional advice given by a physician, psychiatrist, psychologist, or other licensed health or mental healthcare professional. You should not use this information to self-diagnose or try to treat mental health or health problems. Please contact a mental healthcare provider immediately if you suspect that you have an emotional, mental, or medical problem.

Information and statements regarding potential diagnosis and treatment outlined throughout this volume are consistent with the information in the International Classification of Diseases, 10th Edition (ICD-10),¹⁰ the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5),¹¹ and best practices for treatment as described by the American Psychological Association (APA).¹² But information presented within these pages is not intended to diagnose, treat, cure, or prevent any disease or mental/health condition. We assume no liability for inaccuracies or misstatements about treatments.

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INTRODUCTION TO

PSYCHOLOGICAL HEALTH

We have organized this book in a way that describes common psychological difficulties, specific problems connected with psychological disorders, and cultural lenses through which these disorders are understood. In addition, we note that people can experience more than one type of mental distress at a time. The latter is especially important because clinicians often need to sort through the many issues our patients present to separate and rank-order what needs to be addressed first. Trying to deal with every problem at once is often too overwhelming and does not help people feel better.

For example, a person struggling with weight or chronic pain may have a difficult time engaging in the thoughts and actions needed to change things if underlying problems like depression, anxiety, war trauma, sexual assault, or domestic violence are not addressed first.

With that in mind, we first describe how some immigrants experience stress connected with efforts to integrate into their new environment. This is often described as acculturative stress.

It is also important to say that immigrants sometimes experience mental anguish and pain in the form of depression, anxiety, and psychotic disorders which pre-date their journeys. This can be the result of violence and persecution in their countries of origin and may have prompted their decision to immigrate in the first place.

In addition, the immigration journey itself, if hazardous, may entail traumatic events such as assault, rape, other victimization, and injury. People may also experience the death of a loved one and other losses during their efforts to immigrate.

Given such circumstances, the book spends some time addressing issues of grief, including grief resulting from multiple traumas. Because trauma is such a significant experience for many immigrants, we then go on to detail what posttraumatic stress disorder (PTSD) is. This includes what symptoms are usually presented and connected with this diagnosis and how it has been understood across various cultures. We provide some statistics to help illustrate how widespread PTSD is and give examples of what it may look like in the lives of immigrants.

We then follow the same process to describe anxiety and the different types of depression. This includes depression that results from life experiences. We subsequently touch on bipolar disorder.

After that, we briefly describe common symptoms in psychotic disorders and address relevant diagnostics and statistics. We also cite real-life examples drawn from our clinical practice. In addition, we talk about personality disorders in the framework of cultural expectations. This discussion again addresses common problems connected with such disorders and provides examples to illustrate how they tend to impact people’s lives.

Discussions of substance abuse and eating disorders within the context of cultural identity and self-esteem, as well as various definitions of beauty follow. In these topics we describe the special mental health needs of children and adolescents and how to best address them.

Once we have described various kinds of psychological difficulties, we spend some time addressing issues that often become a significant part of clinical treatment. Once again, these issues are presented using examples from immigrant communities. Specifically, we talk about the role of anger, self-esteem, chronic pain, and insomnia. Given that some immigrant groups tend to perform physical labor in which accidents are more common, we briefly address the specific circumstances of an industrial injury (and by expansion injury in general) for immigrant communities. Another essential topic is suicide prevention.

We then review the many professional treatments and community-based services used to help people with the psychological difficulties described above. These include how spirituality, faith, religion, and positive psychology apply. Unfortunately, some immigrant communities also encounter barriers to treatment, an important topic that follows.

Finally, we address specific issues faced by immigrants and their impact on learning a new language, gaining citizenship in countries that require language, and other testing to acquire that status.