Middle of Everywhere - Mary Bray Pipher [116]
When our Bosnian mentor met people from her country, she gave them her heart. She had a client who had lost twenty-two male family members in Srebrenica. The woman said to the mentor, "My pain has killed my soul." The mentor listened to the woman's stories, then she invited her to the circus, which she told me later "was a big hit."
This Bosnian mentor had another client who had suffered many previous losses. All she wanted was a child and she feared she couldn't get pregnant. The mentor took her to a women's clinic where the doctor reassured the woman she could have another child. Then the mentor invited the woman and her husband to her home. The two families stayed up all night drinking plum brandy and singing.
The Bosnian mentor was my most creative mentor. She was warmhearted, helpful, and good-natured. She had common sense and intelligence. When she heard I was writing a book on refugees, she said, "Tell families to get a kitten. We were very lonely and sad until we got our little kitty. Now we have reason to laugh. My daughter jumps out of the bed every morning to check on her kitty. It is the best thing."
At first, the goal of Thrive had been to train mentors to use our system and to encourage their people to use it. As the group proceeded, I found myself wondering why had I assumed that our system was better.
REFUGEES AND PSYCHOTHERAPY
Refugees don't seek therapy for a variety of reasons, some practical and some cultural. First, they often don't know that such a thing exists. They have no transportation to appointments, or they work all the time and cannot schedule sessions, or they have immediate concerns that take precedence over dealing with past pain. Usually therapy is lower on their priority lists than work, housing, or transportation.
Refugees resist therapy because of language and trust issues as well as a lack of understanding about our mental health system. Many refugees come from cultures with no cultural analogue for talking about problems outside the family. Certain things cannot be discussed even within the family. Domestic violence and rape are taboo subjects. In many cultures, the expression of certain emotions, such as anger, is not tolerated.
Often refugees label what we call mental health problems as spiritual problems, physical problems, or the result of a curse or the evil eye. Depending on the labeling process, different kinds of healers are required. A Vietnamese Catholic might talk to a priest. A Kurdish person might consult a tribal elder or visit a sacred shrine. Others might go to a shaman, a curandero, or a medicine man.
Even if refugees come from a culture that acknowledges mental health problems, these problems often are seen as shameful. Many people believe that only crazy people see therapists. Often times, mental health professionals are not trusted. The Vietnamese have a saying: You have to be crazy to understand crazy people.
Beyond these reasons there is another universal reason for avoiding therapy. Talking about trauma is not easy. To remember pain is to reexperience it. Many people just try to blot it out and pretend things didn't happen.
When I first worked with refugees, I thought that, with access and understanding, many would want our services. They were traumatized people who could use therapy to work through their past tragedies and current stresses. Of course, there were refugees who wanted our mental health services. However, I now realize that many refugees choose not to be in therapy. Even when it's affordable, accessible, and user-friendly, and even when they truly understand what therapy entails, they turn down our offers of help.
Refugees are able to partake of the services they truly want in our communities. Because newcomers quickly see their value, they find our schools, job counselors, libraries, doctors' offices, and cultural centers. But in spite of our efforts