There are many circumstances that make one leave their country. Some leave voluntarily, others are forced to do so by threats or for political reasons, still, others go in search of better labor, economic or academic opportunities. And, as I was recently told by a couple, “We’re move to Australia a wait for awhile for the situation to get better, when it does, we can return to our country.”

It starts out like an adventure where meeting new people, finding new places, experiencing another culture, language and social environment are part of the fare. All of this may be exciting at the beginning, but after some time, the excitement passes. Many immigrants experience a lower quality of life in their new home than in their old. And, in the process of getting adapted to the new social and cultural environment, psychological, physical and psychosomatic problems may arise including symptoms of depression and anxiety. Often, early life experiences of traumatic abandonment are re-experienced. The level of difficulty encountered seems to depend on one’s resiliency and frustration tolerance, as well as the person’s ability to go through a stage of mourning and change.

Mourning is defined by Joseba Achotequi “as a process of reorganization of the personality that occurs upon the loss of something significant for the individual.” He says “The immigrant mourns because he is losing contact with family and friends, his first language, his own culture, landscape and mother town, social status, contact with his ethnical group, sometimes even his name and some of his identity.”

Depending on the immigrant’s capacity to resist frustration and adversity, and on the sort of situations he has to face, adaptation to the new surroundings will be easier or harder. Because there is a drop in his standard and quality of life, he has to perform jobs that are below his academic qualifications and personal abilities. He may have difficulties in obtaining a visa, a home or a job and may not speak the language. He may have work problems, not have a work visa, psychosocial support, or health insurance and he may fear deportation. Karen Callaghan says “(It) seems like they are suspended in limbo between the danger from which they flee and the safety which they seek.”

When any of the above conditions are present, the immigrants are exposed to continuous economic and social stressors that can affect the neural system causing anguish, anxiety, depression, guilt, anger, confusion, isolation, desperation, difficulty concentrating and irritability. They may suffer physical symptoms, too, including headaches, pain in the back and legs, insomnia, water retention and hormonal problems.

Those immigrant patients who had an experience of emotional or physical separation from a primary caregiver at an early stage of life, often return to that familiar feeling of missing something, of isolation. When they are away from their family, cut off from familiar comforts, alone and separated from their roots, their feeling of isolation and desolation gets stronger. Often, when they find a person with whom they feel connected in an intimate relationship or friendship, they became very attached to them. Because they seek a sense of safety, the feeling of home, they may fear that the relationship may end. Their body can experience a sense of traumatic shock, the same experience as when they were separated from their mother.

The following is the story of a patient who wanted to share her experience. Her name has been changed to protect her identity.

Patricia arrived in NYC to escape violence and economic difficulties in her home. After three years in the Big Apple, she went to a clinic with symptoms of depression and anxiety. The world had fallen upon her. The trauma of being an immigrant included the difficulty of obtaining legal status; finding a sponsor for a work visa, a decent place to live, and a job; economic difficulties; health issues; and having no health insurance because she couldn’t afford any. She felt overwhelmed.

“There’s nothing I can hold on to. I feel that I suddenly have no point of reference. Sometimes my wish to return to my country overwhelms me, but when I think of the political and economic situation and the insecurity with which life is led in my country, I tell myself that I must believe that it’s better that I stay here. I sometimes feel jealous when I listen to other immigrants talk about their hope of returning to their country. They have something waiting for them—not only their family, but also a country that offers them safety and work opportunities.

“Manhattan is a wonderful place, full of culture, opportunities, ethnicities and eccentricities. I like to feel that I am a part of it. I like what I learn, what I can do and discover, and the opportunities it offers me. But on the other hand, it’s a very lonely, aggressive city, where one has to struggle, as someone said, ‘even to find a place in the subway’. This struggle is stressing, it tires you and sometimes makes you sick.

“I often feel tired, finding it difficult to concentrate and to wake up. I feel lonely and depressed and at times all I want to do is sleep. I do work that doesn’t make me happy, but I haven’t found anything better. My studies in Colombia are of little value here. I miss intensely what I was in my country, where I lived, what I had, my friends and family. There I was “Someone”, here I’m a “Latina”. So, why don’t I return? I fear the violence and the economic situation. I feel at a crossroads.”

After a few months of intensive therapy, Patricia’s anxiety and depressive symptoms have decreased. Through the use of a combination of various treatment modalities including EMDR, an acronym for Eye Movement Desensitization and reprocessing, an specially effective form of treatment for trauma; TFT (Though Field Therapy) a modality design to balance the meridian network system;  SE (Somatic Experience) a special techniques to relief trauma and to  regulate the neural system , an finally hypnosis,  to access the unconscious for optimized healing and integration. She started doing volunteer work, applied for a scholarship and wants to start going to school. Patricia is currently working with a personal coach to assist her with a variety of issues designed to facilitate the transfer of talents and skills into the new culture. These include communication skills, the ability to seek and identify business and educational opportunities, skills for self-promotion and a plan to ensure that her goals are met. It is important to remember that the mourning aspect of immigration encompasses a larger, more general process of change, too, that includes positive aspects like leaving behind violence, insecurity, and other kinds of financial difficulties.

The successful adaptation is influenced by the individual’s desire and willingness to adapt, integrate the two cultures and identify with the new reference group. When the person is facing troubles in the process of adaptation and transition to the new culture and is depressed or anxious, it is important that he seeks therapeutic help, that he doesn’t become isolated, that he shares his feelings with others in the same situation, that he seeks support groups and gets involved in community work. We all need to feel that we belong.

On the other hand, it is important that he learns the language, maintain the legal status, if you have a degree, have a evaluation of your credentials, profits from the opportunities offered by the country, goes out, gets to know, and learns from the culture instead of being critical. Each immigrant must evaluate the benefits of the particular situation in which they find themselves, to help determine what they are looking for. With the help of a competent therapist or social support network, each immigrant can set clear, realistic objectives and design goals to be reached.

“Anyone who isn’t confused really doesn’t understand the situation” Edward R. Murrow

By: Martha Escamilla
Assistances by: Cynthia Davidson- Reid

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