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Article Excerpt
Abstract
Stress associated with immigration, particularly forced migration, may aggravate men's emotional distress and reluctance to seek help. This qualitative study of Central American immigrant and refugee men explored the process of coping with distress during resettlement. "Losing the way," a common theme of resettlement, was frequently a solitary struggle accompanied by anxiety, depression, and/or abusive behaviours. "Finding the way," grieving socio-cultural losses and seeking help, became possible when participants were able to accept responsibility for their behaviour. The role of"belonging" (support groups, jobs, family obligations) was a key motivating factor in the process of accepting responsibility and personal change.
Resume
Le stress associe a l'immigration, en particulier a l'immigration forcee, peut aggraver la detresse emotionnelle des hommes et accentuer leur repugnance a rechercher de l'aide. Cette etude qualitative d'hommes immigrants et refugies provenant des pays de l'Amerique centrale explore comment les interesses arrivent a se debrouiller et faire face a leur situation. << Perdre la vole >> un theme commun en matiere de reinstallation, s'avere etre souvent une lutte solitaire accompagnee d'angoisse et de depression, avec ou non des comportements violents. << Trouver la vole >> c.a-d. pleurer les pertes socioculturelles et rechercher de l'aide devint possible seulement lorsque les participants furent capables de prendre la responsabilite de leurs propres comportements. Le sens d'appartenance (groupes de soutien, emplois, responsabilites familiales) joua un role capital dans le processus de responsabilisation personnelle.
Introduction
The socio-cultural changes that accompany resettlement, particularly in cases of forced migration, are emotionally distressing. (1) Migrating men in particular face gender-specific losses and stressors (2) that may make integration and help-seeking more difficult. (3) This research paper focuses on men coping with emotional distress in the milieu of socio-cultural adaptation and provides a narrative perspective on Central American men integrating into a new country.
The Central American countries of El Salvador, Guatemala, and Nicaragua share a history of political violence and social unrest. More than 90 per cent of Central Americans living in Toronto originally fled their homeland due to political oppression and conflict. (4) Such unrest has left migrants from these countries at high risk for emotional distress (5) and in need of more innovative provision of health care. (6) Latin American immigrant men (7) frequently share a common history of trauma, torture, and violent oppression from their homeland and as a result suffer significant loss of socio-political status and struggle against language and employment barriers.
Literature Review
Psychological Distress in Immigrants and Refugees
Exposure to violence and political persecution in the country of origin, as well as language barriers, unemployment, and socio-economically deprived urban environments in the resettlement city, leave Central American immigrants particularly vulnerable to profound emotional distress. Adjusting to a new economic, social, and cultural climate is an emotionally painful process for most immigrants. Although the experience of immigration itself does not produce mental illness, (8) the multiple processes of dislocation, movement, and resettlement may together place immigrants at risk for emotional problems. (9)
War, poverty, unequal land distribution, and political persecution in Central American countries have led to the killing, torture, disappearance, and displacement of thousands in the post-war era. (10) Refugees, many of whom have experienced war, state-endorsed terror, and political persecution, are at particularly high risk for mental health problems, such as anxiety, stress, depression, and other emotional difficulties. (11)
Salvendy (12) identifies language and cultural barriers, a large socio-economic gap between the society of origin and the host country, and previous psychosocial maladjustment as contributing to the stress of migration and resettlement. The inability for the host country to offer language and culturally appropriate health services may hinder helpseeking behaviour. (13)
Masculine Health Beliefs and Behaviours
Masculine health beliefs often promote secrecy and isolation (14) rather than help-seeking and community involvement. Men often have difficulty articulating their distress and may "act out" their emotions in an attempt to regain control or right expectations. (15) Psychological distress may therefore manifest in the form of alcohol and drug abuse, risk-taking, and physical violence. (16) Umberson et al. (17) suggest that violent behaviour may be an alternative expression of emotional distress that results from socio-cultural stresses. Courtney (18) argues that these masculine health-related beliefs and behaviours contribute to gender mortality (homicide, suicide) and morbidity differences; for example, the higher incidence of suicide among males.
Gender socialization influences health beliefs and behaviours. (19) Brannon (20) identified four major components of the Western male role: the need to be different from women; the need to be superior to others; the need to be independent and self-reliant; and the need to be more powerful than others, through violence if necessary. Sabo and Gordon (21) point out, however, that the root of men's higher risk for disease is not simply based in men's individual psyches but is reflected in men's roles, routines, and relations with others and that these roles are fixed in the larger historical and socio-cultural relations that constitute gender order. Political, economical, and ideological structural changes are therefore necessary if personal changes are to have any lasting benefit. (22)
Freire (23) suggests Latin American immigrant men and women differ in their "core identities"; for example, having paid work is an important "core identity" among Latino men whereas women focus more on the family. Since many of these immigrant men have difficulties finding employment in their field of expertise, due to unavailability of jobs or unrecognized credentials, they are unable to provide financially for their families, resulting in loss of socio-economic status and feelings of inadequacy.
Latino men and women also differ in their behaviour in relation to emotional problems and help-seeking behaviours. While women may present with headaches or crying as symptoms of distress, men may express distress in acting out behaviours such as marital violence or alcohol abuse. (24) Freire states that men typically "resist seeking professional services, [they] do not attempt to create or use existing support systems, and even reliance on friends tends to be minimal or nonexistent." (25) She further suggests that Latin American men have difficulty verbalizing their emotions, particularly vulnerable ones, such as fear, anxiety, and anger. Feelings of inadequacy that result from a decline in occupational status contributed to this difficulty in communication. While the women in Freire's study (26) were able to seek help or assistance for financial or health problems in Canada, men were unable to respond to these challenges in a constructive way.
Freire describes a "gender differentiated pattern of response" (27) between newcomer Latino men and women. In migrating to Western countries, Latino men must adapt to a new gender order: a culture-norm that confers more power and rights to women in relation to the traditional patriarchal societies of Central America. (28) These immigrant men confront new societal values and behaviour patterns and, unfortunately, they may lack the skills to obtain valued goals within this new society. (29)
Emotional Distress "Nervios"
Latin American immigrants in both the United States and Canada experience a wide range of emotional difficulties, including confusion, anxiety, tension, and depression. (30) Guarnaccia etal., (31) in their review of the literature on Puerto Rican mental health in New York, emphasize the importance of focusing on culturally meaningful expressions of distress such as the cluster of emotional difficulties identified in the Latin American population as "nerves" or nervios.
According to medical anthropologist Janis Jenkins, nervios is "an indigenous cultural category widely used in Latin America for a variety of forms of distress and disease ......
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