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VOLUME 30 , NUMBER 2 -February 1999 In Cuba, a revolution bypasses psychologyCuban psychologists are proud of their practice and research, but lack sufficient resources and scientific information.
By Scott Sleek
'The mental health treatment here is very good,' says the University of Havana academic, struggling with his English. 'But the biggest threat is lack of materials, resources, medicines. It makes things more difficult.' Roca's paradoxical message, and similar opinions echoed by other Cuban psychologists, was conveyed recently to clinical psychologist and author Frank Dattilio, PhD, who is associated with the University of Pennsylvania School of Medicine and Lehigh University. Invited to Havana by Cuban mental health professionals and scholars, Dattilio discovered a profession desperately in need of new journals, books, computers, laboratory equipment and other resources taken for granted by most American psychologists. Yet even as they beseeched Dattilio for help, these Cuban psychologists remained proud of the services they provide. 'In one breath, they'll say their textbooks are 20 years old, but that the health care is great,' Dattilio says skeptically. 'Their rationalization is, 'We do our best with what we've got, and therefore it's excellent.''
As part of his trip, Dattilio conducted a videotaped interview with Roca, chief of the university's psychology depart- A respected profession Although Cuban psychologists study the works of such Western icons as Freud, Adler and Skinner, says Roca, their therapeutic approach emanates from Lev S. Vygotsky, the father of Russian psychology. Vygotsky's theories on sociocultural influences helped shape the Soviet Union's doctrinal education system. That foundation was solidified in the 1970s, when the Cuban government sent psychologists to Moscow to study Vygotsky's work. 'Soviet psychology was useful for us,' Roca said in his interview with Dattilio, noting that the university didn't start a training program for psychologists until 1962. 'It offered us something to guide our professional activity, our community principles.' Today, nearly all Cuban psychologists are government employees, Roca told Dattilio. In describing the work routine of psychologists in Cuba, he says university faculty members study a variety of subfields, including industrial/organizational, clinical and cognitive. Roca, for example, studies coping processes in families who have children afflicted with cancer. Most Cuban practitioners work in clinics. Like most other health professionals, they earn as little as $30 a month. They are required only to complete a five-year bachelor's degree program to obtain a license to practice, Roca says. (He earned his doctorate in 1994 in order to teach at the university.) Martinez, who also is among the minority of Cuban psychologists with a PhD, told Dattilio that psychologists enjoy strong respect from physicians and other health disciplines. 'For example,' she says, 'you can see a psychologist working in an intensive care unit in the hospital and they are very well regarded there.' Cuban psychologists also have a favorable reputation among the citizenry, Roca says. His enthusiasm is evident on the videotape: his fingertips pound the table to emphasize his belief in the relatively healthy emotional state of the citizenry. 'The mental health and intelligence of the Cuban people has increased substantially in the last 40 years,' he says, with an uneasy yet earnest look. 'I'm sure about that. In the 1990s [when the Soviet bloc fell and Moscow's financial support all but disappeared], the economic situation has become very difficult. But people continue being inspired, motivated.' Gold bars But both Roca and Martinez emphasized a dire need for modern resources. They currently use outdated psychological assessment instruments, Martinez says. Lab equipment is archaic. Access to the Internet is sporadic because the computer technology works so erratically. Professors even need such simple materials as acetates, overlays and slides for audiovisual presentations. Because of the longstanding U.S. trade embargo against Cuba, American materials are hard to come by. They usually only arrive as humanitarian donations, which are exempt from the embargo. And Cuban psychologists can't afford materials from neighboring Latin American countries. Both psychologists were quick to express their gratitude for two crates of materials Dattilio brought from the United States. 'When I brought them books and journals, you'd have thought I'd dropped off a couple of gold bars,' Dattilio says. Dattilio's gifts may actually be some of the most current information that department has received.'[Usually] it's like you clean up your library and the books you don't want anymore, you box up and send them to us,' Martinez says. 'If we're lucky, we get the bare leftovers.' Reflections Dattilio, speaking with the Monitor after he returned from Havana, said he was shocked by the destitute lifestyles of Cuban health professionals. For example, women physicians told him that some of their colleagues moonlighted as prostitutes in order to draw a livable income. And he regards the Cuban psychotherapeutic approach as a manifestation of Castro's efforts to quell government criticism. Cuban therapists are more inclined to adapt to Marxist ideals rather than focus on individual needs, says Dattilio, who has conducted many international humanitarian trips and authored six books on cognitive-behavioral therapy. 'Say a person says he has a conflict with living under Communism and toys with the idea of defecting,' Dattilio explains. 'Instead of helping them look at their options, they [psychologists] will tell them exactly how to think, how to rationalize life under Communism.' But he also believes in the sincerity and commitment of the Cuban psychologists he met. He's grateful Roca agreed to talk to him on tape as a returned favor for the books and journals. He realizes that open dialogue with Americans is always subject to Cuban government scrutiny. On the videotape, as the interview ends, Roca seems clearly relieved to have fulfilled the debt. Just before the camera is turned off, he smiles and lets out a heavy sigh of relief.
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