Adjusting to America

Psychologist Farah Ibrahim, PhD, likens her immigration to the United States from Pakistan as a 24-year-old graduate student to her world dying and beginning anew.

Her professors thought she couldn't spell and had difficulty understanding her speech because she wrote and spoke using the British English she had learned in Pakistan. And during her first winter in northern Pennsylvania, she was so cold that she stopped other students on the street to ask them how they were keeping warm.

More than 20 years after that first winter when she learned that mittens were warmer than gloves and long johns kept out the winter chill, Ibrahim now teaches students how to interact with immigrant families as a professor and director of the counseling psychology program at Howard University. Her experience reflects the bewilderment immigrants and refugees can feel when they arrive in a different culture.

For years, psychologists--many of them immigrants like Ibrahim--have been working to better understand the needs of those newly arrived in the United States. Today, they have a much better picture of how to ease the often-daunting transition immigrants make. And with one in 10 people in the United States born in another country--flocking to U.S. cities large and small--psychologists' insights are in demand.

"I don't have to be in Los Angeles or New York City to give services because immigrants are moving to all kinds of areas," says Antioch New England Graduate School professor of clinical psychology Gargi Roysircar Sodowsky, PhD, who provides mentoring and acculturation services in rural New England.

It's the difficulty of learning all of the little things at once--from how to get a driver's license to learning what kinds of nonverbal communication are acceptable--that can exacerbate the situation of newly arrived Americans with mental health problems, say psychologists.

"Immigrants and refugees don't have the same type of psychosocial supports around them," explains Tedla Giorgis, PhD, who directed the Washington, D.C., Department of Mental Health's Multicultural Services Division for 13 years and now manages the department's cultural competency program. "We have to look at all psychosocial stressors, whether it's lack of housing, children having school problems or trouble becoming proficient in the English language."

Great expectations

From high-powered businessmen transferred to the United States to refugees fleeing for their lives, those newly arrived in America come with expectations of what the country is like--often stereotypes based on movies, books and stories. But the realities of immigrating to the United States can be quite different--especially if you don't speak English.

"Anyone who comes to a new country and does not know the language and customs well usually has a bit of trouble maintaining the same social status," says Oliva Espin, PhD, a psychology professor at Alliant International University and a Cuban native. She says many affluent professionals take low-paying jobs in America because they lack the proper certification.

Moreover, many immigrants of color also have never experienced the stressors associated with being a minority; they were in the majority in their home country. In Ethiopia, for example, people are not classified by color, but by ethnic affiliation.

"This concept of color really doesn't sink in until you have lived in this culture for a long period," explains Giorgis, who was born in Ethiopia.

Families also face a new set of cultural values, many of which conflict with their traditional beliefs. "Even if you can conceptualize what America will be like, you never realize your values would be so different," adds Ibrahim.

Children often adjust to American culture faster than their parents, and their desire to be American can create family rifts. The "Americanization" of young family members can prompt a redoubled emphasis on traditional beliefs, which widens the gap between children and parents. Women's roles in the family often change as they begin working or seek higher education.

On top of the cultural adjustments that all immigrants face, refugees also experience additional stress, such as coping with traumatic experiences while living in and escaping from their native countries, and feeling guilty about loved ones left behind.

And immigrants also experience a sense of loss on a more personal level. "Once you have lived in another country, you will never again be the person you were before," explains Espin. "I don't know the person I would have been had I stayed [in Cuba]. I don't know who she is."

Pointing out their strengths

Before psychologists can help immigrants address any of these issues, they have to do their homework, says Giorgis.

"You have to develop relationships in the community so you can gain acceptance and credibility," he explains. "Unless we go out into the communities, we're not going to get access to those who desperately need our help."

Ana Gardano, PhD, a Cuban native and psychologist for the Washington, D.C., Department of Mental Health, says that when psychologists work with diverse populations, "you have to not just join the family, but the culture as well. You do that by being part of community organizations and knowing what the services are [for immigrants]."

Go out into the community, urge Gardano and her colleagues, visit community centers, attend local holiday celebrations and film festivals.

"If nothing else, the one thing I could promise is that there is some good food out there," laughs Giorgis, who also encourages psychologists to read the local newspaper every day to stay informed about community issues.

Psychologists should also take stock of their clients' cultural background, including how and when they left their home countries, their immigration status, age, birth order, languages spoken, ability or disability status, sexual orientation, gender, and how their home culture views those characteristics. It's also important to avoid making blanket assumptions about an immigrant's beliefs, says Ibrahim, because immigration itself makes people different from their native culture. In deciding to leave their country, "they've already moved psychologically from their own system," she explains.

Be informed about the history and current events in clients' native lands--and how that might affect them or loved ones still there, suggests psychologist Lillian Comas-Diaz, PhD, whose practice is devoted to immigrants and internationals. "It tells them that you're caring about them," she explains, "And they can share a vital part of themselves with you because they don't have to spend all of this time educating you."

And sharing a little about yourself can go a long way, says Sodowsky, who immigrated from India 22 years ago. She not only makes the effort to learn about her clients and their festivals, religious practices and food, but takes some time to explain her own. Sharing a bit of herself can make others more willing to talk about themselves, she explains. It also emphasizes the value of both cultures, instead of placing more importance on American ideals or the client's native culture.

When immigrants are struggling, "it can be very embarrassing for a person who's actually glad to be here to say, 'This is not so easy and I'm suffering because of all of the things I have left behind,'" says Espin.

But while their situations may be challenging, odds are immigrants have faced and overcome even greater obstacles in leaving their home to get here, say psychologists who have immigrated themselves.

"You have to pull up their strengths to help them see that they were able to cope before in much more difficult situations and that they have the courage and the resilience to solve this problem as well," says Ibrahim. "Their biggest strength is that they have the courage to change and take risks."

"Immigrants and refugees are survivors," says Giorgis. "Given the opportunity, they can thrive."

This article is part of the Monitor's yearlong series on psychology around the globe.