Eso es para locos. Esta generación... siempre inventando. These are the words I'd hear anytime I mentioned therapy or mental health growing up. As with most things throughout my life, my Dominican family believed that we could figure everything out at home, as long as we had each other, that would always be enough.
From a young age, like many children of immigrants, I learned resilience and the importance of building myself up calladita and working hard. But I also knew that this type of self-reliance and refusal to seek out professional help was based on something deeper, a level of deep mistrust in the medical community. I saw firsthand the embodiment of this apprehension in my father's disdain for doctors; this man never took a sick day, nor did I ever watch him walk into a hospital, except for my brother's appendectomy. Many Latinx people feel the same wariness toward the institutionalized healthcare, stemming from salient cases of mistreatment at the hands of the medical establishment, which has historically failed and misrepresented them — therapy and mental healthcare are viewed as part of this problem. "Even though not all therapists are medical doctors, we are part of the medical profession. We're seen in that umbrella for many Latinx folks," says licensed therapist Josie Rosario.
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That figure-it-out mentality and medical mistrust stuck with me throughout my entire life. I endured my parent's divorce; having my face and body rated on a scorecard in multiple beauty pageants; and taking on 21 credits with two internships in one semester of college without adequate guidance, all on my own. I ended up with shingles at the age of 21 (though most common after the age of 50, the virus can also be triggered by stress) — but as long as no one saw me as weak, I was okay. It wasn't until I developed a skin-picking disorder called dermatillomania that I even considered therapy. Having to ask for help seemed, to me, like proof of my own weakness. So even though I walked away from one therapy appointment with a diagnosis that could have helped me overcome my dermatillomania, I never returned.
It wasn't until the world went into lockdown for the COVID-19 pandemic that my mental health reached a breaking point. Although I had the privilege of working from home, I had difficulty coping with this new level of anxiety and constant worry. Then, a racial reckoning ignited — which had me reflecting and unpacking the anti-Blackness embedded in my upbringing and cultural DNA. At that point, I felt a sense of urgency to look into therapy again.
After hearing excellent reviews about a particular Latinx therapist, I immediately inquired and began seeing them over Zoom last May. The level of awareness and self-development that I gained after just a few weeks of sessions was life-changing — so much so that I also signed up for a therapy group for women of colour, founded by my therapist. People around me began to recognize my new attitude and asked what I was doing differently in my life. Still, I held onto my cultural stigmas; rather than opening up about going to therapy, I credited "walks around the neighbourhood" for my calmer and more optimistic demeanour. It wasn't until other Latinx folks around me — including my family members, friends, and familiar faces online — started opening up about therapy on their social media pages that I realized I was not alone, and started sharing my experience too.
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To some extent, the fact that more people were talking about therapy during the pandemic was simply a reflection of the fact that more people were going to therapy during the pandemic. Rosario closed down her client waitlist after it reached 100 sign-ups in three months. Mental health platform Therapy for Latinx garnered over 20,000 followers last summer, according to founder Brandie Carlos. Juan B. Pena, PhD, a licensed clinical social worker, maxed out his schedule with the incoming flood of Latinx solo and couple clients once the pandemic started.
The professionals weren’t surprised by this increase in demand, even taking into account deeply ingrained cultural stigmas against therapy. Work, family, and community are core values of many Latinx people, and the pandemic challenged those foundational cultural pillars. People were grappling with "increased social isolation, loss of employment, moving back home with parents, relationship breakups, lack of self-care activities, and family members dying from COVID. Not surprisingly, this has led to an increase in depression and anxiety for them," Dr. Pena says. Latinx communities in particular faced disproportionate health and economic impacts from COVID-19, including significant losses in employment and a higher proportion of hospitalizations.
On top of that, Latinx folks — including myself — had to unpack the anti-Black racism within their cultures as millions took to the streets and social media to protest police brutality and systemic racism last summer. During this racial reckoning, Brandie Carlos, the founder of Therapy for Latinx, saw the most significant surge in followers and engagement on Instagram, where she was providing anti-racism resources in both English and Spanish. That often emotionally charged work, combined with the pandemic and what was arguably the most controversial election in U.S. history, "caused us on a more macro level to go inward," says Rosario. "There's a critical mass of people talking about it and not just like talking about it, but they're being about it," she says, of all the mental health advocacy work and support platforms online.
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In addition to the burden of stress and trauma many took on over the past year, professionals also feel that therapy is becoming less jargon-y and more approachable, which encourages more Latinx people to seek out help. For me, with every Latinx therapist I found in my search, the more comfortable I felt with the experience. I felt that seeing myself reflected in these faces and names brought a sense of ease — made it feel like I’d be talking to one of my own, someone that could relate to me on certain levels. It was so different from that first visit with a white, non-Latinx therapist years ago. Then, I remember feeling disconnected, and questioning how this person could “understand me” when they couldn’t fully comprehend my reality.
Professionals say there is still more work to be done to address the stigmas rooted in Latinx communities. "It remains a complicated issue where issues of social class and gender intersect," says Dr. Pena. He says he sees almost no working-class Latinx men in therapy, and notes that his immigrant clients especially still use shaming labels, like "crazy," around mental health issues.
But Latinx professionals are continuing their work in destigmatizing therapy, which often means investing more time in these communities. To meet the high demand for new clients and address the lack of community and support that many patients expressed feeling, Dr. Pena founded support groups for people of colour during the pandemic — one for women and another for men. "We have discussed topics such as shame and stigma during our groups, specifically how to reframe unhelpful thoughts and beliefs and learn how to regulate difficult emotions such as shame," he adds. Rosario also had to adapt her services in order to meet the needs of more clients, so she launched 30-minute mental wellness check-ins that followed protocols and confidentiality. "I booked out of these sessions in a matter of hours," she tells R29.
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More Latinx people benefiting from mental health services is, perhaps, the most powerful way to begin to break down the resistance to therapy within Latinx families. Both Dr. Pena and Rosario stress the importance of word of mouth, given the weight placed on family within these communities. A friend, a loved one, or even a social media connection recommending a licensed professional, suggesting family or couple therapy, or just speaking on their experience can be more impactful than hearing the same information from a professional source.
While there’s increased awareness of mental health, there's still a high level of toxic masculinity and all-around shame put on vulnerability. But Dr. Pena sees the light at the end of the tunnel — especially after a year that gave us no choice but to find strength in emotional freedom. "I believe we are approaching a tipping point in many areas of the Latinx community in which going to therapy will be seen similar to going to physical therapy and not as a commentary on character or weakness," he says.
I'm proud of what I've been able to learn about myself this year after committing more to therapy — the generational trauma I've been able to dissect, while never losing an ounce of resilience. I was even able to convince my mother to sign up for therapy, and inspire friends to join POC therapy groups. As Rosario stressed to me: Therapy is an ancestral practice, but with migration and evolving traditions and identity, it looks very different now. It's on those of us who rediscover emotional health to change the course for those that come after us. Now, I say: Esto es para los fuertes. Esta generación... siempre inventando para mejorarse.