Understanding Latino Mental Health with Yesenia Delgado

In the Hispanic community, mental health can be a taboo subject.

I would personally know since I’ve obviously Hispanic and I’ve experienced it firsthand. On this episode, we are going to talk to Gesenia. She is a therapist that treats the Latin community and we’re going to discuss stigmas in the Latin community in regards to mental health. The unique mental health challenges that only pertain to the Latino community. For example, we may have language barrier, immigration status and the stigma surrounding the mental health topic. We’re going to discuss the bioin theory, differentiation of self and how this can be applied in the Latino community. Hi, welcome back to another episode of the Mindful Space.

Today we have Gesenia Delgado. How are you today? I’m good. How are you?

Good. Thank you for coming. Thank you. Thank you for putting in the time. Thank you for having me. Of course. So if you could please introduce yourself.

Well, I already know which to. I’ll move to you, but please go ahead. I’m a licensed marriage family therapist in Florida and Nevada. And I am a third year doctoral student at Nova Southeastern University.

And I am also an EMDR therapist. Love it. Now, today our topic is going to be therapy, Latin community and the bioin theory all in relations to one another.

Correct. How does mental health affect in particularly the Latin? Yeah, it’s a great question because it’s something that we definitely need a lot more awareness on. There’s so many layers to it. It’s like a big onion.

So I’m trying to think of like where do we even start? You know, I think just in overall just like the stigma of not talking about mental health about looking at mental health as is big like taboo or sign of weakness and it affects women and men in the Latin community, right? It suppresses women and suppresses men as well. Well, you mentioned a couple of challenges. Are there unique mental health challenges that are only specific to the Latin community? Absolutely. You know, I think of just like the hierarchy of needs, right? So thinking of a Latino or Latino women’s hierarchy of needs. If their essential needs are not met, they’re not going to be thinking about therapy. So legal status, immigration status, you know, being able to have resources, where to find these resources and also what their family might think of receiving help, right?

When there’s other issues at play. Can we go a little bit into depth when we talk about language barriers and inequity or lack of health insurance? Again, like thinking of like the hierarchy of needs. If we’re looking at, for example, Latin that have just came here from another country, the first thing that they’re thinking about is not going to be therapy. They’re thinking of having their needs met as far as like housing, food, like legal status. So all of that has to be met first now for like a first generation in Latin, like me, I’m Cuban American. I was born here. So I grew up seeing that, you know, mental health is something that is valued versus my parents that they came from Cuba and freedom is valued. So again, like I always just go back to that, like the hierarchy of needs and what an individual might consider important when it comes to therapy.

That makes complete sense. We were talking earlier and you mentioned that you have an interesting story. How you got into this whole world of therapy and you’re also Latin. What generation? I’m British Cuban.

First generation Cuban American. Okay. There you go. So how was your experience? What led you to become a therapist? You know, I think almost everyone that’s a therapist has their own story. I’m sure you connect with that too. I think a lot about and it’s I think part of my training now, especially like being a Boeing therapist, which we use ourself as a tool in the room is has been for me to reflect a lot on what my own level of differentiation is and my own level of why I’m in this field and how I use myself as a tool with my clients. I think of my parents.

Again, like they’re two immigrants that came from Cuba. They had a really abusive marriage and it’s something that I was exposed to since I was very young and I never really had like a neutral or calm like nervous system. I always felt like really highly activated and I always found that like something, you know, whenever I had moments of like stillness, like my body like felt uneasy, you know? So I’ve always been very curious about the dynamics of relationships.

And then when I got to that age where I was able to kind of just like compare my, my family system to other family systems, I was like, there’s something off here. Wait. Yeah. So I became very curious. I became more curious about, you know, what my parents did and how they talk to each other and how they treated each other. And I just became, I think since I was like a little, like a little therapist with my own parents, I would like sit them down individually and try to talk to them and try to, in my own way, just kind of like make sense out of the abuse.

And all of that just led me into the career. And then you realize that’s also not good when the child tries to be the therapist of the parents. Yeah. That’s, you know, most Latino children are preventified in that sense.

So, yeah. Now, when we talk about health insurance and misdiagnosing, how could that be a barrier in the Latin community? I, you know, again, I think it’s important to take insurance. We spoke about this earlier because we give access to those who need help. And I think that it just depends in the context of what you mean by misdiagnosing.

If you can tell me a little bit more about that. When talking about culture, right? If you’re Latin, there’s certain things that for you, it might be, you wouldn’t know how to describe it in the mental health field, right? So, you know, they think everybody’s crazy, but they might misdiagnosing. Like the therapist has to be aware of the cultural differences to be able to diagnose correctly because in different communities that might have a different meaning. So, if I come and say, I’m anxious, but like I’m just using the term loosely. But what I mean is, I don’t know, I’m scared. Like you have to, you know, that’s what I mean by misdiagnosing in that culture.

So, I feel that we need more therapists that are trained in different cultures so they can, you know, have a better diagnosing. Absolutely. To provide.

Absolutely. And I think of like, you know, being culturally sensitive, being culturally inclusive as well. And when you were talking, I was thinking of like, you know, a lot of like Latin moms, they say, oh, I’m having una taca de… They’re… They’re panico.

Yeah. And then, okay, but what does that really look like? And then we examine that and it’s like, it can be from like just having like, day to day anxiety to like psychosis. So, like they use that term, like you said, very loosely. So, it’s good to just as a therapist that wants to be more like culturally sensitive and inclusive to ask questions and to be very curious. And I can see how for someone who’s not Latin, like that can be maybe for a therapist that’s not Latin, they want to be very, they want to honor and respect the client, but we have to be curious and we have to ask those questions to really get at the meaning of things.

Exactly. And you mentioned something earlier, stigma. So, how is mental health viewed in the Latin community? Is there a lot of stigma?

Yes. There’s a lot of stigma. You know, coming, I think, I’m going to speak from my community, like Cubans, right? There’s bigger fish to fry, right? There’s bigger problems like communism and safety and, you know, leaving a country that is pleading people of food, of shelter, of everything and imprisoning them to, you know, for them to leave and come just for new opportunities. So, again, like they’re not thinking too much about therapy, but that stigma of like, I need help, like no, like it’s, they’re all like survival, right?

So, we have to also examine like when we’re talking to people from different cultures, like where are they coming from? Are they in fight-or-flight mode? Are they in survival mode? Or do they have some of their needs met?

Are they able to like now sit with themselves, process what they’ve been through, acknowledge that there’s something that they need to sit with and process and work on their relationships around them? So, let’s answer your question. Yeah, no, I think in my experience, whenever, I don’t want to generalize, right? Like all the ends are the same, but I do feel like older generations don’t believe in therapy, or they see it as, or they think of psychiatrist and medication, you know, they don’t differentiate between like just talk therapy and going to get medicine.

Again, if you need medicine, I highly recommend you go do it. But I do find that a lot in my practice where the parents are like, well, she doesn’t need it, or he doesn’t need it, you know, they see it as like, if you’re crazy, then you go to a therapist. Or it can also be backwards, that and, or, you know, she needs therapy, I don’t. So like they drop off their kid in therapy, they go run errands, and it’s like, oh, let’s all say, let’s like, no, you need to come to, we all need to process. So, and that that’s like avoidance, you know, in the emotional system.

Yeah. Yeah, family therapy, you see that a lot. How about the problem? My child’s the problem. What did you mean?

I don’t need it. How has your experience working with your patients in the Latin community? Have you’ve seen positive improvements?

Do you see resistance? Do you see the stigma? I definitely like to call my, like my individual clients, clients, you know, and I think just part of our training, we try to look at the people that we work with as people, right, and like them as an expert of their own life. And I see a lot of like first and second generation clients that I’ve had really breaking from that transmission, generation, generation trauma.

Yeah. And being the first ones to break those patterns and wanting to first be aware and then, okay, now that I’m aware, how can I separate myself from the system that like desperately needs me to play this role. So it’s really, it’s really hard. It’s very powerful to, you know, to to see that and then not only to see that, but to also align with that myself. Now that you mentioned that, where you like separate yourself, let’s talk a little bit more about the Bowen theory and differentiate, differentiation of self for those who are not aware with the terms, you might explain it. Yes. So a little fancy word I like to connect is like emotional intelligence.

It’s another word for like differentiation. How can you be an observer of your thoughts and your emotion and the role that you play in your family system without being absorbed into it? Just being an observer versus like an absorber. We’re all going to absorb to some extent in our family system. But it’s like checking in with ourselves to see like the roles that we play in our family system and how in tune it’s like our attunement with ourselves like emotionally and in all the connections that we have in all the systems that we’re part of like with with our parents, with our, in our, with our employers, with our clients, with our personal relationships, like our level of like emotional intelligence. How does that play a role in the land community? Do you see it more?

Because I know I do. Like it’s harder for them. How do you see it?

Yeah. I mean, I see it where it’s very hard. The parents put a lot of pressure on the children and they, like they used you for therapy and they used your children to do translation and discussions and tell your dad this and tell it, you know, they’re just, um, or they expect the children to do as they’re told all the time, whether it’s career grades, entertainment, anything sports.

So what do you see in your clients? Is it more predominant in the lives community? Yeah. And I really like how you said triangulation because that’s, you know, definitely a big DMIC. I also see a lot of, um, like first and second generation becoming more aware and then again, trying to break from that transmission process of like the patterns. And I also see like a lot of guilt and shame that these children or young adults are trying to break from and, um, growing up in a household where like your emotions were dismissed and feeling angry or sad or any negative emotion was just not something that was, um, validated at all. So, you know, and I think that’s more, that speaks more on like the capacity that these like older, um, Latino moms and dads, like that they can handle with themselves and their differentiation of self, like they might have not been taught to handle negative emotions. And it’s like, oh my god, just like, just get over it, like just move past it, you know.

And so when they see their children going through negative experiences, you know, they, it could be very dismissive, very invalidating, cause a lot of harm. Um, and I think that it’s not due to maliciousness or it’s just that’s the highest level that they know how to function from at that moment. Correct.

Yeah. How would you advise someone to start the process of differentiation of self? Like if they’re, you know, at that point where they’re feeling it, that they have to go against their Latin family, what would you recommend? It’s really hard. Like case by case.

Yeah. It’s very difficult. And I would say, um, to take your time, um, not being a rush, even though once you start to create more of that awareness, you’re like, what the hell am I doing?

Like how am I allowing this? But it’s more so, okay, like it’s that conflict. And I think that’s the part that I’ve seen that hurts a lot with my clients that, um, you see the good in your parents and like, you see all these sacrifices for you.

And then you also see how much they’ve dismissed and invalidated you. And I’ve always thought that in confliction, like there’s so much pain when like, cause when things are more like this or that black and white, it’s easier, but nothing is really like that. And there’s not a lot of things that I feel like are this and that.

A lot of things are this and that. So to see good and to see pain and hurt in your, in your parents can be very conflicting and hard to be in that process, but it starts with you. And if you can model that and enforce over and over and over those boundaries for your parents, it’s not too late, right? But it is just a lot of work. So it comes down to boundaries. Just like any other relationship.

Yeah. The boundaries with yourself first and then with the people around you. It doesn’t mean that they might honor it, right? But it’s, it’s a start.

Yeah. That’s why you should start with the boundaries for yourself. So whenever you input, replace those boundaries to other people, they don’t want to go with that.

You’ll be okay, which is having to remove them. Have you ever heard of that quote of the people that don’t honor your boundaries or the ones that need them the most? Yes.

Have you ever heard of therapy because of other people that don’t go to therapy? Yes. I go by that one. Yeah.

For sure. When we talk in general about the Latin community, what could be helpful? You know, we can talk about building support networks or encouraging family involvement. What do you think we could do better to assist this kind of demographic or community?

You know, I think just more awareness. I think what you’re doing is great. This is, you know, a great way to talk to the Latin community and to talk to the children of Latin parents and to, at least for us to start, you know, for us to start finding that process of how to break the cycle and model again for our families that it’s okay to get help. It’s okay to go to therapy and slowly kind of like see how we can pull them. That’s what I’m doing in my family, just slowly trying to pull them into therapy and amplify the importance of healing and that you deserve to heal and that you don’t deserve to carry all that pain that you’ve been carrying with from generations ago. Yeah, I completely agree.

Like you said, I think in summary, like we mentioned that accessibility to insurance, psychoeducation to parents, different kinds of generations and just trying to break the stigma by talking about it, that alone has been having a lot of impact. Yeah, absolutely. For a last message to our audience, maybe they’re part of that community, maybe they need some resources, maybe they’re first generation or second generation doubting, do I need therapy?

Or might the black sheet up the family? Cause I’m the only one that wants to differentiate themselves. What do you recommend? What’s your last message? If you feel something in your body that is telling you and like leading you to wanting to be curious about like what you’re feeling and healing, let yourself just experiment with therapy. I always use that word, like just experiment with it. It’s not a commitment until you make it a commitment with yourself, but be curious about everything that your family has gone through.

And don’t be scared. Just to look up, you know, like cultural, inclusive therapists or like Latin therapists, let me say it again, Latin therapists in your community or just there’s a tons of websites that you can just type in Latin therapists around me and make sure that you are choosing a therapist that like really aligns with what you’re looking for. I definitely feel like a lot of people might have heard experiences from other people that they have, might have had a bad experience in therapy. And it’s important to the therapy experience, it’s always about the connection you have with your therapist and you feeling you’re a good fit with them.

And then you feeling seen by them. So that would be the most important thing, make sure you’re choosing a therapist and if the first one doesn’t work, look for a second one, right? I know a lot of people get discouraged when they go to the first one and they don’t have a good experience.

So I tell them the same thing, just keep looking, keep trying, it’s like finding the right doctor, right? You specialize in Bowen theory or it’s something that you use a lot in your practice, correct? Can you explain to our audience what it is, what it consists of and how do you use it? There’s eight concepts to Bowen and the first concept, well they’re not in any order, but the first concept for me that I find really important is to check in with myself and with my client’s differentiation of self and that is their, again, like their emotional intelligence and how well they’re able to separate their thoughts and emotions from the systems around them without being part of it, just observing versus absorbing.

And again, like that’s something that is taught and then there is the transmission process, which is something that we touched on earlier that in like those patterns that are passed down from generations, right? So Bowen, he worked with patients that had schizophrenia. So he worked with the families, he studied them and he noticed that it took three generations of really high intensity in the family system to develop schizophrenia and the same with alcoholism. So it’s really interesting to see that all these looking at anything that has happened in the family system, like abuse, alcoholism, abortions, miscarriages, any major life event that someone would consider important, suicide, right?

All of those things live in the family system and they’re either, it’s a transmission process and there’s this like connection with that, I don’t know if you’ve heard of epigenetics before, but there is kind of, there’s like almost like a mini, like genetic makeup of what that looks like and which can make it really hard to be differentiated in your family system when this is, if it’s a system with a lot of intensity, a lot of abuse, a lot of alcoholism, drug abuse, anything like that, it could be really hard for you to differentiate yourself from that system. Okay, yeah, that makes complete sense. And you said there’s eight of them, like eight principles altogether.

What are, just touch lightly on the other ones? So there is societal regression as well and societal regression is, you know, like the influence that society also has on what we go through and what in our level of differentiation as well. Oh wow, interesting. How do you apply this theory in the Latin community?

How could you? Well, you know, you mentioned triangulation earlier, so that’s also a big thing that we’re looking at in the Latin community, we’re looking at a Latin family. We look at like alcoholism and how a couple can be triangulated with alcoholism and how that plays a role in subsiding and decreasing the, the intensity between a couple, right? So there’s so many ways and then children as well, like children are the biggest, they’re the biggest ones to be triangulated and with triangulation then also comes parentification, which is not a Boeing concept, but it’s something that very much aligns with the concepts in my opinion and something I very much have seen with a lot of Latin children that they become parentified and they essentially like being parentified is when you as a child, like you have these needs, I need to be met emotionally, safety needs, and they’re not being met because your parents are needing you to regulate them. So we are self-abandoning ourselves and we’re too concerned of what’s happening with mom, why is mom screaming, why is mom crying, why is, you know, why are they always fighting, why does she need me to like play this role for her, right? So that causes us to again, like self-abandon and grow up thinking that other people’s needs are more important than our own needs and we’re not concerned about what’s happening with us. So we don’t have that much attunement or differentiation.

Keep talking about triangulation. And I know for us as therapists, pretty clear what it means. Can you explain to our audience, what is it and how does it relate to families in general?

So I think of like a metaphor of like just like a car running, right, and then like there’s like a essential piece of the car that stops working and then the whole car stops working, right? So it plays an important piece in managing relationships. A lot of relationships that we have experienced are based on triangulation and we might, ourselves have been triangulated.

I know I have a lot in my experiences. Playing a role in someone else’s dynamic. So for example, if there’s a couple and one of them is unfaithful, the cheating is part of the triangulation. That is a way that the marriage is stabilizing. Triangulation is merely just how that dynamic stabilizes through the use of another person or thing.

Yeah, addiction or whatever it is that’s forming a part of it. Or if you have the child being in the middle of the triangle and that’s something that we try to avoid and how do you fix that in family therapy or how do you attempt to teach people to get out of the triangulation? So the first thing with Bowen is that we use the genogram. So we do a genogram, which is a family tree. Think of it like that with a lot of lines and we’re looking at patterns. So there’s triangulation and I’m like so visual, I have to use my fingers.

There is triangulation. We see that the mother has triangulated the child to stabilize her marriage with her husband. So that leads the mom and the son to be very amashed together. They have a very amashed relationship. That’s like, and what we call like a mama’s boy, right? But the mom is just very overbearing with the son. And that in family therapy, the first thing we do is just it’s visual, like having that visual. Yeah, identify it.

The genogram is such a powerful tool to be able to show families. One thing is just to talk about it. Yeah, yeah, yeah. Like do you think that you guys are amashed?

You know, say no, absolutely not. And then when you’re seeing like the patterns within those three generations, which is another concept of Bowen, right? The genogram, you start to see and it starts to create this type of like insight with families and like individuals. And it’s like, wow, like I’m overbearing with my son because my dad died, you know, when I was five. And then my mom just had a lot of different boyfriends. And I never had that like stability with like a man in my life.

So I am overbearing with my son for those reasons. And my husband’s a cheater, right? So like it all starts to kind of like make sense together. And then the husband cheats for his own reasons, right? So it’s not self-blaming, it’s just being aware. Yeah.

That’s what I love about Bowen, that we don’t, that’s not judgmental, it’s not self-blaming. It’s just creating awareness to like these transmission process patterns that like we have embedded and we’re like part of. It’s really, really powerful. I’m consciously most of the time.

Yeah, super unconscious. Once you identify them, how might you suggest this triangulation be fixed? Maybe for that example that you gave, how can a family start fixing that just by working on themselves or? Just that awareness in self, right? So we say like just awareness, but awareness in itself can be a big key for change and transformation. And you sort of just see like there’s no like specific intervention, right? Like now that we have this us do this.

No, it’s just okay. Like what’s happening with you? Like what’s happening with your own level of differentiation now that you’re aware of these patterns?

How is this causing shift in you? And then I think as a therapist being very intentional about that, about asking those questions about what is your internal response to this realization? Rather than like, okay, like let’s fix this.

No, like let’s really sit with this. Like let’s feel this like in our bodies and tell me what is happening with you for you to have these realizations with all that’s happening in your family, all this trauma, all this. And it doesn’t need to always be trauma or like this like dramatic thing, right? But it’s always gonna be impactful just to see a pattern in your family system. I mean, trauma depends on the perspective. Everybody’s trauma is different, right?

Big T’s and little T’s. So what’s trauma for me might not be trauma for you. So it’s very case by case. So I’m thinking of like just some incidents where I’ve been triangulated, especially like as a child. Then there was a lot of like triangulation with my parents and me and a lot of pressure on me. So the triangulation, it was not just one parent, it felt like both parents were just really like focused on certain things about my life, like academics, right?

And just being an over-functioner, like that’s how I feel like I grew up feeling like I had to over function. And it happened because that was a way that I stabilized my parents’ marriage. So they did not have to deal with like a lot of like their own issues that they were going through together. They put the energy all into me.

And my younger brother also definitely was triangulated in that sense. But it’s different. There’s like over-functioning and then that can also lead to like under-functioning in other cases.

It’s like high functioning anxiety. At what point did you realize that just wasn’t working anymore or that you were being triangulated? I mean, like definitely not with like the terms until like the past few years. But again, like I think I always felt like there was a lot wrong in my family system. And my nervous system was definitely like a part of that. You know, I developed like an autoimmune disease like when I was really young. And I feel like that there was like no explanation for that besides like you have a lot of anxiety. And I’ve done my own research and I’m like, wow, like yeah, like I have a lot of, I’ve always had like a hijacked nervous system. And that’s been part of the emotional system in my family.

It’s always been at a high with a lot of intensity. And then you look at other emotional systems and some of them are like really high and others are very, very low. Like there’s no energy in that system. What that means is that there’s not much, like there’s not a lot of connection maybe or a lot of like reproduction.

So it can go either or. So that definitely affected you a lot growing up. For sure. Then you became a therapist and found all your answers. I don’t have any answers, Beth. At least most of them. No, I do. I want to think that, but I’m learning. I’m just going along for the ride and I’m not being resistant as much as I used to.

I feel like there was like the six, like resistance before and now it’s just more like acceptance. It is what it is. I’ll let life take me this way that way. Accept and embrace.

Exactly. I can think of, you know, client I was working on for a while and we did a really big genogram of her family system. The genogram is a really powerful tool.

I want to balance eight concepts and it’s a visual that you do with the family or the client that you’re working with within one to two to three sessions. And you gather, it’s kind of like, it’s the three generations of your family. And it’s like a family tree, but with like, you know, different symbols.

Different symbols. Exactly. It’s exactly like a dike.

Dike. And you’re, you know, kind of marking significant life events and patterns. So looking at if a relationship is really a mesh or it’s more rigid or there’s cutoff in a family. So like, my mom doesn’t talk to my mom anymore. Why did that happen? Where did that energy go in the family system?

Something happened after that. So it’s just like looking at the energy because after like, we’re looking at cutoff, right? Another concept. You know, we were just like most common themes of like people pleasing, self-abandoning and doing a lot of like timelines and cultivating themes of the patterns in her relationships. And again, like love visual stuff.

So I think that was very helpful. And she was able to see all the patterns that she’s embedded in her past relationships with that she’s been in the past. And how aligned they are with her parents’ patterns and how her parents are with her. So I think all of that, you know, like her parents putting a lot of pressure on her, being preventive, self-abandoning, all of that kind of led into that pattern of being like, for example, like a people pleaser in most of her relationships. So, you know, I think she found a lot of strength in being able to see that and cultivate, you know, with our sessions, we did a lot of processing on how that felt for her and what that meant for her. I love, you know, checking in with how people feel with how my clients feel, but it’s more so like, how do you make meaning of that for yourself? Our feelings are not very stable sometimes. So, but our meanings and our values for everything are. And that’s how we really do guide ourselves. So I think as she was able to kind of like really sit with how she made sense and made meaning of these patterns, she was really able to kind of like slowly and gradually create new values for herself.

Yeah, I can see how that could be very empowering for someone, just the fact that you bring it out and have the awareness and now you’re able to process it and make meaning for it and eventually, you know, you hope that all of that goes away. It never does, but you get better at it. You get better at recognizing it. And then you get better at recognizing when these patterns may be popping up again, right?

And then what am I doing to enable these patterns? Cause we’re very much part, we take part, things won’t just happen to us. We take part in a lot of things, whether we know it or not. So it’s just being like an active agent for yourself of like awareness. I also feel like once you’re aware of certain things, you can’t just let it go.

Like you see that pattern in that red flag and you’re like, ah, then there it’s all not. Well, thank you for coming. I love this conversation. We’re gonna have a Spanish now for those for the Latin community, right? Cause we do wanna spread the awareness all throughout. I wanna thank you guys for watching or listening. Please leave us a comment, let us know your thoughts, let us know your experience and come see us every Friday in the episode. Bye.