Chapter Nine: Working with Immigrants/Forced Migrants and Trauma

Abstract: Current portrayals of migration focus on “arrival,” indicating that trauma is negated by achieving safety in Canada and is not reflective of the lived reality of immigrants and newcomers to Canada. This chapter presents trauma as ongoing, a loss that moves through time with people.

Key Concepts: Historial trauma, socially produced trauma, Trauma Informed Practice (TIP), Critical consciousness, socially just trauma-informed practice and narrative therapy.

Introduction

Archetypal versions of migration often focus on arrival as the end of the journey. This idealized conclusion is embedded in the Canadian psyche – tweets from Canadians responding to Prime Minister Trudeau’s photo welcoming Syrian refugees saying, “you are home now” symbolize this vision. Arriving in Canada means safety has been achieved, and resettlement (code for ‘catching up’) can begin. Embedded in this idea, is that the factors influencing or prompting migration, or push factors, are negated by arriving in Canada. For example, fear of violence is supposed to be replaced by a sense of safety. Experiences of trauma are now in the process of healing by the mere fact of having arrived, with social services, safety and economic opportunities as a part of resettlement. The stress from lack of opportunities is replaced by the belief in meritocracy and the possibilities of upward mobility. This is also reflected in the social work encounter as practice is centred on the fabled better life image that was promised. Understandings of trauma in migration are not reflective of the lived reality. This chapter presents trauma as an ongoing loss that accompanies people across the various life stages throughout their lifetime, impacting individuals, families and communities. This reflects what people have shared in interviews as well as in my clinical practice. One of the Women Immigrant participants in the Women Immigrants and Mental Health research stated “Migration [itself] is trauma”, which was echoed across projects. This trauma is heightened by the increasing securitization of borders and criminalization of immigrants/forced migrants, all fuelled by anti-immigration sentiments. People on the move are completely at the mercy of border control, immigration policies, and the allocation of funds that decide who and how many people can be granted sanctuary. This understanding sees the intersections of trauma as a political process of exclusion that structures the colonial grid.

“Migration as trauma” is contested in the literature. There is a consensus that the process of leaving, extending into how one resettles over their life course, impacts mental well-being. Despite this acknowledgement in much of the mental health literature, the impacts are seen as temporary and that immigrants/forced migrants will bounce back (Cissé et al., 2020). There are stressors associated with pre-migration, ranging from war to civil unrest created by ongoing coloniality. Furthermore, migration from the Global South can result in deprivation, sexual violence, detention, exploitation, and human trafficking in countries along the route and in Canada. During the resettlement process, immigrants/forced migrants often encounter a system that’s designed for expats from European countries, i.e., lack of recognition of professional credentials from the Global South. Misinformation, a fragmented system, unemployment, under-employment, poverty, unreasonable expectations, and a lack of services that can support their resettlement frames experiences. This continuum of the migration journey can exacerbate and create new stressors and trauma. Socially produced traumas are defined as traumatic events that are rooted in oppressive environmental forces that inflict pain and suffering (Goodman, 2015). Like other traumatic experiences, socially produced traumas can lead to psychological and physical health concerns, interpersonal and educational challenges, and increased morbidity and mortality (Flaherty, 2006).

Research and practice are often focused on the individual, but it is becoming evident that trauma impacts the functioning of both the family and community (Carranza et al., 2022). Additionally, trauma can extend beyond the individual lifespan to intergenerational. War, trauma, fear, oppression, and legacies of colonialism continue to shape people’s intersecting identities, impacting their well-being and resettlement. Key factors, such as acculturative stress and immigration trauma, are usually not explored within the context of assessment and intervention in the helping professions (Carranza, 2017). When working with individuals, families and communities seeking ‘help,’ it is crucial to be mindful of the ways trauma is experienced under the rubric of coloniality, for example, thinking about how colonialism intentionally fractured families and communities.

In the project, Men’s Integration and Resettlement, one woman who had migrated to Canada as a child with her Father said, “Service providers, and people you meet think, “poof, everything changed. You get here, and [being] thankful is assumed to be your only emotion, and this is expected”. Understandings of the lived processes of migration and belonging to Canada are evolving. Citizenship is not only a legality but is a process navigated by immigrants/forced migrants to negotiate their own space and belonging. Feelings of belonging, and if one can feel at home, settled and secure in a place, has as much to do with an individual’s mental health and well-being as the immigration structures and popular discourse. Therefore, policies, initiatives, funding and settlement services to ease the stress are only one piece of the larger process for people and their families. Immigration and resettlement overlap with the majority of areas of social work. There are a couple of key pieces that impact trauma and acculturative shifts from other chapters to keep in mind:

• Migrations occur in various configurations. Some examples are young people migrating alone, families moving together or separate, and parents living in the Global North with children in their country of origin
• Families are in flux, reorganizing to accommodate separations.
• Trauma experienced by one family member impacts the whole -across generations and borders.
• The way that the Global North organizes and understands the gender identity of immigrants/forced migrant can mediate acculturative shifts and trauma
• Acculturation and trauma are mediated heavily by the context of reception. In Canada, this reception can range from lukewarm to violent to welcoming. This is contingent on the colonial grid

Each stage of immigration, from leaving to resettlement to permanency in either a legal or a lived sense, can alter the individual’s and/or the family unit’s ability to function. These stages are unique to each individual, family and community – and are influenced by the receiving society and the reception. While the literature about those on the move continues to grow, common myths still exist and are operationalized in the helping relationship. One such example is that immigrant/forced migrant youth aged 16-25 experience fewer problems during resettlement and acculturate ‘faster.’ Due to age-related perspectives, young people are believed to be less influenced and invested in the language, culture, and ways of life in their country of origin and can assimilate into Canada quickly. It is also thought that younger people can ‘bounce back’ from traumatic experiences, especially those who are ascribed a high level of ‘resiliency’. Research by Carranza and Grigg (2022) with young people from Central America and the Caribbean found this to be a more complex correlation. Both Canadians and adults who had migrated from Central America and the Caribbean believed that young people were more ‘open and adaptable’ to migration. Non-migrant service providers believed that they assimilated quicker due to age as younger people are more flexible and spend less time in their country of origin, so it was easier for them to learn Canadian ways. Along the lines of the colonial grid, these same service providers also spoke of less inherent criminality in young people. Criminality for those from Central America meant being less inclined towards gang affiliations and drug trafficking. Adults who had migrated themselves thought it was because young people had less of an accent and markers of difference and were able to code-switch. It is also believed that young people have a less cumbersome pathway to legal citizenship.

It was found that migratory trauma can, and often does, shift young people’s sense of their own age, responsibilities, peers, and family connections. The responsibility placed on young people altered their growing up/developmental trajectory. One young person from Central America named this “the weight of hope.” Hope existed for young people’s families in the visions for their (potential) future life – the ‘better’, the safe and mobile life. In these instances, some young people noted that carrying their family’s hope contributed to the extra stress on employment, making enough money and being successful in school (Carranza & Grigg, 2022). For some, the cumulative stress of pre-immigration trauma, resettlement and acculturation to Canada resulted in feelings of loneliness, isolation from both homes and depression. Furthermore, not only is migration a significant event for all families in motion, but the Global North – Canada included is founded on principles of individualism. This may or may not be at odds with acculturation as a family process and transnational living.

What does being trauma-informed look like?

Trauma theory has emerged out of a time, place and history of ideas, and since its original formation, has been raced, classed and gendered (Stevens, 2009). Young (1995) argues that trauma theory “is glued together by the practices, technologies, and narratives with which it is diagnosed, studied, treated, and represented and by the various interests, institutions, and moral arguments that mobilized these efforts and resources” (p. 5). Trauma informed Care (TIC), or practice (TIP) is an approach that recognizes the pervasive impact of trauma on people (Wylie et al., 2018). Goodman (2015) moves beyond clinical definitions to include the social structures and contextual elements that create and maintain marginalization, which in turn impacts trauma. Traditional definitions that focus on the individual pathology or psychology may exacerbate systemic oppression and distress. Using Western approaches assesses what is happening for someone as an individual in relation to the incident(s) or sources of trauma (Clark, 2016). By ignoring community and systemic factors, helpers fail to work with people on the spectrum of issues and can potentially miss opportunities for social justice in agencies and beyond (Goodman, 2015).

As theory and practice move away from privileging understandings of mental health and trauma from the lens of the West, flexibility and adaptability are number one for helpers (Wylie et al., 2018). The complexities and multilayered experiences of people need to be taken into account while assessing the social work encounter. Helpers must include how their identities influence this engagement – moving beyond a reflexive account of acknowledging our own citizenship, race, or place on the colonial grid. We must ask, how the concept of trauma-informed services is being enacted in clinical settings and scholarly works? How do people want to work with a helper? In the context of immigrants/forced migrants, TIC ‘trauma’ is understood, experienced, and worked through in various ways across the globe (Carranza et al., 2022). The Western view of trauma, while shifting, remains focused on intrinsic or intrapsychic experiences (Goodman, 2015). One example is Carranza and colleagues (2022) found that in Salvadorians in Canada, there was no Spanish translation or colloquial term for trauma. People made sense of trauma within a collective experience, and it was not individualized. This included transgenerational, intergenerational and community traumatic experiences. In Spanish, Salvadorians said, “The experience was traumatic” versus “I am traumatized.” Trauma is then in movement and not rooted in the individual (Carranza et al., 2022). Experiences of trauma for Salvadorians included their migration and were dealt with at the transnational level. The context in which people experience trauma shapes the way that it impacts them.

Working in a way that incorporates an understanding of coloniality will look different in various contexts, depending on the community and group that you are working with. Referred to as Socially Just Trauma Informed Practice (Domínguez, 2022), this intervention method draws connections between the individual and systemic oppression to the analysis. Coloniality of Power (Quijano, 2000) draws attention to the ways that race is constructed in the present and how the historical past remains. This can provide insights into how racialized immigrants/forced migrants are perceived in Canada based on race, ethnicity and culture and the ways these can construct them as the stranger. CoP informs the ‘war on terror’ and the ‘war on drugs’ and how both forced people into the diaspora and how they are received and encouraged to resettle. Another way social work practice can provide insight into migration and life experiences is to understand how gender-based violence is viewed through the lens of whiteness (Lugones, 2007). This can provide insights into how the world is navigated and experienced by Women Immigrants.

Trauma-informed approaches that use critical consciousness (Freire, 1973) and liberation-based frameworks (Martín-Baró, 1994) encourage people to focus on the systemic elements that contribute to the traumatic experiences. A TIC approach has the potential to connect the individual to present and historical experiences of the community and the global. One way to think this through and practice making these connections is by using the Colonial Grid (Carranza, 2016) and mapping the pieces of identity that people find relevant to their experiences. This exercise in the social work encounter can open discussion for people’s experiences and space for storytelling. However, ‘analysis’ may not always be what people want to discuss. Their needs should be focused on what they consider more immediate.

Helpers must pay attention and speak, where appropriate, to systemic factors. For example, when people have their credentials questioned or are not hired due to an accent, this must be addressed within the comfort level of those engaging in services. Otherwise, the social work encounter runs the risk of individualizing and reproducing the colonial encounter (Carranza, 2022; Goodman, 2015).To deconstruct the sociocultural and geopolitical context, including the history, is to identify all of the systems at play – for example, how social injustices have, and continue to, disproportionately impact immigrant/forced migrant communities during the COVID-19 pandemic (Domínguez, 2020). It is also important to discuss how people navigate and make meaning of how they experience these systems. Immigrants/forced migrants interact with many settlement services and programs, in the healthcare and education systems. To combat invisible oppression all of the individual needs should be integrated in assessments and formulations, thus, accounted for in the needed interventions plan or plans of care. Wylie and their colleagues (2018) suggest that using socially just interventions encourages more collaborative work between helpers and those they are working with. TIC approaches encourage people, including the helper, to reflect on their roots, cultural influences and connections to the community for healing and understanding. Employing forms of understanding and healing that are important to people and relevant to their history and present should be used wherever possible. This does not mean the helper should engage in interventions that are outside the scope of their capacity and practice, rather, incorporating elements that align with the infrastructures of their agencies. For example, storytelling and narrative elements can amplify people’s histories, communities and cultural engagements (Wylie et al., 2018).

This method of TIP can disrupt stereotypes and messages that are overt and covert in Canada for immigrants/forced migrants. While the message of ‘You are home now’ was wildly popular on Twitter – this is not always the truth. One participant in the Women Immigrant and Mental Health project said, “Canadian immigration, they have a three-word logo, ‘Welcome to Canada.’ I think they should change this to ‘not everyone is welcome’ ”. Further, social just TIP links personal, family, and community experiences to the systems of resettlement that may not be working for people. It challenges the ideology of ‘the Canadian dream’ and ‘Canada as a land of opportunities’, turning what is considered a deficit in people into an opportunity for systemic construction. In this chapter, deficit understanding is defined as people needing to find ways to make up for things that are ‘lacking’ – education from the Global North, professional circles and connections. Sometimes this work can fall under the rubric of strengths-based or even empowerment. Shifting this lens encourages a strength-based sociocultural perspective that rejects the notion people need to make up for the created deficits to maintain marginalization.

In the following case studies, try to look at trauma through the following three concepts:

Systemic Oppression and Community Trauma: Trauma is inherently political, given that the events occur within specific contexts and are grounded in societal structures (Burstow, 2003). Community trauma – a shared experience whereby emotional responses are tied to social relations. As such, the expression of emotions and affects are linked to relationships with others in the community (Fuss, 2013). It is important to remember that not all communities and members with shared experiences and identities will connect with this understanding of the collective. However, structural marginalization is a shared experience (Carranza et al., 2022).

Transgenerational/Intergenerational Trauma: This term refers to the impact of traumatic events that are transmitted from one generation to the next. In this understanding, people do not need to directly experience trauma to be impacted (Goodman & West-Olatunji 2008). Trauma can manifest at the individual, family, and community levels (Evans-Campbell 2008).

Ecosystemic perspective (Goodman, 2015): The ecosystemic perspective looks at people’s lives and the systems that overlap, ranging from how they see themselves to the systems-level macro factors. What is being experienced by the individual? What is indirectly happening? What systems have a direct and indirect impact?

Reminder: Review your Colonial Grid and note any colonial conditioning that may emerge when you work through the case studies. Think about what has informed this thinking. How can you make sense of it from an ecosystemic perspective?

Case Studies 

Naya:
Naya, a 33 years-old woman, is a physiotherapist by profession and worked several years in her country of origin, Ghana, before coming to Canada as a Landed Immigrant 12 years ago. She came with her family (partner and two sons, 12 and 10). Like many immigrants, she and her family came to Canada searching for a ‘better life’ for themselves, but mostly their children. A part of this ‘better life’ was financial security – better jobs and upward mobility. However, her education and work experience was not validated. After a year of seeking employment in her profession, she was counselled that becoming a Personal Support Worker may allow her to continue in the care profession. Shortly after her training, she was able to secure casual work. However, several years later, she continued to hold only casual postings, despite her efforts to secure full-time employment. The latter would allow her to have a steady income and benefits for her family. She stayed in this field in order to have a permanent line of seniority, which was important. Nevertheless, she observed that others with less seniority would secure a line, but not her. She added that she would lose her assignments with no explanation. She experienced sexual harassment by some of the males that she provided care for. In spite of reporting this to her supervisor, nothing was done.

She came to therapy referred by her family doctor due to depression. In the initial assessment, Naya reported experiencing low self-esteem and confidence (3), sleeping disturbances, crying spells, anger (10) and anger outbursts, poor concentration (2), poor memory (3), hypervigilance, and sadness (10). She reported feeling like she was “going crazy” – as “nothing made sense” to her.

Prior to her migration journey, she described herself as being a kind, friendly, compassionate, confident, strong, intelligent accomplished woman, neighbour, mother, active citizen, and professional. She stated not being able to understand the way she was feeling at the time of our conversation. She found herself feeling frustrated and unhappy with her partner and children. She added that she was socially withdrawn and apprehensive of people and almost fearful of people.

Julia
Julia is a 50-year-old woman. She came to Canada 30 years ago. While in her country of origin, she was subject to violence due to political turmoil in her country of origin. She was not able to finish high school due to increasing violence directed at youth at this time. Male youth were being recruited into a left-wing group. Female youth were the target of sexual violence and/or taken into the trenches to provide ‘domestic duties.’ She added that her younger sister was raped and murdered on her way home. She and her siblings left the country to seek refuge someplace else. While on her migration journey, she was raped and impregnated by the assailant. Due to her religious beliefs, she decided to carry the baby up to birth. When her daughter was 6, she married and had another two daughters with her partner.

Julia reported experiencing episodic sleeping disturbances and depression. However, in recent years, these difficulties have become more challenging to manage and are now accompanied by a lack of sexual intimacy. Julia’s partner is complaining that she doesn’t love him anymore. She finds herself very irritable with her husband and wants to leave her relationship.

Lydia
Lydia is a 27-year-old, a US citizen by birthright, Canadian by naturalization, and a third-year medical student. She was born in the US to Latin American parents. Her parents met In the US. They each left their country of origin due to political turmoil and lived in the US undocumented for more than a decade. Regardless of this, they had been able to secure employment and belonged to an extensive support network. These provided them with financial security and a buffer to endure the stresses of living in liminality and in a hostile environment due to anti-immigrant sentiment. Due to the US’ ongoing immigration deportation policies, they sought refuge asylum in Canada.

Lydia and her parents sold their belongings and came to Canada, leaving behind their network of support and what gave meaning to their lives. In Canada, they found themselves living in extreme poverty. Lydia missed her friend and the mundane routines her life in the US entailed, i.e., going to the babysitter, playing with her peers and visiting families in her apartment building on weekends. They lived in a ‘run down’ neighbourhood. To make ends meet, they needed to have two jobs—leaving at the crack of dawn and returning late in the evening. This meant that Lydia was left unsupervised for several hours. She had to get herself ready for school by bus, do her homework and prepare and have dinner alone, after her return home. When asked, she had to lie about her age, stating that she was older. She had been instructed by her parents to do so. This made her feel nervous, as it contradicted what her parents had taught her about not lying. After a few years of this “hard work and savings”, her parents made great efforts to live within the boundaries of a “good school” so she could be exposed to ‘good’ (white) people.

Lydia stated feeling “odd” and “different” in her new school—as she was the only racialized child in her grade. However, due to her well-developed social skills, she was able to make friends very easily. She got to hang out with the “cool kids”. She learned that the children who attended this particular school came from wealthy households and had access to things and activities that she didn’t. She experienced poverty and shame – as she felt embarrassed of her clothing, her house, their furniture, the car her parents drove, etc. She preferred not to have friends over and not to be picked up by her parents (who now had a lax schedule). She’d had her parents’ friends drop her off a block before her house (where the nice houses ended). She stated that at the time was difficult for her to understand the reason behind her parents working so much, not having access to a “pretty house”, a dog and a nice car in comparison to her parents’ friends. She added that due to her friends, she had access to private country clubs and other luxuries.

However, she delved into her schoolwork and was the best in her class. Yet, she reported that she learned soon enough that her academic performance was contested, but not that of the white youth she academically mentored. She was referred to the school social worker due to depression and suicidal ideation.

Ideas on working with People: Working from a Strength-Based Perspective

Strength-based approaches remain crucial in this work but not as a part of the deficit model. Interventions must be informed by deconstructing the colonial impetus to privilege certain identities and ways of being strong. For example, the myth of meritocracy, the idea that if a person works hard, they will get ahead based on effort and diligence alone and can overcome adversity, informs the (fabled) Canadian or American dream (Carranza, 2017). Another example is valuing independence over interdependence, that is, working together and depending on one another – this, too, is a strength when looked at from outside of the lens of the West. One way to approach notions of strength for helpers is valuing in thought and practice the range of experiences and histories of people, honouring how they exist in the world. Lee and Bhuyan (2018) note that the counselling relationship can often remake these norms of independence found in the Global North and Western lens that devalue collaboration and community. This approach can disconnect people and place additional pressure to ‘solve’ one’s own problems.

Question: How would this approach to strength alter a Western perspective on Naya’s situation?

Narrative Therapy

The stories that people tell have a social, cultural, political and historical complexity (White, 2001). Narrative therapy, or elements of it, can assist in re-storying and deconstruction, with a focus on conversations and collaboration. As an intervention, narrative therapy separates the person from their problem (White, 2007). In using narrative for social justice, ‘problems’ are connected to the larger social structures. TIP can utilize narrative therapy techniques to address the sociopolitical context, to unpack hegemonic narratives that are impacting people’s lives (Brown, 2020). In working together, the social work encounter can use counterviewing to question the assumptions and taken-for-granted realities that hegemonic narratives create (e.g. white men in leadership positions). This hegemonic narrative works to inform the colonial grid where, to some degree, many of us see this positioning as natural – leadership as an extension of maleness and whiteness (Carranza et al., 2023). Counterstorying, where the development of a new story emerges, builds upon strengths and resists dominant narratives (Brown, 2020). A counter-narrative can illuminate the systemic nature of lived reality.

Question: How could this thinking be applied to Lydia’s experiences of shame?

Privileging Non-Western Ways

This approach places value on healing in ways that are not part of the medical model or Western ways. It also removes the helper as the ‘knower.’ Goodman (2015) suggests that people engaging in helping can and should step away from frameworks learned in Eurocentric settings. This could privilege the viewpoints and practices that are meaningful to individuals, families, and communities without being appropriative or exploitative. Using art-making as a way to encourage communication and healing, photography or perhaps gentle movement. People have ways that they can make meaning from healing and this should be centred in their way of knowing. This approach is less prescriptive than narrative therapy and can and should be implemented on a case-by-case basis. It is also important to be mindful of the trappings of cultural competency and cultural humility. Being open to when an identity is not shared, or as a helper you are not invited in, you may need to seek additional guidance. Social and collective action has been identified as a way for people to challenge the structures that disempower them (Herman, 1997). Connection can be, not always, a powerful way to work with people and their communities. A collective co-created project can bring people together to discuss their shared struggles and, if they choose, social action (Goodman, 2015).

Question: How could a helper value Julia’s own knowledge and healing?

Conclusion

The literature on trauma and resettlement acknowledges that the legal aspect of the immigration process is highly stressful due to its arduousness – from the paperwork to navigating the court system and lengthy waitlists. It is, too, very costly for applicants (Carranza, 2017). Further, migration, acculturation and integration are often saturated with stressors and uncertainty, concerns for safety and economic instability. Upon arrival, the experience is less than magical, as portrayed in the media and collective imagination. Once in their new home, immigrant/forced migrants often experience multiple barriers, such as language, accessing meaningful employment, and recognition of international credentials (Carranza, 2017; Lee & Bhuyan, 2018). Racialized immigrants/forced migrants face multiple added oppressions such as racism, discrimination, and unequal access to services (Comas-Díaz & Greene, 2013; Lee & Hadeed, 2009), as well as exclusion from economic integration and advancement (Creese, 2005; Galabuzi, 2004). Resettlement is a gendered process, for racialized women, they face an income gap of 47% with non-racialized men, and earn 59% less than non-immigrant men. It is likely that racialized immigrant women experience the highest income gap in Canada (Statistics Canada, 2016).

In the TIP approach detailed in this discussion – how do we connect this to the local, national and global? How do all of these experiences create or exacerbate trauma?

Trauma-informed practices with immigrant/forced migrants require a shift away from the medical model formulation of the intrinsic or intrapsychic. Trauma is political, and as such, where privilege exists, we should be engaging in advocacy, activism, and action. This starts with interrogating how intervention theories informed by coloniality create trauma. Adding in information and knowledge from the community can begin to shift away from Western lenses and Eurocentric education. At the micro level, examine the policies, directives and practices within where we work and volunteer. How do they support or reproduce coloniality? For example, how is ‘foreign’ knowledge and education valued or devalued? Are interventions geared only toward the individual? At the macro level, how does coloniality inform policies at local, national, and international levels? If it is safe for us to do so, asking how might policies be creating or exacerbating traumatic stress?