Latina Women's Mental Health: Overcoming Adversity and Stigma*

Latina Women's Mental Health: Overcoming Adversity and Stigma*

Key Note Speech given at NHCSL, National Convention of State Senators and Legislators, Hispanic Caucus, July 27th, 2010, Louisville Kentucky

* Irene Vilar was featured in a September 2014 Denver Urban Spectrum article about the Americas Latino Eco Festival, which she founded. This speech provides greater insight into her background and inspiration for her cultural activism.

 I am Irene Vilar, a Latina, and a Puerto Rican American mother and writer who has lived through major depression and self mutilation resulting in a horrifying, reckless number of abortions. I stand here today after flying in from Boulder Co on a red eye flight ( so I could tuck in my girls, something I’ve had the privilege of not missing since their birth), I stand here this morning before you with one simple, straightforward testimony: The ways of overcoming adversity and stigma are as varied as the reasons for shame and suffering but one fundamental change must occur for healing to take place and that is doing away with alienation.

Alienation is the beating heart of depression and some of its major arteries are made up of primitive parenting, neglect, social and political ignorance, inept historical families.

My personal mandate in exploring alienation in my literary work has been to establish right from the start the complexities of my destructive actions and to frame the story at hand as one women’s attempt at examining her life and grasping its meaning by asking how conscious she is of what she does to earn a feeling of worth and by what lies she tells herself. The results have been the confirmation that in overcoming a wounding neurosis one mends a torn self, and that in regards to the particular forms my depression have taken, more often than not the power of procreation can be tragically alluring to powerless young women resulting in impossible motherhood “syndromes” that act out old childhood hurts, the full sense of which cannot begin to be grasped without examining one’s parents and/or caretakers, one’s family, one’s culture, one’s country, and ultimately, one’s own complicity. 

I grew up in Puerto Rico with a depressed woman who had been sterilized by an American led experiment (by 1977 Puerto Rico had the highest rate of sterilized women in the world with a horrifying number of 37% to 40%). My mother was the wife of a man who did not value her, the daughter of a nationalist mother who chose public myth making over mothering her (Lolita Lebron spent twenty five years in a US prison for her attack on Congress in 1954), and a suicide who had flirted with death to the evening she succeeded at it by throwing herself from a speeding car while I tried to hold her back. Six and a half years later, at fifteen, I graduated from high school and pressured my dad to let me leave the island to attend Syracuse University. I wanted nothing more than to escape and be in absolute control of my life and my body. Looking back I know I was running away from many things but one of them, I suspect, turned into some fine stow away deep in my psyche: it was that six vowel monster that everyone talked about back home and at our dinner table and who was the biggest perpetrator of my mother’s final demise, the one who had sent her home without a reproductive system, no hormonal treatment, an addiction to valium, and the promise of no children: It was La Operacion.  My mother’s emotional verbal landscape the years before her death was riddled with neurotic mourning for her reproductive body capabilities, the arrested procreation that could not give her another child, the sister she wished she could have given me.

At seventeen I fell in love with my literature professor. He was a philosopher and self proclaimed feminist who wanted no children and thought that women should be sterile if they wanted a career and a true life of freedom. Call it an act of adolescent rebellion, the “reckless” desire to be fully a woman for a couple of days, whatever, but I “unconsciously” and systematically forgot to take my birth control pills and defied him. Thinking back through our mothers, as Virginia Wolff said, I know today that with each pregnancy I defied him as much as I defied the politics of sterilization that took my mother away from me. It was not a rational behavior, of course, when one is looking for a strategy of survival with very limited tools one uses what makes sense in a sick way. I wanted control over my body and the way I chose to have control could not have been more terrible. Getting pregnant brought a strange feeling: I could bring it on with nobody's permission and I could interrupt it with nobody's permission. Of course this did not mean that I wanted to do it again and again-I was a creature in suspended animation addicted to the high of agency in pregnancy and the shame of the down side, the inevitable termination built into the cycle in order to not lose my husband and also in order to be close to my mother, by identifying with the subjugated, powerless version of her. My mood altering experience was a shape shifter. It took different forms with the subtle changes in the drama I acted out over and over again. At times the high took place before pregnancy, waiting for a missed period, my body basking in the promise of being in control, and in the love fantasy of bearing a child, loving a child, being loved back. At other times it was the pregnancy itself, the power and agency I embodied, if only for a couple of months, and still other times it was leaving the abortion clinic, feeling that once again I had succeeded in a narrow escape. The time of my drama was my time, no one could interrupt it, and what was more important, I could not interrupt it to meet others' needs. Feelings of inadequacy, helplessness, and disorder faded in the face of the possibilities of my reproductive body. An excitement, hyper-arousal, almost euphoria surrounded my maternal desire. The craving gave structure to the confusing morass of events that was my life.

Tension would gradually build as my pregnant body crowded out all other things and emotions. After a few weeks, stress would set in and grow more acute by the day and with the physical changes in me. I would go in and out of denial. At times I would forget I was pregnant. Other times I could not think another thought.  I would stop eating. By the time I lay in an abortion clinic waiting for the procedure to begin, I would feel nothing but disgust and shame. When I left the clinic, I felt a calm respite, surrender. I always said to myself then, “this has to end.”

My blinding desire for the one and only love story with a baby  was at the core of my neurosis. And so was the blinding desire for control. The desire for control- I am certain now- was informed by my mother's lack of it in the face of her family, her marriage, her culture, and La Operacion. 

I can’t think about my mother and most Puerto Rican women without thinking about “choice.”  Throughout my mother’s childbearing years, from 1955 to1969, Puerto Rico was a human laboratory for the development of birth control technology and population control policies.   My mother was sixteen when she gave birth to my brother Fonso in January 1956. In April, she became pregnant with Cheo and gave birth in October to a six-month preemie. Shortly after that, she began using Enovid, the controversial 10-milligram birth control pill. In September 1961, after the birth of my brother Miguel, the public hospital staff threatened not to provide care if she did not consent to a tubal ligation. Eight years later, my mother’s tied tubes became untied and I was conceived. In 1974, when a pap smear showed nonmalignant, abnormal cell growth, the doctor recommended a radical hysterectomy. My mother was sent home without a reproductive system and no hormonal treatment. She was thirty-three years old.

Most of the conscious memories I have of my mother belong to the time after her hysterectomy.  Depression and mood swings fastening her to a chair or sending her away in the middle of the night. Migraines curled her blood-clotted body in bed. Irritability slapped me for asking a question. Bloating and weight gain shamed her in the mirror. What growing up poor and an orphan, the daughter of a woman imprisoned in the United States and the wife for twenty-three years of a womanizer, the U.S. mass-sterilization program and its population-control ideologies did. Self medicating with Valium and acting out a ransacked, frantic, if vacant, sexuality, my mother came undone while I watched.

Traumatization occurs when our resources are inadequate to cope with the threat stemming from the violence. Violence challenge’s one’s most basic assumptions about the self as invulnerable and intrinsically worthy. When the persons who are supposed to be the sources of safety and nurturance become simultaneously the sources of danger against which protection is needed, children maneuver to re-establish safety. They blame themselves and become hungrily attached and anxiously obedient. Sudden, uncontrollable loss of attachment bonds is an essential part in the development of post-traumatic stress syndromes. Trauma injures the private self. Without a well-developed private self we fear growth and self assertion. The fear that accompanies trauma victims is the fear at the possibility that the injury could happen at any time and once again, catching one unaware.

The human response to trauma is summarized by Van der Kolk: that the central nervous system seems to react to any overwhelming threatening and uncontrollable experience in a consistent pattern; that traumatized people tend to respond in an all or nothing way with anxiety and social/emotional withdrawal; that PTSD symptoms underlie psychopathology of addictive behaviors; and that the intensity of the autonomic arousal, formerly adaptive preparation to cope with stress, eventually becomes itself a precipitant of fear and emergency responses. Animals exposed to inescapable shock develop analgesia when exposed to another stressor shortly afterward; this response is mediated by endogenous opioids and is reversed by nalozone, and chronic stress induces a physiological state that resembles dependency on high levels of exogenous opioids—It is this ‘addiction to trauma’ that characterizes in part the human fascination to chronic re exposure to dangerous/self harming situations...”

If recent animal research is any guide, people, particularly children, who have been exposed to severe stress, will experience extraordinary increases in both catecholamine and endogenous opioid responses to future stress. The endogenous opioid response can produce both dependence and withdrawal resembling those of exogenous opiods. This could explain, in part, why childhood trauma is associated with future self-destructive behavior. Self-mutilation in my case, as it manifested in the pregnancy/termination drama could also be seen as a response to abandonment accompanied by both analgesia and an altered state of consciousness, and it provided relief.

I once read that the big achievement of human species is our self-consciousness; the awareness of oneself and others as unique selves with a history. Early humans began to evolve this self-consciousness through slowly improving parenting, resulting mainly from mother’s growing empathy toward her child. When a mother betrays this higher consciousness parenting by losing empathy for the child-as my mother did—and hers-- our humanity regresses, is deeply hurt. The same can be said of nations; politicians legislating against citizens by slashing away child care and education funding, siding with immoral health and banking practices,  ignoring the conditions of poor and middle class people and mothers forced to work multiple jobs outside and inside the house with no real/significant maternity leave rights. We live in a society with  increasing parent-child attachment dysfunction; a scary regression.

In this context I have elaborated, my testimony is grounded in national and generational trauma and the ways the political and colonial can work its way through a woman's body. We are all the products of our culture, our values , our upbringing. The way " we choose" our neurotic rebellion is certainly influenced by all of the above. I did not channel my rebellion against forced sterilization and alienating motherhood through political pamphlets or taking to the streets.  It is only in retrospect that I can link my depression and dysfunctional reproductive drama to my refusal to submit to my husband's belief that women should not have children. I recognize now that in part I projected on his views the ones pervasive in Puerto Rico: Women need to be contained in the home with multiple babies or should be made barren to control the growth of an undesirable population. In a way, I was reproducing the empire. The imprints of shame, inadequacy, subservience, fear of growth are the makeup of women’s politized wombs. Abortion and Norplant were the measures for the fertility control I reenacted. My husband was the colonialist state. I was the perverse subject. I had more ‘rights’ and ‘choice’ than my mother—I was a girl of globalization, after all-thus I could afford a more intimate, ‘individual’, drama. I set a stage where I had no reproductive freedom or choice but conform to someone else' project. I abused my freedom because I was not free, as simple as that.

The feminist pamphlet " the personal is the political" has been preceded for centuries by women who used their own bodies as a form of resistance against the system. They were called hysterics and were often locked up.  There is a huge feminist literature showing how hysteria is the god mother of feminist theory.

Yes, I believe my Puerto Rican and immigrant experience informed the shape of my depressive states and false liberation strategies but I’m solely responsible for my actions and that’s what my work is about, a search for understanding and self-accountability

I learned from my parents the grammar of mixed message, that feeding and caring and nurturing can go hand in hand with neglect and violence, that outpouring daily gestures of love can coexist with crushing depressives states, suicide attempts, addiction, abandonment. At the core of my childhood was parental love and lack of protection and the model that no conflict can end well.

The psychohistorian DeMause writes in “The Emotional Life of Nations” that the source of most human violence and suffering has been a hidden children’s holocaust throughout history, whereby too many of human beings have been routinely abused by their parents, caregivers, governments so that they grow up as emotionally crippled adults and become bound to re stage their early traumas in ways that shape nations and wars. He argues changes in child rearing precede social change and lays out a psychogenic theory of history that answers the question of why it happens-a theory of historical motivation.

As I look at my own suffering in the context of a whole family’s dysfunction, I realize that what held us back for so long is that we were brought up emotionally crippled so that we spent most of our energies chasing “ghosts from the nursery”—religious, political, economic domination group-fantasies-rather than joining in together to solve the real tasks of life.

William Faulkner wrote, “The past is never dead. It is not even past” . The psychogenic theory of history believes in shared re staging of dissociated memories and early traumas. Psychic content is organized by early relationships so that psychic structure is passed from generation to generation through the narrow funnel of childhood. Thus child rearing practices are not just a cultural trait but the very condition for the transmission and development of all cultural models. Child rearing is crucial because it organizes the emotional structure that determines the transmission of all culture and places limits on what can be achieved by society. This is a social theory that posits love as the central mechanism for historical change because clinical sciences show that love produces the individuation needed for human innovation and cultural evolution.

I have spent most of the last twenty years trying to investigate, mainly through writing, my actions, reading books on psychology, philosophy, cultural and women studies and now infant development, searching for all the ways I can protect my girls from everything hurtful, including myself. I don’t want them to ever succumb to the dismembered life of a false self (The Ladies’ Gallery). I don’t want them ever to lie on a stretcher at an abortion clinic (Impossible Motherhood). Their fate depends, to a great deal, on me, I think. And at first, writing has become my own fantasy of shielding them from my history. The most real and authentic protection of my girls I can offer is to fully understand the emotional poverty of my historical families that has crippled communication and cooperation and turned conflict into panic of growth rather than an essential part of growth.

The further back in history one goes the lower the level of child rearing, and the higher the amount of houses of horror where children lived and dissociated. Psychiatric studies have shown that there is a direct correlation between elevated levels of dissociative symptoms—separate alters, depersonalization, derealization—and the amount of early physical, sexual and emotional abuse. Historical evolution of the psyche, psycho history tell us, is the slow, uneven process of integrating fragmented selves into the unified self that is the goal of modern, sophisticated, empathy driven parenting.

It is of absolutely necessary and urgent to talk about depression and abortion with the lack of shame, taboo, etc of any other public health issue. As we open up the discussion and generate a new language to speak about our mental health and reproductive bodies women will most certainly see themselves with new insights. And the people who want to comfort them will be better equipped to do so. But we will gain the most if we start to recognize the high numbers of depression in Latina women and the reality of repeat abortions as the sequela of suffering that are the widespread consequences of sexual ignorance, social injustice, and personal trauma ignored.

I am often asked how did you do it Irene? How did you heal?  It is a difficult question to answer and I’ve always had trouble with it, for healing, I suspect is paradigmatic, one particle of the healing process today is the right caress at the right time twenty years ago. To fix the “results” entirely in time and “turning” points does not feel authentic to me. I usually say of course, heavy duty psychotherapy for three years three times a week; writing, yes, a life work of self examination, and also, and perhaps most important what I call Latina spirituality, a resilience quality that cushions catastrophe in most surprising ways and I don’t fully understand. Nevertheless, the experience of being a mother and educator (I home school my girls) is increasingly making me consider the importance of my liberal education in boarding school in New Hampshire and in college at Syracuse University. As I look back I see how crucial liberal education was in cultivating my humanity, offering a Socratic mandate of self examination that was a “cleansing”, a welcomed transparency and order in the face of my ambivalent and ambiguous historical families. I essentially developed ,along with the stupidity of my actions and self-obsession as a depressed teenager, three capacities that would eventually help me realign my life and transcend my dysfunction-the first is the capacity for critical thinking about one’s own culture and traditions. The second is the capacity to see oneself as a human being who is bound to all human beings with ties of concern. The third is the capacity for narrative imagination-the ability to empathize with others and put oneself in someone else's place. I often went to bed hugging Anne Franks Diary, Martin Buber’s I and Thou, Eduardo Galeano's Open Veins of Latin America, Simone Weil

Basically, my liberal education turned me into a world citizen, one who’s personal pains, tics and antics grew small in the face of other’s realities. Socratic criticism when applied to other cultures is actually a way of respecting them and you can’t come out of that process without feeling some respect for yourself. My liberal education connected me to others, shook me awake a bit from my suspended animation ways, and undermined my alienation.  I am convinced this foundation allowed me to seek and endure therapy, end my toxic relationships, fulfill my dream of motherhood without neurotic hangups. If I am ending my talk with this aspect of  the importance of liberal education is because today in elementary, middle and high schools all over America, literature and the arts are being slashed away, since they look like useless frills that don’t help America make money. Many colleges are downsizing or eliminating the arts themselves.Literature is still hanging in there. But wait twenty years and this may be a thing of the past. The Indian poet, philosopher, and educator Rabindranath Tagore, builder of an experimental school and a liberal arts university, observed already in 1917 that the demands of the global economy threatened the eclipse of abilities that were crucial for a world of justice and peace:

{H]istory has come to a stage when the moral man, the complete man, is more and more giving way, almost without knowing it, to make room for the ...commercial man, the man of limited purpose. This process, aided by the wonderful progress in science, is assuming gigantic proportion and power, causing the upset of man's moral balance, obscuring his human side under the shadow of soul-less organization.(2)

In Dr, Martha Nussbaum’s study of the Indian state of Gujarat, which has for a particularly long time gone down the road of no critical thinking or imagining in the public schools and a concerted focus on technical ability, one can see clearly how a band of docile technicians can be welded into a murderous force to enact the most horrendously racist and anti-democratic policies.

Lobby with your state and national representatives for more attention to the humanities and the arts, which even President Obama seems bent on neglecting. Spread the word that liberal education is crucially relevant to the future of democracy in the nation and the world. The person who comes to understand that reason, and not money and status, is the true source of our human dignity will be likely to respect all reasoning beings equally, across barriers of class, gender, and nationality. This equal respect, if one could achieve it, would profoundly transform the whole of social life. Democracies have great rational and imaginative powers. They also are prone to some serious flaws in reasoning, to parochialism, haste, sloppiness, and selfishness. Education based mainly on profitability in the global market magnifies these deficiencies, producing a greedy obtuseness , technically trained docility, and a emotional poverty that threaten the very life of democracy itself. Lobby that human beings  have a dignity that deserves the respect from laws and social institutions.

A truly human life is characterized at the very minimum by the possibility of functioning in certain ways. We can judge whether this bare minimum is met by asking not about how satisfied people are with their lives, nor even about the resources they have at hand, but about what they ‘actually are able to do and to be’. There are ten such capabilities (suggesting a parallel set of Ten Commandments to honor them), and they include not only ‘being able to have good health, including reproductive health’ but also ‘being able to form a conception of the good and to engage in critical reflection about the planning of one’s life’, and ‘being able to work as a human being, exercising practical reason and entering into meaningful relationships of mutual recognition with other workers’. Since one of the foremost goals of the ‘capabilities approach’ is to maximize individual choice, the point is not to force people to function in certain ways, but to hold polities accountable for providing ‘conditions that permit’ individuals ‘to follow their own lights free from tyrannies imposed by politics and tradition’. The idea is not that no one should choose to fast but that no one should have to starve. Some women may prefer a life of ‘female modesty, deference, obedience and self-sacrifice’, but political and economic opportunities ought to be such that women have options other than serving and obeying others. Aristotle very well said that one cannot think well if one is hungry. One cannot act justly if one is denied the rights and privileges of citizenship. One cannot be generous if one has nothing to give. One cannot maintain friendships if one is enslaved or imprisoned. His elegant analysis of the ways in which material and institutional resources support our ability, as humans, to function in a truly human way has been extremely influential in political thought -- in particular, as it concerns the alienation of workers from their full humanity. Aristotle's conclusion is that the designers of governments need to know all of this, in order to make a design that guarantees to "anyone whatsoever" the opportunity for effective pursuit of the human good. The reality that so many Latina women drop out of high school or do no to pursue higher studies, a horrifying 42 percent, part of which is attributed to Latinas having the highest teen pregnancy rates of "of any racial or ethnic group.", is a problem of justice. That they too show the highest rates of depression and more so if the have been born in the US only compounds the fact of an unequal failure to attain a higher level of capability, and this again is a problem of justice.

It will not be too long before my four and six year old daughters become Latina teenagers. I can only hope that when this time comes I and those around them will have prepared them to champion the diversity of their condition enough to make a dent in the adversities and stigma so many of their Latina sisters face today.


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