APA Final Paper on Immigration

Analyses of Social Issues and Public Policy, Vol. 00, No. 00, 2011, pp. 1--10

This paper is part of an ASAP special collection on Social Psychology and Contemporary Immigration Policy

Immigration Reform and the Potential for Psychosocial Trauma: The Missing Link of Lived Human Experience

Lisa Lopez Levers∗ Duquesne University

Debra Hyatt-Burkhart Slippery Rock University

Immigration reform has come to the forefront of the political arena again, most recently sparked by the controversy surrounding Arizona Senate Bill (ASB) 1070. Mostly missing from these discussions is a focus on the impact upon lived human conditions that may result from such legislative reform. This article examines the literature regarding the stress and potential psychosocial trauma that may be associated with immigration and the acculturation process, with an emphasis on the effects of the ASB 1070. The article concludes by identifying relevant implications for research.

During the mid-cycle elections of 2010, the issue of immigration re-emerged as a polarizing controversy between conservatives and liberals in the arena of political debate. Immigration-related divisiveness has sprung from the controversy surrounding Arizona Senate Bill 1070 (ASB 1070), which was signed into law on April 23, 2010 (State of Arizona, 2010). What is lacking in the discussion in favor of aggressive reform is a humane consideration of the people who are central to this issue. Involved in this controversy are families, women, and children who may have experienced stress or trauma as a result of migration, and who may face the possibility of further distress from new legislation enacted under the guise of national security and protection of the American way of life. We are not suggesting that the process of immigration necessarily causes trauma or that simplistic cause-and-effect evidence can lead to quick solutions for a complex and

∗Correspondence concerning this article should be addressed to Lisa Lopez Levers, Duquesne University, Pittsburgh, PA; [e-mail: [email protected]].

1

DOI: 10.1111/j.1530-2415.2011.01254.x C© 2011 The Society for the Psychological Study of Social Issues

2 Levers and Hyatt-Burkhart

emotionally charged issue. Rather, we suggest the need for a more compassionate consideration of what we believe is the missing link between immigration and the potential for psychosocial trauma in the face of policy reform; we believe, very simply, that what is missing is a consideration of the lived experiences of the human beings involved in this situation.

Part of our focus here revolves around the impact of ASB 1070 on immi- grants. Historical trauma, or intergenerational stress response, has been theorized as having an impact on the physical and mental health of marginalized individuals, including African Americans, Holocaust survivors, and Native American Indians (e.g., Duran & Duran, 1995). Estrada (2009) has hypothesized that there is a connection between “the militarization of the United States-Mexico border” (p. 334), intergenerational stress response theory, and potential health influences upon Mexican Americans and indigenous Mexicans living in the United States. Based on the tension surrounding ASB 1070, such historical trauma may be rekindled even among those who have lived legally, for generations, in the United States. While ASB 1070 has created a political polemic, we assert that the mental health needs of immigrants in Arizona need not be politicized.

Many of the recent immigrants in Arizona have arrived under difficult circum- stances, and have experienced high levels of stress. ASB 1070 has the potential to intensify the burden of distress and to have profound effects on families and chil- dren. The purpose of this article, then, is twofold: first, to illuminate the psychoso- cial antecedents and consequences of immigration and their potential impact upon immigrants; and second, to explicate what is known about the lived experiences of families and children concerning the psychosocial trauma that may be asso- ciated with their immigration status. We end with a summary discussion of con- clusions and research recommendations informed by our review of the literature.

Trauma-Related Psychosocial Antecedents and Consequences of Immigration

Silka (2007) has argued that purely disciplinary solutions are not adequate for considering the psychosocial and trauma-related problems of many immigrants. Cross-disciplinary literatures regarding immigration identify multiple foci, offer- ing various discussions of such pertinent issues as assimilation, enculturation, marginalization, multiculturalism, postcolonialism, social cohesion, and transna- tional engagements. While a full discussion of these foci is beyond the scope of this article, discipline-related dimensions of these issues have a great deal of over- lap with the literature on immigration trauma. Thus, our aim here is to regard the immigration of Hispanics as ecologically as possible. In no way do we intend to equate immigration with symptoms of Post Traumatic Stress Disorder (PTSD), yet

Immigration Reform and Trauma 3

we wish to propose that the intemperate use of legal force may have the potential to cause untoward distress, anguish, or even trauma in an already vulnerable pop- ulation. In this light, we have examined and discussed the relevant associated contextual issues from bio-psychosocial and cultural perspectives in the follow- ing subsections: (1) the nature of trauma, (2) acculturative stress and immigrant trauma, (3) marginalization and powerlessness, and (4) cultural engagement.

The Nature of Trauma

The word “trauma” often is used to indicate almost any stressor experienced by an individual. However, in its clinical sense, trauma refers to events that are extremely difficult and overwhelming for individuals (Briere & Scott, 2006). In the Diagnostic and Statistical Manual, 4th Edition, Revised Text (DSM-IV-RT), the American Psychiatric Association (APA; 2000) defines trauma as

. . .involving direct personal experience of an event that involves actual or threatened death or serious injury, or other threat to one’s physical integrity; or witnessing an event that involves death, injury, or a threat to the physical integrity of another person; or learning about unexpected or violent death, serious harm, or threat of death or injury experienced by a family member or other close associate (Criterion A1). (p. 463)

Researchers and practitioners have documented many of the types of pro- found loss and grief that may be experienced by immigrants and that may result in PTSD (e.g., Fortuna, Porche, & Alegria, 2008; Rasmussen, Rosenfeld, Reeves, & Keller, 2007; Silka, 2007). Beckerman and Corbett (2008) have suggested that “some immigrants may experience a profound or incapacitating sense of loss, disassociation, flashbacks or nightmares about separation from the homeland or family of origin that may be consistent with the symptoms of Post Traumatic Stress Disorder (PTSD)” (When Common Challenges Become Mental Health Concerns, para. 2). Concomitant with the issue of immigration-related trauma, 11% of Latino immigrants have reported previous exposure to political violence, and 76% have described additional lifetime traumas (Fortuna et al., 2008). Traumatic experi- ences for immigrants may include sexual or physical assault, domestic violence, witnessing violence, effects of transactional sex (including HIV infection), human trafficking, combat, detention, deportation, chronic community violence, expo- sure to drug-related and political violence, or any of other types of traumatic incidences.

This is not to suggest that all immigrants have experienced psychosocial trauma or that immigration-related stress is equivalent to clinically defined trauma. It is not our intention to psychopathologize the immigration experience or to try to fit Latino immigrants into a diagnostic category. The positive experiences of many Latinos in the southwestern part of the United States certainly counter such a premise. Rasmussen et al. (2007) have suggested the relevance of developing

4 Levers and Hyatt-Burkhart

better understandings about resilience in relationship to immigration. However, the focus here remains on the needs of a particularly vulnerable part of an immigrant population exposed to the potential for severe stress or trauma.

Acculturative Stress and Potential Immigrant Trauma

Immigration to a foreign country is rife with psychosocial stressors; assimi- lation and enculturation into a new society can be marked by acculturative stress, even in positive circumstances. Acculturative stress refers to assimilating to a new culture, leaving one’s family and support system, being immersed in a new lan- guage, and finding employment and housing (Hovey, 2000). Thus, acculturative stress is endemic to the experience of migration. Often a result of the cumulative effects of acculturative stress, mental health conditions such as anxiety, depres- sion, and substance use disorders are common in immigrant populations (Arbona et al., 2010; Beckerman & Corbett, 2008). Not endemic, but perhaps more com- mon than thought, are the intensely negative experiences that can be characterized as immigrant or immigration trauma (Foster, 2001).

Qualitatively different than acculturative stress, immigrant trauma refers to clinical levels of distress manifest in PTSD, clinical depression, and acute anxiety disorders (Arbona et al., 2010; Cavazos-Rehg, Zayas, & Spitznagel, 2007) that are a result of traumatizing or derailing experiences that occur throughout the entire span of the immigration process (Foster, 2001). Such trauma is delineated in the literature as four distinct stages: (1) premigration trauma, (2) in-transit trauma, (3) resettlement trauma, and (4) trauma of general postmigration living conditions (Foster, 2001). Distress related to immigration is common to both legal and undocumented immigrants, but recent literature has shown that the intensity and severity of symptoms are greater in populations who enter the country illegally (Cavazos-Rehg et al., 2007). Premigration trauma, sustained through surreptitious border crossing, crowded and unsanitary conditions, and the inhumane treatment that is characteristic of human trafficking, cement a foundation that is ripe for compounded trauma once immigration has been achieved.

Recent figures indicate that approximately one fifth of the Latino population in the United States comprises undocumented immigrants (Pew Hispanic Center, 2009). After the passage of the Antiterrorism and Effective Death Penalty Act of 1996 and the Illegal Immigration Reform and Immigrant Responsibility Act of 2001 (i.e., the USA PATRIOT Act), the atmosphere surrounding illegal immigration into the United States has become considerably more oppressive (Brabeck & Xu, 2010). Undocumented immigrants have faced expanded conditions for deporta- tion and decreased judicial discretion regarding the interpretation of immigration law; local law enforcement professionals have faced increased pressure to uphold immigration statutes (Brabeck & Xu, 2010). These changes have exacerbated ac- culturative stress and immigration trauma among undocumented immigrants. A

Immigration Reform and Trauma 5

continued tendency not to seek mental health treatment, medical care, or social ser- vices assistance, for fear of legal entanglement or deportation, has compounded the mental health conditions of the U.S. immigrant population (Arbona et al., 2010).

Marginalization and Powerlessness

The passage of ASB 1070 propagates another category for immigration trauma that can be labeled as postimmigration fear. Although there are laws that ban profiling individuals based on racial appearance, ASB 1070 seems to open the gates to questionable application of its procedures. This potential has served to amplify the psychological distress of those in this country illegally. Living with the fear of detainment and deportation may well lead to an increase in mental health disorders among the United States’ immigration population. In a Pew Hispanic Center (2009) survey, 57% of Latinos have indicated that they experience significant worry about their deportation or the deportation of family or friends. Concern over deportation has resulted in higher levels of extra-familial acculturative stress than was observed in families where fear of deportation was reported to be minimal. The notion of ongoing anxiety within family systems has had significant implications for the children, who are the powerless and helpless victims of stringent immigration reform. Herman’s (1992) assertion—that “Psychological trauma is an affliction of the powerless” (p. 33), in many ways, has marked the plight of undocumented Hispanic immigrants.

Cultural Engagement

Immigrants’ postmigration adaptation and psychological well-being have de- pended largely on an ability to engage their new culture (Ryan, Dooley, & Benson, 2008). But it has been difficult for immigrants to experience social cohesion in an environment of fear, prejudice, and racial bias. The nation has been divided, and ideological differences have become common facets of everyday life.

Esses, Dovidio, and Hodson (2002) suggest that public attitudes toward im- migration are important. Portes (2010, p. 18) has described the tension between public opinion and reality: He notes that public opinion consists of strong ideolog- ical adherence to “intransigent nativism” (keeping immigrants out) and “forced assimilationism” (turning immigrants into monolingual Americans as quickly as possible), which is in contrast to the economic and social reality of America’s need for “foreign labor at both ends of the labor market” as well as strong and growing “networks between immigrants and their communities of origin . . . [and] . . . between immigrants and their employers.”

The current social climate makes it difficult for immigrants to engage in their new culture. Yet in reality, immigrant workers tend to enhance the economic

6 Levers and Hyatt-Burkhart

conditions of their community. The result of one recent study “suggests that the economy absorbs immigrants by expanding job opportunities rather than by displacing workers born in the [US]” (Peri, 2010, p. 1). Analyzing the dynamic impact of immigration over time, Peri states that data show that “immigrants expand the U.S. economy’s productive capacity, stimulate investment, and promote specialization that in the long run boosts productivity” (2010, p. 4). Peri further asserts that “there is no evidence that these effects take place at the expense of jobs for workers born in the United States” (2010, p. 4). It is clear that undocumented Latino workers fulfill low-pay/ardent-labor roles, which otherwise go unclaimed by American workers, but the myth that they “take American jobs” continues to have a hold on some segments of the American psyche (Pew Hispanic Center, 2009).

Children and Families of Immigration

There are approximately 5 million children in the United States who reside with at least one parent who is an undocumented immigrant (Capps, Castañeda, Chaudry, & Santos, 2007). In this climate of increasing pressure for the arrest, detainment, and deportation of undocumented immigrants, these children are put at risk for psychological trauma, abandonment, and distress. As stated above, in families where there is significant anxiety regarding the threat of deportation, children are subjected to and affected by the psychological distress of their parents. These 5 million children, two thirds of whom are birthright citizens of the United States, are victims of a system that wants to ratify easy solutions to a complex problem. The children are not themselves at risk of deportation, but the risk to their undocumented parents leaves them at the mercy of immigration officials who may not choose to explore the family status of their detainees. In fact, many parents detained in work-place immigration raids choose not to disclose that they have children for fear that the children also may be detained, deported, or placed in the care of social services (Capps et al., 2007). Although single- parent detainees usually are released in order to care for their children, release may be protracted, which results in the children being cared for by babysitters, neighbors, or friends due to the impromptu nature of immigration enforcement. Even in circumstances where children reside in two-parent households, when a parent is detained and deported, there is significant distress. Children experience fear, confusion, uncertainty, anxiety, and even chaos regarding the status of the detained parent. Additionally, the family unit is likely to experience economic hardship from loss of income, legal costs, and increased childcare costs.

One of the most noted mitigating factors of acculturative stress and immi- gration trauma is the presence of a supportive social network and a strong family unit. It is therefore probable that immigrants who migrate with their family units

Immigration Reform and Trauma 7

experience less stressful migrations than those who do so alone. Removing or deconstructing the existing family relationships and supportive social networks through deportation can be detrimental to the psychological well-being of af- fected children. Such distress is even more likely when the detainee or deportee is the mother of the child left behind. Any immigration reform must consider the children and family members who experience the repercussions of detainment and deportation. ASB 1070 does not appear to encourage the adequate judicial oversight necessary to protect the children of undocumented individuals who are detained. ASB 1070 makes no provision for individualizing the implemen- tation of the law based on the needs of the children of those detained or slated for deportation. Although the children are U.S. citizens and should be subject to every protection affordable to our nation’s children, ASB 1070 contains no consideration of the significant stress and psychological damage that can result from rigid application without individual oversight. If judicial authority is lim- ited to strict application of the statutes without consideration for the individual circumstances of family and children, there is no doubt that we will continue to perpetrate further trauma on some of the most helpless and powerless among our citizenry.

Conclusion

The United States is not alone in its struggle with immigration. Greece has been referred to as the “European Union’s Arizona”. Recent accounts in the popular media (e.g., Harrell, 2011; National Public Radio, 2011) have described Greece’s border with Turkey as the back-door gateway for about 90% of the illegal immigrants to the European continent. As in the southwestern part of the United States, fearful people there want to build a border fence. As with the immigrant population in Arizona, those migrating via the Greece–Turkey border largely are poor and members of ethnic minorities. These analogous situations point to global immigration issues with undertones of racism and bigotry. Having asserted this, we believe that social science researchers have the potential to contribute to this discourse in positive ways. We offer several research implications below.

First, upon reviewing the extant literature, we discovered that there is a great deal of recent scholarship that crosses the boundaries of specific disciplines, thereby having the potential to facilitate a more informed discussion regard- ing the reality of immigration in the United States and related policy reform. However, because much of this information is erudite, sometimes even esoteric, and tends to be so discipline-specific, important considerations of the matter have not yet entered the discourse. We believe that translational research in this area could offer relevant cross-disciplinary input to assist in explicating what

8 Levers and Hyatt-Burkhart

currently is known, especially for the purpose of humane and socially just policy reform.

Second, situational analyses of high-immigration areas in the United States could contribute to a better understanding of the risk and protective factors in- volving groups of human beings and their intergroup relations. While this article has emphasized the risk factors involving vulnerability and immigration, we see how situational analyses could illuminate matters relating to the resilience and hardiness of immigrants.

Third, Hebl and Dovidio (2005) note that trends in the literature suggest that research concerning stigmatizers and their targets has declined. They suggest that more interactive studies could contribute to better understandings of stigma- related phenomena. Given the divisiveness in U.S. society that is based largely on identity politics, research aimed at examining the dynamics of stigma would assist in understanding current ideological conflict.

Fourth, although those who support ASB 1070-like immigration reform claim that their efforts are not based on racist ideology, the construct of aversive racism needs to be examined in the context of immigration reform in the southwest region of the United States. Fifth, professionals need to collaborate with immigrants in constructing culturally sensitive counseling services and building the capacity to address the multiple and complex lived experiences of immigrants. Finally, more interdisciplinary research needs to be conducted to elucidate the most salient issues associated with immigration-related trauma or stress.

Immigration reform continues to be a divisive matter. Conservatives point to the issue as a virtual panacea for encouraging the reduction of the size of government, improving the nation’s economic condition, upholding American values, and protecting national security. Liberals point to the services provided by immigrants, their job functions, economic contributions, taxpaying, limited con- sumption of resources, and enhancement of cultural diversity as strengths worthy of consideration. What both sides seemingly fail to discuss is the potential for trau- matic disruption and ongoing trauma, which may be associated with immigration, for individuals, families, and children.

Immigration reform proposals such as ASB 1070 do little to expose the human side of the law. With provisions for swift detention and deportation, the acculturative stress experienced by immigrants is apt to increase. Coupled with anxiety and a fear of deportation, individuals predictably are less likely to seek assistance for their mental health issues in a climate sometimes erupting with over- zealous or indiscriminate applications of the law. Clearly some type of immigration reform is needed, but the just course of action must take into consideration the human element that is at the core of the issue. No reform can be socially just without substantive concern given to the potential for immigration-related trauma and the missing link of people’s lived experience.

Immigration Reform and Trauma 9

References

American Psychiatric Association. (APA). (2000). Diagnostic and statistical manual of mental disor- ders, 4th edition, text revision (DSM-IV-TR). Washington, D.C.: Author.

Arbona, C., Olvera, N., Rodriguez, N., Hagan, J., Linares, A., & Wiesner, M. (2010). Acculturative stress among documented and undocumented Latino immigrants in the united states. Hispanic Journal of Behavioral Sciences, 32(3), 362–384..

Beckerman, N. L., & Corbett, L. (2008, Summer). Immigration and families: treating acculturative stress from a systemic framework. Family Therapy. Retrieved from http://findarticles.com/p/ articles/mi_6897/is_2_35/ai_n30931668/.

Briere, J. N., & Scott, C. (2006). Principles of trauma therapy. Thousand Oaks, CA: Sage. Brabeck, K., & Xu, Q. (2010). The impact of detention and deportation on Latino immigrant children

and families: A quantitative exploration. Hispanic Journal of Behavioral Sciences, 32(3), 341–361.

Capps, R., Castañeda, R. M., Chaudry, A., & Santos, R. (2007). Paying the price: The im- pact of immigration raids on America’s children. Washington, D.C.: National Council of La Raza and the Urban Institute. Retrieved from http://www.urban.org/UploadedPDF/ 411566_immigration_raids.pdf

Cavazos-Rehg, P. A., Zayas, L. H., & Spitznagel, E. L. (2007). Legal status, emotional well-being and subjective health status of Latino immigrants. Journal of the National Medical Association, 99, 1126–1131

Duran, E., & Duran, B. (1995). Native American postcolonial psychology. Albany, NY: SUNY Press. Esses, V. M., Dovidio, J. F., & Hodson, G. (2002). Public attitudes toward immigration in the United

States and Canada in response to the September 11, 2001 “Attack on America.” Analyses of Social Issues and Public Policy, 2, 69–85 [doi: 10.1111/j.1530-2415.2002.00028.x].

Estrada, A. L. (2009). Mexican Americans and historical trauma theory: A theoretical perspective. Journal of Ethnicity in Substance Abuse, 8, 330–340.

Fortuna, L. R., Porche, M. V., & Alegria, M. (2008). Political violence, psychosocial trauma, and the context of mental health services use among immigrant Latinos in the United States. Ethnicity & Health, 13, 435–463 [doi: 10.1080/13557850701837286 Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2771411/pdf/nihms-154136.pdf].

Foster, R., P.,(2001). When immigration is trauma: Guidelines for the individual and family clinician. American Journal of Orthopsychiatry, 71 (2), 153–170.

Harrell, E. (2011, February 3). How we see immigration — and why we’re wrong. Time. Retrieved from http://www.time.com/time/world/article/0,8599,2045932,00.html

Hebl, M. R., & Dovidio, J. F. (2005). Promoting the “social” in the examination of social stigmas. Personality and Social Psychology Review, 9(2), 156–182.

Herman, J. L. (1992). Trauma and recovery. New York: Basic Books. Hovey, J. D. (2000). Acculturative stress, depression, and suicidal ideation in Mexican immigrants.

Cultural Diversity and Ethnic Minority Psychology, 6(2), 134–151. National Public Radio. (2011, February 15). Greece may build fence to stop illegal immigrants. Amer-

ican Public Radio, Marketplace. Retrieved from http://marketplace.publicradio.org/display/ web/2011/02/15/greece/.

Peri, G. (2010, August). The Effect of Immigrants on U.S. Employment and Productivity. Federal Reserve Band of San Francisco (FRBSF) Economic Letter. Retrieved from http://www.frbsf.org/publications/economics/letter/2010/el2010-26.pdf

Pew Hispanic Center,(2009, April). A portrait of unauthorized immigrants in the United States. Washington, DC: Pew Hispanic Center.

Portes, A. (2010, April 23). America and its immigrants: A game of mirrors. Lecture presented at the meeting of the American Philosophical Society, Philadelphia, PA. Retrieved from http://cmd.princeton.edu/papers/wp1004.pdf.

Rasmussen, A., Rosenfeld, B., Reeves, K., & Keller, A. S. (2007). The subjective experience of trauma and subsequent PTSD in a sample of undocumented immigrants. The Journal of Nervous and Mental Disease, 195, 137–143.

10 Levers and Hyatt-Burkhart

Ryan, D., Dooley, B., & Benson, C. (2008). Theoretical perspectives on post-migration adaptation and psychological well-being among refugees: Towards a resource-based model. Journal of Refugee Studies, 21(1): 1–18 [doi: 10.1093/jrs/fem047].

Silka, L. (2007). Immigrants in the community: New opportunities, new struggles. Analyses of Social Issues and Public Policy, 7, 75–91.

State of Arizona. (2010). Senate Bill 1070. Retrieved from http://www.azleg.gov/legtext/49leg/2r/ bills/sb1070s.pdf

LISA LOPEZ LEVERS, Ph.D. is a Professor of Counselor Education and Super- vision at Duquesne University. Prior to becoming an academic 22 years ago, she worked in the community mental health and private practice sectors for 15 years, with a clinical emphasis on trauma recovery and psychiatric rehabilitation. Her research interests involve marginalized populations, including the cultural impli- cations of the HIV and AIDS pandemic in sub-Saharan Africa; the relevance of indigenous knowledge and the role of indigenous healers in constructing cultur- ally appropriate interventions; the impact of trauma on child development; adult sequelae associated with early childhood trauma; culturally sensitive community- based services for orphans and other vulnerable children; and psychosocial issues related to disability.

DEBRA HYATT-BURKHART holds a Ph.D. from Duquesne University in coun- selor education and supervision. She is a member of the faculty of the Department of Counseling and Development at Slippery Rock University. A practicing coun- selor for over two decades, Dr. Hyatt-Burkhart specializes in work with families and adolescents, and she also provides clinical supervision to several community mental health agencies. She has a strong interest in the field of trauma work, with areas of study including trauma informed care, vicarious trauma, and post- traumatic growth. Most recently, she has focused upon vicarious post-traumatic growth as a topic of exploration.