Undocumented Therapist Weighs in on Mental Health

A graduate of California State University, San Bernardino (CSUSB) with a Master of Science in Clinical/Counseling Psychology, Barragan-O’Brien said she spends time understanding her clients’ situations and gaining their trust. She stressed the importance of having therapists who are immigrant-friendly and trauma-informed. Barragan-O’Brien disagreed with the idea that youth are told to seek out help but often without available resources. She also stressed the importance of setting boundaries and self-care and compassion. 

This interview has been edited for brevity and clarity. 

CG: What are some of the challenges for undocumented people seeking mental health services when they are told to not share about their status? What are your thoughts about encouraging youth to seek help from a professional? 

MBO: I really dislike when people say, “Reach out for help or seek a therapist,” especially from those people in positions of power. Are you putting money where your mouth is? Are you providing that funding for therapists of color to be able to provide those resources that these youth need? Who are you sending them to? Are you sending them to where they're not trauma-informed, where they're not immigrant-friendly or where they don't work with people of color? You can't just say “Open up to a professional, open up to an adult,” when you yourself are not giving those resources for them to be able to open up.

Now, with that being said, as a trauma-informed professional, and as an immigrant myself, at the very first session, I let all of my clients know, everything here is confidential, except for a couple of limits. One, if you were to tell me that you are about to hurt yourself, or you're about to hurt another person. Two, I do my best to not call 911 unless it is absolutely necessary. I always have an emergency phone number [given by the client]. I explain to the person, I do my best. It is only if it's absolutely necessary, then I will involve 911. Other than that, I will do my best to call the emergency contact that you provided me to keep you safe. Another limit of confidentiality is if a child, an elderly person or a disabled person is being abused. Then I will have to break that confidentiality to keep them safe. If I'm working with a minor, I will do my best to only break that confidentiality if I know that the minor is going to be safe.

I always let them know “You tell me about your immigration status, or your parents' immigration status that is not a reason, there will never be a reason for a therapist to break confidentiality.” That's how typically they start sharing that information when they know if I'm a safe person or not. I let them have that autonomy and make that decision of what they want to share.

CG: Many of the undocumented people I‘ve met are advocates working to support other immigrants. What advice do you have for undocumented folks who do that type of work at the frontline of the immigration movement?

MBO: There's this saying that goes, “When we share your pain with others, it gets cut in half.” I feel that sharing your story is a powerful tool to decrease the pain that you may be feeling. My advice for those listeners is that it's OK to set boundaries. If you don't have the emotional capacity to take on that trauma, it's OK to say it.
It's OK to set that boundary. It's OK to be truthful and say, “I want to be there for you. But at this moment, I don't have the emotional capacity. Can you please check in at another time?” Also, if you're going to be the sharer, check in with that person that's typically your listener and say, “I'm struggling a lot. Is it OK if I share with you this heaviness that I'm carrying?” I think asking for permission is just such a great, respectful way to continue that relationship. Immigrants Rising has a mental health connector, which consists of connecting clinicians with people, for free, pro bono and a lot of them are currently undocumented, formerly undocumented. And if they are not, at least they are knowledgeable and working with immigrant communities. Provide what you have the capacity for, the knowledge for and be there for the other person only when you can. There's such a thing as vicarious trauma, which is when you hear a lot of trauma, you kind of start internalizing, and you start having those PTSD-like symptoms. It's OK to protect your energy.

CG: What advice do you have for folks who feel like they can’t slow down and assess their well-being?

MBO: It's OK to sit in with that feeling. Feeling so uncomfortable when resting. Because this is what happens, you've been in this survival mode for so long, that you've gotten used to it. And typically, when you slow down, you start feeling uncomfortable. You're like, “OK, I'm gonna sit down, I'm gonna watch a movie.” You're sitting down and your mind is racing, because you're like, “Oh, I got to do this, I got to do that, I got to work on that, this is my to-do this.” You feel so anxious about resting. So you get up and you start doing things and you feel tired. But then if you try to lie down, you start feeling anxious again. That's a vicious cycle. When you rest, you are going to feel anxious, you are going to feel very uncomfortable. It's going to be a practice to sit in while feeling uncomfortable. Because we've been running from our emotions for so long. We've been receiving those messages that if you rest, it means that you're lazy…you're not being productive, you're not a good immigrant, you're not gonna get that A, because you're not working hard enough. I would recommend, it's OK to sit while feeling uncomfortable. And then the other thing is to practice self-compassion. Self-compassion is going to be vital in your healing journey. 

CG: What should adults who work or take care of undocumented youth keep in mind? 

MBO: When you're young, there are so many changes within yourself, within your body, within your mind. You're in this stage in life, where you're trying to find yourself. All kids are experiencing these changes, and wanting to have a sense of identity or trying to find their identity. When you have these added layers like uncertain immigration status, where you don't know where you belong, and/or you're a part of the LGBTQIA+ community, how do you share that information, and keep yourself safe? That is just so challenging. Adults seem to forget that. Most of them think like “Oh yeah, I had my emo stage” or “I had my skater stage,” but, for undocumented there is more than just that aspect. There's so many layers to it. I wish more people understood. I wish more people reached out to our youth, not from a place of authority, where I know what you're going through. But more of a place of an equal, a place of “I want to guide, I want to walk this with you.” Walk with them, reach out to them. Don't wait until they reach out to you. If you have the power to reach out to them. Why not do that? Why not be there for them? That's what I try to do. I think that as adults, we are the ones that are supposed to be doing a little more for them, instead of just waiting for them to reach out to us.

CG: What advice do you have for undocumented youth who feel helpless?

MBO: One of them is, I know it feels lonely. Please know that you're not alone. And two is, there was life before DACA. There was life and joy and success before DACA and there will be life and joy and success after DACA. You're worthy of the good things in life, just because you exist. You didn't need to earn any of that. You deserve it. Hang in there because there's a lot of us out here rooting for you, and wanting to support you.