When You Don't Know You Need Help: Obstacles to Care

I am a migrant who moved to the United States from Guatemala in 2017, hoping to earn the money to pay debts at home and to support my children as well as my mother’s medical needs. Without feeling and noticing it, I also came here as a victim of psychological and emotional trauma from abuse by my former husband, as well as other events I experienced during my childhood and youth.

I was not paying attention to how this trauma was manifesting itself in my body and mind. I only knew that my stay in the United States initially made me feel like a zombie. Life was routine and mechanical. I felt deep humiliation from many years of mistreatment from my husband. He had looked at me as a child-making machine that had no other value when I was no longer able to bear children. He not only left us, he left us in heavy debt. This is when I adopted the name Olga and asked my closest friends and family to start using my new name. I considered Ana to be dead. 

The change of name was a facade to also hide other situations in my life. At a young age I was sexually abused on two occasions, without my parents realizing it. I was the victim of other types of harassment in school and in society. When I came to the United States, harassment became a latent experience in my housing complex. 

After working for two years selling produce in a shop outside of Philadelphia, I began to feel deep back pain that limited my mobility and ability to work. I went to a city health center but could only book an appointment for months later, so I went to a private American doctor who gave me pain medication but also sexually harassed me. When I finally got in at the city health center, I was examined and referred to a specialist who diagnosed my pain as psychological, coming from extreme stress and a deep depression. There was no need for pain medication; my pain needed other forms of treatment. 

I started psychological treatment with a therapist. I found it incredibly hard to talk about myself and to recognize the events that had been causing me so much distress. My victimizers were people I once knew and trusted, and I cried as I told my therapist what had happened to me. It was so painful that I often refused to take the time needed for my therapy. Then, when my therapist told me that we were going to see each other less frequently, my commitment to treatment changed because I feared losing it. I started allowing myself to unravel my story and truly started understanding the importance of psychological treatment.

Two years into treatment, in 2022, I began to recognize my potential as a person. I apologized to my therapist for not using my real name and said that my real name was Ana. This moment was crucial for my existence. Allowing Ana to live again made the constant thoughts of death stop— something that had been the norm for me since I was a child. As I started to recognize myself, I started realizing that my life had been full of joyless actions. As I began to live more authentically, I realized that I had always been a joyful person, but that part of me had been overshadowed by so much pain. Today, providing support to others, both in my personal and professional life, comes from my true self. I now see the help I give others as acts of love and no longer as being used by other people for their own purposes. 

As I began my own work to promote mental health, I would tell people, “When we go to primary care doctors, we allow them to undress us, examine us, and tell us what is wrong and how to fix it. When it comes to mental health, we have to be willing to do the same. We have to be willing to open up our minds, to examine what is hurting us, and to come up with how to fix it.” My own experiences have led me to recognize the true importance of mental health services. Our minds need to be healthy to live full and harmonious lives.

My two years of therapy transformed my way of thinking about and seeing life. It also allowed me to become a more authentic and empathic supporter of my family, my friends, and my community. I no longer feel like a flower bud that refuses to open; instead, I am blooming every day.

To hear my name again, to feel like the true Ana that I am, makes me able to look in the mirror and say that I admire and love myself, that I can be vulnerable and not defeated. I love life and I water it constantly with my resilience. 

Ana Pelico works for Nuevo Movimiento Santuario, a faith-based organization for immigrants, and also is a community health worker for Puentes de Salud, a health and wellness center for Hispanic immigrants in Philadelphia.