2. Some consequences of forced migration processes and acculturation

2.1. Acculturation and reconstruction of identities²

Acculturation is defined by Berry (2005, p.698) as the process of cultural and psychological change that takes place as a result of contact between two or more cultural groups and their members. In other words, it is the process of a person adjusting to a new society, and vice versa.

Despite the importance of the model proposed by this author to understand acculturation, here we will make an alternative proposal starting from this point that has tried to cover some of its limitations. One of these proposals is the Interactive Model of Acculturation of Garza and Lipton, 1982 (cit. in Garza y Gallegos, 1985). This proposal presents five interconnected components that have to be contemplated in every acculturative process: 1. Socio-ecological influences (socioeconomic or environmental factors); multicultural influences (language and social norms); family influences; social behavior and individual level (personality, affective and cognitive components). All these levels influence each other, although obviously not to the same extent.

To better understand the process of acculturation it is necessary to contemplate the asymmetry of power between the individual or group that arrives in the new setting and the society that receives it. The Psychology of Liberation calls these elements factors of oppression (García Ramírez et al., 2006). Situations of oppression provoke psychological patterns characterized by feelings of inferiority and impotence, which act as a barrier to action and maintain the conditions of oppression (Watts y Serrano-García, 2003; Moane, 2003); to this effect it is called internalized oppression and explains why some immigrant groups legitimize the fact of being "second-class citizens" in a receiving country. However, the conditions of oppression don't only lead to negative psychological patterns, but strengths have been repeatedly identified in these situations, such as perseverance, resistance, generosity, courage, creativity and solidarity (Martín-Baró, 1994; Miller, 1986). In particular, resistance -or resilience- is a key element, since it is considered by Watts and Serrano-García (2003) as an emergent liberating behavior. Resistance leads to positive attitudes and emotions in oppressive conditions and implies recognition that things should not be as they are and can be improved with individual and collective effort (Watts y Serrano-García, 2003).

The mechanisms of control -or of oppression- that affect integration, include: violence, political exclusion, economic exploitation, control of sexuality, cultural control and social fragmentation (Moane, 2003). Given these conditions, a psychosocial intervention would have to pursue the activation of a process of empowerment that allows the attainment of well-being at the individual, relational and community level (Paloma et al., 2010).

The process of acculturation involves much more than a "cultural change" (Bhatia and Ram, 2001). Rather, it carries with it, among other transformations, profound changes in personal identities. This being in relation to different areas of the individual's life. We are referring to cultural identity, of course, but also to gender identity, group identities and, in general, to all areas of identities. Some authors point out that it is necessary to pay special attention to the processes of identity reformulation that take place in the individuals who are acculturating themselves (Weinreich, 2003; 2009). From the cultural psychology it is considered that our meanings about the relationship between the self and the others are mediated, structured and organized by our participation in the daily sociocultural practices and in the social relationships that are embedded in those practices.

In the field of transcultural psychology, Camilleri and Malewska-Peyre (1997) point out that when individuals are asked to define themselves, they usually give answers that refer to three types of areas:

• The values that they assume, that is, their representations of how things are and how they should be and the implicit meanings that they attribute to life.
• The categorical attributes that are assigned to themselves as members of social groups (roles, social status).
• Personality traits.

From this perspective, the self is not attributed a homogenous and rigid character but a distributed one. In this sense, Jerome Bruner (1996), a cultural psychologist who has made fundamental contributions in this area, considers the self as "a swarm of participations", product of the situations in which the person participates. The person, from this point of view, builds their identity as a differentiated individual from others. In this sense, the separation of identities in dimensions or spheres such as personal identity or social and cultural identity is still an abstraction. Immigrant status places the individual in a situation that is certainly unstable in terms of their own identity: neither citizen nor foreigner, nor totally beside oneself, nor totally next to the other, the immigrant is situated on the border of a social being and a social non-being (Bourdieu, 1991).

When a person moves from one cultural context to another, as in the case of immigration, there can be serious cultural conflicts that generate difficulties to build a coherent identity. Sonn and Lewis (2009) emphasize that the experience of "relocation" associated with immigration can be profound, in the sense that identities and many sources of meaning that are taken for granted are disturbed. In cases like this, people must struggle to maintain a sense of being equal in time and space while integrating new experiences, values and representations. Immigrants encounter cultural discrepancies and must negotiate different and often contradictory norms and attitudes. They develop cognitive strategies to avoid or reconcile contradictions and to preserve the congruence of their identity.

Migrants inhabit two different "worlds", two contexts that suppose much more than two different places. They are also two ways of seeing the world, two authentic "I's" that correspond to their personal histories in the two cultures (Schrauf, 2000).

Camilleri and Malewska-Peyre (1997) have developed a close approximation to that of Berry in which they pay special attention to the question of the identity of migrants. They point out that the migration situation produces cultural discrepancies and often conflicts between the pragmatic need to adapt to the dominant culture and the "ontological" need to remain faithful to the culture of origin. Faced with conflicts between both needs, individuals often develop different types of strategies to maintain a minimum coherence in their identities.

Among the strategies put into play to maintain a certain degree of coherence between the ontological and pragmatic aspects of identity, Camilleri and Malewska-Peyre refer to the strategies used by migrants to avoid the stigmatization and depreciation of identity associated with racism and prejudice. They distinguish between individual strategies and collective strategies. Among the first, the authors include the following:

1. Going unnoticed, trying to be like the members of the culture of origin, but without aspiring to occupy the same social position. This involves not causing, not disturbing, not asking too much, living quietly "in a corner".
2. Suppressing and denying the racist experience. This can make the anxiety caused by this experience more tolerable (even if it has other important costs).
3. A more sophisticated form of this strategy is to do it consciously, explicitly behaving as if that experience did not exist.
4. Another individual strategy is that of assimilation to the dominant group, trying to resemble this group to the point of internalizing the dominant culture and denying their own difference.
5. Accepting and even increasing the value of the their own differences.
6. Aggression can also be another active response to rejection and contempt.

Collective strategies can lead to a deeper political commitment, as well as to the idealization of one's culture and the development of a critical attitude towards Western civilization. Some of these strategies consist in looking for values common to the two cultures, for example, supranational values related to egalitarianism and human rights. These types of strategies, according to the authors, go beyond the individual and can offer a solution to the individual problems of identity without having to deny their own uniqueness.

The choice of identity strategies depends on the personal resources of the individual, as well as the social and cultural context. In situations of great cultural distance, social exclusion and discrimination and rapid social change, individuals will use different strategies to face the challenges posed by these situations, depending on the sociocultural and personal factors to which we have referred.

In short: To analyze the changes associated with immigration in people, we must analyze the processes of transformation of identities (personal and cultural), going beyond the notion of acculturation, assuming what is produced is an authentic reconstruction of the self, which affects all areas (personal, gender, cultural).

2.2. Processes of acculturative stress³

One way people express the consequent imbalance caused by changes, before any readjustment, is anxiety and stress. Both have to be evaluated, not as pathological symptoms, but as a "healthy" alert that translates that same change that is taking place and to which attention needs to be paid so that it can be elaborated.

Stress can be understood in multiple ways, but one of the most well-known is as a consequence of perceiving a substantial imbalance between the demands of the context and the person's ability to respond (Lazarus y Folkman, 1984).

In this sense, the greater and more important the change, the greater the experience of instability or imbalance will be, at least in the first stage, because the need to generate new strategies will be greater and, therefore, the probability of experiencing stress and anxiety will be greater, as well as other symptoms. All this, of course, is modulated by both individual and contextual factors; that is, the peculiarities of people and their different contexts of origin and residence will make the experience vary in intensity and in its manifestations.

In principle, this process of readjustment and restoration of equilibrium in the symbolic systems in which individuals and families have to develop will be more complex insofar as the cultural distance between both contexts, of origin and destination, is greater. And it will be more complex, also, in the measure in which the different members of the family unit have different processes of acculturation (or rhythms).

Another reality that makes acculturation more complex is that some family members were born in a country of origin different from the one they reside in, while others, usually daughters and sons, have been born in the country where their parents reside. The cultural references of origin become multiplied, and the different processes of identification with the culture of origin, on the part of the parents and the daughters and sons, constitute an often conflicting reality that they have to learn to manage in order to restore the family balance and the place of both cultural frames in the life of each of its members.

The economic crisis and its consequences on immigrant people and families is one of the most influential contextual factors in recent years. Not because of the initial readjustment process, but because of the great difficulties that this context generates in the maintenance of the migratory project of the families, many of them having already been settled in Spain for years. When economic conditions do not allow us to move onwards and there is no safe horizon that helps to foresee a certain range of possibilities, anxiety and stress skyrocket, leading people to processes of psychophysical and emotional wear and tear and, in many cases, causing internal family crises when less personal resources (serenity, predisposition, capacity for dialogue...) exist to address them.

2.3. Multiple mourning, disarray, and living standards⁴

In addition to stress, and the need to generate new ways of coping with life (feelings, concerns, ways of acting...), as we mentioned above, the immigrant is involved in a process of reorganization of their personality and their identity that takes place when something significant is lost. That is to say, they become immersed in a mourning.

Moreover, and following authors like Achotegui, the mournings facing the migrant are numerous:

• Family and loved ones;
• Language;
• The homeland (landscape, colors, luminosity, smells, temperature...);
• Contact with the group to which they belong.
• Culture, understood as worldview, customs, values;
• Social status (administrative situation, access to opportunities, housing, work, health...);
• The risks for physical integrity, when they are present (on the journey, during departure, upon arrival, situations of defenselessness or persecution...);

Again, the intensity of the mournings will depend on each case, and on both individual and social factors (conditions of departure and residence in the destination or country of transit). In this stage of multiple mournings, the person no longer feels that they belong to the world they left, but they do not feel part of the one they arrive at. On these occasions, a bitter sense of uprooting may be experienced, which means the lack of roots and references, the lack of a "floor" upon which to sustain what the person feels they are, the feeling of being lost, the lack of senses and belonging to something in everyday life...

This word, uprooted, is often linked to exile, to refugees... but not exclusively. It appears in many experiences that, as stated above, force the person to leave the place to which the person feels part of, where their processes of socialization and identification with others have taken place.

Many of the difficulties of acculturation may be related to this lack of elaboration of the losses, since, generally, people do not know what resources they can turn to when dealing with the discomfort they feel or they do not even consider that this intense discomfort should be heard or addressed.

The elaboration of the various mournings and the overcoming of the experience of uprooting will depend, to a large extent, on the type of support that the person has previously, on those that they find around them -in the family, friends, etc.- or that the setting offers.

But the mournings and the uprooting are reactivated in situations of social instability. In this sense, we should not only think that these situations are experienced by people who have arrived fairly recently. A family settled for ten years in Spain can see their unresolved mournings reactivated, on the one hand, as well as feel uprooted again due to the lack of solutions to the crisis situation that our society is experiencing and the lack of alternatives. The vital questions are reopened - where to live, how long to wait, how to support economically and emotionally in the place of origin - and, although they are very significant life questions, which in most cases have taken a long time to answer, they are suddenly opened by the conditions of the context.

Therefore, alongside the mournings and the uprooting, the conditions of life must be considered. Living conditions that allow people to live with dignity, or other support that allows the person to sustain themselves, develop losses, generate new alternatives and responses to the new situation, find a meaning and a way of existing in the new context, re-situate oneself regarding the reality from which the changes that the family-economic situation has experienced in the context of residency, to seek support and relationships or groups in which to participate and to which they feel they are a part of... will be key factors in their integrity, and with it, in their health (understood in a bio-psycho-socio sense), in their conditions of life and in their real possibilities of acculturation from a commitment to integration.

2.4. Risks of the migratory experience on mental health⁵

The migratory experience, like all human experiences that can bring a person to their limit, can be an experience of risk for mental health. Especially when there are multiple and intense conditions of stress as well as a lack of social support.

Migratory mourning means, therefore, maintaining and reworking links with lost objects, as well as adopting and developing new links with the host society. This work on mourning can be simple if the conditions where it develops are favourable, or complicated if it is carried out in unfavourable conditions due to adverse personal or social conditions in the country of origin or in the host country. It can also be extreme, because the subject is immersed in social and economic conditions of extreme difficulty with the risk of marginalization and exclusion.

People who live these conditions of intense, chronic and multiple stress experience a series of symptoms that have been described by Achotegui (2002) as Ulysses Syndrome. The author considers these manifestations part of a healthy mind, but on the boundary between this and pathology. That is to say, it is a moment of risk for the person who experiences it. In some sense, this Ulysses Syndrome could be considered reactive symptoms to a series of chronic stressors and very high intensity: it is a humanly limited situation before which the biosystem responds as a healthy alarm, alerting the person to greater risks.

Migratory grief should not be considered as a mental illness, but as a natural process formed by a set of emotions, mental representations and behaviours, with ambivalent experiences and linked to the culture in its way of manifesting itself (Tseng, 2001). We all laugh, we cry, we get angry, we feel joy and sadness, etc., equally. What changes is the way of expressing these emotions and feelings, which is cultural. The idea of guilt, for example, acquires little meaning in certain cultures that emphasize shame and / or dishonor; Likewise, hearing voices of the deceased spouse in the Amerindian culture is part of the mourning and is not an auditory hallucination (Martínez-Hernáez, 2006).

In migratory mourning, not only a single object is lost. The loss is multiple, of people and of abstractions. The individual who emigrates loses family and friends, social status, their life project, language and culture, group and sense of belonging, land and landscapes, etc. All of which requires of the subject a work of mourning that is different to the usual, with emotions amplified in their intensity and ambivalence. It is a mixed mourning, that is, loss (social status, life project, etc.) and separation (family, friends, country, etc.).

In the case of people and families who have been fleeing situations of armed conflict, the losses and the level of stress take on an even greater dimension, given that in many cases they have seen loved ones die, have left their homes destroyed and do not have a physical or emotional place to return to⁶. Therefore, the manifestations and consequences of these experiences for their health will also be more acute.

The most frequent manifestations of migratory grief are: a) Depressive symptoms: sadness, crying, tendency to isolation. Apathy and decreased activity are less frequent, because the subject has to keep fighting for adaptation and survival; b) State of anxiety, due to stress, which is manifested by tension, nervousness, recurrent thoughts and somatizations such as insomnia, headaches, irritability, etc.

In extreme and critical situations of social and emotional instability, without socio-familiar support, and in environments experienced as hostile that make it difficult for immigrants, the establishment of solid relationships and low self-esteem, depressive and adaptive disorders may occur; as well as confusional syndromes such as temporal and spatial disorientation, alterations of memory; depersonalization and even psychotic syndromes. In these extremes we can talk about the consequences and complications of unprocessed mourning.

From all this derives the importance of social support and intervention to facilitate working through multiple mournings and reduce the stressors of the situation that the person is in. This would act as a preventive factor with greater consequences for physical and emotional health, favoring, in turn, the process of acculturation in the new society.

2.5. Updating the life project⁷

Another relevant factor, as much for working through mourning as in the facilitation of the acculturation process, is the updating of the life project.

The initial expectations of people who undertake a migratory project in a forced way, whether it is recognized as susceptible to international protection or not, are often not accompanied by the reality with which they subsequently find themselves. Moreover, these expectations may change over time. Thus, a person who has just arrived in a country will bring expectations based on the reasons that led them to make their decision, the degree of knowledge of the country they are heading for, the key informants they have had, the networks that have established the perceptions and living conditions of these persons, etc., at the place of destination so far.

After a few years, these starting points will have been contrasted by the knowledge that the own experience has been able to transmit to them, the social networks will have grown or changed, and with that, what they initially thought to find... In many cases, the decisions to return, family reunification, family relationships, etc., are subject to change over the years.

All this leads us to ascertain the need for the person himself to update their own project, taking into account the time factor in two ways:

• What is related to their migration experience: every migratory process has some "phases", so that the project of the person in the first moment in which they arrive can not be the same as when a few months or years pass, as inevitably their experiences are going to shape their expectations and horizons, as well as their ways of understanding life, understanding themselves, making decisions, moving in society...
• What is relative to the different stages of their life and their life cycle, by which the perceptions and needs will necessarily be different and specific in one of those stages. The migratory project will not be the same at twenty years old as with forty, nor when one is single or when one has formed a family.

From this derives the importance of facilitating personalized processes versus the elaboration of intervention itineraries for "migrants" in a generalized manner or for "refugees", so common in the institutions that work with these groups.

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² This section is extracted from: De la Mata, M. L., García Ramírez, M., Santamaría, A. y Garrido R. (2010). La integración de las personas migrantes. Un enfoque desde la Psicología Cultural y de la Liberación En: Melero, L. (coord.). La persona más allá de la migración. Manual de intervención psicosocial con personas migrantes. p115-148. CeiMigra: Valencia. Available online at: http://www.socialjesuitas.es/documentos/download/13-manuales-de-intervencion/29-la-persona-mas-alla-de-la-inmigracion

³ This section is extracted from: Melero, L. y Die, L. (2010). El enfoque psicosocial de las migraciones. En: Melero, L. (coord.). La persona más allá de la migración. Manual de intervención psicosocial con personas migrantes. p71-114. CeiMigra: Valencia. Available online at: http://www.socialjesuitas.es/documentos/download/13-manuales-de-intervencion/29-la-persona-mas-alla-de-la-inmigracion

⁴ This section is extracted from: Melero, L. y Die, L. (2010). El enfoque psicosocial de las migraciones. En: Melero, L. (coord.). La persona más allá de la migración. Manual de intervención psicosocial con personas migrantes. p71-114. CeiMigra: Valencia. Available online at: http://www.socialjesuitas.es/documentos/download/13-manuales-de-intervencion/29-la-persona-mas-alla-de-la-inmigracion

⁵ This section is extracted from: Sayed-Ahmad, N. (2010). Experiencia de migración y salud mental. Hacia un nuevo modelo de salud. En: Melero, L. (coord.). La persona más allá de la migración. Manual de intervención psicosocial con personas migrantes. p259-296. CeiMigra: Valencia. Available online at: http://www.socialjesuitas.es/documentos/download/13-manuales-de-intervencion/29-la-persona-mas-alla-de-la-inmigracion 

⁶ In this case, we should discuss post-traumatic stress. But it is a subject that is beyond the scope of this document.

⁷ This section is extracted from: Melero, L. y González-Sala, F. (2012). Cultura de origen y variables psicosociales implicadas. Máster en Políticas de Integración Ciudadana, V edición. Universitat de Valéncia.