Alejandro (name has been changed to protect confidentiality) is a 21 years old male who have some social struggle with his new environment because of ethnical diversity. He goes to university and have some problems with his new environment. He lives alone without any of his family members. At the first he seems relaxed, not any anxious expressions and make some eye contact; sometimes he shows some disappointments when he talks about his social interaction problems. He is talkative and likes sharing his problems with me during our conversation.He sometimes shows some depressed thoughts and rest of the conversation he was confused even he was so talkative. His appearance was good clean clothes and combed hair with good behaviours. The room that we were in was well lighted our chairs placed side by side no too close, not so far where I can clearly see his hand/head gestures.
Client1:I am kind a feel sad let’s say…
Trainee1: Why?
C1: Because you know I am foreigner, I am from Mexico and I don’t really like being here to be honest weather is really, really, really bad…
T1: So please tell me what is the problem?
Comm1: I could understand that the client was feeling homesick, and wanted him to elaborate further on his problem. An analysis of his non verbal actions showed that he was depressed and lonely, and wanted to open up, and was clearly in search of someone who would listen to him. The fact that he is redundant in his speech while referring to the weather of England and the way he emphasizes on “really” must be taken into account. I can decipher from this that weather was clearly not the problem here; as a matter of fact, he was slightly reluctant to speak his mind, fearing that I might judge him. His reference to himself as a foreigner is also crucial; the client is unable to fit in to his new environment in England, and feels like a fish out of water. However, I tried to extend my warmth and empathy towards him, and the client reacted positively to it.
C2: I am not feel comfortable in this country I miss my home and its very far and miss my parents…
T2: So… you feel some kind of a homesick?
C2:Yeah
Comm2: I reflected on his statement and arrived at the conclusion that he had been feeling homesick, a feeling that he had initially projected on the weather. Homesickness may be defined as the distress that some people might feel when they are placed in an unfamiliar and new environment (Fisher, 2016). Usually, it is characterized by an intense desire to return home, coupled with depressive moods and some somatic complaints. For example, the client looked like he was fatigued and exhausted, which is a common symptom of somatic disorder. Homesickness, while common, is also one of the leading causes of clinical depression amongst people and is a common ailment plaguing first year students at university. Key features of homesickness would include a preoccupation with home, family and friends and a negative attitude towards the new environment (Khademi & Aghdam, 2013). As was evident, the client did not like the ambience in England, stating that bad weather was the problem, when in reality, he longed for home and familiar surroundings. As a matter of fact, I used a conceptual framework to understand the client’s state of mind. As has been shown by research, there are essentially six criteria that determine the extent of the problem. One, homesickness may occur irrespective of age groups. Two, usually feelings of homesickness are not paid heed to and dealt with intrapersonally. This is what the client was doing; he was feeling homesick, but was not exactly keen on opening up (Sun & Hagedorn, 2016). Like most people, he did not consider homesickness to be an actual psychological problem, which leads us to the third point. Three, homesickness is often accompanied by denial and embarrassment (Terry, Leary & Mehta, 2013). The client showed signs of homesickness, but his speech shows that he was not only in denial about it, but also slightly embarrassed to voice his feelings. Four, there persists a kind of persuasive feeling regarding his homeland (Macaskill, 2013). This is also termed as nostalgia in common parlance, and that can be evident from the way he says that he missed his family and home. Five, people suffering from homesickness are usually not encouraged to speak up (Mesidor & Sly, 2016). Perhaps I should have pressed the matter and asked him to elaborately state what his feelings about his hometown and his present environment were. Five, somatic symptoms are usually common. As can be seen, the client is extremely uncomfortable and even miserable in his present situation, which might be the initial stages of depression.
T3: Did you get any support from your close friends or your family?
C3: (Umm…) Yeah… I supported by my family I talked with them on skype and they say “You are going to be good son, don’t worry”and I am…. “Thanks!” (nervous laugh)
Comm3: In here he was kind of disappointed about his family. His head was down and I feel that he cannot get that help that he expected. When he impersonalised them (his family), his voice was nervous and he covered up his nervousness with a laugh. It must be remembered that social support is instrumental in making a student feel at home (Baba & Hosoda, 2014). During such trying times, it is important for the family members of the client to make him feel better by trying to be optimistic and positive about the bigger picture. However, while the parents tried to keep the client’s spirits up by telling him that he would do well, their words did not have the intended effect. Instead of feeling optimistic and uplifted, the client felt disappointed; this is probably because he expected words of comfort and empathy from his parents. I deduced from his manner of speaking that he may be blaming his parents for his miserable state, coupled with the fear of not being able to live up to their expectations of him being a “good son.” The nervous laughter may be a defence mechanism that is a meagre attempt to hide his anxiety behind opening up about his feelings. The anxiety could be a result of meeting me or could be the result of cross cultural adjustment in the transition from Mexico to England (Yakunina et al., 2013). Typically, such nervous laughter is an example of fake laughter which one uses as a mechanism in a potentially awkward situation (Foot, 2017).
T4: You tell me that you feel sad
C4:Yeah
T4: Do you have any particular thing to feeling sad?
C4: I cried inside myself…
Comm4: I reflected back on his reply, and realized that he may have been a little embarrassed to admit that he had been crying. The fact that he had been crying all to himself shows how lonely he had been at university; probably, he had been feeling that no one would understand him or that no one would pay heed to his emotions, and thus felt the need to hide them. It is important to understand the reason for his tears (Cacioppo et al., 2015). It could be due to extreme homesickness that he has already admitted before. Or it could be due to his disappointment in his family (Jaremka et al., 2014). I concluded that inner desolation may be the cause of his sadness. This can be defined as an innate human experience where the person would feel unhappy, discouraged r dispirited and might even feel despondent, melancholic or dejected. However, while desolation is relatively common and a part and parcel of being human, it might lead to clinical depression if treatment is not sought (Koenig et al., 2014). However, I felt that I probably should have probed further into the way he expressed his emotions, to pave the way for a healthier outlet.
T5: Are there any particular situation that you struggle with in here?
C5: In England…
T5:Yeah
C5: Weather, racism, (long thinking process) … some cops think that I am criminal, drug trafficking, also when I go to nightclub everyone gets drunk so easily and I am like seriously?
Comm5: The client paused after uttering the word “racism”, which gave me an idea about the nature of his problem. According to him, racism and racial discrimination is rampant in England and he has faced discrimination on grounds of his skin colour. In this confession, I noticed some irritation and annoyance in the way he spoke. He seemed to be fed up with the people in England, their way of thinking, their lifestyle and also the cops who judge him on the basis of his skin colour. In this aspect, it can be deduced that the client was feeling victimised because of the prejudice that exists against Mexicans. Prejudice may be defined as the unjust or unfair behaviour meted out to a certain individual because he belongs to a certain social group (Whitley & Kite, 2016). Out of the four or five types of prejudice that exist in the world, the client appeared to be facing ethnic or racial prejudice, and he seemed to slowly lose patience because of this (Bar-Tal et al., 2013). He is unable to adapt himself to the lifestyle in England and the way people behave; he is also unable to see eye to eye with them, which has led to him feeling uncomfortable. He also keeps comparing his present surroundings to his homeland, which triggers his misery.
T6: So you feel some kind of a insecurities in there
C6:Yeah… Basically it is an another world for me
Comm6:. Here, I was trying to get the client to open up more about his insecurities. However, I should have been more specific. A more fitting reply would have been “Could you talk about the insecurities you face while interacting with people here?” Again the client emphasizes how he does not fit into the world or the environment here, hinting at racism and how ethnic and cultural diversity was proving to be a problem for him here.
T7: So you make some comparisons about your country and England also you find it out England is a little racist…
C7: Yeah… (nervous laughs)
Comm7: The nervous laughter again shows a degree of uncertainty and insecurity in the client (Gregory, 2013). The purpose of my statement was to instigate him to elaborate on his problem. However, his monosyllabic reply here has a different connotation; he was probably fearing judgement from me and was unsure as to what my stand would be on ethnic diversity and racism in England.
T8: So you don’t have anything in your country like this… Any racism, any drunk people or… (hecut off my sentence), drugs…
C8: I am going to talk about it of course we had the bad sides; and of course there is a racism in my country but something for the “gringos” aka. I think everyone knows what “gringo” means… I try to explain the “gringo” means
Comm8: I reflected back on this exchange and could understand that the client was beginning to get a little defensive. He may have wrongly assumed that I did not believe in his suffering or misery caused by racial discrimination. On reflection, it may have been my fault; the fact that I hinted at the racism in his country might have triggered some suppressed anger. Defensiveness may be defined as the psychological response which is a direct result of an imagined or perceived threat to one’s sense of self, which in this case is directly linked to his homeland (Hart, 2015). The client becomes shifty and agitated and cuts me off before I could complete my sentence. This is known as defence mechanism (Freud, 2014). This may be his defence mechanism against the preconceived notions about his homeland; there are common perceptions that Mexico is steeped in crime and drugs, which might be the foundation for racism and ethnic discrimination in England. Reference to that may have brought out a need to defend his homeland or his country. That is why he also refers to the word gringo, which is often used in a derogatory sense and his immense dissatisfaction with the usage of the term.
C9: …Gringo means non-Spanish Portuguese speaker (thinking process) usually call them to the British/American people and it is like white people let’s say…
Comm9: Here, the client continues to emphasize on his problems and his rejection of the term, “gringo”, which has been used to discriminate against him. I could sense the dejection and despair evident in his tone, along with the anger and agitation he faced when called by such names.
T10: Hmm… you think that they discriminate you
C10: Yeah. Because I am foreigner
Comm10: Having sensed his agitation, I proceeded to complete his sentence and voiced his feelings. This would help me gain his trust because he would now understand that I am not one of the “white people” who judge him and discriminate against him on the basis of race; instead, I am someone who could help him – who acknowledges his feelings and empathizes with him, a sense of comfort that he seeks from his family but is unable to get. I also sensed that he suffered from an inferiority complex, in the way he classifies himself as a foreigner. In students coming from non English speaking backgrounds and receiving higher education in foreign universities like the ones in England, there is always a tendency to compare oneself with their peers and native classmates (Thoits, 2013). As a result, the “foreigner” might find himself to be inadequate or lacking in some aspect, which he believes to be the cause of racial discrimination (Berger & Sarnyai, 2015). Inferiority complex is defined in psychology as a state where the person develops insecurities about himself or herself or the social group he belongs to (Valentine, 2015). Such inferiority complex might make the person feel depressed, desolate, lonely, anxious, awkward and even nervous in the present of others.
T11: How can they understand this?
C11: Sometimes just because I am speaking on the phone another language… One of the times when I was in London… In Central London to visit my friend, out for dinner I was speaking on the phone with my friends… in Spanish… and someone just said to me if you speak in another language just leave the train please here we only accept English speaking… I was pretty shocked… people look at me like in a way they agree with that…(deep sights)
Comm11: This is the first time the client actually opened up about his problems. He gave me an example which revealed to me the gravity of the situation and the barriers standing in the way of him leading a normal student life here in England. The fact that linguistic differences are creating a boundary between him and those around him seems to bother him. Language barriers have always posed a threat to people being able to settle in effectively in a new land. Such barriers not only prove to be a problem for the foreigners, but also welcome discrimination from the locals (Pescosolido et al., 2013). Moreover, the fact that the client sighs at the end shows how stressed and upset he was with the whole situation. Sighing, in psychoanalysis, is usually considered to be a deep, enhanced kind of breath that is distinct from the ordinary eupneic breathing – it has psychological, physiological and neurobiological connotations. A person usually lets out a sigh when he is upset with something or is feeling a sense f hopelessness about his situation or is on the verge of giving up (Truong et al., 2014). I could understand from the client’s non verbal actions that he was facing utter hopelessness about his circumstances here in England. He could not find a way to fit in here, and those around him certainly did not make it easier for him to feel at home. Additionally, people attacking him about his mother tongue or his ethnicity made him feel powerless and helpless; he had also lost all hope of the situation improving.
C12: Yeah but I just need to be/feel secureI can do nothing, if I do something I may get deported
T12: so (yeah) its quite you know… when you feel insecure… it is quite harmful (C: hmm mm) for you and your mind
Comm12: At this point, the client was beginning to get slightly agitated as he focused on his hands being tied. He felt that he was helpless and that no one could help him out of this situation. I tried to make him understand that suppressing his feelings of insecurity was detrimental to his mental and physical well being.
T13: Do you have any friends that with the same struggle with you?
C13: Yeah… from my country. (T: they are a lot of friends or?) Usually most of them they feel the same like… also I have one he was heading to Manchester so he came to London for took a train (long thinking process) he has a lots of bags of course (T: hmm mm) and he was get into the train they complaining about him it is like these freaky immigrants always the same like come here… it was touched … as well. (sigh) but what else I can do… I can do nothing…
T13: So yeah maybe you can do but for yourself (he repeated me) You not going to save the world or something… (he interrupted me again) but just for you need to (find your) relief for yourself in this situation its quite dangerous and harmful
Comm13: I tried to hint at the fact that maybe he should focus on settling in and getting better instead of his friends. The purpose of bringing his friends up was to show that he was not alone. However, he seemed to get all the more agitated, as can be seen from the way he kept interrupting me; thus, I told him that the onus to save the Mexicans from their plight in England was not on him.
T14: What you think that you need to relief these problems?
C14: Ignore them… try to ignore even it’s really touching and I want to give it back but in the physical way (T: oh my god…) yeah…say like what is that (say something in foreign language) or something like that people get really, really mad but I try to make calm (I try to ask something but he wants to continue his sentence) I think about my family
Comm14:At this point, I understood that the client was clearly suppressing anger against the white people in England. Unable to retaliate when being met with racial slurs, the client wanted to hurt them physically, but ended up restricting himself. Such anger management issues are usually common when it comes to racial discrimination; however, this could prove to be dangerous especially if the client fails to control his actions. However, I was glad to hear that he was able to stay calm during the high pressure situations.
T15: I see you show some passive aggressive…
C15: Yeah… I try to avoid the physical fight (T15: …behaviours…) try to ignore (T15: yeah…) keep it cool (T15: yeah…), put music higher do not listen them and “everything is going to be allright”… Calm down that I try to relax myself …
Comm15: The client prefers to use a passive aggressive method while dealing with the racial discrimination. A person is described as being passive aggressive when he or she tries to avoid direct confrontation and attempts to resist to something indirectly. Such passive aggressive behaviour might also include expressing hostility in an indirect way. I concurred with him when he said that he needed to keep calm during such tense situations. Perhaps, I should have been more empathetic and explain ways of keeping calm during such situations so as to prevent any kind of damage to himself or others.
T16: Did you share anything with your close friends and family (C16: Yeah…) Because sharing going to be caring
C16: I share… (hmmm…) I share I have always tell my family (hmm mm) my family always said to me have a bit patient because I know it is hard (laugh)
Comm16: I encouraged the client to open up to his parents and wanted to know if his family had extended any support during such times. While speaking about his family now, he did not feel awkward or show signs of disappointment. From what I could understand, the client’s family wanted him to be strong and patient and he tried to keep their words in mind, which helped him stay calm.
T17: Yeah… it is a hard situation very hard. Maybe it is you know about your area that you lived in. Maybe there are a lot of local people that live in there and they do not like the foreign people… so maybe?
C17: I am not sure, I am not them,I am not on their minds…
T17: But… In here local people is not (supposed to be) our problem (to focus on) so we need to focus on you (C17: Shows himself by both his index finger) … yeah… and your problem and how to relieve it
Comm17: I reflected back on his problem and told him that we would need to find ways of relieving his problem. I hinted at the fact that maybe the location he was residing in could be the problem; in an area with a large number of locals, there might be some discontent if foreigners invade the community – this might be the cause of hostility from the locals. However, the client still seemed hopeless about the situation. I helped him understand that the point of the session was not to deal with just racism and ethnic diversity, but to focus on his ability to deal with them. He was getting preoccupied with the negative mentality of the people who discriminated against him or taunted him instead of focusing on getting better himself.
T18: You do think that anything going to be alright you will get used to with your social issue?
C18: Yeah… I think I just get used to it I see every country has problems with drugs walls and the like the walls of the U.S.A and the… let’s say criminals here we had problems… we had these… with the people complaining about the immigrants but I think we just get used to it relax and just focus on your own friends and going to all right
T18: I think there is a lot of living in there so they are not need to be behave like this… They have no right to behave like this because they already okay with a lot of immigrants (C18: Yeah) and they cannot behave(treat) you like this (unfairly) so again we are not consider about the local people or the racist people we are going to only care about you because you are struggled in many ways.
Comm18: Here, the patient seemed to be trying to make sense and fit into the situation that had been handed to him. For the first time in the conversation, he seemed to be reassuring himself, in contrast to the hopelessness and desolation that was evident previously. The purpose of my question was to understand his opinion about his problem and to understand what he felt about it. I told him that it was unfair, what was happening to him, however it was not within our control. I made him understand that we could only control the client’s own behaviour; I also wanted him to realize that I could feel his situation and was empathetic towards him.
T19: Did you feel that this environment effect your school life, your succeed or your achievements, your grades
C19: Let’s say that this issue effected me a little bit because it doesn’t give you that huge motivation to study (mm hmm) and that huge motivation to be in the university (hmm mm) imagine I wake up have my breakfast and my morning routine to university I don’t like to see someone (impersonalize someone) “hey you immigrant get back to your home get back to your place where you came from (T19: Yeah) the still doing their jobs. I don’t want to hear that every morning (T19:Yeah)
T19: So it is decrease your motivation?
C19: but Yeah… So when I could do university I just avoid that (T19:hmm mm) there is people actually to do this to avoiding these thing
Comm19: From this, it is clear that the student has been feeling homesick and uncomfortable due to the aforementioned problems which have directly impacted his studies. He is unable to concentrate on his curriculum. I realized how dire the circumstances were when he said that he did not find the motivation to even go out of his house in the morning. Not finding the motivation to go to class or even study could be one of the early signs of depression.
T20: I think you found your own defense mechanism like avoiding…
C20: Yeah… I agreed avoiding by put headphones (T20: hmm mm) listening music and just keep going…
Comm20: I approved of the student’s defence mechanism. Every individual has their own mechanism, by means of which they deal with tough situations. The client in this case preferred to plug in his earphones and simply avoid people who mocked him. I showed my approval by agreeing with what the client said.
T21: Except of all of these negative sides have you had any positive feelings about living in foreign country?
C21:Hmmm mm yes. There is good thing I am close with my mom so there are no (say something foreign) (with nervous laugh) no flip flop, no beating that is like the best thing. And there is no one screaming in Saturday morning said (something foreign language) which means “come clean the house”. (Errmm…) if I do not I got my beat with (something foreign word) again and if I do not obey to my mom my dad goes with a belt at to me and that thing hurts…
T21: So maybe your violated behaviour involved with this childhood?
C21: No, no, no because all my friends we got to use to this
T21: it is all about… (he interrupted me)
C21: …it is just for education in order to have some respect from your parents. Because parents are the most important persons in your life. That’s the reason we got to beating. It is just for education do they think its violated its nothing connected to our parent education. It is nothing connected (hands clapped) I am not showing the flip flops to peopleoutside on the street (saying something foreign) … I am not doing that. So… (nervous laugh)
Comm21: The purpose of my question was to get a glimpse into his childhood, which appeared to be a slightly violent one. The client reported that he would be physically hit when he made a mistake or if he failed to live up to his duties. When I tried to assert that such a violent childhood may have something to do with the issues he is facing now, the client vehemently denied such a possibility and got defensive again. He interrupted me and emphasized on the fact that such reprimands and beatings were to educate him – it was to teach him the difference between right and wrong. He also specified that he was not replicating such behaviour to people around him; however, the nervous laughter may have been because of he was worried about the kind of image he painted of his family to me, thinking that I may be judging him or his family.
The client had been feeling homesick and was unable to settle down in a foreign land; the fact that he had a different skin colour or linguistic barriers were some of the factors that stood as a barrier between him adapting to life in England. For any foreigner, it can be difficult to adjust to a new way of living, which is mostly related to cultural differences (Dronkers & Van der Velden, 2013). However, the client’s situation was worsened by the fact that people around him were discriminating against him on the basis of ethnic diversity and he had been the victim of racial slurs, with people and even cops thinking he was a criminal simply on grounds of his skin colour. I tried to make him realized that he was not alone and that he was not the sole victim. In addition, I tried to emphasize that while friendship was essential, he need not get bothered and upset by what his friends were facing and instead focus on his own well being. This may not have been welcomed by the client.
The client showed signs of inner desolation, coupled with a sense of hopelessness and despair – this can be understood from his frequent sighs, nervous laughter resulting from awkwardness and non verbal actions. The client also hinted that he had been suppressing anger for a long time and had often felt the desire to lash out or even hit the ones who were mocking his accent or ethnicity. However, the client chose to go with a passive aggressive method where he simply avoided those bullying him. He also relied heavily on his family’s support and it was their reassurance and memory that prevented him from retaliating. Nevertheless, at the end of the conversation, the client briefly mentioned how his parents would beat him as a child; this could be one of the underlying causes of anger management problems. However, the client became defensive when I mentioned his family and how his upbringing could be one of the underlying causes of his failure to adjust in a new environment, an example of defence mechanism (Kalsched, 2014).
I reflected back on our conversation and realized that I found it difficult to relate to his problems, which he may have perceived. Additionally, I was also vague in some statements; I should have been more directive in my approach, so that the client would be able to open up more. The client may have felt that I could not empathize with him, which may have a negative impact on our therapeutic relationship.
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