Cultural Bereavement: Naming the Grief Refugees May Feel

7 months ago 16

The things Nataliya Pleshkova misses most about her childhood home in central Ukraine are the smells.

In 2011, Ms. Pleshkova, 42, moved to Estes Park, Colo., with her daughter, seeking better work opportunities, and, in September of this year, her mother followed, fleeing their war-torn homeland.

“Mama packed some of the clothes I had left in Ukraine, and the first thing I did was bury my head and nose into the pile because it smelled like home,” she said. “Memories of my childhood rushed through my head. I remembered playing hide and seek in the wardrobe where these clothes hung.”

For her mother, Tamara Plieshkova, it is her husband’s grave in the cemetery back home that she knows she’ll miss, and her pets — a dog and a cat — that she had to leave with a neighbor.

“She said she feels like she’s an old, mature tree being replanted into new soil,” Ms. Pleshkova said, translating for her 69-year-old mother who does not speak English, and was fresh off a 96-hour journey from Ukraine to the United States, via Poland and France.

Feeling uprooted is something many immigrants are familiar with, split between the here and the back there, between the push to assimilate and the pull to preserve parts of themselves and their culture. And it is often the intangibles from home — the smells and sounds, the metaphors and jokes in a native tongue that can’t be translated, and cherished rituals — that they long for.



Credit...Top left and bottom: Theo Stroomer for The New York Times; Top right and middle right: via Nataliya Pleshkova

Though it is not well-known, that feeling has a name: cultural bereavement. Coined in 1991 by Dr. Maurice Eisenbruch, a psychiatrist and professor at Monash University in Melbourne, Australia, while interviewing Cambodian refugees, it is more complex than culture shock. Dr. Eisenbruch felt as though he needed more precise vocabulary to capture the refugees’ emotions and mental health; their experiences did not fit neatly under anxiety or depression or post-traumatic stress disorder, he explained in a paper at the time. Research from 2005 expanded the concept beyond refugees to all migrants and also children of migrants.

“The tragedy for migrants is that their identity as a migrant quite often trumps everything else,” said Dinesh Bhugra, a professor of mental health and cultural diversity at King’s College London and the lead author of the 2005 study. “You are not a doctor who just happens to be a migrant; you’re suddenly a migrant doctor.” That “reorganization of the self” can lead to “multiple layers of stress,” he added, and depression or high levels of anxiety.

Now, the term is slowly gaining recognition. Researchers around the world are starting to explore the phenomenon further, applying Dr. Eisenbruch’s original framework to other groups of refugees and migrants. One small study of Ethiopian refugees in South Korea, published in January, confirmed that cultural bereavement is characterized by complex mental distress. Nonprofit organizations that regularly work with refugees and new migrants are beginning to open up conversations about the phenomenon.

But it is still rarely taught in the Western-trained mental health sphere or understood among clinicians and therapists. “While I was in grad school, I was taking a grief-counseling class, there wasn’t anything that covered cultural bereavement in what I was learning,” said Sahaj Kaur Kohli, who received a master’s degree in clinical mental health counseling and created Brown Girl Therapy, a social media account that discusses the specific mental health struggles that people of color experience.

This summer she shared on social media that she was navigating cultural bereavement, and said in an interview that it quickly became one of her higher-performing posts, with dozens of people commiserating in the comments.

“I just assumed that there was always going to be a part of me that felt alone and isolated. I would feel ashamed because I should know more about my family or my history,” Ms. Kohli said. “But when I talked about it openly on Brown Girl Therapy, I realized, oh my gosh, we’re all kind of navigating this in some capacity.”

What complicates matters is that cultural bereavement often manifests as amorphous depression or anxiety without an obvious cause, experts said. And the more an immigrant assimilates, the more intensely they might feel the grief of “losing familiar social structures, cultural values and self-identity,” as Dr. Eisenbruch described it.

“When refugees or immigrants come to America, we know we’ve lost our country, food, language, all those clear objects, but we quickly jump into assimilation,” said Shinhee Han, a psychotherapist at the counseling center of the New School in New York City and co-author of the book “Racial Melancholia, Racial Dissociation.” “We think ‘I must lose the accent’ or ‘I must not smell like my food,’ without stopping to think about the consequences of shedding those parts of an identity.”

The pandemic, which hindered family reunions, might have also intensified those feelings. “The losses that have been incurred over time or intergenerationally exploded during the pandemic because, all of a sudden, we couldn’t go see our families. I have patients who still have not been able to go to Hong Kong or other parts of the world to see their family members,” Dr. Han said. “So there is this kind of melancholia — an undercurrent of mourning.”


Credit...Top and Bottom: Christopher Lee for The New York Times, Middle left and middle right: via Min Jin Lee

Dr. Eisenbruch noted in his 1991 research paper that a big part of the sadness associated with cultural bereavement comes from the inability to complete significant rites and rituals, like birth ceremonies or burials, in culturally specific ways.

Paurvi Bhatt, 56, a health care executive in Minneapolis, Minn., said one of the hardest parts of losing her parents — who migrated from India in the 1960s — was recreating funerals for them the way that her family might have done at home. “We have to scatter the cremated ashes into the water,” she said. “That is very difficult to do here” because individuals have to get permits to dispose of anything into the water, hindering her ability to carry out that Hindu tradition.

The author Min Jin Lee, 53, who often touches on the feelings of loss and grief associated with migration in her work, including in her novel “Pachinko,” witnessed degrees of cultural bereavement in her own parents after they moved to New York from Seoul, South Korea, in 1976. Her father was a marketing executive back home. After moving, he bought a newsstand in what is now the Koreatown neighborhood of the city.

“I remember, as a little girl, watching people throw a dime at him or 15 cents to purchase the daily paper,” she said. “In Korea, when you hand an object to another person, you use both hands. That’s a sign of respect and he faced so many of these kinds of indignities.”

Ms. Lee found others expressing that same sentiment when she conducted interviews for her books. “It’s not a nation or a place and it’s not just that they miss the taste of food — it’s that all those things are essentially associated with a loss of an identity.”


Credit...Top, middle left, and right: Gabriela Bhaskar for The New York Times; Middle right: via Sahaj Kaur Kohli

Though Ms. Pleshkova moved to the U.S. for better professional opportunities, she could only find work as a camp counselor and a day care worker, despite her experience as an English literature professor in Ukraine. “I was upset when I found out that the payment is not adequate,” she said. “And I did feel like I could do better. I’m suddenly at the bottom of the food chain.”

She eventually decided to put aside her passion for teaching and now works in event planning for a steakhouse in her town.

The fact that people from different cultures tend to express sadness in different ways can further complicate how those individuals seek help, said Ms. Kohli. Oftentimes, given cultural stigmas around mental health, many people might not feel comfortable asking at all.

“When my dad is stressed out, he’ll never say he’s stressed; he’ll say, ‘My feet are hurting.’ Or my mom will say, ‘I have a headache.’ She won’t say ‘I’m overwhelmed,’” Ms. Kohli said. “And that will show up in the room with a clinician as well, and there’s no rule book for a Western-trained practitioner that says, ‘Here’s the criteria for this type of grief, here’s how to medicate it, treat it and so on.’”

Ms. Kohli suggests seeking out therapists who may have a deeper understanding of different cultural expressions of grief or anxiety and depression. During the pandemic, more and more of her Brown Girl Therapy followers were reaching out to Ms. Kohli asking for references to therapists who would understand their cultural background, so she made a spreadsheet of names that she linked to from her Instagram page.

Even using and understanding the term cultural bereavement can be “powerful,” she said.

“Naming it makes the grief more manageable. If you were to go to a clinician and say, ‘I think I’m struggling with cultural bereavement,’ I would hope a good clinician will do their research and will want to explore that with you to understand how it’s impacting you,” she said.

There are also ways to cope beyond therapy. While it can look different for everyone, dealing with cultural bereavement often involves variations of two things. The first is rediscovering or relearning one’s history, culture and self, said Dr. Han, and the second is finding and building your community.

She often recommends that her Asian American patients, for example, read books by Asian American authors or watch movies that represent their different cultures so that they can see their own experiences reflected back and feel less alone in their grief. It also helps resurrect the things — the food, the language, the smells — that were perhaps pushed to the side in an attempt to assimilate.

After Ms. Kohli’s last grandparent died in 2019, she realized that she had lost all physical connection to her ancestry. So she started relearning her mother tongue, Punjabi, and is hoping to learn some family recipes from her mother.

Seeking out community, Dr. Han said, can reduce feelings of isolation and help people recreate the kind of social network they might have had at home. This can involve befriending people at work or in your neighborhood who might have similar cultural backgrounds, and participating in or even organizing culturally specific annual celebrations, like the Lunar New Year.

When Dr. Bhugra moved from Punjab to Cork, Ireland, in the 1980s, no one spoke his language. One day, “somebody told me about a guy in Dublin who spoke Punjabi,” Dr. Bhugra said. He looked up this stranger’s phone number and “rang him, just to speak Punjabi. I know it sounds rather silly but you miss those things; you miss language, you miss art and so on.”

Ms. Bhatt said her parents were very deliberate in building community around them. “My mom and I would have a Diwali open house,” she said, referring to the annual Hindu new year festival of lights. “We’d open our doors, our neighbors were invited, anyone and everyone could come. That became a way for us all to feel a bit closer.”

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