My Name is Nobody

In Greek mythology, Ulysses, King of Ithaca and strategist who devised the famous Trojan horse, embarks on an epic voyage back to his native land after a decade at war far from home. During this journey, he faces the wrath of gods, defies cyclops, sirens, and giants, and endures seven years as nymph Calypso’s prisoner, always yearning to recover everything he had left behind. Because of his constant yearning and the hardships he endures along the way, Spanish psychiatrist Joseba Achotegui designated as “the Ulysses Syndrome” a series of effects that migratory processes have on the wellbeing of migrants.

The Ulysses Syndrome is also known as the “Immigrant Syndrome of Chronic and Multiple Stress.”  This syndrome refers to situations where certain burdens or demands, whether acquired during the migratory journey or during the prior or subsequent stages, are so grave, that they seriously affect the emotional and physical health of migrants, because they are “experiencing inhuman stressors before which there is no possible adaptive capacity.” If they are not reduced, they can lead to the development of mental disorders such as depression, anxiety, or post-traumatic stress disorder.

A migrant worker in Thailand. Source: ILO in Asia and the Pacific, Flickr (CC BY-NC-ND 2.0)

To illustrate this syndrome’s characteristics, let’s imagine and accompany Alba. In order to protect and conserve her dignity and her life, Alba must leave her home towards an uncertain future in another country, leaving behind her two children and her community. At her destination, her language is not spoken, she cannot practice her cultural expressions, she does not belong to any community, and she does not have a regular migratory status. She begins to work in a factory where she is paid too little for too many hours of work and where she is victim to xenophobic comments. To be able to send enough money to her children, she lives in an unsanitary apartment with many other people and does not eat properly. Alba misses her children, longs to be in her land, and be part of her community, but going back would mean the failure of her migratory project. Besides, she is afraid that the rejection towards her could become violent, that she could be exploited at her job, or that she could be discovered by the authorities and deported.

Perhaps she could manage her extreme grief (caused by the various significant losses she has endured) and intense stressors (the physical, mental, or social burdens and demands she faces) if she were not experiencing them at the same time, or if her migratory conditions were better (for example, if she had a formal migration status or better living or working conditions). However, in light of this situation of loneliness, hopelessness, and fear, she cannot. Facing these stressors for a prolonged period, without having a support network, she loses the sense of control over the conditions of her life and they are pushing the limit. She feels profound sadness and blames herself for being far from her children and for not being able to fulfill the goals that she had set before migrating. Moreover, she feels nervous and disoriented in her new city, doesn’t sleep well, forgets simple things, and suffers from headaches and abdominal and muscular pain.

If Alba were able to access the health system, it’s possible that doctors and psychiatrists would not find biological explanations for her physical aches, and that they would dismiss her emotional struggles or misdiagnose them as mental illnesses – especially if they are not conscious of the ways that migration affects mental wellbeing. However, it is more likely that she would not be able to access these services because she is an irregular migrant. Although the response of the States to the physical health needs of migrant populations is insufficient, it is more so in the case of their mental health, ignoring that they are closely related. Perhaps this is because physical effects seem to be more evident and urgent, for instance when we think of Venezuelans who migrate because they cannot access medicines or treatments, in migrants and refugees in Greece who cannot avoid preventable diseases in camps, or in that, in order to reach the Mediterranean Sea, migrants from sub-Saharan Africa must cross the hostile Sahara Desert, exposing themselves to the lack of water and extreme temperatures.

We often think of the immediate needs of migrants, but we do not always think of the ways that the entire migration process affects the emotional and physical health of these people. Source: Fotomovimiento, Flickr (CC BY-NC-ND 2.0).

Furthermore, it is possible that, because of the constant threat of deportation, Alba would not even dare to seek the support that she needs and her suffering would remain in anonymity. In his journey, Ulysses tells the cyclops “My name is Nobody . . . everyone calls me Nobody,” hiding his true identity to protect himself. As a human being, Alba needs to be able to assume her identity without fear. But if the conditions she experiences persist and the impacts on her health are made invisible, she could end up having this name that no human being should ever have – whether as a survival mechanism or because of her state of marginalization.

Let us ask ourselves then, who is Alba? She could be a Central American woman at the southern border of the United States, encountering armed resistance, tear gas, and the impossibility of requesting asylum in that country. She could be a Venezuelan man walking for days seeking treatment for his cancer, diabetes, or HIV, or ways to feed his family. She could be a Bangladeshi person in India, living with the uncertainty of migratory irregularity and the risk of statelessness, or any of the more than 258 million migrants currently around the world, all of them with proper names and innate dignity that must be respected.

A migrant worker in Virginia, USA. Nearly three-fourths of hired workers on farms in the United States are immigrants. Source: Bread for the World, Flickr (CC BY-NC-ND 2.0)

To begin ensuring this respect, there must be an acknowledgement and understanding of the emotional difficulties specific to migratory processes, as well as psychosocial prevention and intervention strategies. Thus, it is much more likely that migrants’ adaptive mechanisms – those that we all have and allow us to manage and overcome daily life’s stressors and griefs – won’t be overwhelmed because of the extreme struggles they face. The good news is that positive advances can begin with raising awareness among not only health professionals, but social workers, community leaders, educators, humanitarian assistance personnel, and any other person who might have an influence on the psychosocial adaptive processes of migrants. Policies that guarantee access to psychosocial services, the remediation of the precarious life conditions for migrant populations, and the minimization of chronic and multiple stress situations are also needed.

Ulysses was one of the great Greek heroes, “who nevertheless, barely survived the terrible setbacks and dangers that he was subject to, but the people who arrive today to our borders [such as Alba] are merely people of flesh and blood that nonetheless experience episodes as or more dramatic than those described in the Odyssey.” It should be easy for us to recognize that the factors that lead to people leaving their homes, the uncertainty and the monsters they may encounter along the way, and the barriers and struggles in the destination countries could exceed their adaptive capacity and in this way, recognize, support, listen to them, and ensure that they will never be called Nobody.