Struggling to cope
Cecilia Terrero is 62-years-old. Born and raised in Argentina’s largest city and capital, Buenos Aires, she is a true “porteña” (a resident of Buenos Aires).
Like many Argentine women her age, Cecilia lives alone. She occupies a charming, but modest flat—characterized by vintage peach sofas, crotchet pillows and an impressive book collection that spans the entire length of one living-room wall. Scattered along these bookshelves are an assortment of religious trinkets—framed prayers, laminated saint cards, illustrative crosses—all of which signify that strain of devout Catholicism so distinctive of Latin America. She speaks openly and passionately about politics, enjoys at least two cups of coffee each day and shares in the national predilection for tango and soccer. Many would say, based on this description alone, that Cecilia is the embodiment of Argentine culture—religion, politics, coffee, tango, soccer. But there is one more facet of Cecilia’s life that makes her especially Argentine.
Cecilia is a psychologist.
It is a generally well-known fact that Argentina has a fascination with psychotherapy. In 2005, the World Health Organization reported that Argentina has more psychologists per capita than any other country in the world—there were about 121 psychologists for every 100,000 inhabitants. Compared to second-place Denmark’s 85 and the ninth-place United States’ 31, this proportion is exceptionally high. In 2008, researchers posed an even higher number for Argentina—about 145.
The omnipresence of psychotherapy in Argentina is especially apparent in large cities like Buenos Aires. Situated just blocks away from the trendy downtown Palermo, is Villa Freud—a neighborhood named for its high concentration of shrinks. Nearby cafes like Freud & Fahler and until recently, Bar Sigi, also serve as testaments to what many agree, has become a national adoration of Freud himself.
In Buenos Aires, foreigners may encounter taxi drivers, waiters or storeowners who openly speak about their therapists. In fact, the concentration of psychotherapists in the capital is nearly 5.5 times that of the entire nation—that is, 789 psychologists per 100,000 “porteños.” Compare that with the 100 psychologists per 100,000 citizens of New York City, and you have a lot of psychologists.
What is the explanation for this abnormally high consumption of psychotherapy? Many scholars attribute the high demand to a turbulent history—one that includes a search for personal identity in a nation of immigrants, the devastating aftermath of the 1976-1983 military regimes and the distressing economic crisis of 2001 (google Argentina 2001 for some disturbing images).
Yet, with the challenges Americans have faced in recent years—educational needs of the younger generations, career dilemmas (or lack of opportunities) among graduates, unemployment among middle-aged Americans, lapse of family savings and evaporating retirement nests, guns in schools, war, etc.—most would agree that we too are struggling to cope. Why then, aren’t Americans as attracted to psychotherapy as the Argentines?
I have two answers.
The first reason has to do with access. Psychotherapy in Argentina services a multiplicity of needs and is offered at each step of the socioeconomic ladder. In many provinces, public health care centers have attempted to integrate modern psychotherapy with traditional healing methods, conventional psychotherapists working alongside indigenous healers. Although services can sometimes be restricted due to limited resources, psychotherapy is generally far more accessible in Argentina than it is in the United States. This is because for us, psychotherapy is a luxury, primarily reserved for those who have mental health insurance or can afford it out of pocket (these people are often one and the same). Government funded services do exist, but they are often inundated and unable to provide ongoing care.
In a 2008 analysis of the state of psychotherapy in the United States, psychologist Heidi Hartston writes that Americans struggling with emotional problems are reaching out to their primary care physicians rather than psychotherapists, despite an abundance of psychotherapists. Although every medical doctor in Argentina can practice psychotherapy without specialization, the same is not true for us. For Americans, the problem then is not the practice of psychotherapy. As Hartston notes “It is alive and well.” The problem is that these services are not being extended to those who need them the most.
Secondly, Argentines do not stigmatize psychotherapy in the same way Americans do. Psychoanalytical discourse pervades the national airwaves; from radio and television programs to military and political speeches, psychoanalytic themes are everywhere. In her last campaign, President Cristina Kirchner vowed to reinstate Argentine “self-esteem”—rhetoric that demonstrates the cultural importance placed on the national and individual psyche. Psychotherapy is not a service reserved for the “sick” or “mentally ill.” Rather, it is a tool used to enhance the quality of life and aid personal development. According to Argentine psychologist Dr. Héctor Fernández-Álvarez, it has become part of everyday life.
Even though we continue to reassess our model of health care, it may be wise to consider psychotherapy as an essential and affordable benefit that should be available to everyone. As attested to by the Argentines, making psychotherapy within reach for all may allow us to more effectively address the socioeconomic and cultural challenges we Americans now face in our diverse society.
Sonia Havele is a Trinity junior and is currently studying abroad in Buenos Aires, Argentina. Her column runs every other Friday.