Abstract/Acknowledgements/Table of Contents -

Introduction - Chapters 1 |  2  |  3 |  4  |  5 |  6    - Conclusion – Appendices–

 Bibliography

Matthew Gutmann (1996:244)

Michel Foucault (Martin et al.1988:9)

Anthropologists read and write about people. Like most literary, humanist and social science scholars, anthropologists are interested in how people’s lives relate and contribute to the social world. A key contribution of anthropology, in particular, has been to point out that the process of reading and writing about people is a positioning act. That is, we read and write from somewhere. Several factors¾ including gender, class, race, ethnicity, age, sexual orientation, and so on¾ influence the ways in which we read and write. It is argued, therefore, that anthropologists need to be critically aware of the positionalities of the people they read and write about, as well as of their own. And this critical awareness must in turn be reflected in the ethnographic writing itself.

I raise these points to highlight the kinds of thoughts and concerns I brought to this research project. Following Gutmann’s caveat above, I wanted to be attentive to how my own assumptions and beliefs about gender, health, and migration might shape the course of the research. So, as a general introduction to the discussion of literature and methodology in this chapter, I want to emphasize the selective nature of the readings I have read and words I have written for this thesis. My research was based on background reading and interviews and conversations with Guatemalan immigrant men and women in Toronto, and, I hope, will contribute to our understanding of the interconnections between gender, health and migration. But the reader must also bear in mind that the literature review and methodology for this study were, of course, shaped by my own interests, decisions and discoveries along the way.

There is only a small handful of studies on Guatemalans in Canada. Recent statistics from Employment and Immigration Canada estimate that 8,450 Guatemalan refugees have resettled in Canada (1,695 in Toronto), the majority of whom migrated during or immediately after the violence of the early 1980’s (Statistics Canada 1996). In one study, Diane Meredith examines the processes of psychosocial, sociocultural and socioeconomic adjustment of Guatemalan refugees in Toronto (1992). Taking a linear view of refugee resettlement she argues that a range of interrelated factors—social, cultural, political, economic—affect the process of integration into Canadian society (Meredith 1992:5).

While Meredith offers an impressive range of quantitative and qualitative data on psychosocial, sociocultural and socioeconomic adjustment among Guatemalan refugees in Toronto, there are several gaps in her study which I think are important to address. First, as a general critique, the reader is left with little understanding of how Guatemalans in Toronto construct and enact the various categories of adjustment she outlines. For example, she observes that Guatemalan immigrant men and women experience high rates of depression and guilt due to lack of employment and poor English language skills. But because Meredith utilizes so few stories from her subjects, the reader is left with a limited understanding of the meanings that the participants in her study attach to these and other experiences. What are depression and guilt according to these men and women? How are these embodied and narrated? How might men and women, Ladinos and Mayas, and working and middle class Guatemalan immigrants experience depression and guilt in similar or different ways?

Second, with respect to processes of community formation in particular, Meredith tends to homogenize Toronto’s Guatemalan population. Meredith emphasizes that in order to understand the adjustment of Guatemalan refugees to Canadian society, we need to understand "their culture" (1992:46). In so doing, she assumes that there is a sense of shared culture within this population and that by "knowing" this culture we can begin to understand¾ and resolve¾ a wide range of psychological, social and economic issues. Culture, in this view, is shaped by an overarching set of beliefs and practices that determines the thoughts and actions of a group of people. Definitions of culture that emphasize fixity and sharedness neglect the contingent and dynamic processes by which culture is shaped and reshaped over time and space. One consequence of this is that the categories by which people are defined, labeled, and disempowered are left unchallenged. Thus, while Meredith may implicitly recognize the diversity of Guatemalans in Toronto¾ if indeed they view themselves as "Guatemalans" in the first place¾ she simultaneously endorses a notion of culture not as process or as a site of becoming, but as something that a particular group of people either has or does not have. This construction of culture potentially undermines her argument about the resilience and strength of Guatemalan immigrants. That is, the reader is left with little sense of how Guatemalans may change to cope with violence, migration, institutional racism, and emotional problems, or how they may salir adelante ("move on") by remembering or forgetting their past. I address these particular concerns in the Conclusion ("Writing Against Pathology").

In a collection of stories from Guatemalans in Toronto, Catherine Brown (1997) documents the struggles of Guatemalans adjusting to life in Canada. Guatemalan Stories: A Collection of Immigrant Experiences, an English-as-a-Second-Language teaching tool, presents the stories of several Guatemalan refugee men and women focussing on such themes as trust, family separation, feelings toward "home," alcoholism, machismo and others. In narrative form, Brown’s edited collection vividly captures the experiences of flight, resettlement, and return for this population. Although Brown offers no analysis and little contextualization of these stories, her collection provides a useful¾ and touching¾ glimpse at the effects of exile on the lives of Guatemalans in Toronto.

In contrast, approximately 200,000 Guatemalans have migrated to the United States, most to Florida and Southern California. In one study, Miralles (1989) focuses on the health and health seeking behavior of Guatemalan Maya refugees in Indiantown, a small agricultural town in Southern Florida. Miralles notes that little has been documented on the health care needs of Guatemalans as refugees (1989:1). To introduce her study, Miralles asks the important question: "What do people do to maintain or restore their health and why?" (1989:8). In addition to illustrating the wide range of health beliefs in this population¾ the importance of humoral balance, the distinction between strength and weakness, and influence of supernatural forces on well-being¾ Miralles explains that being ill carries a stigma of weakness and an inability to carry-out responsibilities (1989:89). What is markedly absent from this study, however, is any discussion of the gendered dynamics of health and illness. How are "strength" and "weakness," for example, constructed and enacted by Maya men and women in Florida? What impact, if any, has migration had on gender identities and what impact might these sorts of transformations have on health status and beliefs? If my study is any indication of the important role that gender plays in influencing health-related behavior, then Miralles’ analysis begs several questions about the nexus between gender, health and migration.

In one study of Guatemalans in Los Angeles, Popkin (1999) explores the limits to physical mobility on the establishment of transnational linkages. Popkin begins his study by arguing that scholars need to further explore the relationship between settlement and transnationalism, and to determine how migrants maintain transnational connections in contexts in which their mobility is limited (1999:268). One interesting finding from Popkin’s study is that resettlement may bridge some of the historical differences that have separated Guatemalan indigenous and Ladino populations (1999:275). Popkin concludes that by engaging in dialogue with the Guatemalan consulate and Guatemalan community organizations in Los Angeles, and interacting with churches in home villages in Guatemala, Guatemalan immigrants have more access to the Guatemalan state and home country institutions than individuals enjoyed prior to migration (1999:285). Thus, limits to physical mobility in the diaspora do not necessarily impede the formation of transnational linkages.

My study of Guatemalan immigrant men in Toronto is situated within a wide range of literature that attempts to understand identity-making among immigrants and refugees. Recent research with immigrants and refugees has illustrated that the process of "integration" into the host society is rarely a linear one. Newcomers adjust in a variety of ways to living in a new society, and this process of "adjustment" is shaped by several factors including employment, language skills, family and community cohesion, and emotional well-being (Haines and Baxter 1998). The process of integration is influenced both by the host society and the identities and resources of the refugees themselves (Krulfeld and Camino 1994; Krulfeld and Macdonald 1998a). Further, scholars have emphasized that the development of a socially recognizable collective identity has implications for individual and refugee community integration in the host society (Earle 1994:207). Refugee well-being, in this view, is shaped by the dual processes of institutional integration and ethnic community formation.

In several works on refugees and displacement, Liisa Malkki (1992, 1995, 1996) has argued that the media and humanitarian and social service organizations have pathologized refugees by labeling them as passive or needy. Refugees do not constitute a naturally self-delimiting domain of anthropological knowledge, according to Malkki, but rather "Forced population movements have extraordinarily diverse historical and political causes and involve people who, while all displaced, find themselves in qualitatively different situations and predicaments" (1995:496). Previous literature in refugee studies has tended to assume that to become uprooted is to automatically lose one’s identity (1995:508). Malkki’s pivotal work in refugee studies has provided a basis for my own exploration of the multiple sites of identification for Guatemalan immigrant men in Toronto, and has encouraged me to pay close attention to the diversity of people and experiences within this population.

As a way to address this complex process of identity formation among populations on the move, diasporization has become an important conceptual tool in the social sciences in recent decades. Originally, "the Diaspora" referred specifically to the exile and dispersion of Jews (Safran 1991:83). Today, "diaspora" is an analytical category used to make sense of the movement of all sorts of groups of people: immigrants, refugees, ethnic and racial minorities, migrant laborers, and so on. Older concepts like community have been critiqued for emphasizing homogeneity, stasis, commonality and coherence, rather than process, change and context (Winland 1995:7).

In his essay in the journal Diaspora, William Safran (1991) proposes criteria for what he calls "genuine diasporas." Flight from a "homeland," the maintenance of collective memory, marginalization in the country of resettlement, and ongoing commitment to the safety and prosperity of the "homeland" are each considered important characteristics of a "diaspora community" according to Safran (1991:83-84). In another formulation of diasporan identity, Stuart Hall emphasizes the dual nature of people’s relationship with the host country and the homeland (1990; see also Winland 1995). Hall and other identity theorists have drawn attention to the processes, productions, and contingencies of making diasporan identities (Soysal 2000; Yon 2000). As Hall notes, "Identity is not already ‘there’; rather, it is a production, emergent, in process. It is situational¾ it shifts from context to context" (2000:xi). Rather than try to discern whether or not a group is diasporan (as in Safran’s approach), Hall and others instead attempt to understand the ways and contexts in which identities are multiply produced and represented, and how these representations in turn influence identity-making.

In a more critical mode, Soysal questions the deployment of diaspora as an analytical category in explaining the contemporary immigration experience (2000:1). Diaspora theorists, according to Soysal, accept the formation of tightly bounded communities and solidarities (on the basis of common cultural and ethnic references) between places of origin and arrival (2000:2). "The concept of diaspora," in Soysal’s view, "effortlessly casts contemporary population movements as perpetual ethnic arrangements, transactions and belongings" (2000:13). As an alternative, Soysal draws attention to "new formations of membership, claims making, and belonging" by focussing on the appeals to universalistic principles and discourses of equality, emancipation and individual rights (2000:2). Soysal’s work therefore, writes against a peculiar passion for ethnicity in contemporary scholarly and popular discourses.

Another effort to move beyond theorizing ethnic forms of identity and belonging for displaced populations is Nigel Rapport and Andrew Dawson’s innovative work, Migrants of Identity (1998a). As opposed to concentrating on the identity of migrants, the researchers in this volume argue that movement in itself¾ and how migrants narrate about movement¾ have become fundamental to modern identity (1998b:6). Rapport and Dawson argue that "home" is not simply where one lives or would prefer to live. Home is "an amalgam, a pastiche, a performance" (1998b:7). That is, home is not only a spatial or geographic entity but also "where one best knows oneself" (Rapport and Dawson 1998b:9).

Jose, a 38 year-old man who fled Guatemala for Mexico before moving to Canada in 1990, seemed to articulate a more situational notion of home when I asked him whether he considered himself to be Canadian or Guatemalan:

I don’t feel Guatemalan just because I was born there. I think my people are those who understand me. Those who think what I think. If I meet with somebody from Argentina or you, those are my people. I am not a chauvinist; I don’t say "That is my country." I think we as Guatemalans don’t have a strong nationalism. Because we don’t really know who we are.

By suggesting that his home is with "those who think what I think," like Rapport and Dawson, Jose forces us to consider other forms of identification beyond rigid, geographically defined notions of "home" and "away."

Feminist scholarship in the social sciences has built a foundation for recent explorations of masculinity and "maleness." Complexities of the feminist movement and feminist scholarship aside, these pursuits have provided a critical perspective on women’s relative subordination to men¾ in both historical and contemporary forms¾ and on the agency and diverse experiences of women worldwide based on differences in race, class, ethnicity, sexuality and (dis)ability. These studies give important insights into the power relationships among women and between women and men. They also encourage scholars (anthropologists in particular) to rethink the voices and stories of the people included in their ethnographies and to critically examine the effects of the researcher’s gender on the research itself. More broadly, these studies suggest that the category of gender is not natural or stable but rather is shaped by changing social relations over time and space (Allen 1996). Gender is now generally seen as a fluid, contingent process, rather than a fixed, bounded category (Ong and Peletz 1995).

Recent research in gender studies has argued that in the process of critically examining women’s multiple identities and struggles, the study of men’s identities and struggles has been relatively neglected (Kimmel and Messner 1998). In anthropology, beginning in the early 1970s, feminist scholars researching women’s political, economic and social struggles in various parts of the world argued that studying a particular group of people had typically meant collecting the stories and experiences of men only. Women’s stories had gone relatively unheard. Thus, there was a widespread shift toward exploring women’s lived experiences¾ in their own words. What several contemporary scholars of masculinity suggest, however, is that men’s identities continued to be homogenized in these new, critical studies of women and women’s identities (Kimmel and Messner 1998). A dearth in research on subordinate and dominant forms of masculinity meant that we could only have limited understanding of how men exercise power over women and other men. Further, with scant knowledge of how men construct and act on their identities as men, we could not gain a holistic view of how power relations are formed in local contexts.

My work on gender identity is guided in part by Sabo and Gordon’s point that there is no such thing as masculinity; there are only masculinities (1995:10; see also Cornwall and Lindisfarne 1994:13). While there are power relations that shape individual gender identities, there is no stable set of determining and essential gender qualities. In Gutmann’s words, "there are ruthlessly emergent gender variations" (1996:9). My work is thus guided by those ethnographers of masculinity who study the particular locales and historical situations in which gender identities are transformed (Archetti 1999; Cornwall and Lindisfarne 1994; Gutmann 1996; Herzfeld 1985; Vale de Almeida 1996). But I also attempt to avoid a "me-tooism" in reaction to increasing rights of women in northern industrial countries and the academic disciplines that have been formed to capture and critique these developments (Gutmann 1997b). We must not lose sight of fundamental inequalities between men and women in our attempts to document immigrant men’s struggles with identity transformation and well-being.

Research in a wide range of social science and health research fields suggests that although the experience of migration itself does not inevitably produce mental illness (Beiser 1999; Hyman et al. 1996), the multiple processes of dislocation, movement, and resettlement may, together, put some immigrants and refugees at risk for emotional problems (Desjarlais et al. 1995; Jenkins 1991; Losaria-Barwick 1992). For refugees in particular, experiences of war, state endorsed terror, and political persecution can result not only in physical health problems (due to torture, for example) but also may cause anxiety, stress, depression, and other emotional difficulties. For many immigrants and refugees, the process of "adjusting" to a new economic, social, and cultural climate in the host society can be painful (Beiser 1999; Meredith 1992). In particular, previous studies have demonstrated a strong relationship between employment and health (Beiser 1999; Freire 1995). Immigrants and refugees may have difficulties finding satisfactory or fulfilling jobs in resettlement countries, and thus many suffer from a loss of status that in turn can produce emotional difficulties such as "nerves", isolation, and loss of hope. Social researchers have argued, therefore, that health problems are intrinsically linked to¾ and cannot be understood apart from¾ social problems (Kleinman et al. 1997).

Several researchers have called for increased attention to the health and resettlement of Latin American refugees (Freire 1995; Jenkins 1991; Losaria-Barwick; 1992; Meredith 1992). War, poverty, unequal land distribution and political persecution in most Latin American countries have caused the killing, disappearance, and displacement of millions in the post-World War Two era (Desjarlais et al. 1995; Suárez-Orozco 1990). As a result. the Latin American "community" is one of the largest and fastest growing immigrant groups (most arriving as refugees) in Canada in the last decade (Vidal 1999). And since many of these individuals have been exposed to violence and political persecution in their home countries¾ as well as unemployment and underemployment in the country of resettlement¾ the mental health of Latin American refugees must be made a research priority.

There is a wealth of research reporting on the mental health difficulties faced by some immigrants and refugees in host societies. Research with Latin Americans in the United States and Canada suggests that refugees may experience a wide range of emotional difficulties, including confusion, anxiety, tension, and depression (Freire 1995; Meredith 1992). Particular attention has been paid to a cluster of emotional difficulties identified as "nerves" or nervios. According to medical anthropologist Janis Jenkins, nervios is "an indigenous cultural category widely used in Latin America for a variety of forms of distress and disease…and may refer to a variety of bodily and affective complaints" (1991:146). While social theorists have argued that nervios is a metaphor for political oppression and poor socio-economic status (Guarnaccia and Farias 1988; Lock 1989:85; Low 1989a:40) or a somatization or embodiment of terror (Low 1994:140; Taylor 1998:154), it is also a source of distress which not only affects individual well-being but also the family and social relations of the sufferer.

Studies in medical anthropology have illustrated the various ways in which nervios is manifested in individuals, and how nervios sufferers explain their illness. Nervios may be expressed somatically as headaches, dizziness, and difficulty sleeping (Lock 1990:241), or as emotional problems such as loneliness, isolation, nostalgia, and boredom (Guarnaccia and Farias 1988:1224; Farias 1991:179-184). Importantly, researchers have suggested that embodied complaints of nervios call into question Western/biomedical distinctions between the mind/body and mental/physical, by demonstrating that nervios is an idiom of distress for social problems or other health conditions (Jenkins and Valiente 1994:166). Efforts to narrowly categorize suffering as a clinical or culture bound syndrome risk dehumanizing and dehistoricizing the lived experiences of refugees (Green 1998:5).

Individuals with nerves in a variety of cultural and social settings may consider the condition "normal" to the extent that "having nerves" or "being nervous" is a part of everyday life (Davis and Low 1989; Lock 1990:249). Individuals tend not to seek care until nerves are perceived as serious or chronic in nature. These findings have implications for clinical practice, as nervios may be a metaphor for the everyday struggles of immigrants and refugees, but may also signal the onset of more serious mental illness. It has also been suggested that nervios among refugees may take different meanings and levels of severity in the country of resettlement. My project is grounded in the belief that health researchers and practitioners need to be aware of these spatial and temporal dynamics (and narratives) of nervios, as well as of the cultural shaping of health and illness in general.

Relatively little applied or theoretical research has addressed the intersection of gender and nerves among immigrant and refugee populations. While some studies have suggested that nervios is largely confined to women (Bourgois 1985:300; Guarnaccia et al. 1989), other investigations have argued for increased attention to the influence of gender on the levels and expression of nervios (Low 1989a). In one review article on the cross-cultural meanings of nerves, the authors ask the important question: "To what degree is nerves a gender-related illness?" (Davis and Low 1989:xiii). In response, they argue that "although gender plays a role in modeling the expression of nerves, the experience of nerves is not necessarily gender specific" (Davis and Low 1989:xiii).

Research with El Salvadoran refugee men and women in the United States has demonstrated that nervios among men was expressed in a variety of ways, most commonly as loneliness, isolation, and anxiety (Farias 1991:173). Nervios was also seen as an infringement on being "able bodied" (Farias 1991:179). Although there were also similarities in the ways men and women embodied nervios, women typically expressed it as headaches, crying uncontrollably, and loss of breath (Farias 1991:186-7). Based on these and other findings, several researchers have concluded that nervios is an idiom of emotional distress for both Latin American men and women (Farias 1991; Guarnaccia and Farias 1988; Low 1989a; Lock 1990). My project builds on this research by calling attention to how nervios and other emotional problems are expressed¾ or not expressed¾ by Guatemalan immigrant men.

An important difference exists between men and women’s pattern of care seeking in relation to nervios and other idioms of emotional distress. Two studies have reported specifically on the reluctance of immigrant Latino men to use formal health services or to discuss emotional problems with friends or family (Freire 1995; Meredith 1992). Marlinda Freire notes that men typically "resist seeking professional services, [they] do not attempt to create or use existing support systems, and even reliance on friends tends to be minimal or nonexistent" (1995:24). Freire further shows that Latin American men have difficulty verbalizing their emotions¾ particularly negative ones, such as fear, anxiety and anger¾ because of feelings of inadequacy resulting from a decline in occupational status (1995:23). Diane Meredith (1992), in a study of Guatemalan refugees in Toronto, also demonstrated that men tend to be resistant to reporting and discussing intimate problems. Other studies of immigrant and refugee health suggest that men tend to avoid discussing or dealing with health problems (Koss and Chioino 1989; Lock 1990; Low 1989a), but these studies fail to analyze the gender and cultural dynamics of care seeking. In anthropologist Setha Low’s review of a series of articles on the cross-cultural meanings of nerves, she notes that:

Most of these papers discuss nerves as a woman’s disease but can we fully support the argument when analyzed in a clinical setting in a culture where men are actively discouraged from going to the clinic for anything but the most life threatening diseases? (1989b:93)

Despite this evidence, few studies specifically address the cultural, social, and economic factors that influence patterns of dealing with health problems among immigrant and refugee men and women. My study discusses these and other issues related to emotions and care seeking not simply to fill a research gap, but to suggest that gender has been generally overlooked as a significant factor that shapes responses to emotional and physical health problems.

Recent medical anthropology scholarship suggests that experiences of political persecution, torture, and atrocity are inscribed on bodies in suffering and silence. Kleinman and Kleinman (1994:710; see also Kleinman et al. 1997) use the term "sociosomatics" to describe how fear "infolds into the body, and how bodily processes outfold into social space." In China, according to Kleinman and Kleinman, dizziness, exhaustion and pain indirectly express social distress and shared criticism of current political conditions (1994:715). These symptoms of social suffering are the lived memories of the Cultural Revolution and political turmoil in China (Kleinman and Kleinman 1994:716). Bodies recovering from war and trauma, therefore, do not simply represent political processes in any simple way, but rather display these processes as the "lived memory of transformed worlds" (Kleinman and Kleinman 1994:716).

My discussion of health problems among Guatemalan immigrant men builds on previous medical anthropological research that observes that individual narratives of distress are as much about health as identity and history (O’Nell 1996:8). And one productive site to explore this relationship between distress and identity is the body. A wealth of literature in recent years has identified the body as critical to our understanding of the cross-cultural expression of health and illness (see Becker et al. 2000; Csordas 1990, 1994; Lock 1993; Kleinman et al. 1997; Scheper-Hughes and Lock 1987). Most importantly, I aim to understand how immigrant men’s bodies are potential sites of disruption, where a sense of not belonging in Canada is manifested as nerves, alcoholism, depression, and several other forms of distress. The body here is understood as the medium through which people experience and perform their cultural world (Becker et al. 2000:142). While Guatemalan immigrant men’s bodies contribute to the world they live in¾ through work, fathering, political activism, drinking¾ the lived experiences of displacement and resettlement also contribute to the constitution of their bodies. Conceptualizing the relationship between the social world and men’s bodies in this way allows us to critically engage the interconnections between gender, migration and health.

The scant attention paid to belonging as a meaningful idiom in the lived experience of displacement is surprising given the wealth of literature on identity and diaspora that has emerged in recent years. In most of these studies, "belonging" is treated as a natural, universal mode of experience where individuals¾ or, as in the case of immigrants or refugees, groups of individuals¾ feel a sense of attachment to a particular place. For example, Burns (1993) explores the resettlement experiences of roughly 4,000 Guatemalan Maya in "Indiantown." Burns argues that the experience of migration has resulted in the development of a different identity in the United States (1993:125). "The identity of Maya in exile," according to Burns, "is one in which refugee locales like Indiantown are infused with a sense of belonging to a natural community in Guatemala" (1993:130). Burns further suggests that the term "Guatemala" is a source of pride among most Guatemalan Maya and non-Maya (1993:136). While Burns’ analysis is useful in terms of identifying some sources for identity-making for displaced Guatemalans, he does not discuss in any detail the gendered dimensions of "belonging," nor does he explore the meanings that Guatemalans in Indiantown attach to the term "belonging." What does belonging mean to these Mayas and how is belonging shaped by social and historical factors? Although these questions may be beyond the scope of Burns’ study, I believe that they are important issues to address in any study of refugee identity formation and transformation. How people construct and act on notions of "belonging," I will argue, can have an impact on individual well-being.

Studies within medical anthropology have identified the family as a source of belonging for people suffering from the effects of war (Queseda 1998) and for individuals with chronic illnesses (Becker 1997). Queseda (1998:64) argues that the family provides a sense of belonging for survivors of war¾ especially young survivors¾ in Nicaragua who are searching for a sense of normalcy or stability in times of unrest. Similarly, in a large-scale study of infertility among men and women in the United States, Becker (1997:71-79) states that for people who can no longer procreate, belonging may be linked to maintaining strong familial bonds. While both Queseda and Becker provide valuable analyses of one institution through which belonging may be expressed¾ the family¾ their work begs several questions about how belonging is shaped by social, cultural and historical contexts. Why do people highlight the family as a source of belonging? What are the meanings attached to the family that make it an important site for belonging? These sorts of questions can lead us to understand belonging as a process; a process that is an important part of identity-making among immigrants and refugees.

More detailed studies of identity-making have moved further towards understanding processes of belonging as shaped by specific contexts. In an innovative and thought provoking discussion on the salience of "diaspora" as an analytical category for studying immigration and settlement, Soysal (2000:2) directs scholars’ attention to "new forms of membership, claims-making and belonging" among immigrant populations in the contemporary world. "The axiomatic primacy granted to nation and nation-states," Soysal suggests, "is difficult to hold in the face of contemporary changes in the geography and practice of citizenship and belonging" (2000:2). Soysal clearly writes against the academic tendency to privilege ethnicity and race as the most important sites of identity-making for immigrant and refugee populations, and instead calls for a broader look at how discourses of emancipation, human rights and citizenship contribute to identity (trans)formation. But what Soysal neglects to discuss is what she means by "belonging" and how it may be different from the other sources of identity-making that she outlines: "membership," "claims-making," "transnational communities." Although she calls for a renewed look at how identities are (re)made in a globalizing world, she leaves social science concepts¾ such as belonging¾ unproblematized. By analyzing the narratives of (not) belonging among Guatemalan immigrant men in this chapter, I aim to build on the work of Soysal and others who express discomfort with the current conceptualizations of identity-making among immigrants and refugees, and aim to provide new ways of understanding the relationship between displacement, identity and health.

In a similar vein, anthropologist Daniel Yon (2000) examines how identities are produced among¾ and for¾ high school students in Toronto. Paraphrasing Doreen Massey (1994), Yon suggests that "the place to which we belong might best be thought of as a part and moment in the global network of social relations and understandings" (2000:16; see also pp. 134-135). Here, Yon eloquently points our attention to belonging as situated, as process. He writes that belonging¾ and what it means to (not) belong¾ is contingent on the opportunities and closures in people’s everyday lives. This is refreshing. But what I wonder is whether people necessarily belong somewhere. In other words, is belonging always spatialized? Do individuals always strive to belong to a particular place? Might thinking of belonging in this way prevent us from conceiving of, say, gender, work, family or language as sites for belonging? Rather than ask where Guatemalan immigrant men belong, therefore, I suggest that asking how these men belong can move us closer to understanding belonging as a process.

To understand the complex relationship between (not) belonging and well-being among Guatemalan immigrant men, I draw on Theresa O’Nell’s (1996) excellent medical anthropological study of depression and identity among the Flathead Indians of the American Midwest. Asking the question, "What does being depressed mean?" (1996:5), O’Nell brilliantly weaves together Flathead narratives and anthropological analysis to understand the nexus between identity and suffering. "Sadness and loss," O’Nell argues, "are nestled within a rich language of loneliness, which in turn is nestled within an ideology and praxis of belonging" (1996:177). Of course, the experiences of Flathead Indians and Guatemalan immigrant men have been shaped by widely different social and cultural factors¾ both in historical and contemporary times¾ but O’Nell’s findings resonate with some of my own observations about how belonging matters to Guatemalan immigrant men and how individual well-being is influenced by identity transformation.

I have found medical anthropologist Gay Becker’s (Becker 1997; Becker et al. 2000) concept of "disruption" illuminating for my own analysis of changing identities among Guatemalan immigrant men. In an impressive collection of ethnographic studies with refugees, the elderly, disabled persons and the chronically ill, Becker suggests that people endure disruptions to their sense of self when they are forced to live in drastically different sets of circumstances than those with which they are familiar. When disruption occurs, argues Becker, a person’s loss of sense of "fit" with society calls into question their personhood, their sense of identity, and their sense of normalcy (1997:30). Disruption and difference is part of everyone’s lives, notes Becker, but refugees in particular are confronted with major challenges to what they consider to be "normal" in their everyday lives (2000). Although Becker’s theory of disruption risks overstating (and perhaps romanticizing) refugees’ lives in their home countries as orderly¾ and in turn potentially simplifies the lived experiences of displacement, movement and resettlement¾ she does provide a useful theoretical foundation for my own exploration of gender and exile.

Narrative, as both method and theory, has gained increasing interest among social scientists in recent years (Fulford 1999; Good 1994; Greenhalgh and Hurwitz 1999; Mattingly 1998; Mattingly and Garro 1994; Muller 1999). Narratives, Muller argues (1999:221), are "stories that relate to the unfolding of events, human action, or human suffering from the perspective of an individual’s life." Of course, stories have always mattered to social scientists; yet they have often not been aware that they are collecting stories. A narrative approach to qualitative research contrasts with a positivist scientific paradigm by demonstrating that an individual’s lived experiences are nestled within a particular cultural context, and cannot be confidently "known" in any detached or objective sense (Muller 1999:223). By paying attention to how these men and women narrate health and illness, we can begin to appreciate the contradictions, ambiguities, and stereotypes that people actively produce in their everyday lives. Following Mattingly and Garro’s suggestion that "narratives provide a vehicle for confronting the contradictions between an individual’s experience and expectations based on shared cultural models," my discussions with Guatemalan immigrant men involved attention to the contexts in which they did or did not share stories about health and illness (1994:771). Direct questions about health, for example, often prompted responses like "I’ve never thought about that" or "my health is fine." In these same interviews, however, questions about community or migration would occasionally lead to accounts of alcoholism and violent behavior, or to conversations about strategies to improve health. In short, the very structure of individual interviews began to reflect the deep entanglements between social problems and health; entanglements which in turn formed the core of this study. By focusing on how and when narratives are produced, therefore, I could analyze the appropriate and meaningful contexts in which Guatemalan men share "emotion talk" (Abu-Lughod and Lutz 1990).

This section outlines the methodological approach used to study Guatemalan immigrant men’s health and identity in Toronto. This project involved conversations and interviews with Guatemalan immigrant men and women in Toronto, and participant-observation in soccer matches, human rights activities and Guatemalan Community Network (GCN) events. Beyond simply reporting on the methods used in the study, in this section I also discuss some of the pleasures and perils of doing medical anthropological research, and offer a critique of recent literature on methodological approaches to studying refugee and immigrant health.

As is often the case with any kind of research, it is difficult for me to trace exactly how and where the inspiration and ideas for this thesis began. I could suggest that my volunteer work with Central American refugee teenagers in a junior high school ESL class in Victoria, BC was when I first developed interest in the lives and struggles of newcomers. Or I could suggest that a Project Accompaniment video on the return of Guatemalan refugees that I watched in an undergraduate anthropology class was when I became interested in Guatemala and human rights issues. Or perhaps my interest in the experience of migration began after listening to the dressing-room stories of my Central American soccer teammates in high school. In any case, there is a wide range of experiences, images, stories, and writings that provide the background to this thesis. Research, of course, doesn’t come from nowhere; and these memories of my younger years provide important points for reflection on how the questions in this thesis were developed.

Preliminary research for this thesis began in October 1998 with conversations with four community health workers and three Guatemalan immigrants (two men, one woman) on health and health care utilization among immigrants and refugees. The purpose of this preliminary work was to get a sense of key issues in health and health care for health professionals working with diverse patient populations, including Guatemalans. It also sought to establish relationships with several key informants in the Guatemalan "community" in Toronto. Several of these early contacts were secured through my work as a research intern at a community health centre in Northwest Toronto (Dunn, In press). Others were established through casual conversations at Guatemalan community activities.

My initial interest was to examine why immigrants and refugees tend to underutilize biomedical health care services, a finding in the literature on migration and health (Beiser 1999; Harwood 1981; Kinnon 1998; Losaria-Barwick 1992; Masi 1993). This original focus shifted, however, as I became increasingly interested in the gendered dynamics of health and illness among Guatemalans in particular. One discussion with a Guatemalan health educator during this preliminary stage, for example, brought to my attention the reluctance among Guatemalan men¾ and Latino men more broadly¾ to discuss emotional distress and family problems. She and two other community health workers (both men) I spoke with commented on the relatively large number of Central American women who seek help not just for their own individual health problems, but also to discuss the health problems of their husbands, boyfriends, brothers, and male friends.

Preparation for the formal stage of interviewing involved a language and cultural immersion trip to Quetzaltenango, Guatemala, in May 1999. The aim of this three-week trip was to enhance Spanish fluency and gain familiarity with social and cultural life in a provincial town. As a student at Ulew Tinimit (Maya-Quiche for "Land of the People"), I improved my Spanish through intensive, one-on-one instruction, as well as through conversation with my host family, neighbors, and other students. This training also involved attending lectures and traveling to nearby sites¾ farming co-operatives, rural education programs, and tourist attractions. This brief trip also provided me with an opportunity to engage "Quetzaltecos(as)" in conversations about gender and health. Though I did not formally collect data in Guatemala, my experiences there enriched my interest in diasporic connections between "home" and "host" countries and encouraged me to think about how migration might influence health and health beliefs. These experiences also became a common topic of conversation at the beginning of most interviews. Stories and photographs of my trip were shared, gifts were exchanged, and the current state of el país (country, nation) was discussed. These verbal, visual and material items were critical sources for establishing trust with participants and forging friendships with key informants.

This study employed a "network building" or "snowball sampling" approach to contacting participants (Omidian 1994; Trotter and Schensul 1998). Building on recent qualitative research with refugees (Krulfeld and Macdonald 1998b), random sample techniques or questionnaires to recruit people for interviews were not used because many refugees typically do not trust professionals or academics who ask many questions. Network building by referral through trusted friends and organizations was necessary because there is no area in Toronto with a high density of Guatemalans; there is no "little Guatemala," as discussed in Chapter 2. This required the use of a "non-random sampling technique" (Bernard 1988), whereby participants were contacted primarily through friends or contacts at the community health centre where I was a research intern. As such, three Guatemalan key informants and one non-Guatemalan community health professional provided the bulk of the names of potential participants.

Semistructured interviewing for this thesis began in June 1999. Between June 1999 and November 1999 I interviewed 28 Guatemalans (23 men, 5 women) in English and Spanish (15 English, 13 Spanish), depending on the preference of the participant (see Appendix I for demographic data). Most of the interviews were conducted in the participants’ home or at nearby parks or cafes (one interview was carried out in my home). These interviews were complemented by participant-observation of community activities in Toronto, including a museum exhibit, memorial service, community dance, Maya ceremony, going-away party, Guatemalan-Canadian Chamber of Commerce meeting, indoor and outdoor soccer matches, and Guatemalan Community Network (GCN) events. Although interviewing for this study ended in November 1999, I continue to participate-observe in soccer matches and community events. This ongoing participation provides an excellent opportunity to update participants on the status of this project, and to ask follow-up questions on a casual basis.

Semistructured interviews were conducted to allow informants to have some control over the interview process. Semistructured interviews are based on a short list of questions to be covered in a particular order, as well as more open-ended questions designed to elicit participant narratives on certain issues (see Appendix II). This method is particularly important in working with survivors of political persecution who may feel threatened by too many questions (as in questionnaire formats) or rigid interview formats (as in structured interviews) (Omidian 1994).

Researchers working with refugees have emphasized the importance of providing alternatives to written informed consent forms. In a study of Southeast Asian refugees in the United States, Zaharlick (1998:176) points out that people who have suffered from political persecution, war, and displacement may be reluctant to sign consent forms because they can trigger memories of negative experiences with authorities in their home countries or in refugee camps. As such, written informed consent forms may become barriers between researcher and researched (Fluehr-Lobban 1998:188). Participants in this study were given a choice of providing a verbal agreement or signed, informed consent (Appendices III and IV). The verbal and written agreements contained the same information. In most cases the participant would read the Spanish or English version of the verbal agreement form, and then grant consent to be interviewed. All of the participants except two preferred to give oral consent because most individuals felt a verbal agreement was adequate. Written informed consent forms were generally seen as unnecessarily formal.

Interviews varied from forty-five minutes to two hours each, and all interviews except two were audio taped. Portions of interviews were transcribed in the language of the interview by the author. I transcribed and translated the English and Spanish interviews, but I was also assisted with the Spanish interviews by one key informant and two native Spanish-speaking friends. Following the suggestion of Levy and Hollan (1998:354), typed transcriptions were limited to those sections of each interview that were directly relevant to the study. While interviews were structured around questions on health and identity, interviews would often progress in unpredictable directions depending on the interests and experiences of the participant. As such, I selected and transcribed narratives based on their resonance with key themes or their illustrative or provocative quality. Although the literary quality of this thesis depends heavily on the words of the participants, I have always had the final say in how¾ and if¾ they would be conveyed in the final project

The disproportionate number of interviews with men vis-à-vis women in this study reflects the emphasis on collecting Guatemalan immigrant men’s narratives on displacement, resettlement, and emotional well-being. Since one of my aims was to talk to men and women about men’s health¾ and not to produce a comparative set of data on women and their health and migration experiences¾ the numbers of interviews with men and women are not balanced. My main objective was to gain a better understanding of how some Guatemalan women construct men’s identities and make sense of why many men have difficulty salir adelante ("moving on"; "getting ahead"; "getting on with things"). The responses by the five women in my sample were highly overlapping. These women linked attitudes of machismo to a reluctance to deal with health problems, and argued that men have more difficulty salir adelante than women.

These interviews also produced a significant amount of shadow data. Shadow data, argues Morse (2000:4), are when respondents discuss the experiences of other people and reflect on how and why these experiences resemble or differ from their own. "Shadowing" gives the researcher an idea of the range of experiences and the domain of the phenomenon beyond the single participant’s personal experience (Morse 2000:4). These women shared numerous stories on the men in their lives and reported on other women they knew who struggle with abusive husbands, or enjoy happy family life. One of the explicit aims of conducting interviews with women was to produce shadow data rather than elicit detailed, personal stories about women’s health.

Before George Marcus and Michael Fischer (1986) published their influential book, Anthropology as Cultural Critique¾ or perhaps before Dell Hymes’ pivotal 1969 book, Reinventing Anthropology¾ representation was not a key concern in ethnographic writing. Prior to these important works, anthropology was carried-out with little concern for how ethnographers were portraying their subjects. Today, largely as a result of the post-colonial and post-structural movements in anthropology and other disciplines, ethnographic writing is commonly regarded as a political or positioning act; anthropologists now pay attention to why they write about people in particular ways, as well as to the potential effects of their "ethnographic gaze."

Which Guatemalan immigrant men and women I was representing¾ as well as how I was representing them¾ were ongoing concerns while researching and writing this thesis. First of all, with a qualitative, exploratory study of gender, migration and health, I did not intend to represent Toronto’s Guatemalan "community" as a whole, nor did I expect to capture the full diversity of this population. Instead, due to a number of factors including contact sources, time, and level of research expertise, I was working within the types of contingencies that typically shape ethnographic research. As a result, although my sample was diverse (some spoke fluent English, others spoke only Spanish; some arrived during the late 1970s, others in the early 1990s; some were willing to tell me their life stories, others refused to be interviewed), the participants were mostly middle-class, university educated, Ladino men from Guatemala City who had arrived in Canada during the late-1980s or early-1990s as either convention or claimant refugees.

Given these methodological constraints and concerns, like most ethnographers (especially those who work with refugees and other so-called "vulnerable" populations) I was faced with the challenge of how to write about and represent these individuals and their experiences. One pressing question became whether, and in which cases, to quantify or chart the data on the 28 Guatemalan immigrant men and women that I interviewed. It may be argued that a table containing demographic data and the health experiences of my sample would provide the reader with a quick, "at a glance" companion to the text. More importantly, this tool would also enable the reader to delineate more clearly the specific relationships between the participants’ migration experiences, gender identities and health status (for example, "Ricardo" arrived in 1984 as a convention refugee, does not see himself as a macho, suffers from loneliness etc.).

I have resisted this approach on both methodological and theoretical grounds. First, and most importantly, a chart providing this sort of detailed, easily readable and accessible information would be a breach of confidentiality. At the beginning of each interview, I assured each participant that his/her anonymity would be preserved through the use of a pseudonym and by withholding any information that s/he deemed potentially risky. Out of respect for¾ and solidarity with¾ the people I’ve studied, I am limiting my quantification to a simple demographic table (see Appendix I) and to footnotes throughout the text. A more candid and convenient presentation of the material, I argue, would potentially threaten the livelihoods of the men and women in my study, as well as their families. So, in recognition of the political nature of ethnographic writing and the need for anthropologists to "write against terror" (Sluka 2000), the narratives in my thesis provide portraits or brief testimonios of participants’ lives and health experiences (not detailed life histories), and the analysis is limited to an exploration of themes and a discussion of the theoretical, methodological and practical implications of this study.

My second reason for not including a detailed "cast of characters" is based on the fragmentary nature of some of the data, and a concern that charting particular types of information (such as responses to my questions about what it means to be a man, feelings of (not) belonging, and levels of drinking) will give the impression that the participants’ constructions of these concepts are fixed and static. Since I am primarily concerned with narrative and the contexts in which people discuss particular topics, I am hesitant to suggest that the absence of, say, the topic of drinking in my interview with "Ricardo" means that he has never struggled with alcoholism. No set of data is "complete"; and thus I resist the lure of quantifying my data to somehow suggest that it doesn’t contain gaps. Instead, my approach is to discuss these very issues and concerns as they arise in the course of the text.

In short, my position is that such a detailed chart or table on health and identity "characteristics"¾ even if accompanied by caveats and footnotes¾ freezes the data and fails to capture the lived experiences of the Guatemalan immigrant men and women in my sample. Of course, any kind of study (qualitative, quantitative or otherwise) records people’s experiences at a particular time and place, and thus represents some kind of "conclusion" about a particular group of people. But in light of my concerns about confidentiality, style of representation, and data quality, I am providing a narrative-based, qualitative exploration of gender, migration and health that is supplemented by quantitative data on demography and health status where applicable and reliable.

The methodology for this study was also informed by some key concerns and contributions in the fields of medical anthropology and gender studies. I address issues of gender and emotional distress among Guatemalan immigrant men with attention to recent methodological debates among ethnographers and other scholars on culture, gender, migration and health.

First, recent studies of men and masculinities suggest that men’s identities cannot be understood without attention to women’s changing identities and roles in political, economic, and social struggles (Gutmann 1996, 1997a). In a study of working class men and women in Mexico City, anthropologist Matthew Gutmann argues that "male ethnographers working exclusively with male informants on questions of masculinity primarily constitute a methodological manifestation of a conceptual error" (1997a:841). In this project, I found that discussions with Guatemalan women about Guatemalan men and their health and personhood were critical to developing a broader perspective on the ways in which men deal¾ or do not deal¾ with health problems, and the ways these behaviors affect the lives of friends and loved ones.

Second, I have aimed to critically evaluate the power differences that have shaped the processes of fieldwork, analysis and writing-up (Krulfeld and Macdonald 1998b). Throughout the research process I have paid attention to the ways in which my positionality as a white, middle-class, male researcher has influenced the relationships I have formed with male and female participants. For example, my interest in social issues, soccer, and teaching meant that I developed stronger friendships with some participants rather than others. However, because I am male did not necessarily mean I shared some kind of natural camaraderie with the men participants in my study. In fact, as I describe below, my "maleness" did not prevent me from forming trusting relationships with female participants despite the contrary claims of some social scientists.

To address these concerns, I situate my research within recent debates on the gendered dynamics of conducting ethnographic research (Dewalt et al. 1998; Gregory 1984; Gutmann 1997a). In one article, Gregory argues that it has been accepted as a truism that male ethnographers encounter problems collecting information about (and from) women (1984:316). Similarly, Dewalt and others claim that "women [ethnographers] may find it easier to gain access to some aspects of men’s lives than men ethnographers find it to gain access to the worlds of women" (1998:278). Although well-intentioned, these arguments rather naively ignore the ways in which culture and gender may influence the degree to which it is acceptable for men and women to "talk" about certain issues in the first place. My study lends support to the argument that "not talking" about emotional or health issues, in particular, is a gendered practice (Courtenay 2000a; Freire 1995; Low 1989b). The small sample of women I interviewed were much more willing than the men to discuss the emotional difficulties that Guatemalan immigrant men and women face. While there were certainly exceptions to this pattern¾ some men talked for hours about their struggles with loneliness, drinking, and abusive behavior¾ it was often difficult for men to share stories about personal matters.

Orlando: We sometimes don’t express everything because we are ashamed maybe, to say things.

Sam: Do you remember a particular time when you were ashamed to talk about something?

Orlando: In Guatemala when I was younger, I have always loved women, always. But when I was younger I was very timid. I was a very shy guy. Girls used to come for me, looking for me. People used to say I was good looking , you know (chuckling together). And a lot of girls used to come for me you know.

And then when I was eighteen, nineteen, or twenty, before I came to Canada, I used to have some problems sexually speaking. I wanted to be with [girls], I got very excited thinking about them, but when I was with them I got so nervous and I couldn’t perform. I know that is normal, but this is the first time I am telling anyone.

Some of my friends knew and used to joke, "ahhh, you are not a man." That is normal too, you know. Between friends those things happen. But I couldn’t tell this to anyone.

Orlando’s narrative on his struggles to deal with threats to his perceived sense of manhood has implications for researchers concerned with how gender influences the process of collecting ethnographic data. To suggest that men ethnographers may have more difficulty gathering information from women than from men participants fails to take account of how the very issues being discussed¾ or not discussed¾ are influenced by gender.

But I am not under any illusion that my own identities as a student and as a white, middle-class "Canadian" did not shape the kinds of responses I received from participants. Although it is difficult (and perhaps impossible) to state conclusively how participants perceived me, my impression is that I was generally viewed as both an "outsider" (non-Guatemalan, non-native Spanish speaker, non refugee) and "insider" (male, soccer player, enjoy a drink now and then). Of course, the terms "insider" and "outsider" are crude explanatory concepts that fail to capture all the nuances and power relations of doing ethnographic fieldwork (Narayan 1993); but they do provide starting points for critically reflecting on the dynamics that shaped my relations with participants "in the field." As I discuss in Chapter 3, my questions about what it means to be man, for example, provoked some interesting and somewhat surprising responses. Many men had difficulty answering this question. But my follow-up query ("What does it mean to be a Guatemalan man in Canada?") for those who struggled to understand or respond to my initial and admittedly vague question, typically produced a flood of stories about struggles (and accomplishments) in Canada.

In my view, this scenario suggests two distinct yet related issues. First, as a male researcher asking male participants about what it means to be a man provided respondents with little context to reply. Since I was a man and should therefore know what it means to be a man, men participants may have perceived this question as asking about the obvious or mundane. Second, by asking the follow-up question, "What does it mean to be a Guatemalan man in Canada?," a sense of difference¾ based on ethnicity¾ was produced (or imposed) that seemed to allow participants to find meaning in the question. I would suggest that this follow-up question provided a different context for these men to reflect on their gender (and ethnic) identities both in comparison to the identities of other men (and women) they know, as well as my own. In sum, the contexts

in which these men did or did not talk about "being a man," for example, illustrates that gender identities (and narratives about gender identities) are co-constructed and always produced in relation (Nelson1999).

Try to be a little bit desconfiado, try to be a little bit untrusting when you interview…since you are asking things that Guatemalan men don’t talk about too easily….Most of the people are afraid that if they say something then you are going to know something that they don’t want anyone to know about. Try not to believe everything. With certain answers try to come later from another way just to see there is no contradiction with something.

Pablo

Pablo expressed concern about the accuracy of the data I was collecting and the degree to which participants’ responses would be "truthful." Pablo explained that many of the Guatemalans in Toronto that he knew do not trust professionals, students, and others who like to ask a lot of questions. As such, he provided me with advice on how to work with Guatemalans in a way that was sensitive to experiences of repression, movement and resettlement, and how to get to the "truth" about their lives.

My conversation with Pablo reproduces a set of debates among anthropologists and other professionals working with refugee and immigrant populations on issues of health and resettlement. I found it interesting that Pablo, a bank employee, reiterated many of the methodological recommendations that I had read in the scholarly literature on qualitative research. This literature discusses the degree of sensitivity necessary to ensure the comfort of research participants. As a way to empower interviewees who have survived political persecution, Aron (1992), Warner (1998) and others argue that a testimonio approach to collecting personal histories and narratives can empower subjects: "the testimony is a first person account of one’s life experiences, with attention to the injustices one has suffered and how one has been affected by them" (Aron 1992:174). Testimonio is a narrative process that moves between dialogue and first-person narration (Warner 1998:87).

In this study, the testimonio method was useful insofar as it alerted me to the sensitive nature of war and displacement for many Guatemalan immigrant men and women. I wanted to ensure that participants felt comfortable talking about these experiences, and hoped that they would be empowered by the process of reflection through narration. These were lofty goals, and perhaps a little misguided. In hindsight, my attention to participants’ violent histories, and my attempts to ask appropriate questions about persecution, migration and resettlement may have resulted in a kind of "over-sensitivity" to the point where I was ill-equipped to ask direct questions about violence, emotions, and family relations. With these developments, I became cognizant of Levy and Hollan’s argument that "inexperienced interviewers sometimes…avoid topics of importance that they inappropriately fear are too sensitive (1998:348; italics in original). More likely than not, according to Levy and Hollan, interviewers are much too cautious, and in so being "close off the discussion of critically informative feelings, evaluations, concerns, and experiences" (1998:349). To a degree, follow-up interviews and conversations were useful in guarding against this problem. However, my impression is that most participants were perhaps more prepared than I was to talk about their experiences with war and political persecution. Pablo’s suggestion that I should "get to the truth" about what people were telling me seemed to mirror my own hope that I could be sensitive toward the experiences of the men and women in my sample, and also assert myself as a researcher.

The issue of "sensitivity" towards refugees on issues of violence and displacement, therefore, may say less about the experiences of participants than about the expectations and assumptions of the researcher. Future studies with refugee and immigrant populations need to critically engage the methodologies employed to study health, illness, and "emotion talk." Pablo’s subtle hint that I may have failed to address some key issues in his life was both a valuable piece of advice and a commentary on the power dynamics that shape relationships between researcher and researched.

Abstract/Acknowledgements/Table of Contents -

Introduction - Chapters 1 |  2  |  3 |  4  |  5 |  6    - Conclusion – Appendices–

  Bibliography

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