Language Often a Barrier to Therapists

In 1984, a gunman named James Oliver Huberty walked into a McDonald’s restaurant in San Ysidro and murdered 21 people. Fifteen others were wounded, and many of them needed psychological counseling--immediately.

Many of the wounded, whether adults or children, spoke only Spanish. At the time, concerns were voiced about San Diego County not having enough Spanish-speaking therapists to cope with the crisis.

Is the situation any different five years later? And what about San Diegans who speak only Italian? Or Portuguese? Or Swiss-German? To whom do they turn in a crisis? How easily could they find a therapist in the Yellow Pages?

‘A Giant Problem’

Jose Fernando Bayardo, a psychiatrist with a practice in Hillcrest, said the lack of psychological help for people of different cultures is “a giant problem.” From 1972 to 1977, he said, he was the only Spanish-speaking psychiatrist in the county.

“Now we have seven,” Bayardo said, not without a touch of sarcasm.

Many psychotherapists attempt to meet the needs of foreign-born patients by using interpreters. Bayardo uses that approach with several clients who were born in Cambodia and do not speak English.

“For many of these people, life in San Diego is heartbreaking,” he said. “The change in culture is severe. The meals, the seasons, the customs . . . everything is different.”

Recently, one of his Cambodian clients put his feet on the waiting-room sofa. The patient was admonished by Bayardo’s secretary and was embarrassed for something that, in his country, is common.

“That’s just a small example,” Bayardo said. “Many Cambodians here suffer from acute depression and cultural-shock deficiencies, which lead to nothing less than the breakup of the family.”

Reading from a list published by the San Diego Medical Society, Bayardo noted that, out of seven Greek physicians in the county, none are psychiatrists; out of nine Armenian doctors, only one practices psychiatry.

The county offers one Czech-born psychiatrist, none who speak Portuguese and, most startling of all, he said, none fluent in Japanese. The language problem is especially worrisome to the San Diego Society of Psychiatric Physicians, Bayardo said, of which he is a member delegated to address the problem.

Clinic Recently Opened

The need has become so great that a clinic--the La Jolla Institute for Psychotherapy--opened recently to serve mainly a non-English-speaking clientele. Ina Schmilovici, a therapist born in West Germany, speaks German, English, French, Spanish, Italian, Dutch and Romanian. Her superior, clinical psychologist Barbara Alvarez, was born in Austria and speaks German, Italian, Spanish, English and French.

Schmilovici has been here for eight years, Alvarez for two. They say the most obvious--and arresting--fact of San Diego life is that the city is growing by leaps and bounds, becoming ever more cosmopolitan--and, in some cases, more unlivable for non-English-speaking people.

Schmilovici tells the story of a couple--a West German woman and a Middle Eastern man--who were seeking a divorce. Life in San Diego had greatly complicated the couple’s problems, Schmilovici said, and not knowing the language had tangled the web even further.

The woman was aided by a therapist who spoke her language. The man, unable to find one who shared his language or culture, is now very unhappy, Schmilovici said.

“Knowing the culture and customs of a place, and the way families are organized in such countries, makes a person feel like someone understands,” Alvarez said.

She cited the case of one client, a 38-year-old Mexican-born man who lives at home with his parents.

“He goes out on dates, and all of the women think he’s weird because he shares a home with his mother and father,” Alvarez said. “In Mexico, that is very common. Now he doesn’t want to (date) at all, and he’s very depressed.”

A therapist’s inability to understand a patient’s language can border on the lethal, Bayardo said, noting a case in which a Spanish-speaking man in El Centro could not make an English-speaking therapist understand about the “tic” in his neck.

“The therapist thought he was saying that he saw ticks--meaning insects--circling around his neck,” Bayardo said. “So the therapist prescribed heavy doses of tranquilizers to a man he thought was hallucinating. It’s a good thing he didn’t kill the guy, because he could have. So, you see, this language problem can be serious.”