Abstract
We are a group of 11 women in Albuquerque, New Mexico. Nine of us are immigrants from Mexico. One of us is from an immigrant household. One of us is neither. We have been working collaboratively on a research study called Tertulias (Spanish for “a social gathering”), which is an innovative women’s peer support group approach we created to reduce social isolation, depression, and stress among women immigrants from Mexico, and to increase their resilience and sense of empowerment. In the process of implementing the Tertulias study, we are revealing the profound power of peer support, friendship, and small, quotidian kindnesses. But we are also exposing the immensity and scope of trauma, fear, loneliness, depression, and self-blame that exist in the Mexican immigrant community because of domestic violence. Our experience with domestic violence and with the consciousness-raising and support we found in Tertulias has made us want to be involved in a positive manner to do something about this issue in our community. We want our experience to mean something—to be used to make a difference. We are opening our hearts and sharing our stories and ideas. We wanted to be included as co-authors of this article because we want our stories to be received and heard by other women. We want to plant seeds to help other women find their inner strength to be able to escape from their chains. We have to return for others. It is a commitment—to understand how we were able to do it and share that with others. Through our experience participating in Tertulias, we learned that we could overcome what felt overwhelming and impenetrable. We could leave the violence and rediscover and recreate ourselves and our lives.
Introduction
We are a group of 11 women in Albuquerque, New Mexico. Nine of us are immigrants from Mexico. One of us is from an immigrant household. One of us is neither. We have been working collaboratively on a research study called “Tertulias,” a community-driven, community-engaged, randomized control trial. In this study, we are implementing an innovative women’s peer support group approach we created to reduce social isolation, depression, and stress among women immigrants from Mexico, and to increase their resilience and sense of empowerment.1 –3 “Tertulia” is Spanish for a “social gathering,” and we call the peer support groups “Tertulias.”
Tertulias is designed using an equity-based theoretical architecture that integrates three theoretical frameworks (Figure 1) 1 : (1) “Gendered emplacement theory”4,5 gives value to the connection between place and health, including the importance of connection to social spaces and how both women and immigrants experience this differentially. (2) “Cultural and contextual situatedness”6,7 requires that we integrate components of the intervention with the participants’ culture and values on different levels and in different ways. (3) “Women’s funds of knowledge”8,9 places value on and integrates the experiential knowledge and skills that women bring to an intervention, whether or not this knowledge is derived from formal education. The Tertulias groups used a “structured dialogue approach”10 –12 that challenges the normative structure of the design of the research and the way research is practiced and “fuses” our theoretical frameworks through the incorporation of food, storytelling,13 –15 arts-based research, and facilitated bidirectional conversation. Our hypothesis, based on our previous research,10 –12 is that this design will decrease social isolation, depression, and stress and increase empowerment, resilience, adaptability, social support, and social connectedness.
Tertulias Theoretical Architecture.
For this study, we are recruiting adult women who were born in Mexico, self-report income below 250% of the Federal Poverty Level, and who speak Spanish fluently. All participant-facing aspects of the study are conducted in Spanish. The study is designed to have approximately 240 participants in 4 cohorts of approximately 60 women each. Half of the participants are randomized into the intervention arm, and half are assigned to a placebo control arm. Participation lasts 12 months. We are just began cohort 4 (ending July 2024). We have enrolled all 252 participants; 189 have completed participation, 63 are currently participating and will end August 2023.
Each cohort of the study has three Tertulias groups of approximately 10 women. The groups meet weekly for 2 hours via Zoom. 4 As a community-driven, community-engaged study, the majority of the research team includes individuals from the population of study (female Mexican immigrants), and most are not University employees or academic researchers. Two co-facilitators, a coordinator, and the Principle Investigator (PI) attend the groups. As indicated above, our theoretical architecture for Tertulias is designed to respect the lived experience that each of the women brings to the group and to appreciate and embrace a shared cultural heritage. As a participatory study, the group process in the meetings is not hierarchical—members of the research team attend the meetings as co-participants and as participant observers—and they share their own thoughts and experiences and participate in the group process equally with the enrolled participants. In the process of implementing the Tertulias study, we are revealing the profound power of peer support, friendship, and small, quotidian kindnesses.2,16 But we are also exposing the immensity and scope of trauma, fear, loneliness, depression, and self-blame that exists in the Mexican immigrant community because of domestic violence.3,17 In this context, we are discovering that pathways to healing, reclaiming self-identities, and recovering self-power are all possible.
When women come to the United States from Mexico, they leave behind their family, friends, favorite foods, and special places. In other words, they leave behind part of their life, their identity, their history, their culture, and places where they feel a sense of belonging. Bereavement over this loss, social isolation in the new context, and loneliness contribute to high levels of depression.18 –22 Here in the United States, barriers related to language, economics, politics, racism, structural racism, and discrimination make it difficult for women immigrants to build new social networks or to access information and resources. In their hometowns, Mexican women tend to create very deep relationships with sisters, friends, neighbors, and other women who become their confidants. These types of relationships are very difficult for them to develop when they immigrate to the United States. Women who immigrate to the United States, are often socially isolated, regardless of what type of job they have or whether or not they work outside the home. And at the same time, women generally take primary responsibility for caring for family members through food shopping, cooking, cleaning, children’s schooling and doctor’s appointments, and in many other ways. The burden of these responsibilities, together with barriers they encounter to making social connections, means that women immigrants often lack opportunities or time to learn to speak English or to make friends. For women without legal immigration status or for those with family members who lack legal immigration status, fear of discovery adds to the isolation. In this context of bereavement, social isolation, and fear, combined with cultural dictates associated with the exaggerated masculinity of machismo, 23 women immigrants from Mexico become especially vulnerable to controlling and abusive behaviors from intimate partners.24 –26
In consultation with some of our participants, including four of whom are co-authors on this submission, we decided to write and submit this article because during the Tertulias groups, a disturbingly large number of participants—nearly 60%—have disclosed that they have experienced (or that they are currently experiencing) different sorts of domestic violence at different times in their lives. Our research1 –3 and that of others27 –29 has demonstrated that group interventions are a culturally informed approach for supporting Latinas with different sorts of mental and behavioral health issues, including dealing with domestic violence. The Tertulias peer support groups create a space where women in the group feel safe and have a place of refuge.1 –3 They learn to trust each other and to grow. During group meetings, members recount their personal stories, tell each other about their everyday lives, celebrate life’s joys, describe their struggles, share strategies they have used to overcome challenges, encourage each other, and teach each other to flourish. In this context, four of our co-authors and compañeras who were participants in the Tertulias project recognized that what they were going through in their lives had a name—it was domestic violence. They learned that this was unacceptable but that there was an alternative. They were able to go beyond merely surviving to transcend and revitalize their lives—to rediscover their inner selves and the power to become whole again. They have come forward to co-author this article because they have a unique perspective. They are interested in doing something to make this issue and their experience with it more public. We found the submission category for a Patient Perspectives manuscript in Women’s Health, and it seemed like an excellent fit. The focus of this article is to provide a “patient perspective” on the issue of domestic violence, and it includes four co-authors who were participants in the Tertulias study who have lived experience with domestic violence. They want to share what they have learned from the experience of being in an abusive relationship, leaving the abuse and the abuser behind, and transcending feelings of shame and oppression—and to describe the role that Tertulias played in this journey. We believe that from a “patient perspective,” readers of Women’s Health will find what they have to say and the way that they choose to say it to be interesting and valuable.
Our stories
Violence, victimization, and survival
Our co-authors with lived experience of domestic violence want to share their stories:
For me, the violence began with a six-year, coercive plan by my husband to manipulate me to become totally enamored of him. In Mexico, he pressured me until he was able to convince me to marry him and come to the United States with him. I was aware that he had children from a previous relationship who were ill and needed organ transplants, but what I was not aware of was that he was manipulating me to marry him for the sole purpose of bearing children who would be able to donate organs to his older children. We went through a process of in vitro fertilization because I couldn’t get pregnant, and I ended up with a triplets pregnancy. When the babies were six months old, the violence began. After a medical checkup and being told the babies were healthy, he said “Qué a toda madre que mis hijos están sanos.” (“It’s f%^&* awesome that my children are healthy”). He took me to an isolated house and told me of his plot to have me conceive children to serve as organ donors. When I refused this, he started beating me. He cut open my head, twisted my arms and hurt my shoulder, and began to choke me. My three-year-old son started screaming very loudly. When I was able to, I called 911. I didn’t get much support from the police because they didn’t speak Spanish. Because of this, the police report only stated that he had beaten me and not that he was choking me to the point of almost passing out. Only one of them spoke a little bit of Spanish and he was the one who sent me to a shelter. No criminal charges were brought against my husband and the only thing I got from the court was a restraining order. A worker from a nonprofit organization that focuses on legal support for low-income people told me that I might be better off if I went back to Mexico with my children.
My domestic violence experience was gradual. It started slow and increased with time. He would threaten me with calling immigration to have me deported, but he taunted me, saying that before I could be deported, I would be put in jail for three years where I would get raped. I stayed quiet for three years. It got to the point that I would be asleep, and he would start hitting me and kicking me until he would push me off the bed. Then he would ask me for forgiveness, claiming that he was asleep and didn’t know what he was doing. The punches were such that he dislocated my jaw and it is permanently damaged. Whenever I move it, I hear a crackling noise. He didn’t like when my son came to visit, and he wanted me to make my son leave. When I refused, my husband threatened to provoke my son so that my son would hit him and end up in jail. My husband had all the bills and the apartment under his name and didn’t want to release them to me. He wanted to be able to have all the services cut off and get me evicted if I made trouble. He used to say that he was an American Citizen and that I was a dirty Mexican immigrant.
My story is horrific and traumatic. This violence involved both my children and me. It was physical, emotional, verbal, economic, and psychological. I have permanent hearing loss as a result of the physical abuse to my head. He would hit me in ways and in spots on my body where people couldn’t see the bruises. He used to surround himself by people that I feared who owned guns and were police officers. I didn’t believe in the judicial system.
In my case, it was very humiliating because my husband would make me feel less than other people. My husband would call me bad words and, in his eyes, everything I did wasn’t good enough. He had problems with alcohol. When I began to go through menopause, things got worse. He became very disrespectful. He was having affairs and drinking and then he was responsible for a car accident that put my children’s lives in danger and that made me wake up because I realized that I could lose them. The love and trust I had for my husband were both lost, and I decided to leave him. Currently, we are going through the divorce process. Although we are separated, he continues contacting me. But, I am very firm in my decision and there is no turning back. I don’t want to go through what I experienced with him ever again.
Survivance, transcendence, and revitalization
We suffered in these relationships, but with the help of Tertulias and others supporting us, we found our power. We got out of these toxic and dangerous relationships, and we are actively refashioning our lives. We are becoming whole again:
My healing process was very tough. A non-profit organization focused on domestic violence didn’t believe that I would leave my husband because I had so many children. Even when I told them I was leaving him, they would insist that I was going to go back with him. The Psychologist guided me, but did not help me heal completely. My healing really began when I joined the Tertulias project. I found support, tranquility, peace, confidence, sincerity, and affection. I began to be myself again—but a stronger self. Through Tertulias, I learned about resources. You sometimes need a little push to move ahead. I want women to know that you can make it regardless of how many children you have. It doesn’t matter if it is one or many. I am recovered now, and I don’t want to hide anymore. The woman that does not give up has gotten out! I want to tell women not to be fearful to take their abusers to court because the laws are by our side.
At the beginning, I used to always report during the Tertulias sessions that I was fine. I always kept quiet what was going on until I couldn’t take it anymore and I opened up to the group. My group members as well as the coordinators in the Tertulias project guided me and supported me. They would tell me “Take care of yourself, protect yourself” and were always looking out for me. They are all tattooed in my heart. They did everything without judgment and without breaking confidentiality. I shared the fact that I was experiencing domestic violence with the group, but there were certain details that I only worked with the project coordinators. Because of all the resources I received, I was able to become a Community Health Worker (CHW). Then, Enlace Comunitario, a nonprofit focusing on issues of domestic violence, invited me to be part of their team of Health Leaders. Women like me need “big angels” to help us gain our confidence and faith back to be able to move forward. Thanks to Tertulias, and to Enlace, I was able to obtain a restraining order and get divorced. It’s been a year since I got divorced. It seems wrong that I still have physical and psychological damage, but that he just walked out freely without any consequences.
The way I started to heal was leaning on groups. I spent time living in a domestic violence shelter. Through Tertulias and Enlace, I learned that there were other people who were going through domestic violence. Tertulias opened a pathway to begin my healing. They referred me to psychosocial therapy to be able to heal myself and my children. I am very thankful that someone helped me and provided me with moral support. I am cognizant that someone “came back” for me—someone supported me. I believe so much in “going back” for the rest and being their support. I also believe in community services because,
For me, the violence happened during the last few months of the Tertulias sessions. I already trusted my group because by then, we had developed a trusting friendship. There was no judgment in the group, and I felt I could share what I was going through with them. I felt their support and day by day I was feeling stronger to overcome my problem. My friends would give me advice and offer their support. Before Tertulias, I didn’t have any friends. I didn’t have anybody to talk to and that’s why I didn’t feel strong to be able to move ahead. The only person I could count on was my sister, but unfortunately, she passed away and I ended up without my confidant and my support. I was a very shy person and didn’t trust other people. I was embarrassed to talk to other people but in the Tertulias group, I developed my self-esteem and gradually increased my trust in other people. I stopped being so closed-in, and now I am more open to communicating with others. I feel liberated and have the confidence to talk to other women who are going through the same situation that I went through. It’s very important that we value and love ourselves to get out of the vicious circle that we fell into with the violence that we experienced because this hurts us and our families too. This cycle needs to be broken. We need to ask for help anywhere we can. We shouldn’t be afraid and shouldn’t stay silent.
What our co-authors with lived experience of domestic violence want all of us to know
Recognizing domestic violence
We want other women and members of the Mexican immigrant community to know that domestic violence is not just physical abuse and doesn’t always produce a black eye, a bruise, or a broken arm. When your partner hits you, the violence is obvious. But shaming, humiliation, insults, and name-calling can all be forms of verbal and emotional violence. Threats of physical violence or threats to a woman’s immigration status or legal custody of children are forms of violent manipulation. Controlling a woman’s daily activities and ways of being by imposing rules on when and where she can go, who she can talk to or socialize with, or how she dresses, are forms of violence to a women’s personal autonomy. Surveillance of a woman’s phone or email communications, computer searches, or monitoring of her social media accounts are manipulative and controlling behaviors that constitute another form of violence. And excessive control over a woman’s spending or her access to money, or denying her the ability to be named on a bank account, a mortgage, or a house deed are all forms of economic abuse. Before Tertulias, we did not really comprehend the complexity of violence in our lives, and part of the impetus for this article is that we want others to be conscious of different forms that domestic violence can take—physical, but also emotional, mental, verbal, social, technological, and economic. We four co-authors with lived experience of a violent relationship now realize that before we became cognizant of these dynamics, we were trivializing and normalizing these “other” types of violence as insignificant and that by doing so, we were empowering our abusers.
Structural violence
When we were being oppressed and victimized by our intimate partners, we were also experiencing the structural violence of the immigration and legal systems. 30 People think that immigrants shouldn’t have the same rights as people born in this country or that we should keep silent about what we are experiencing. They don’t want to hear about it if it is unpleasant. We suffered discrimination. A worker from a nonprofit organization told one of us, “wouldn’t you be happier just returning to Mexico with your kids?” To say this to us when what we needed was legal help was unconscionable. The legal system makes it easy for the abuser to continue the cycle of abuse. The laws are very lenient toward the abuser. For the most part, they only receive a slap on the wrist. The legal system is broken in so many ways when it comes to victims of domestic violence, and too often does not empathize with the victim. The laws are not enforced properly, the system does not create proper channels for the abuser to change behaviors, and they ultimately end up in a cycle of recidivism.
What we learned
A way out
We were women who didn’t talk to anybody. We didn’t have friends. Through Tertulias, we found friends. We want others who are living the same experiences to know that there is a way out—that we are women who have lived through the same thing and have come out on the other side stronger and triumphant. Women can be warriors. Knowing that you are not the only one, that you are no longer alone and isolated in a cage from which you cannot escape—this knowledge can become your superpower. There are other women who are going or have gone through the same as you, and we can learn from each other. There are people and resources to support you and give you strength. There is a network of support. When you find others who you can relate to—you realize there is empathy. We learned that information is power.
Solutions
Our experience with domestic violence and with the consciousness-raising, “awakening,” 27 and support we found in Tertulias has made us want to be involved in a positive manner to do something about this issue in our community. We want our experience to mean something—to be used to make a difference. It is a humanitarian labor. How powerful it will be to have other women see that they are not alone. We are opening our hearts and sharing our stories and ideas. We wanted to be included as co-authors of this article because we want our stories to be received and heard by other women. We want to plant seeds to help other women find their inner strength to be able to escape from their chains. We have to return for others. It is a commitment—to understand how we were able to do it and share that with others.
Through our experience participating in Tertulias, we learned that we could overcome what felt overwhelming and impenetrable. We could leave the violence and rediscover and recreate ourselves and our lives. Tertulias was an open door for us where we were not judged or criticized. Our stories were not diminished or trivialized. We were able to be seen and heard. There were resources and people to support us to empower ourselves to leave the cycle of violence. Through self-care and nurturing our emotional well-being, we became assertive, confident women. We changed and grew. We want to share the dignity that we have found with other women to let them know that they can reclaim their lives and move forward. We want them to know that groups like Tertulias exist. But it isn’t just Tertulias. We know that other groups exist, but we wish that Tertulias could be disseminated so other women could know that they are not alone and that there are supports and help—shelters, lawyers, the “U” Visa and the Violence Against Women Act (VAWA), and other resources.
But at the same time, we know that it is not just up to individual women to be strong and resourceful. There needs to be more support and investment in programs to prevent domestic violence and to assist women who are going through the horrors of abuse. We need more support in the legal system, more support for housing, and more support from legislators to make investments in women like us and make legal reforms to support us and not embolden and nurture the abusers. We have come out the other side, but unfortunately, it has more to do with our own fortitude than with the support of systems that we thought would help us. Programs like Tertulias are not expensive and can be replicated.
Our voices, our lives: our unforeseen stories
Through Tertulias we found the women we used to be, we became the women we are, and we revealed the women we have the power to be. It was a turning point. We were one type of women before and now, we are a different type of women—stronger women. We feel empowered. It is not just us who feel this way, but the others in Tertulias and our families who have seen us change. It doesn’t matter who you are or what level of education you have. You can do it. You can leave and escape the violence and say, “
Footnotes
Acknowledgements
We would like to acknowledge other members of our team: Daniel Perez Rodriguez, Cristina Murray-Krezan, Reuben J. Thomas, Elaine L. Bearer, Megan Rivera, Pachely Mendivil-Aguayo, Alejandro Aragon, and Bill Wagner. We would also like to acknowledge the members of our Advisory Board and our Data and Safety Management Board.
Declarations
Authors’ note
Four of the co-authors on this manuscript have lived experience with domestic violence. They have chosen not to identify themselves individually here for reasons related to personal safety.
