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Liliana Luna started the counseling practice Esperanza Wellness Center to provide mental health care for the Latinx immigrant community in Portland.

Liliana Luna started the counseling practice Esperanza Wellness Center to provide mental health care for the Latinx immigrant community in Portland.

Liliana Luna

Once a week, Liliana Luna sits in front of her computer, turns on her Facebook Live stream and virtually welcomes people in. Luna is a Portland couples and family therapist who runs the counseling practice Esperanza Wellness Center.

These weekly Facebook Live chats are one example of Luna’s guiding principle as a therapist:

“I am coming up with ideas to make counseling a lot more accessible for everyone,” she said, “so that no one, no one should go without services.”

Most of Luna’s clients are undocumented immigrants. And she knows firsthand how hard it can be for them to find mental health care. She’s a DACA recipient who came to the United States when she was 15 years old.

Related: Black Oregonians struggle to find mental health care amid increasing need

The first few years Luna was in the U.S. were so traumatic that she’s blocked most of the memories.

“The only thing I remember is when I got here it was very cold, and then pictures of myself crying here and there,” she said, “because I just didn’t want to be here.”

Luna’s family struggled with their own trauma as well. And all of that impacted her.

Psychologists have a name for what Luna was experiencing: intergenerational trauma.

Research shows that trauma can be passed down through families. When a person experiences something traumatic, they may develop certain behaviors in response. They could become hypervigilant, or more anxious. In turn, those behaviors can affect the way their children see the world. Some studies show that when an individual experiences trauma, it can even affect their children’s genes.

For communities that have historically experienced oppression and violence, that trauma can affect generations.

Intergenerational trauma was first recognized by psychologists in the 1960s, when children of Holocaust survivors started seeking out therapy in large numbers. Now, research shows that intergenerational trauma is common for children of refugees, descendants of slaves, Native Americans and other groups that have endured violence.

Portland psychologist Jenjee Sengkhammee says that there are not enough mental health practitioners of color in Oregon to fill the need for culturally competent care.

Portland psychologist Jenjee Sengkhammee says that there are not enough mental health practitioners of color in Oregon to fill the need for culturally competent care.

Samantha Matsumoto

Portland psychologist Jenjee Sengkhammee is also personally familiar with intergenerational trauma.

Her parents lived through the U.S.-led Laotian Civil War in the 1960s. Her father was a Hmong soldier who worked with the CIA. Because of unrest caused by the war, Sengkhammee’s family had to flee Laos in the middle of the night. They lived in a refugee camp before they came to the U.S.

As a child, Sengkhammee remembers thinking some of her mother’s behaviors didn’t make sense. Her mother would meticulously check that every door and window in the house was locked. Every time they got into the car, she’d do the same thing.

“She was always incredibly worried, incredibly hypervigilant about what we did, where we were, who we were with,” Sengkhammee said.

Now, as an adult, Sengkhammee can see that those behaviors were a result of her mother’s trauma. And she sees how it affects her personally.

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“I am incredibly aware of how I am, because guess who closes all their windows and doublechecks and triplechecks all their doors? I do,” she said. “I’m really aware of … what the impact has been on the way I see the world.”

Liliana Luna also sees the impacts of intergenerational trauma regularly with her clients in the Latino community. Centuries of colonization and racism, and the trauma of leaving behind their home countries to immigrate to the U.S., have affected the way they experience the world now, she said.

“Through all the hurts we’ve been through, I think there is a wound that has not healed,” she said.

She sees it playing a role in the struggle for immigrant rights now. Some of her clients are descendants of slaves who endured inhumane working conditions. Then, she said, they come to the U.S. with the belief that they are here to work. That’s coupled with the stereotype that immigrants should come to the U.S. to work hard in low-paying jobs to make a way for themselves, Luna said.

The result, Luna said, is that some of her clients may not feel like they deserve to be treated with dignity.

“This person may feel that he doesn’t have the right to even explore his own mental health (or) his own health in general,” she said. “And you see that play again in the next generations.”

But it can be difficult to find a therapist who understands intergenerational trauma from a culturally competent lens. That’s in part because there’s a shortage of mental health care clinicians of color in Oregon.

Luna also has personally struggled to find a counselor who understood her experience as a Latina immigrant.

A few years after she came to the U.S., she wanted to talk to a therapist about issues she was having with her family. She found a therapist through a program at Portland Community College, where she was a student.

But when she tried to talk to her therapist, she felt misunderstood. The therapist advised her to move out of her family’s house, which was taboo in Luna’s family. Instead of focusing on her mental health issues, Luna often found herself explaining her culture to her therapist.

Luna was disappointed. She only saw that therapist a total of three times.

“I just needed someone to talk to,” she said, “and I wanted that person to relate to me, relate to my story, understand the cultural components of my story.”

But that experience made her want to become a counselor herself. Now, she offers the sort of therapy that she was looking for back then.

Her approach is conversational and culturally specific. She compares processing emotions to cooking carne asada. She incorporates Indigenous Mayan and Aztec beliefs into her sessions. In order to make therapy more affordable, Luna offers sliding scale rates and group therapy, which costs less than individual sessions.

Jenjee Sengkhammee says that kind of culturally competent care is important. But the need is much greater than the number of clinicians who can provide it.

Like Luna, many people of color want to specifically see a therapist of color who can understand their experiences. But the shortage of clinicians of color in Oregon makes that difficult. Only about one-in-five mental health care practitioners in the state are people of color.

Sengkhammee has had to turn away many people seeking treatment because her schedule is full. For people of color seeking services, that’s especially damaging, she said.

Research shows that people of color tend to seek out mental health care less frequently than white people. That’s in part because of stigma, and because services are often less accessible to them.

“We need to be really careful about when they are there at your door, saying ‘I am ready for this,’ we need to open a door for them,” Sengkhammee said.

Liliana Luna often encourages her clients to think about the trauma passed down through their families, and think about how that trauma impacts them now.

“To me, if we can cut that generational trauma… that hurt is not passed on into the kids,” she said. “That’s when we’re doing better.”

That healing can happen, she said, when everyone can access the mental health services they need.

This story is part of OPB’s series on mental health care for Oregonians of color.

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