1. Well-Being, Justice and Power in the Lives of Immigrants Isaac Prilleltensky University of Miami isaacp@miami.edu http://www.education.miami.edu/isaac

2. Migrants Today 100 million of international migrants First quarter of 2005: 81,900 asylum applications to UNHCR Dominant movement of asylum seekers is from eastern Europe and former Soviet Union into Western Europe and North America “The social injustice experienced by civilians who eventually become refugees, internally displaced person….has often had a direct impact on their health status” (Michael Toole, 2006, p. 190).

3. The Social Ecology of Well Being Stokols’ view “The healthfulness of a situation and the well-being of its participants are assumed to be influenced by multiple facets of both the physical environment (e.g., geography, architecture, and technology) and the social environment (e.g., culture, economics, and politics). Moreover, the health status of individuals and groups is influenced not only by environmental factors but also by a variety of personal attributes, including genetic heritage, psychological dispositions, and behavioral patterns.”

4. Stokols continues….. “Thus, efforts to promote human well-being should be based on an understanding of the dynamic interplay among diverse environmental and personal factors rather than on analyses that focus exclusively on environmental, biological, or behavioral factors. (Stokols, 2000, p. 27)”

5. Seligman’s Authentic Happiness (2002, pp. 61) “If you want to lastingly raise your level of happiness by changing the external circumstances of your life, you should do the following: Live in a wealthy democracy, not in an impoverished dictatorship Get married Avoid negative events and negative emotion Acquire a rich social network Get religion”

6. Seligman’s Authentic Happiness (2002, pp. 61) “As far as happiness and life satisfaction are concerned, however, you needn’t bother to do the following Make more money Stay healthy Get as much education as possible (no effect) Change your race or move to a sunnier climate (no effect)”

7. Seligman concludes…. “Even if you could alter all of these external circumstances, it would not do much for you, since together they probably account for no more than between 8 and 15 percent of the variance in happiness” (Authentic Happiness, 2002, p. 61). Really?

8. Is happiness really an inherited phenomenon? Lykken and Tellegen (1996, Psychological Science). In the Minnesota twins study, authors report, “Neither socioeconomic status, educational attainment, family income, marital status, not an indicant of religious commitment could account for more than about 3% of the variance in WB” (in monozygotic twins) “We estimate that the heritability of the stable component of subjective well-being approaches 80%” Let’s examine opposing evidence…….

9. Change in life satisfaction over the years (Inglehart, 2004)

10. Russia’s happiness and satisfaction plunges

11. Place Matters

12. Place and class in infant mortality

13. Income Matters for Well-Being

14. Wealth matters for life expectancy

15. Income is not everything though

16. Education Matters

17. Relative deprivation matters in Sweden

18. Relative deprivation matters in UK

19. Inequality and male mortality Sweden and Japan Canada and France UK USA

20. Chinese happiness and democracy

21. Lessons for Well-Being Subjective well-being goes up and down depending on social circumstances (Russia, Belgium, Switzerland) It is highly unlikely that gene pool of countries varies in a few years Absolute poverty predicts low levels of physical and mental well-being, within and across countries (Kleinman, Eisenberg, etc.)

22. Lessons for Well-Being Absolute poverty predicts low levels of physical and mental well-being, within and across countries (Kleinman, Eisenberg, etc.) Relative deprivation predicts social gradient in physical and mental well-being within countries (Marmot, Wilkinson) Freedom is important in subjective well-being, but there are exceptions like China Wealth does not necessarily lead to a happy or meaningful life (Adams, Cushman, Sloan, Ryan)

23. What is Well-Being? Well-being is a positive state of affairs in individuals, relationships, organizations, communities, and the natural environment, brought about by the simultaneous and balanced satisfaction of material and psychological needs; and by the behavioral manifestation of material and psychological justice in these five ecological domains.

24. Well-Being in the Lives of Migrants: Protective Factors Environmental health Employment Justice Safety nets Multiculturalism Quality education Child care Adequate housing Cohesion and support Access to health care Language preparation Good parenting Mutual Support Good mental health Psychological preparation Physical health Migration by choice Friendships Language knowledge

25. Well-Being in the Lives of Migrants: Risk Factors Poverty Toxins Air quality Forced migration Injustice Exclusion Discrimination Acculturation stress Loss of social network Marginality Bigotry Iatrogenic morbidity Role strain Unemployment and Underemployment Absence of family Family expectations Marital conflict Isolation Intergenerational conflict Loss and grief Guilt and shame Status inconsistency Life change events Homesickness PTSD

26. Ecological, Material, Psychological, Axiological Model of Well-Being Sites of Well-Being IndividualRelationalOrganizationalCommunalEnvironmental Material/ physical signs health networks resourcessocial capital low emissions Psycholo gical signs efficacyvoicesupport belonging safety Values as source and strategy autonomy caring participation diversityprotection of resources Justice as source and strategy My dueYour due Its dueTheir due Nature’s due

27. Model of Migrant Well-Being: Some positive and negative factors Sites of Well-Being IndividualRelationalOrganizationalCommunalEnvironmental Material/ physical signs +health - illness +networks -isolation +resources - lack of resources -social capital -lack of trust +clean air -pollution Psycholo gical signs +efficacy -lack of control +voice -repression +support -isolation +belonging -rejection +safety -fear Values as source and strategy +autonomy -lack of power +caring -neglect +participation -marginality +diversity -discrimination +protection of resources -depletion of resources Justice as source and strategy My dueYour dueIts dueTheir dueNature’s due

28. Martha Nussbaum “ In this increasingly interdependent world, we need to consider issues of justice raised by inequalities between rich and poor nations that affect the life chances of their citizens” (2006, p. 18) The issue involves a “serious asymmetry of power and capacity” between one national group and “some dominant group” (2006, p. 22)

29. What Is Justice? General well-being depends on justice Migrant well-being depends on justice Individual, relational, organizational, communal and environmental well-being depend on justice An understanding of justice is crucial Dominant definition of justice is To Each According to His or Her Due

30. Sedgwick’s definition in 1922 Cardinal question of justice is whether there are “any clear principles from which we may work out an ideally just distribution of rights and privileges, burdens and pains, among human beings as such” (p. 274).

31. Miller’s 1999 condensed version To each his or her due Isaac’s four questions First Question: Who Or What Is Each? Second Question: How Do We Decide What Is Due A Person, Family, Or Group? Third Question: Who or What is Responsible for Distributing Resources and Obligations? Fourth Question: How Do We Decide what is Due From a Person, Family, Group, or Institution?

32. First Question: Who Or What Is Each? Dominant ideology Individual Alternative ideology Individual Family Community Government Environment Animals

33. Second Question: How Do We Decide What Is Due A Person, Family, Or Group? Dominant ideology Ability Effort Alternative ideology Ability Effort Needs Rights Opportunities Power

34. Third Question: Who or What is Responsible for Distributing Resources and Obligations? Dominant ideology Individual employer, Government, with little popular participation, and great influence from power players Alternative ideology Individual Family Community Participatory mechanisms to influence government

35. Fourth Question: How Do We Decide what is Due From a Person, Family, Group, or Institution? Dominant ideology Needs Ability Charity Alternative ideology needs, ability, obligation, duties, opportunity and privilege.

36. Revised Definition To each (individual, family, community, government, animals and environment) according to their needs, ability, effort, opportunities, rights and power, and From each (individual, family, community, or government) according to their needs, ability, obligation, duties, opportunity and privilege.

37. The role of context context should determine what criterion or criteria must be preferred in each case In social conditions of inequality, we must accord preference to needs over ability Under conditions of relative equality, where the gap between classes is not very pronounced, it is possible to favor effort over needs.

38. Context of Plenty of Opportunities In a context of plenty of opportunities for everyone, it is possible that ability and effort will be the preferred choice.

39. Justice Out of Context Societies aspiring to justice must seek equilibrium among all criteria When context of inequality calls for need and equality, but culture favors effort, it’s because privileged groups benefit. As a result, group interests that influence the choice of allocation pattern often disregard the context-specific situation.

40. Well-Being  Justice Well-Being is enhanced by Justice is enhanced, and contributes to well-being, by the power, capacity, and opportunity to Self-determinationExperience voice and choice, participate in decision making Caring and compassion Experience nurturing relationships free of abuse Equality and freedom Benefit from fair and equitable distribution of resources and burdens

41. Experiences of Poor Migrants: Injustice Leads to Suffering Material deprivation Exclusion Insecurity Humiliation Sickness Helplessness Powerlessness

42. The Role of Power in Justice and Well- Being Power is an essential component of justice and well-being Power is an essential component of the context in immigrants’ lives Experiences of powerlessness Experiences of exclusion and marginalization Experiences of economic insecurity Power should be taken into account when analyzing and partnering with immigrants to promote their well-being

43. The Concept of Psychopolitical Validity can help to incorporate power in practice Psychopolitical validity derives from the consideration of power dynamics in psychological and political domains of health. The main objective of psychopolitical validity is to infuse in community psychology an awareness of the role of power in wellness, oppression, and liberation at the personal, relational, and collective domains.

44. Psychopolitical validity In order to attain psychopolitical validity, investigations and interventions would have to meet certain criteria. These criteria have to do with the extent to which research and action incorporate lessons about psychological and political power.

45. Psychopolitical Validity I: Epistemic This type of validity is achieved by the systematic account of the role of power in political and psychological dynamics affecting phenomena of interest Such account needs to consider the role of power in the psychology and politics of wellness, oppression and liberation, at the personal, relational, and collective domains.

46. Table 1 Guidelines for Epistemic Psychopolitical Validity in Community Psychology ConcernsDomains CollectiveRelationalPersonal WellnessAccounts for role of political and economic power in economic prosperity and in creation of institutions that promote equality and public health Studies the role of power in creating and sustaining egalitarian relationships, social cohesion, social support, respect for diversity and democratic participation in communities, groups, and families Studies role of psychological and political power in achieving self-determination, empowerment, health, personal growth, meaning and spirituality OppressionExplores role of globalization, colonization and exploitation in illness and suffering of nations and communities Examines the role of political and psychological power in exclusion and discrimination based on class, gender, age, race, education and ability. Studies conditions leading to lack of support, horizontal violence and fragmentation within oppressed groups Studies role of powerlessness in learned helplessness, hopelessness, self- deprecation, internalized oppression, shame, physical and mental health problems and addictions LiberationDeconstructs ideological norms that lead to acquiescence and studies effective psychopolitical factors in resistance to norms that cause illness Studies acts of solidarity and compassion with others who suffer from oppression and illness Examines sources of health, strength, resilience, solidarity and development of activism and leadership

47. Psychopolitical Validity II: Transformational Transformational validity derives from the potential of our actions to promote personal, relational, and collective wellness by reducing power inequalities and increasing political action

48. Table 2 Guidelines for Transformational Psychopolitical Validity ConcernsDomains CollectiveRelationalPersonal Well-beingContributes to institutions that support health, emancipation, human development, peace, protection of environment, and social justice Contributes to power equalization in relationships and communities. Enriches awareness of subjective and psychological forces preventing solidarity. Builds trust, connection and participation in groups that support social cohesion, health and social justice Supports personal empowerment, health, sociopolitical development, leadership training and solidarity. Contributes to personal and social responsibility and awareness of subjective forces preventing commitment to justice and personal depowerment when in position of privilege OppressionOpposes economic colonialism and denial of cultural rights. Decries and resists role of own reference group or nation in oppression of others and deterioration of health in other groups Contributes to struggle against in- group and out-group domination and discrimination, sexism and norms of violence. Builds awareness of own prejudice and participation in horizontal violence Helps to prevent acting out of own oppression on others. Builds awareness of internalized oppression and role of dominant ideology in victim-blaming. Contributes to personal depowerment of people in position of privilege LiberationSupports networks of resistance and social change movements that pursue health and wellness. Contributes to structural depowerment of privileged people Supports resistance against objectification of others. Develops processes of mutual accountability Helps to resists complacency and collusion with exploitative and illness producing system. Contributes to struggle to recover personal health and political identity

49. There are many ways to advance the transformative impulse Creating awareness among colleagues about how power differentials get enacted in interactions with immigrants seeking health related advice Forming research and action groups in the workplace to explore how practices may be more empowering of immigrants

50. There are many ways to advance the transformative impulse Increasing political literacy of immigrants to empower them to scrutinize the practices of health and helping professionals Establishing practices that enable participation of immigrants in management of human services

51. Promoting Migrant Well-Being: From DRAIN to SPEC From Deficits-based Reactive Arrogance Individual blame To Strengths-based Primary Prevention Empowerment Community Change

52. Strategies: Time and Place Collective Individual ReactiveProactive X

53. 9/7/1854…Removing the Handle

54. Big wake up call!!! No mass disorder, afflicting humankind, has ever been eliminated, or brought under control, by treating the affected individual HIV/AIDS, poverty, child abuse, powerlessness are not eliminated one person at a time.

55. It’s like Venice…..

56. Venice’s Lesson “The psychotherapist, social worker or social reformer, concerned only with his own clients and their grievance against society, perhaps takes a view comparable to the private citizen of Venice who concerns himself only with the safety of his own dwelling and his own ability to get about the city. But if the entire republic is slowly being submerged, individual citizens cannot afford to ignore their collective fate, because, in the end, they all drown together if nothing is done” (Badcock, 1982)

57. Quadrant III Examples: Crisis work, therapy, medications, symptom containment, case management Quadrant I Examples: Community development, inclusive policies, multiculturalism, high quality schools and health services for migrants Quadrant II Examples: Skill building, emotional literacy, language programs, fitness programs, personal improvement plans, work through identity issues Quadrant IV Examples: Food banks, shelters for homeless people, charities, prison industrial complex Collective Proactive Individual Reactive Strategies: Time and Place

58. Strategies: Abilities and Participation Strengths Deficits DetachmentEmpowerment X

59. The Grameen Bank

60. Quadrant I Examples: Voice and choice in celebrating and building competencies, recognition of personal and collective resilience of migrants Quadrant II Examples: Voice and choice in deficit reduction approaches, participation in decisions how to treat affective disorders or physical disorders Strength Empowerment Deficit Detachment Strategies: Ability and Participation Quadrant III Examples: Labeling and diagnosis, “patienthood” and clienthood,” citizens in passive role Quadrant IV Examples: Just say no! You can do it! Cheerleading approaches, Make nice approaches

61. Nussbaum’s Principles for the Global Structure Nations have responsibility to their citizens National sovereignty should be respected, within the constraints of promoting human capabilities Prosperous nations have a responsibility to give a substantial portion of their GDPs to poorer nations Multinational corporations have responsibilities for promoting human capabilities in the regions in which they operate

62. Nussbaum’s Principles for the Global Structure The main structures of the global economic order must be designed to be fair to poor and developing countries We should cultivate a forceful global sphere All institutions and most individuals should focus on the problems of the disadvantaged in each nation and region Care for the ill, the elderly, children, and the disabled should be a prominent focus of the world community

63. Nussbaum’s Principles for the Global Structure The family should be treated as a sphere that is precious but not private All institutions and individuals have a responsibility to support education, as key to the empowerment of currently disadvantaged people.