Cynthia Cerrato is not your average kind of therapist. From her private practice in Los Angeles, Corazón y Aire, Cerrato is actively working to decolonize therapy, the goal of her sessions being to create a diverse space for healing that is culturally competent, sensitive, and affirming of Latinos’ experiences.
“I just want to empower our community to reclaim their healing,” she told Latino Rebels, explaining that she wants Latinos to abandon the belief that seeking therapy is a sign of weakness or something you pursue because you’re “crazy.” For Cerrato, seeking therapy is a way a person can advocate for the support they need.
“We all need support. Therapy should not be seen as ‘I’ve hit my rock bottom,'” she said. “Therapy should be seen as ‘This is how I’m reclaiming my health.”
When navigating mental healthcare, Latinos are likely to face microaggressions or receive treatment that perpetuates oppressive structures, especially when the provider is a stranger to the nuances of the Latino upbringing.
According to the American Psychiatric Association, in terms of mental health, Latinos are more likely to report poor communication with their health provider. Studies have found that bilingual patients are evaluated differently when interviewed in English as opposed to Spanish, and that Latinos are more frequently undertreated.
For Cerrato, having a therapist that understands you culturally is fundamental to the success of the treatment. She explains that when a patient and therapist share the same experiences, it evens the power dynamic in their relationship.
“I feel like my clients come into my space knowing, like, ‘She knows what I’m experiencing. She gets it,'” Cerrato said.
Cerrato recalls that, at the beginning of her therapy journey, therapists were almost all white. “That’s all that was offered for me at the time,” she said, adding that directories like Therapy for Latinx, Latinx Therapy, or the National Queer and Trans Therapists of Color Network weren’t available.
Although it is a bit easier now to find a culturally competent therapist, such professionals are still in the minority. According to a 2021 study, of the 192,497 therapists employed in the United States, only 7.9 percent are Latino.
Besides the lack of diversity among therapists, there is also a mismatch between the American Eurocentric therapy model and the specificity and variety of Latino culture.
Through its experience serving and advocating for the Latino community in western North Carolina, with a focus on farmworkers and uninsured, low-income adults, the nonprofit healthcare organization Vecinos found a gap between the individual traits and independence favored by the American Eurocentric therapy model and the values held in high esteem by Latino culture, such as family and the role of the individual in their community.
Vecinos also found that Latinos are more likely to vent about feeling anxious or depressed with a family member or friend, and more likely to consult a member of the clergy or a local healer.
“When we go to grad school, we’re trained through this really Western and pretty patriarchal lens,” Cerrato said, explaining that once she expanded her practice beyond what academia usually teaches, she had more freedom to provide therapy through a holistic, culturally sensitive approach.
“I’m really trying to instill in my clients that they have the power within to heal themselves,” she said about her work with community mental healthcare in the Boyle Heights area in Los Angeles.
“I never wanted to do it from an office, ” Cynthia said, explaining another characteristic of her practice that works to decolonize it and helps to achieve the rapport she wants to establish with her clients. Clients are invited to her house to interact in the green spaces around it, practicing breathwork and meditation.
“It’s kind of like what happened back in our Indigenous times: We used to go to someone’s home to get a limpia,” she said.
Vecinos also reported that, besides the fear of being labeled as “locos,” or “crazies,” many Latinos do not seek mental health treatment because of shame. Even while one in five people in the United States is affected by mental illness, Latinos still feel shame about their community finding out that they are doing it. This may be due to a lack of understanding about confidentiality in treatment, in which nothing can be disclosed without a patient’s consent.
Cerrato prefers not to diagnose her client’s experience, despite it being a protocol demanded by most insurance companies to accept paying for the service. Companies usually cover only what is deemed as affecting and interfering with the person’s overall functioning on a daily basis in a “clinically significant” manner, wrote James Killian, the principal therapist and owner of Arcadian Counseling in New Haven, Connecticut. If what a patient needs is to talk about their imminent divorce, losing a close relative, or sometimes feeling like an impostor, insurance won’t cover it.
“I do not diagnose in my practice. I am big on normalizing what my clients experience,” Cerrato said. “I’ve come to understand that we over-pathologize a lot of our mental health realities. To me, these are the realities of the world that we live in. They are not disorders.”
Cerrato stresses that the path to emotional wellness through therapy is a journey of the soul. Her job is to help every client discover what that journey is so that they can reach a place in their lives where they become their authentic whole selves. Getting to that place, she says, requires a lot of undoing and unlearning of the messages people receive throughout their lives.
The goal of her sessions is not to identify if there is something wrong with the client but, instead, why a person functions the way they do based on their life experiences, trauma history, and the stressors of the present-day world.
“What’s wrong is the world that we live in and how it is affecting us,” she said.
Often, Latinos who are first-generation or the first in their families to go to college have been exposed to constant messages that make them feel less-than or othered. Among Cerrato’s Latino and other clients of color, a recurrent belief is that they have to overextend themselves at work to prove their worth, thinking that they can’t say no to their bosses at the expense of their wellness.
Cerrato challenges these beliefs by introducing other ways of perceiving labor and money. “Money is energy,” she explained. “It comes and goes, it is good and bad.”
She says that work is also about honoring when one is at capacity and that there is the possibility to stop. “What about just being okay with what I’ve done so far?”
Cerrato believes that a way to bring more Latinos into therapy is to let them know that therapy is about the power of speaking your truth and having someone to receive your grief.
“You get to dump your sadness, your tragedies, your anger on someone that has the capacity to hold that for you,” she explained. “That’s a big deal.”
Juan de Dios Sánchez Jurado is a writer, lawyer, and journalist from Colombia, he is currently studying at the Craig Newmark Graduate School of Journalism at the City University of New York. Twitter: @diosexmaquina