6.) You have done some really interesting international work, serving as the Dean of Counseling at a university in Ecuador. Can you talk about that experience?

Sinead: For starters, the populations I worked with in Ecuador were exceptionally diverse.  Ranging from the indigenous people who were coming to the university, to some who were more middle class, to the very affluent, elite members of the community.  It was such a great experience.

One of my greatest learning experiences involved my volunteer work at an orphanage for girls who had been removed from their homes.  The average age there was 12-13 years old.  They all had pretty severe trauma exposure – either physical or sexual abuse.  I remember really being struck by some of their stories.

For example, there was this girl who had lost her brother in a fire.  We’d work together and whenever I would try to touch base with her about something related to that loss, she’d say, “you know what, that happened in the past, I have to move forward.”  And, it was like she needed to just focus on what she needed to – to get through school, for example.  There was this absence of self-pitying that you might expect from somebody who has gone through a loss like that.  Clearly, her response may have been a defense, but at the same time, I realized that she didn’t have the luxury of indulging in this place of “how hard my life is” because she still had so much she needed to work through.

The other thing that struck me related to a case with another young girl at the orphanage.  She was this wonderful, really sweet girl.  I knew her story of how she had been raped by a family member.  I had so much empathy for her and despite her traumatic past, she was still this very loving, resilient young person.

At one point, she wrote me this note, saying that she had to share something, but she was too ashamed to tell me, so she needed to write it.  So, here I am thinking, “it must be something related to the rape.”  But, despite how horrible that was, it turned out that the thing she felt most ashamed of was an experience in the past when she and her mother had to pan handle for money because they were so poor.  I was so surprised to hear that this would feel more shameful to her than something like sexual abuse.  This just gave me such an awareness of how you can’t assume what the most salient points in one’s life story are.  That was such a life lesson for me – to never assume what feels the hardest to somebody or to underestimate what may feel like a huge deal for somebody.

In terms of other more general experiences I had, I found that a lot of the affluent people in Ecuador were rather receptive to receiving mental health counseling.  I did a lot of work with people around eating disorders, which at the time was an area of mental health that wasn’t really in the lexicon there.  People who struggled with this problem were quite open to getting support.

I found it to be quite different working with people who were more affluent in comparison to those from lower income backgrounds, which seemed to be related to issues of privilege.  With lower income folks, there’s less hope for the future, and they face a lot of class discrimination.  With this population, people were coming in highly stressed out about getting tangible needs met, like how to pay their bills. People from more privileged backgrounds were able to do less crisis-oriented work.

KP: I’m glad that you’re touching upon the impacts of classism, which is a type of oppression in every culture around the world, but perhaps even more so in third world countries where you often find huge wealth disparity. It’s so hard to compare the stress level of people’s lives.  Life is hard for everybody, but then when you have the added stress of really limited resources, of not having basic needs met, that adds another significant layer.

Sinead: Yes, if you have to get up at 4 o’clock in the morning to catch 3 buses to get to your job, where you’re getting paid a dollar an hour to be cleaning homes – that’s incredibly stressful.

KP: Yes, and this speaks to the hurtful nature of class oppression and lack of economic equality, like the powerful example you gave earlier about the girl who was sexually abused – that the panhandling was what felt most shameful to her.

Sinead: Exactly, in her mind, the worst thing to her was being poor.  Granted, we could analyze this from many different angles, such as the possibility that she was blocking out the impacts of the rape, or that there was some piece of internalized sexism that somehow diminished the shame around the rape by making it more acceptable.  But, it did seem to me like being poor was what felt the worse to her.

KP: What initially brought you to Ecuador?

Sinead: I had just graduated from Smith College and decided to do some traveling before I settled down in Boston. I grabbed a backpack and I was planning to spend three months traveling through Ecuador, Peru and Bolivia before heading back home. One thing led to another and I became curious about opportunities to work there, in the areas that I’d been trained in clinically.

One of my graduate school internships was at the UCLA Neuropsychiatric Institute. I was trained to work with a Spanish speaking population there, consisting of immigrants from Mexico and Central America, working with them on common immigration issues related to anxiety, poverty, etc. I also worked with the inpatient and outpatient eating disorders clinic there which was an unbelievable experience. I had outstanding supervision in both of those areas, with Angela Farrell Powers, LICSW as my primary supervisor at the Spanish Speaking Clinic and Carlyn Lambert, LICSW in the eating disorder clinic. The Director of the program is Michael Strober, MD, who is renowned in this field.

It was such an incredible opportunity at UCLA that when I got to Ecuador I thought, “let’s see if I can continue doing that work here.” So I started speaking to the ex-pats who were in the field of psychology and I kept getting the same answers  – that the only people who practice psychology in Ecuador were found in private practice settings.  At the time in Ecuador, there wasn’t such a thing as community mental health centers or clinics designed for the treatment of addiction or eating disorders.

So, I was a little disillusioned, but a few weeks after asking around I got a phone call from an ex-pat psychologist and she said “you’re not going to believe this, a woman just opened the first ever eating disorders clinic in the country, and she needs therapists…would you be interested?” So, of course I was a shoe in. I worked there for about a year and then I was recruited to take on the position of Dean of Counseling at the University of Quito. It was really a “right time, right place” situation where everything fell into place.

And, while I was at the University of Quito I was able to have a small private practice where I saw therapy clients in the evening and on Saturdays.  So, I was really able to work with a diverse population.

KP: Is there anything else you want to say about that experience working in Ecuador as a mental health clinician?

Sinead: I’m immensely grateful for the years that I was there. I feel like I had experiences there I never would have been able to have in the United States. I was there for a total of seven years.  Working closely with so many Ecuadorians, in so many different environments – whether volunteering in the orphanage to later on when I was Dean of counseling, from the indigenous to some of the more affluent students – was a real privilege. I learned so much and am so grateful for it.

Collaborating with my colleagues was also a great experience. I worked with them on several different social and health campaigns.  We were able to do things likes put condom dispensers in male and female bathrooms at the university.  It felt incredible to be part of sending a message of safe sex, in a place where the assumption is that you don’t have sex until you’re married.  Yet the kids were, so it was something that was really an incredible experience to see that.

I also collaborated with other staff members to put together campaigns against drunk driving at the university.  For example, right before winter break, we got a hold of demolished cars from a junkyard and stuck them in front of the university entrance for the students to see, along with all this information about drunk driving statistics – all to make a powerful mark in their mind before they left on vacation.

We also did campaigns for LGBT (lesbian-gay-bisexual-transgender) students. We’d have conferences and people speaking about things that weren’t easily talked about. It was wonderful to be part of that and experience such receptivity from the university community, and even parents, on these sensitive topics.

Next Section: 7.) What kind of advice would you give to recent social work grads as they embark on their career?