Every family has more than one secret that is hidden and never transmitted from one generation to the other. It could be the alcoholism of one of its members; or the sexual abuse—perhaps molestation—committed by a parent, grandparent, or a relative; or maybe it is the wife’s adultery or the husband’s out-of-wedlock child.
My family of origin has a few well-kept secrets, but I guess that the most secretive one was the mental illness of my maternal aunt. Her name was Margarita. She was short, slim, and had beautiful green eyes. She was the youngest of four siblings. I know that she started to have the “symptoms” (or “manias” as my mother called it) when she was in her late adolescence.
One of my early recollections of her illness was a visit that we did to a santero in Jovellanos, a town in Matanzas, Cuba, in the hope that he could get out of Margarita all the bad spirits that possessed her. Santeria is a polytheistic religion whose divine beings, or orishas, are deified ancestors. The santeros call on them to solve problems. The Regla de Ocha Ifa, known as Santeria, was one of the most widespread cults of African origin in Cuba, and the town of Jovellanos was known for having “the real” santeros.
At the time of this visit to the santero I was young, maybe less than four years of age, because I don’t remember being there with my siblings. My mother, my maternal grandmother, Encarnacion, my aunt Margarita, and I went to this town one hour away by car from our hometown, Central España, to see him. Probably my family received testimonies or recommendations of other believers who had found peace, health, or good luck due to the influence of this man. I recall that he sat on the floor, totally dressed in white. The room was dark, but there was smoke coming from incense burning inside black small calderos de hierro. I do believe that he was a black man. He probably did some rituals, but I don’t remember anything more of that visit.
Another strong image that comes to my mind and is associated with Tia Margarita is waking up in the middle of the night and listening to conversations in the living room: “Margarita left the house and is at large.” My maternal uncle Manuel was telling my mother while my father was quickly dressing himself to run and search for her. They found her in the middle of a sugarcane field, in the fetal position, her mind lost. I remember that they brought her home and my mother cleaned her face and her body, changed her clothes with love and with that special kindness that I always found in my mother when she was taking care of her sister. My mother gave her a hot drink and tried to calm her with sweet words and warm touching. Then my father came with a rented cab and he and my older maternal uncle, Baldomero, drove her to Quinta Covadonga, a health hospital in Habana sponsored by immigrants from Asturias, Spain. Margarita was at the mental illness ward for women for a while.
My mother and my grandmother Encarnacion never stopped fighting for Margarita’s health. I want to emphasize the fact that abuela Encarnacion and my mother, Gelasia Alés, never gave up. When my father was asked what Margarita had, he repeated the diagnosis received from the doctors in Habana, without understanding its scope and nature of the illness. Margarita was suffering paranoid schizophrenia, one of five subtypes of schizophrenia. Its main features are a preoccupation with one or more delusions or frequent auditory hallucinations. The delusional content (the beliefs) of the person with paranoid schizophrenia is marked by grandiosity or persecution, or both. Anger, irritation, or argumentative behavior may be the most prominent features, as is extreme jealousy.
However, when my mother was asked what Margarita had, she repeated that Margarita estaba mala de los nervios (she was suffering from her nerves), but she would recover one day when the “right cure” was found. Because of that, my father, my mother, and my abuela were always looking for new places or for new doctors or for new medications or for remedios that could reverse the course of the illness. That level of commitment to Margarita’s cure was something that I started to realize in my early adult years—as I began to study psychosis and mental illness. From that moment on, I not only deeply admired them, but it made me feel very proud of my family.
I was especially proud of my father, who played a very important role in my Aunt Margarita’s life. He was the person who always had las connecciones, because he had a lot of friends within the “Masonries” and because “the masons were a fraternity all for the one who is in need,” as he used to say. I don’t remember my father discussing the money that was needed to find la cura. He was always the one who traveled with Margarita and some other relative to the different hospitals in the capital Habana, or the one that went to take Margarita from hospitals to my grandmother’s house in Reglita, the small and poor suburban part of Central España where my grandmother was living with her younger son, Manuel.
In the decade of the 1940s, there was a Cuban psychiatrist who became famous for bringing to Cuba the Electro-Shock treatment for mentally ill patients. He constructed a brand new clinic, Hospital Galigarcia, at the entrance of capital Habana with trees and gardens for the patients to enjoy outside activities instead of having them in closet wards, sometimes with bars closing the entrance and big keys to open the lockers. I still ask myself how my poor family got the money to bring Margarita to that sophisticated psychiatric clinic. She was one of the first persons who received the treatment. Once per week for about two months my father rented a cab and traveled for five hours to Habana to bring Margarita for Electro-Shock treatment. He waited for her recuperation after it, and returned back with her to Reglita. She noticeably improved after the eight sessions, but a few months later she started to deteriorate again so she went back to La Quinta Covadonga for the rest of her life.
When I went to study in Colegio El Apostolado, a boarding school in Habana, every time that my parents brought me to the school or came to pick me up for vacations, we stopped for an hour in La Quinta Covadonga to visit Margarita. At the entrance of the hospital were men selling fruits for the patients. The fruits were tempting: the smell and the colors anticipated the delicious flavor. I loved those beautiful apples, pears, peaches, grapes, and bananas—fruits that we could not buy for ourselves because they were very expensive. My mother selected a few of them and with a paper bag we began to walk to the ward that was located toward the end of the center. I clearly remember the strange sensation I had always in my throat while we were walking through the different avenues to the last two wards: the one for the mentally ill men and the one for the mentally ill women.
I knew that we were going to visit mi tía en el manicomio and we wondered how we were going to find her on that day. After calling the door and waiting for a while, Margarita came with one health worker. Sometimes, she took the bag with fruits from my mother’s hand and started to bite the apple. But other times she was looking at us with her absent eyes, maybe trying to match our faces with her memories. My mother always cried when she saw her sister. She combed her hair, cleaned her hands and face, and commented about her clothes. She also asked the mental health workers how she was doing. The employees always said, “Esta mejorcita.” (She is a little better.) Sometimes Margarita recognized me and said, “Mira la Nena qué crecidita esta” (Look how big Nena is now). She usually put her hand on my head as if she were going to comb my hair with her hand. I have no recollection of a warm or caring feeling in the touching, but it was a touching that everyone appreciated as a sign of improving “because she recognizes Nena” (ella reconoció y recordó a Nena), her oldest niece.
Still today that memory and other memories of her comments hit very deeply in my heart because in one way or the other I felt and feel that we were linked one to the other, because she remembered me, she recognized me, because I was someone in her memory, because I had my space in her lost mind. In other opportunities, her eyes were empty, as if she were looking but not seeing, as if she were in other place, or occupied in other deeper thoughts and rejected the interruption. I remember the feeling upon the door being closed again and Margarita returning to her world as we needed to leave her behind to be cared for by others that were not her family. I felt and still feel such a deep sadness. I felt and feel sad for my mother, I felt and feel sad for my abuela, I felt and feel sad for Margarita, and I felt and feel sad for my family. I felt how sad it was for someone losing her or his mind, how sad a mental illness was.
From all the possible illnesses that a person can suffer in life, it is possible that the least understood and least known even today is the mental illness. At the time that Margarita was diagnosed as mentally ill many people like her had suffered discrimination and social disadvantage because they had a psychiatric diagnosis or a history of psychiatric treatment. The idea that mental illness should be treated with support, moral guidance, and kindness was not yet arrived to the mental health understanding of the Cuban psychiatry. As I related before, the more innovative form of treatment were the electro-convulsive therapy, which induced brain seizures by the application of high-voltage electric current. There were many theories that attempted to explain the function of Electro-Shock. One theory suggested that the personality was brought down to a lower level and adjustment was obtained more easily in a primitive vegetative existence than in a highly developed personality. Years later, the advent of tranquilizers provided an alternative. Tranquilizers are central nervous system depressant drugs classified as sedative-hypnotics. At therapeutic doses, tranquilizers generally relieve anxiety and may in some people induce a loss of inhibition and a feeling of well being. Many tranquilizers tend to induce sleep. As the dose of the tranquilizer is increased, so are the degree of sedation and the impairment of mental acuity and physical coordination.
For years I had this image of Margarita in my mind: her pale face, her bright eyes, and her delicate figure. Margarita was such a beautiful woman! Today I recognize that deep inside I was also very angry at the whole situation, because she could not live a normal life and because my mother was suffering so much for her. When I learned to pray, I always prayed for Margarita. “Para que Dios la cure de su mente.” (So God cures her mind.) A year later, during my adolescence, when I studied elements of psychology in tercer año de Bachillerato (third year of high school), there was a chapter dedicated to abnormalities of the mind: neurosis, psychosis, and illnesses related to the central nervous system. The memory of Margarita was in my mind and I really wanted to open myself to “Dra” Grace York and to my peers, and to ask questions about her illness, but I felt ashamed that my peers might found out that I had una tia loca (an aunt who is crazy). However, that class opened the door to my professional future: without doubts, I decided that I was going to study psychology, because I wanted to find all the responses. Moreover, I wanted to accompany those people that have lost their minds and through my support and undivided attention help them to break the illness cycle. I did want to discover all the secrets of the big mystery in front of me: mental illnesses.
Throughout my adolescence, I desperately wanted answers to the what, the why, and the how of mental illness. Later, during my adult life, I got degrees in the fields of clinical psychology and school psychology. I have studied how the mind develops and the description of abnormal minds, but I still have not found the answer to cure the mental illness. I guess that maybe there are many answers or because the answer has a little of all and every one of the other responses. However, what I have found is that prevention is, if not more important than the treatment, at least a new ground to break in the process of helping mentally ill patients, their families, and the communities where they are living. I do agree that we can and must prevent the spread of mental illness by educating and training people on mental health issues and that we can and must accompany families in distress. And in case it is needed, we must intervene to help family members to realign themselves after unexpected crisis. We can and must accompany students at risk due to poor self-image or to learning, neurological and emotional disabilities, we can and must break or change the black cloud before it becomes an irreversible crisis. The keys are education, support, advocacy, and real understanding of the physical, psychological, social, and even political conditions that foster people’s breakdowns.
As I will discuss later, after the Instituto de Cooperadoras Diocesanas ended its existence I went to work for two years at the Psychiatric Hospital of Habana, called Mazorra, where I was assigned to work with the psychotic patients—both men and women. At that moment the administration of the hospital was committed to change the conditions of the mentally ill patients. They just were hiring people for a new program called Ergotherapy or work therapy. I was part of the staff of this new department. Every morning I went there with my senses open to learn from the patients, to discover their inner secrets, the twists of their minds. Most of them came to the program so medicated that they were unable to produce responses. It was a real struggle between a few of us that wanted to provide intervention to motivate and to give a new avenue for the patients and those with long-time experience dealing with the patients that knew that they “must be” medicated so they can, at least minimally, function. A small group of the patients enjoyed doing drawings and paintings. I wrote a paper with the analysis of their paintings and with their testimonies. I even compared some of their styles with the styles of some painting schools of art, such as expressionism, cubism, and realism. That year, 1970, one of the members of the staff as well as the director of the department brought to an international exposition the paintings done for our patients as well as the paper written by me. It was an open-mind experience for the hospital but also for me—an experience that took me further in my professional life as psychologist.
Then I went to work with Los Hermanos de San Juan de Dios, in its Sanatorio for mentally ill patients, in the neighborhood of Los Pinos. My four years working with them was also a valuable experience for my future life as psychologist. From the brothers of San Juan de Dios, I learned that the unconditional acceptance of the mentally ill person is what really makes the difference in their lives. The magic word learned from the brothers of San Juan de Dios is compassion. To feel compassion for other is something more than to understand the emotions the other person is feeling, but it is lending a hand to the person, is holding the person, is walking with the person no matter what emotions they were projecting or experiencing at any given moment.
During all my life as professional psychologist, I have walked with the memory of Margarita in my intentions and deeds. At conscious and at subconscious levels, every time that I approach a child, an adolescent, and/or an adult who was or is suffering from emotional, psychological, neurological and/or psychiatric difficulties, I remember her and I care for every one of them as if he or she were another Margarita. Moreover, like my mother and my abuela used to take care of her, I never give up on them.
Margarita survived her mother and all her siblings. She died one New Year’s Eve when only my younger sister Yoya was in Cuba. She took care of Margarita’s funeral. She was the only one that went with Margarita to the cemetery.