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— 'Go to the border between 5:00 and 7:00 in the morning, and you can understand something about my patients' lives. At that time in the morning, the border is crazy. People honking, yelling, fighting for a place in line. These people are under tremendous pressure to arrive on time to their jobs in San Diego. They're afraid that if they're late, they'll lose their jobs. And the border's always unpredictable. You can never be sure how long it's going to take you to get across. So the day begins in a very stressful way, and then there's the usual stress at work. Usually, you get home at around 9:00 at night. Often, there's lots of traffic getting back into Tijuana. You have just a short time to eat, talk with your children, take care of family matters. You go to sleep early because you have to get up early to cross the border. Then the whole process starts again. Where I work in Colonia Libertad, a great many people work in San Diego. This is what their lives are like. People come home at night, and they're hungry, exhausted, and they argue. That sort of life is hard on marriages. It's not so surprising that such marriages end in divorce."

Olivia Aguirre is, to her knowledge, the only psychotherapist in Tijuana who deals primarily with children of divorced parents. ("There are certainly other psychologists and therapists who see children whose parents are divorced, but these kids make up the bulk of my practice.") Although she has no hard statistics on the incidence of divorce in Colonia Libertad, she does know that, according to statistics published last year by the Mexican government, the divorce rates in Tijuana, and Ensenada, are some of the highest not only in Baja California, but in all of Mexico.

"It's not only that border life is itself stressful, but Tijuana is less traditional than other cities in Mexico. People here have come from everywhere. In many cases, they've left their extended families behind. They don't have that support."

Aguirre's family moved from Guadalajara to Tijuana when she was six years old, and she returned to Guadalajara to attend a Jesuit university, where she studied psychology.

"The Jesuits have a very open-minded approach to psychology, with a great emphasis on serving the community. The most important thing they taught us was humility. They taught us that it wasn't enough just to study psychology. You studied psychology in order to serve people. Which is why I think my practice in Colonia Libertad is important. A lot of people there don't have many resources. I can really make a difference in their lives.

"In some ways it's an unusual community. It's one of the oldest that was established outside downtown Tijuana. It has a reputation for being a poor neighborhood. People in Colonia Libertad feel a strong tie to the place. They may go to San Diego to work, but they don't venture much into Tijuana. They say, 'Why leave the neighborhood? We have everything we need right here. Bakeries. Butcher shops. Hospitals. A hotel. When I drive around Tijuana, I get lost.'

"My uncle, who's a pediatric surgeon, has a clinic in Colonia Libertad, and another, just a short distance away, in Zona Rio. Sometimes when he can't see patients at his Colonia Libertad clinic, he suggests they go to the one in Zona Rio. They say, 'No, thank you. I'll wait until you can see me here.' They have a very different mentality."

In the early 1990s, Aguirre interned at the AIDS Foundation San Diego. One of her closest friends had died of the disease, and she felt her work at the foundation was a way of honoring her friend. Her experience, however, prepared her for her work in Colonia Libertad.

"At the time I was at the foundation, there were very few Latinos working with AIDS patients and their families. What I learned was how important it is for a patient to have someone who speaks his language. In reality, there are very few people in the United States who are truly, 100 percent bilingual. There are professionals, of course, who speak good Spanish, who are quite fluent. But there are many cultural references they don't understand or fully appreciate. Simple things, like the importance of the Virgin of Guadalupe in Mexican culture, or references to food, or even Mexican sports teams.

"I know these things sound insignificant, but in order for therapy to be effective, in order for it to truly help, there has to be a sense of empathy between therapist and patient. Humor, for example, is an important way that people become more comfortable with each other and establish empathy, a rapport. Mexicans are very playful in Spanish, and there are lots of Mexican puns. It's extremely rare to find a non-native speaker who understands and appreciates Mexican wordplay. Without that sort of understanding, an important element of communication between therapist and patient is lost.

"There's also the issue of slang, which is very elaborate in Mexico. There are also Mexicans who don't speak Spanish all that well. For indigenous people in Chiapas or Oaxaca, for example, Spanish is their second language. If you haven't been raised hearing all the slang, all the variations of Mexican Spanish, you can have a hard time understanding what a patient's trying to get across.

"Language is one reason that some of my patients come from as far away as Los Angeles and San Jose to my clinic in Colonia Libertad. They need to see a therapist who truly speaks their language and knows their culture. Often they've sought counseling or therapy in the United States, but they didn't feel they were really being understood. Another reason is money. They can't afford to see a therapist in the United States. I charge only $20 per session. In Tijuana, some family therapists charge as much as $75. In Colonia Libertad, no one could afford that. Another reason they come from so far away to see me is that they're afraid that if they go to a therapist in the United States, either their children will be taken from them, or they'll be deported, or both.

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