mental health – katherine stanley obando

What makes mental health such a ‘dirty word’ in Costa Rica?

Posted on January 29, 2020January 28, 2020 by stanleyobando

For this month’s Daily Boost focus on mental health, I knew I had lots of questions for Cris Gomar. I’ve written before about the founder of Vaso Lleno, a mental health initiative that encourages people in Costa Rica to open up and share their stories without fear of judgment, and how quickly she’d impressed me with her honesty and enthusiasm. This time around, however, I gave her the third degree. What I wanted to know, more than anything, was what she had learned from her work with Vaso Lleno about why mental health is such a challenge for infamously “happy” Costa Rica.

Here’s what she had to say. Excerpts follow.

Costa Rica has received tons of international attention as “the happiest country in the world,” but there are high suicide and bullying rates and other mental health challenges that you’re addressing with Vaso Lleno. Do you think that “happiest” reputation is harmful?

I’m not sure it is. I think that what has a bigger impact than that is the fact that Costa Rica is such a small country. We all know each other and, from my perspective, there is… an exaggerated fear of being judged. People panic and are ashamed to say that they aren’t as happy as people think. Costa Rica is like a small town, una finca, and that’s the reality.

Cris Gomar. Via Instagram @sharingmindspodcast

The thing about being the happiest country in the world has some valid and important elements. Education, the [lack of an] army, interpersonal relations, flora and fauna per square meter. We could take advantage of this much more. People are afraid to talk about mental health… How many businesses truly have a mental health protocol in their offices? How many offer psychologists or psychiatrists among their benefits?

When it comes to bullying, we need more data, and with suicide, there are data at the hospitals or the Judicial Investigation Police (OIJ), but they’re skewed because there are many suicides that aren’t identified as such.

What has surprised or taught you the most as you’ve developed Vaso Lleno?

I never thought Vaso Lleno would be so popular… the biggest lesson might be the enormous fear I have noted to be judged. There are so many things we don’t do because we are afraid of what people will think. These are barriers we create ourselves. A second really nice surprise and lesson has been the facility people have to connect when we start off believing that we are all human beings with feelings, and that we can use vulnerability as a tool.

Cris uses texts to show what anxiety looks like on the Vaso Lleno Instagram feed.

The third lesson is how much we dismiss how people feel. We have been taught to be afraid of sadness… and anger. If a child is crying, we say, “Stop crying,” before we ask, “What’s wrong?” Sadness and anger… are the body physically having a reaction. Your body is telling you that you need to do something about this. But diay, they told us that no, we can’t be sad.

How did you come to create Vasoterapia?

When you put two people who have never seen each other before at a table and ask them about their greatest regret… suddenly tears will flow, or one will embrace the other. You understand that we are made of emotions and stories and struggles, too, and successes. …How can we connect more? I can celebrate when my friend has a baby, but when she has post-partum depression, how many people come around?

Cris with a Vasoterapia set, designed to jumpstart conversations.

I realized that saying “mental health” is like saying a dirty word. People think that when you talk about mental health, you’re going straight for depression and suicide. When you talk about sex ed, you’re not going to talk only about prostitution… Mental health is really about respect. So I started to think about, how can we talk about mental health without talking about mental health? That’s what Vasoterapia has become. How people can recognize and identify their own emotions and lose their fear of talking to their partner, their families, take off all these masks we wear.

What we all need is support, with all our imperfections and opportunities and strengths and demons.

What’s next for Vaso Lleno?

Diay, pues, changing the world! I’ve realized Vasoterapia is a very good tool, so I’m making a children’s version, a Volume II, a couples’ version, and of course versions in English… And I’d love to continue doing monthly gatherings, spaces that are free from judgment and full of empathy. I’d like to visit more businesses, and schools as well. We’re taught all about the cordilleras and valleys and mitochondria, but not what to do when Grandpa dies, or when we break up, or lose a job, or when Dad is in a tough economic spot and we don’t know what to do. I’d like to work with little kids all the way up to teenagers: social media and how they affect our mental health, eating disorders, relationships, bullying.

And I want to write a book… I breathe and sweat mental health. I am fascinated by everything to do with it.

Learn more about Vaso Lleno and Vasoterapia here. Cris and I had planned to raffle off a set on the Daily Boost this month, but – she’s sold out! Stay tuned for a future raffle. Read more from this month’s special focus on mental health: TeenSmart’s inspiring stories of mental health victories by teenagers, tips from Margarita Herdocia for mental health for migrants and all those of us facing stress, and some further reflection on that “happiest country” title.

‘Be brave, because you are worth it’

Posted on January 21, 2020January 28, 2020 by stanleyobando

One of the unhelpful things people tell parents of young kids is, “Just wait until she’s a teenager!” I always say some version of, “You truly don’t need to remind me. I have been terrified of that since before she was born.”

As a middle-school teacher, I loved my students. I also saw the gap that, necessarily, grows between them and their parents. Now that I have a six-year-old telling me every thought that enters her brain, I’m even more aware of the chasm ahead – especially when I think about teenagers’ mental health and the isolation that can come with that time of life.

All of this is to say that I am already so grateful to Joven Salud, the platform that the international nonprofit TeenSmart International is using to serve more than 50,000 young people throughout Latin America and build dozens upon dozens of public-private partnerships that surround many of those teenagers with in-person attention. They can start with something as simple as reaching out to a trained online coach for support (up to 500 teens do so every week), or build to something as intensive as becoming a volunteer and leading programs for other young people. The online platform can reach young people few other programs can, including migrants and refugees.

Joven Salud recently shared the story of 18-year-old Yareth:

Thank you, Joven Salud, for putting this kind of support available to young people like Yareth. We need to make sure all of our teenagers have this tool in their pockets, especially those who need it most. At a time when some of Central America’s most vulnerable youth are on the move, losing access to the already tenuous services they might have had at their school or in their communities, a tool like Joven Salud and an organization like TeenSmart isn’t just a nice option. It’s vital.

Lessons at 40

Posted on January 20, 2020January 28, 2020 by stanleyobando

Since my birthday is in January, I get to mull over the past year of my life and the past calendar year all at the same time. Here, in random order, are some of the things I learned from a bumpy 40/2019:

Having a sunny view of life is a gift. If you consistently overestimate people, you will get hurt sometimes – but it’s probably worth it.
You must, however, find people you trust who tend to think the worst of people, and tend to be right. You then need to listen to them. Even if you plunge ahead despite their warnings or have no choice in the matter, they’ll help you fall a little more gracefully.
An obsession with unicorns is contagious. (Sighs, sips from unicorn coffee mug.)
It really is true that everyone should go to therapy at some point. I am totally going to be that mom who offers to buy her teenage daughter some therapy sessions and is met by an eye roll so intense she will need medical care afterwards. You think that running is your therapy, or your best friend is your therapy – but only therapy is therapy. There is nothing like talking for an hour a week to a person whose only job is to look out for your mental health and well being.
Women are incredibly resilient. Also: many people, including many women, love to talk about women being catty, or stabbing each other in the back, but that’s the biggest scam in history. It’s absolutely astonishing the things women will set aside when their principles are on the line.
Media organizations should be owned by journalists.
Confidence and talking about your own accomplishments are not the same thing. In fact, they often have an inverse relation.
Eighty percent of insects have not even been named yet. Isn’t that insane?
Vulnerability is the source of all power, because power comes from not caring what else happens to you next. Only when you are at the bottom looking up, or laying everything bare because there is no other option – only then are you truly powerful.
Finally: Adulthood is not conferred by any particular milestone, but rather revealed by sudden stress. You expect it when you get your diploma or your first paycheck, or when you walk down the aisle, or when you get wheeled into the delivery room, but it never arrives at those moments. You realize that it has happened when something unpleasant and totally unexpected takes you to the edge of a chasm, and you have no choice but to take a step out into the ether like Indiana Jones and hope that a bridge appears. It sucks, and it’s awesome, because when that bridge materializes under your foot, it’s made of everything: every shitty life lesson you would rather have skipped, every meaningful mistake, parents present and gone, friends and foes, hidden treasures you didn’t know you had. I look at my daughter and imagine that moment in her future. I am not eager for it to arrive, but it gives me additional understanding of why helicopter parenting is so silly. It all goes in the concrete mixer, good and bad: both valuable, both sturdy enough when the time comes.

That’s what I’ve got. What did you learn last year?

The overlooked mental health of migrants – and a wellness tip for all

Posted on January 15, 2020January 28, 2020 by stanleyobando

In what I think of as both of my countries, the United States and Costa Rica, waves of migrants and refugees fleeing violence and oppression have dominated plenty of headlines in recent years. However, the impact of migration on mental health is generally not at the forefront, at least not for adults. Since I’m an immigrant myself, this topic is close to my heart, not despite the privileged way I migrated but because of it: the fact that I immigrated voluntarily with every economic, linguistic and cultural advantage, but experienced loneliness and homesickness nonetheless, makes me particularly keen to know more about how the migrants and refugees pouring over borders are coping.

I know lots of Daily Boost readers are in the same camp, so this seemed like a natural place to start when exploring mental health this month. Obviously, it’s incumbent upon the countries that receive migrants and the public and private entities that serve them to provide medical care for serious mental health issues, but I was also curious how organizations are dealing with the earlier steps – providing general support and alleviating sadness. To learn more this, I called Margarita Herdocia.

Margarita Herdocia (second from left) with HUG fellows. Via FB/Ticos y Nicas

Margarita is an extraordinary leader in business and philanthropy whose life story could take up this whole post, but who, among many other efforts, is the president of the Asociación Ticos y Nicas Somos Hermanos, which helps fight xenophobia and support migrants to Costa Rica. Passionate about the violence taking place in her native Nicaragua and the need to help young refugees here continue their university education, she has spearheaded the Humanitarian University Grant (HUG) Program and to fund the continuing education of more than 21 young Nicaraguan refugees.

Thanks to donations from many supporters, the group keeps growing so that these bright young Nicaraguans don’t miss their chance to continue learning. The way Margarita sees it, it’s a huge opportunity not just for Nicaragua’s future, but also for Costa Rica as the host for these brilliant young people – and having met some of the scholarship recipients, I fully agree.

Here’s what she had to say about ways she seeks to support the mental health of her students, and how these practices can apply to all of us:

To learn more about the HUG program or the Asociación Ticos y Nicas and how to sponsor a HUG scholar, visit their website and Amigos of Costa Rica affiliate page. Read more about my January focus on mental health here.

Green spaces for a new generation

Posted on January 14, 2020January 28, 2020 by stanleyobando

One of the changes I’ve noticed anecdotally over my years in Costa Rica is that the gap between city and country seems to have grown at a dizzying pace. While my husband was raised minutes from where we now live, this fully developed area was pure cafetal during his youth; he spent many childhood days playing outside among the coffee plants, trees and rivers. He has been working since the age of 14 and therefore never took long trips, it was easier and cheaper back then for families to get out of the city limits (which were also much smaller) for a few hours or a night. As a result, when we head to the country, we had not to some foreign place but to the Costa Rica of his youth. He may not know how to deliver a calf, but he is, let’s say, conversant with country living.

I worry about the San José kids of today. Their lives are so different – both from my husband’s childhood (“in the age of yore,” as my six-year-old daughter says) and from their rural peers’. Heightened costs mean that many San José families are less likely than before to explore the country in a meaningful way. Safety concerns mean that most of them don’t play outside alone anymore, a change that sometimes bleeds into not playing much outside, period. Screens – well, we all know about screens.

It’s hard for me to believe that the new generation of urban Costa Rican youth will be as comfortable with the country’s flora and fauna as their predecessors. This has serious consequences for the environment, but also for the mental health of that generation. You don’t have to be a forest bathing devotee to understand that a relationship with nature makes a difference in our lives. Costa Rica is a place that people visit from all over the world to rekindle that relationship, but its city dwellers are increasingly cut off from it.

That’s why I like the efforts to teach us about our urban trees and plants. It’s not a new idea – the B Corps Bioland has been planting and labeling trees for years – but I’m seeing it more often, including in our town, where the Municipality of Curridabat’s Ciudad Dulce and iNaturalist programs are identifying trees and even providing QR codes so you can learn more about the species that make even urban spaces such biodiverse places in Costa Rica. When we saw one the other day, my husband said, “That’s silly – every Tico knows what that plant is.” But I’m pretty sure today’s youth do not. If one out of 1,000 read the sign or scan the code – and if the rest of us are gently reminded that “the environment” is not something far away but the spaces we live in every day – then it’s all worth it.

I know that municipalities without the staggering resources of Curridabat, home to some of the country’s richest districts, have other priorities to attend to. So I’m grateful for all those that manage to keep their green spaces on at least their back burner, and for initiatives like Rutas Naturbanas (more on them soon!) that help bridge the gap. Costa Rica’s natural beauty should not be reserved for people with cars, or people with money, or people who live in neighborhoods with resources to lavish on their parks. In fact, the future of those natural resources depends on how well the country makes natural experiences accessible to everyone, the future voters.

Why Costa Rica should back up its ‘happiest country’ brand with real talk in 2020

Posted on January 13, 2020January 28, 2020 by stanleyobando

Happy Monday! In 2020, I’m taking the Daily Boost up a notch with a monthly theme, and this month’s is (drumroll please)… mental health! Yes, I’m starting late this month because my mother was visiting, and there’s nothing more important to my mental health than soaking up every minute she’s around.

Every month, I’ll highlight changemakers related to the theme, sharing not only their stories and work but also their tips for travel and living in Costa Rica. I’ll even do a giveaway related to the theme because, in Costa Rica, name just about any social or environmental issue, and I’ll show you small businesses, artisans or nonprofits creating cool products within that wheelhouse. Obviously, not everything during a month will relate to the theme – I’ve gotta save room for plenty of randomness.

So why mental health for January? Because this is a critical and exciting time in Costa Rica for people who care about this issue, and I couldn’t think of a better way to start the new year. First, the critical: Many in the country’s tourism industry tout Costa Rica’s reputation as “the happiest country on earth,” but it is struggling with high suicide rates. The public health care system is working to improve its attention to mental health issues; as with any kind of health care, access is vastly different for different economic groups and geographies, and stigma surrounding mental health disorders worsens this breach. Last year’s emergence of sexual assault and abuse allegations surrounding public figures in Costa Rica provided a glimpse into the massive lack of resources and support for people grappling with mental health challenges arising from abuse. A massive influx of migrants, especially from Nicaragua due to the terrible violence there, has created its own set of emotional problems for people living in exile and isolation.

The exciting part? In Costa Rica, as in many places around the world, mental health champions are not only working steadily in the shadows as they have for years, but also harnessing the power of social media to start lifting the veil on these issues and casting aside the shame that so often results from and contributes to mental health disorders. What’s more, nonprofits focused on teen health and migrant well-being are finding new ways to offer support. In the coming days I’ll be sharing insights from Cris Gomar, founder of Vaso Lleno; migrant rights advocate Margarita Herdocia; and the outstanding nonprofit TeenSmart.

Assessing the happiness of a population is a worthwhile task, because it’s part of creating national indicators that go beyond the economic. What’s more, the public health achievements and strong social networks that help power Costa Rica’s high happiness rankings are worthy of celebration and study. However, the downside is that the “happiest” label makes it even easier to sweep problems under the rug. Here’s to a year in which Costa Rica’s happiness titles are increasingly used as a conversation-starter, rather than a reason for self-congratulation. That way, the studies and accolades will not only celebrate Costa Rica, but also make it a happier place – for real.

Day 58: A champion for mental health in Costa Rica

Posted on December 4, 2019 by stanleyobando

I met Cris Gomar for the first time earlier this year to discuss a potential journalism project. She is literally dedicating her life to creating safe spaces for people to open up, so it’s probably no surprise that we quickly fell into one of the most honest and vulnerable conversations I’ve ever had, all in the middle of a crowded coffee shop. I was fascinated to learn about the mental health initiative Cris had started, Vaso Lleno – more on that on a minute – and the inspiring way in which she, by being honest about her own mental health challenges, was opening the floodgates for people in Costa Rica to ask for help or simply tell a painful story they’ve kept secret for years.

I told her how much I would like to cover and engage in her work through the media organization I was leading at the time. After we finished our long conversation and said goodbye, I stayed behind at the table to do some work. An older woman who had been sitting at the next table and whose group was getting up to leave came over and touched my arm.

“Don’t forget about the men of Los Santos,” the woman said quietly, referring to a coffee-growing region in the mountains to the east. “The suicide rates are very high there. They need a way to share their stories, too.”

And she left.

I tell you this to illustrate how urgently the work of Vaso Lleno, Cris’s mental health initative, is needed in Costa Rica, a country where a variety of cultural factors often lead people to hide their struggles. I’ve learned from Cris and other advocates that some of those factors include the lighthearted, “pura vida” good humor that makes people assume their fears or pain might not be taken seriously. Machismo, which makes many men feel that there’s something wrong with them if they feel bad. A widespread assumption that if you do need to talk to someone, that someone should be your priest – which, especially for women and the LGBTQ community, moves an awful lot of topics off the table.

Enter Cris. Through Vaso Lleno, she is sharing stories of anxiety, depression and other challenges from her own life and the lives of the people who, in her growing online community, are opening up about the problems both big and small that have made their lives more difficult. She was inspired to do this work after experiencing a debilitating anxiety attack and learning first-hand what can happen when we push our mental health problems out of sight. Vaso Lleno means “full glass,” and she says she chose the name because your glass is always full – even if there are bad experiences in it, you can transform them. It began as a thesis project in 2010 and is now a vibrant social outreach initiative.

She creates anonymous surveys where people can simply tell their stories – and to which Costa Ricans respond in astonishing waves that show the extent of the problem. In November, she launched a survey just for men, and from her updates, it seems that she received an epic response. She organizes support groups and other in-person experiences. She shares posts both hilarious and heartbreaking that illustrate what anxiety looks like. She gives speeches that spark massive responses from people who are so relieved to feel that maybe they aren’t so alone after all – like this one, where she also talks about what it’s like to be a tall woman in Costa Rica. (Yes, this is another reason I could relate to her so quickly.)

Now, Cris has created Vasoterapia, a pack of conversation starters. I haven’t gotten my hands on one yet, but from the looks of them, they are a mix of funny and deep, just like Cris herself. She says they are great for kids, families, couples, friends, any group – and the people are already contacting her to let her know how much fun they had and how they learned surprising new things about the people in their lives. (I’d venture to say that this would probably be a great gift for a Spanish teacher in your life.) My main reason for picking them up is that I’m more and more convinced every day that Vaso Lleno is filling an urgent need in this country and world, and I want to support it in any way I can.

I’m hoping to do a deep dive into wellness in Costa Rica in January, so you will be hearing more about Cris and mental health soon. Until then, if you’re a Spanish speaker, I invite you to follow her on Facebook or Instagram (as I write this, it looks like the way to acquire Vasoterapia is by simply messaging Cris there). One thing’s for sure – there is much more to come from this rising leader.

Day 43: The curse of multitasking

Posted on November 13, 2019 by stanleyobando

Costa Rica is one big invitation to stop multitasking, but San José is all about it. This is partly because of all the traffic. How are you not going to distract yourself with your phone while on a bus for two hours or sitting motionless in a car?

Yesterday I announced triumphantly to my husband that I had written 3,500 words of my novel on the way home. He looked appropriately alarmed. I explained I had just turned on voice-to-text and narrated aloud, producing such sentences as “She miss being and not T cozies” but capturing a huge chunk of action nonetheless.

Somehow this morning, while thoroughly distracted, I stumbled on this six-year-old piece by a young mother that says it all. I never had a moment of panic the way she did, but I think most parents today have experienced that panic in smaller ways, which is why her piece resonated so much: it’s the panic of that sudden return to the self, the kid tugging on your sleeve, the “Why am I even doing this right now?” mini-epiphany that fades away the next time technology beckons. We think that something needs to be done now, and it doesn’t. Our kids, who are always now, get less of us as a result.

I don’t think that’s always so bad. It’s fine for kids to be ignored sometimes: it balances out some of our weird helicopter-parenting era and gives them some time and space to create cool things. Sometimes, when I’m busy and my daughter wails, “I’m bored!” I even smile to myself, knowing that with luck, this declaration means that thirty seconds later I’ll find her immersed in an amazing game of her own creation. Only we, the parents, know the difference – the difference between insisting on five more minutes to finish writing something that really matters to me, and half-listening to her story because I’m dealing with some work email that no one even expects me to answer til the morning.

Has anyone out there, reading this, found ways to become one-taskers more often? I have a very pretty Phone Box that I need to dust off and start to use again, but I’d love to hear other ideas. Most of all, I hope to listen a bit more to the rest of Costa Rica, the land that lies outside these city limits, full of places that call to all of us to do only one thing at a time.

Day 38: Let’s talk about anxiety

Posted on November 6, 2019November 5, 2019 by stanleyobando

At some point, if you’re serious about boosting your spirits over the course of a year, you’ll pull some nasty tangles out of dark corners and see if they look different in the light. Sometimes they don’t. But it never hurts to try.

Earlier this year, a doctor used the word “anxiety” to characterize some of my behaviors for the first time ever, and I’ve been pondering it ever since. I was taken aback, but quickly realized he was calling a spade a spade: it was like seeing the hidden shape in a Magic Eye drawing all of a sudden after years of squinting away at it. I chose this photo of a hummingbird for today’s post because that’s the best way I can think of to describe it – what one mind might achieve in long, deliberate wingstrokes, mine achieves through teeny tiny flutters.

This morning a hummingbird got stuck underneath our eaves. It couldn’t figure out that an overhang of clear plastic roofing was actually a solid object and tapped away at it frantically for what my husband said was just a few minutes but which, to my anxious brain, seemed like hours. Meanwhile, another hummingbird kept darting back and forth, trying to show its friend that it was really, really easy to find another way out. The confused bird finally noticed the giant park just to its left and darted away. I watched it, thinking, I see you, buddy. I’ve been there. Maybe I’m there right now.

I can’t trace this to any particular cause. It’s just the way my brain seems to work. Sometimes I swear you can hear my mind whirring away, my hummingbird next to my husband’s hawk, surveying the world from the heights. “What are you thinking about?” I’ll ask him sometimes, and he might reply: “Nothing much.” This is unfathomable to me. My thoughts spin, incessant.

It’s what makes writing so easy and fast for me, and true rest so difficult. It’s why I attempt meditation and then swear. It’s why I love running, I think, because it moves the hum in my head to my legs and then lets my brain slow down just a touch. It’s why sadness or depression make me speed up instead of slowing down.

I don’t have anything profound or useful to add to the conversation I see happening in the world about anxiety, but I do want to be one of the people who is open about her struggles, especially since I think that openness is just starting to come to Costa Rica and should be hastened along wherever possible. I want to be more like Cris Gomar, who, through her mental health initiative Vaso Lleno here in Costa Rica, has been creating some terrific posts about anxiety lately in hopes of removing some of the stigma from it and raising awareness of what it’s like to be inside our heads. For example, her friend texts her simply, “Cris,” and her mind responds with a host of worst-case scenarios (the friend hates her, family members have been hurt) before the friend continues by asking if she can borrow a shirt.

Yup. Sounds about right.

Costa Rica is often hailed as the happiest country on Earth – it even says so in our airport – and every time I see that title now I wince a little, because I don’t think such a silly title is good for mental health. This is a country of wonderful serenity and positivity, and it is also home to cities that are very difficult to live in, and an extraordinarily high cost of living and economic stress, and brutal inequalities, and so forth. You’re not a freak if your brain generates six different alerts between your name and “can I borrow a shirt?” You’re a human. You’re a human in a country where mental health struggles and suicide are very real, and where pulling crap like this out of our closets is a much needed exercise. Maybe our fast-moving hummingbirds do better once they get out from under the eaves.

Have you found or hear about any good strategies for dealing with anxiety? Have you noticed any differences in attitudes towards anxiety or mental health across cultures (or even across languages)? My ups and downs over the past few years have left me with what I think will be an enduring fascination with this topic, so I’d love to hear from you.

Day 29: Is there a park calling your name?

Posted on October 24, 2019October 23, 2019 by stanleyobando

Can you name the Costa Rican park where I took this photo? Do you have a favorite – national, city, private? Dog park (man, I know a nice one in Eastport, Maine)? Random-corner-that-isn’t-technically-a-park-but-makes-you-happy? I’ve been collecting parks in Costa Rica for 15 years, and there are few habits that have done more for my mental health than those escapes, no matter how short.

If you can, wherever you are today, drop by a park and take a break. Because sometimes, #travelthursday is just that simple.