Meanings of “Sadness” and the Use of Religious Beliefs and Practices by Brazilian Women in the Boston Area

-Andrea Allen

The “Mental Health: Culture, Race and Ethnicity” supplemental report to the Surgeon General’s Report on Mental health issued in 1999, concluded that minorities are less likely than white patients to receive accurate diagnoses and proper treatment for mood disorders, due to factors such as racism and discrimination. Additionally, a most revealing finding of the study was that ways of defining and describing symptoms of emotional distress may differ, based on the ethnic and racial demographics of the patient.¹ This study explores the articulation of emotional distress and its relationship with religious beliefs and practices among Brazilian women in the greater Boston area.

In the last decade there has been a great influx of Brazilian immigrants to the United States due to economic and social conditions in Brazil. Unfortunately, the 1980 and 1990 U.S. censuses were not accurate indicators of the Brazilian population in the U.S. According to one scholar of Brazilian migration to the United States, Maxine Margolis, there may be perhaps 350,000 – 400,000 Brazilians in the United States.² A large number of these immigrants live in New England. An official of the Brazilian Immigrant center in Allston, Daniel Tavares, has estimated that about 150,000 Brazilians were living in the New England area, with 70,000 individuals living in the greater Boston area and in Worcester and Middlesex counties.³ The presence of Brazilians is also vividly felt in cities in Massachusetts such as Cambridge, Somerville, and Framingham. Medical professionals within the field of mental health, and especially general practitioners in urban centers of New England, are therefore likely to come into contact with Brazilian patients.

Yet despite their presence in the New England area, New York City, and West Coast cities such as San Francisco, Brazilians could be considered an invisible minority in the United States and within the overall Latino community in this country.⁴ Linguistically and culturally, Brazilians differ from other Latin American countries, because Brazil was a Portuguese colony whose society was deeply influenced by African traditions and cultures. During the colonial era, 40% of the enslaved Africans sent to the Americas became inhabitants of Brazil. Consequently, there are more people of African descent in Brazil than in any other country in the Western hemisphere, and second only to Nigeria in the world.⁵ The Brazilian community in the greater Boston area is therefore an example of a group that fits into both categories of being Latino and having members of its community be a part of the African Diaspora.

Due to the influences of language and culture, however, Brazilian Americans have routinely been overlooked in Latino discourses. For example, several studies have been done specifically looking at Latinos and depression in the United States. One study compared suicide rates and the relationship with major depression among whites, blacks, Mexicans, Cubans, and Puerto Ricans in the United States.⁶ Another study analyzed the relationships among depression, social interest, and acculturation of Latinos from at least 15 Latin American countries.⁷ Both studies failed to include Brazilian Americans.

Ethnographic studies have shown that there are a variety of ways that cultures describe emotional states and feelings. More specifically, these expressions do not necessarily have direct English equivalents.⁸ Hence, mental health diagnoses may become problematic for American clinicians when treating patients from other cultures whose primary language may not be English.

Ethnic or racial groups also have unique cultural traditions and heritages that may reflect or intersect with specific religious ideologies. The diversity of religious or spiritual expressions is another factor that the medical community may encounter when dealing with Brazilian patients. Various forms of Christianity such as Catholicism, Pentecostalism, and Protestantism constitute the religious background of Brazilians. In addition to the practice of Christianity by Brazilians, Umbanda, Candomble, and Spiritualism are also religions that are part of Brazilian society.

Research focusing on culturally defined emotional states and related recourse to religion is important because of some individuals may rely on their faith as a primary source of healing. As these individuals encounter biomedical clinicians, misunderstandings and lack of knowledge on the part of the clinician may decrease the possibility of a patient finding satisfactory healthcare. In order for the medical community to be aware and cognizant of the notions and concepts about cultural perceptions of emotional states and mental illness, and the influence of religious beliefs and practices that Brazilian women bring to a doctor’s office or a clinic, research is necessary.

Indeed, medical anthropological literature indicates that there is a significant relationship between mental health care and religious beliefs and practices. For example, a study was conducted in Campinas Brazil that investigated the correlation among religious affiliation, mental illness diagnoses, and hospital stay of Pentecostals and Catholics.⁹ Several articles or reports investigated the role Afro-Brazilian religions as sources of mental health care.¹⁰ However, all of these studies were conducted in Brazil, and not the United States. Also, they did not primarily focused on women.

This study will contribute to the building knowledge of how ethnic or racial groups, specifically Brazilian women in the United States, talk about culturally-based ways of describing and expressing feelings and/or symptoms that come under the broad heading of “sadness,” or “tristeza.” We will also ask how women may employ spiritual beliefs and rituals as one way of responding to these feelings. There is a range of emotional states and expressions of sadness in all communities and societies. Comprehending how Brazilian women form notions surrounding emotional well-being will provide physicians necessary information in order to give culturally competent healthcare to their patients.

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