Elena Makarova, MFT Psychotherapy in Palo Alto, South Bay and Mid-Peninsula
Therapy for Immigrants and People with Multicultural Backgrounds

After many years of clinical practice as a bilingual and bicultural psychotherapist, I have become an expert in working with immigrants and people from various multicultural backgrounds. For Russian-speaking clients, I offer psychotherapy and marriage counseling in Russian language. However, for immigrants who came from other cultures, I have found that experience and the particular issues that arise are often the same, regardless of culture or country of origin.

Moving to a new country is a complex multidimensional process that requires significant adjustments and changes in one's life. People with whom I have worked have shared with me their stories about settling down in a new land. Each story is beautifully unique, but each story is also full of challenges.

Below I have listed a number of psychological outcomes that may occur as a result of immigration:


"Nostalgia" - feelings of sadness and loss of native country. This often is a byproduct of having difficulty in assimilating to the differences of a host culture.
"Culture shock" - feelings of either dislike or worry resulting from a sudden change from a familiar cultural environment to an unfamiliar one.
"Dealing with a multicultural partner or spouse" - being overwhelmed by the added challenge and complexity due to the cultural differences between spouses.
"Disillusionment" - feelings of a disappointment in a new country as a result of any number of factors: being away from one's family, having left everything at home, living in a difficult climate, etc. This may cause difficulty in assimilating.
"Geographical change didn't result in better life" - recognition that the hope for a better life, a better relationships, and more opportunities for one's children has not resulted from immigrating. Rather, old problems and personal challenges have followed one to the new country.
"Adjusting to immigration at an older age" - feelings of loss of grown-up children who are now well assimilated into the new culture. Need to talk to someone in their native language.
"Increased stress" - feeling overwhelmed by too many tasks: supporting family, developing social networks, acquiring a new professional identity, and adjusting to a challenging work schedule. Rebuilding a life is not a small feat.
"Loneliness and alienation" - feelings of deprivation in familiar social network, language, friends, and culture with increasing awareness of living in a non-human world.
"Concern for aging parents" - feelings of distance and guilt towards aging parents, either due to being far away from them or need to find long-term care for them.
"Parenting issues" - feeling estranged from one's young children who are immersed in a new culture; feeling marginalized and not accepted in a school or other local communities.
"Survivor guilt" - feelings of having done wrong or not enough by surviving the traumatic event that triggered one's need to leave his or her native country or being forced to immigrate.