Cultural Trauma of Elderly Refugees from Bhutan: Spiral of Loss and Cultural Bereavement in Resettlement

Background and Purpose: Refugees from Bhutan represent a large portion of the overall refugee population currently being resettled in the United States. With the Bhutanese refugee elderly population comes specific barriers that serve to marginalize this community. Barriers such as inference in cultural identity and transmission, acculturative stress, unmet expectations for cultural practice, and language barriers serve to challenge the Bhutanese refugee’s ability to cope resettlement stressors and integrate into the host community. Additionally, Bhutanese refugee elders are at a higher risk for adverse experiences due to the health and mental health concerns related to both aging and migrating experiences.  This paper explores adverse intercultural experiences among Bhutanese refugee elders with a focus on cultural losses and bereavement and discuss the importance of cultural resources in life transition.

Methods: The current study adopted a qualitative research method, using focus group interviews with 24 Bhutanese refugees who are over 50 years old. This study was conducted as part of community-based participatory research (CBPR) to develop and implement community wellness workshops. Focus group interview questions were embedded to the community workshops to explore refugee experiences in Bhutan and Nepal, differences between home country and the U.S., and adjustment to the U.S. A thematic analysis was employed to extract and categorize themes aligned with theoretical framework of cultural trauma and bereavement.

Results:  Results showed a thematic pattern of how cultural losses and challenges among Bhutanese refugee elders impede daily functions and resettlement outcomes. Transitioning to individualistic Western society from a communal lifestyle has added tremendous stress and eroded traditional coping resources that are based on cultural and religious practice. Bhutanese refugee elders have gone through such cultural trauma as losses of language, native customs, and religious practices in the home country that caused forced migration. It was notable that cultural trauma continues after resettlement and such trauma is characterized by not only acculturative challenges but also difficulties in accessing religious and cultural coping, such as communal space or time for mutual aid, grief and celebration. This transition likely leads to loss spiral and devastates emotional distress particularly among Bhutanese Hindu refugee elders. The loss of cultural identity continues coupled with diminished social support systems has had a tremendous effect on the Bhutanese refugee community.

Discussion: This study revealed how Bhutanese elders experience the marginalization of the Hindu Bhutanese culture through the diminishment of the native language, religious practices, and professional and functional abilities of cultural knowledge. The current study highlights that cultural trauma is an ongoing experience in Bhutanese refugee elders at both individual and communal levels, which informs the importance of interventions and services to empower cultural and religious practices both in refugee individuals/families and the community.