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A Book Review of The Pain We Carry

The Pain We Carry. Healing from Complex PTSD for People of Color
by Natalie Y. Gutiérrez

The Pain We Carry. Healing from Complex PTSD for People of Color by Natalie Y. Gutiérrez (New Harbinger, 2022). Paperback, 188 pp.
A review by Lucila Vargas
I've often been frustrated with self-care books because most focus on the individual, neglecting the societal structures that enable and constrain the agency of individuals and communities. But reading Natalie Y. Gutiérrez's The Pain We Carry. Healing from Complex PTSD for People of Color was deeply satisfying.
When reading the book, I felt like a caring voice was talking to me, frequently stopping to ask me to check how potentially triggering content landed on my soul. Also, I appreciate her vulnerable disclosure of her heart-rending memories. As a Latina like Gutiérrez, I identify with her, and her disclosure reaffirms that the pain I carry is indeed our people's pain.
Gutiérrez (a pen name for Natalie Yvette Román Cortés) is a curandera and a licensed marriage and family therapist. She belongs to the decolonizing mental health movement that rejects the dominant healthcare paradigm and denounces the traumatizing effects of colonization. Her book is one of New Harbinger's Social Justice Handbook Series and comes with a foreword by Jennifer Mullan, author of Decolonizing Therapy (W.W. Norton, 2023). Accordingly, Gutiérrez argues that liberation is the purpose of self-care and that racism is the root cause of complex PTSD among Black, Indigenous, and people of color (BIPOC).
The phrase on the cover describes the book in a nutshell: "Reclaiming wholeness despite the burdens of systemic, intergenerational & attachment trauma." Gutiérrez considers several levels at which wounding and healing can occur: the individual, the family and lineage, and the "culture" or system.
The book mostly follows the self-care genre's conventions. Each of its four parts has three chapters similarly organized to include a vignette(s), an explanatory section, and an "empowerment step" with practice guides. Gutiérrez dedicates the first two parts to the mainstream psychological models she applies, attachment theory and internal family systems. She also incorporates other significant cutting-edge contributions, such as polyvagal theory.
Gutiérrez discusses intergenerational trauma and disconnection from the Self and the Spirit in the remaining two parts. Here, she expands on racism's cultural legacy burdens and hones on internalized racism. And, without disregarding structural constraints, she underscores individual agency: "You are the source of your healing. You are the medicine for complex posttraumatic stress" (p. 173). She writes that you can heal yourself by "living with intention and making choices from a place of awareness" (p. 179).
Roughly half the book consists of practice guides for spiritual growth and for developing body-based self/coregulation skills (many of the latter are inspired by J. Eric Gentry's Forward-Facing Trauma Therapy). Further, audio recordings of several guides are available at newharbinger.com, and the book includes numerous creative prompts for reflection and journaling. But what I find particularly refreshing are the guides for spiritual growth that include making altars, invocating ancestors, and performing limpias (soul cleanses).
Applying Richard Swartz's Internal Family System model, Gutiérrez recognizes four cultural legacy burdens: racism, patriarchy, materialism, and individualism. She centers racism and endorses a collectivist and spiritual orientation to mental health care. However, I wish she would also have examined patriarchy. There are two women for every man who has complex PTSD, most likely due to the prevalence of femicide, sexual assault, and intimate partner violence.
Gutiérrez frames the book with her "Cultural Empowerment Approach to Healing." The word "empowerment" has been co-opted and diluted. Still, it's worth reclaiming it, albeit with an updated conceptualization of power as diffused and multidirectional, as illustrated for example by French philosopher Michel Foucault. This will encourage authors like Gutierrez to fully consider the role oppressed individuals and communities play in the reproduction of society.
To her merit, she stresses colorism among the global majority and recognizes her privilege as a light-skinned Puerto Rican. "Colorism is a painful personal burden, fueled by the cultural burden of racism that's perpetuated among the Latiné community and other Communities of Color" (p. 40), she writes.
I see her approach as an effort to foster what Brazilian theorist and educator Paulo Freire called "critical consciousness" (as opposed to dominated consciousness) in his influential Pedagogy of the Oppressed (1968). His ideas are closely associated with Liberation Theology, and they inspired Ignacio Martín Baró's liberation psychology, which has gained momentum in Canadian and U.S. circles in the last decade or so.
The tenets of liberation psychology overlap those of the decolonizing movement, and Gutiérrez is probably familiar with them. Yet, I wish she would have acknowledged this important Latin American school of thought, especially because it highlights economic oppression. After all, the colonization project has robbed land, extracted natural resources, and transformed the colonized people and their labor into a commodity.
Gutiérrez strives to be inclusive of various social differences (e.g., gender), but Swartz's model is limiting because it overlooks political-economic oppression. Consequently, the book would have benefited from due attention to poverty, classism, and the colonization of our most intimate realms by market principles in late capitalism.
Given that the book spotlights racialization, I would have liked to see more inclusion of Asian Americans. This shortcoming probably has to do with the publisher's imperative to issue a short book for a vast readership. Asian Americans are even more diverse than Latinés, and they deserve a whole other book.
Yet, this is a short book with a broad scope; by necessity, it has limitations. Overall, its significant contribution to the BIPOC self-care literature convincingly outweighs its weaknesses. This rare, culturally responsive book affirms the therapeutic value of healing practices that Eurocentric psychology deems backward and still seeks to eradicate.
Despite the emphasis on the effects of racism on BIPOC bodies and minds, this book does not foster victimhood. It's a hopeful book celebrating our past and present resilience and the resources inherited from our ancestors and ancient cultures. And it's a book that encourages readers to make a choice—and effort—to reclaim wholeness.
For Gutiérrez, reclaiming wholeness is an opportunity for resistance. She trusts that personal healing will encourage community healing. The Pain We Carry is far more than a self-care book. It's an activist's endeavor to save the world by helping Black, Indigenous, and People of Color reclaim wholeness—as a right, as a value, and as a liberatory practice.
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