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keywords:

Ulysses Syndrome, Migratory Mournings, Five 
Protective Factors, Migrants, Immigrants, Refugees, 
Healing, Trauma, Cultural Bereavement, Stress 

abstract
As a director of a community-based organization who 
works predominantly with immigrants and refugees, 
Lucy Morse Roberts noticed immigrant clients and 
colleagues were often experiencing ill-defined malaise, 
headaches, and insomnia. After visiting doctors, the 
immigrant clients and colleagues were still unwell. She 
and her team sought to understand and address this 
suffering and seek ways to heal. Research on migratory 
mournings by Joseba Achotegui offered her team one 
lens through which to understand and better respond 
to the physical and psychological ailments experienced 
by immigrant and refugee clients. Achotegui’s research, 
including that on the Ulysses Syndrome and cultural 
and situational responsiveness, directly changed the 
programming and priorities at Hui International under 
Lucy Morse Roberts’ leadership. This article first 
defines migratory mournings and the Ulysses Syndrome. 
Second, the article offers community partners’ personal 
and professional insight as to how and why this research 
is relevant and transformative. Lastly, the article offers 
an organizational framework for effective application 
and intentional community engagement.  

I have long loved what one can carry.

I have long left all that can be left

behind in the burning cities and lost

even loss – not cared much

or learned to. I turned and looked 

and not even salt did I become.

From Solmaz Sharif’s poem, “Without Which” 

Sharif’s poem continues, “I am-even when inside the 
kingdom-without” (Sharif, 2022). As an immigrant 
herself having been born in Turkey and raised in 
Iran and in California, her poems often speak to the 
challenges faced by the world’s diaspora. Hers is a 
single voice that speaks to the experiences of many. 
According to UNHCR, over 100 million people are 
currently “without” (displaced) worldwide (UNHCR, 
2022). Those displaced find themselves labelled by their 
plight of absentia from their land of origin and often 
struggle to create new lives in new places. Many of 
those who find themselves new to our communities feel 
without, without a sense of place and with a sense of 
mourning for what was once a part of their lives and is 
no more.  

Understanding the Ulysses  
Syndrome, Effective Engagement, 
and Ways to Heal

Authors
LUCY MORSE ROBERTS, Executive Director of Hui International/CalGalsMedia 
JOSEBA ACHOTEGUI, Psychiatrist. Tenured Professor of the Barcelona University 
RACHEL C. ALLEN, Director of the Peace and Justice Institute at Valencia College 
MARTHA LOPEZ, Program Coordinator for Hui International 
MUZHGAN FAKHRI, Host of the Unlimited Possibilities podcast, a Hui International/CalGalsMedia project



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According to Dr. Joseba Achotegui, from the University 
of Barcelona, this sense of “without” experienced in 
the extreme can lead to physical and psychological 
symptoms and can adversely affect one’s health and 
well-being. These symptoms caused by migratory 
mournings in difficult situations are often referred 
to as the Ulysses Syndrome (Achotegui, 2002). Dr. 
Joseba Achotegui first wrote of the Ulysses Syndrome, 
named after the Greek mythological hero Ulysses, 
in 2002 and the migratory mournings in 1995. The 
Ulysses Syndrome is not a mental disorder but extreme 
migratory grief. “Today, migration is becoming for 
millions of people, a process that has such intense stress 
levels that they can exceed the adaptive capacity of 
human beings” (Achotegui, 2015). 
 
The most important stressors of Ulysses Syndrome as 
pointed out by Achotegui (2002) are: 
 
1. Loneliness and the enforced separation, especially 
in the case when an immigrant leaves behind his or her 
spouse or young children. 
 
2. The sense of despair and failure that is felt when the 
immigrant, despite having invested enormously in the 
emigration (economically, emotionally, etc.), does not 
even manage to muster together the very minimum 
conditions to make a go of it. 
 
3. The fight merely to survive: to feed themselves, to 
find a roof to sleep under. 
 
4. The fear, the afflictions caused by the physical 
dangers of the migratory journey, the criminalization of 
the migration, helplessness. 
 
The harmful effects caused by the adversities 
and dangers that the immigrant must face are 
greatly increased by a whole series of unfavorable 
characteristics associated with stressful situations, 
which, as Achotegui (2002) points out, are the 
following: 

• Multiplicity (the greater the number of adversities and 
dangers, the greater is the risk to the mental health). 
 
• Chronicity.  These situations of extreme hardship can 
affect immigrants for months on end, even years. 
 
• The feeling that whatever the individual does he will 
not be able to change his situation (learnt helplessness, 
Seligman, 1975). 
 
• The enormous intensity of the stressors (quite unlike 
the stress associated with being stuck in a traffic jam or 
sitting an examination). 
 
• The marked absence of any network of social support, 
absence of social capital (Coleman,1984). 
 
• The symptoms themselves (sadness, weariness, 
insomnia, etc.) become an additional handicap that 
hinders the immigrant in his attempts to survive. 
 
To all this, we need to add the classic shocks the 
immigrant must come through (coming to terms with 
a new language, culture, environment) and, to these 
shocks, we must now add the severity of the present 
extreme stressors. What’s more, the health system often 
does not provide adequately for individuals suffering 
from physical and psychological symptoms associated 
with the Ulysses Syndrome: either because this problem 
is dismissed as being trivial (out of ignorance, a lack 
of sensitivity, prejudice and, even, racism, etc.) or 
because this condition is not adequately diagnosed and 
immigrants are treated as being depressive or psychotic, 
thereby giving the immigrant even more stressors to 
face. Their psychosomatic symptoms are not seen as 
connected to psychological issues and they are therefore 
subjected to a series of tests (such as colonoscopies, 
biopsies, etc.) and given inadequate, costly treatment. 
The health system, though intended to be a solution, 
then can become a new stressor for an immigrant. 

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Migrations and misunderstandings related to the 
migrant experience have coexisted for a very long 
time. Migration is ancient, as old as humankind. 
Physically, we are designed to move. We have feet and 
have evolved to move as needed. Migration is one of 
the three evolutionary pillars along with mutation and 
natural selection. Culturally, we evolved to recognize 
migration as part of our human experience. All three of 
the Abrahamic religions include welcoming the stranger 
as inherent to being an adherent. Our literature also 
reflects the strengths and sorrows of the immigrant. 
The Odyssey by Homer is a classic example of the 
“displaced” from which Dr. Achotegui drew his 
reference for the Ulysses Syndrome. 
 
Because migration is part of human history, many now 
and in the past have experienced the Ulysses Syndrome. 
Unfortunately, however, few have heard of it. For 
those focused on engaging the newcomer in their land 
and those who are the newcomer, understanding the 
Ulysses Syndrome and ways to heal is essential. This 
understanding is foundational to empathy and empathy 
is foundational to effective engagement. Because 
information on the Ulysses Syndrome is key to effective 
immigrant and refugee outreach, the challenge facing 
agencies and individuals was/is how to translate Dr. 
Achotegui’s research and present it in a way that is 
accessible to all. 
 
Community partners, Martha Lopez, Arezoo Pamiry, 
and Muzhgan Fakhri helped create the solution. 
Together with Hui International, they developed info 
sheets and videos as tools to share information on 
the Ulysses Syndrome and ways to heal. The goal of 
the info sheets and videos is to help disseminate Dr. 
Achotegui’s research in a way that is accessible to 
agencies and individuals. Lopez, Pamiry, and Muzhgan 
are from Mexico and Afghanistan, respectively. Their 
experiences and input helped Hui International not only 
see the relevance of Achotegui’s research but also the 
need to share it more widely. 
Martha: I heard about the Ulysses Syndrome during 

a seminar I attended for work. The moment I heard 
about it, I wanted more people to be aware of Ulysses 
Syndrome and the physical and psychological symptoms 
associated with the stress of migrating from one place to 
another. Hearing about the Ulysses Syndrome also made 
me reflect on my own personal experiences when I came 
to the United States at age 10 from Mexico. My dad had 
been working here and acquired the green cards for the 
rest of our family and me. I still remember feeling sad, 
rejected, and unsupported when I started school and hurt 
by other students who made fun of me for not speaking 
English. 
 
After attending the seminar, I began to wonder what 
others experiencing the Ulysses Syndrome would need 
to do/have to become more resilient and thrive in new 
places. I work with other immigrants and know some 
people who have gone to the doctor to get medicated 
for different reasons like those associated with the 
syndrome. Often the medication eased their symptoms 
but did not address the cause of these symptoms. That’s 
when I realized that the work that I do can help heal the 
root cause of the suffering many new to our country 
experience. I love working with families to help, 
support, and empower them by providing educational 
information, resources, and new techniques that 
teach them about the importance of adapting the Five 
Protective Factors into their lives and communities. 
 
Immigrants and refugees need to know they are not 
alone in their suffering, and it is okay to seek help, 
support, or advice. Having just one person they trust to 
guide them, support, and uplift them when they might 
feel like giving up can make a positive difference in a 
life and each of us can be that person. For me when I 
was new to this country, that one person was my teacher. 
 
Muzhgan: As an immigrant myself during these six 
years of my life, I had all the mixed feelings and sad 
emotions that were mentioned in Dr. Achotegui’s 
research. I was a human rights attorney in Kabul and 
was forced to leave when my life was at risk. When 



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I first arrived in the United States, I felt useless and 
hopeless. Life where everything was different from my 
home country, where none of my beloved ones were 
with me seemed unmanageable. I feared becoming 
homeless. At that time, I needed someone to calm me 
and say everything would be alright one day. That 
is why I feel this topic is important to me and other 
immigrants. We and others are with them, and our work, 
videos, and info sheets offer tips and ideas on how 
immigrants and refugees can heal, accept change, and 
feel accepted in their new environment. We hope the 
information will reassure those who struggle, and they 
find a new life here filled not just with problems but also 
positive possibilities. 

The United States is one of the top countries that 
welcomes thousands of immigrants yearly. Therefore, 
we must talk about the Ulysses Syndrome and share 
the information among immigrant communities, so 
they don’t feel alone. Every immigrant should know 
that feelings of sadness and emptiness are normal for 

many and, knowing this, immigrants should not feel 
embarrassed for seeking help. By creating the Ulysses 
Syndrome info sheets and videos, we are raising our 
voices and engaging others so that those who are 
struggling with their adjustment to a new land do not 
feel alone. Arezoo, Martha, and I helped design info 
sheets and videos in a way we believe acknowledges 
shared suffering and helps fortify individuals and 
families. 

The info sheets and videos mentioned by Muzhgan aim 
to validate migrant experiences and prevent dismissal 
of suffering and marginalization. The videos and info 
sheets can be found at https://www.calgalsmedia.
io/ava/the-ulysses-syndrome-project. The following 
graphics on the seven migratory mournings, physical 
and psychological symptoms associated with the 
Ulysses Syndrome, and the graphic on ways to heal are 
based on the info sheets and videos. 
 
7 Migratory Mournings that can trigger physical 
and psychological symptoms are…

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The Ulysses Syndrome, the physical and psychological symptoms associated 
with migratory mournings, can adversely impact our health and well-being 
and our relationships with others including our families.

The good news is there are many ways to heal, build resilience, and strengthen 
ourselves and our families. The Strengthening Families’™ Five Protective 
Factors offer a framework for and strategies to address stress in healthy ways.

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We can help increase protective factors in our 
communities by offering programs and resources 
that support and fortify immigrants and refugees, that 
support and fortify anyone. We can help build the five 
protective factors through relationships, too. Social 
connections are one of the five protective factors and 
transformative relationships (as opposed to transactional 
relationships) are essential to effective engagement and 
building resilience. Transformative relationships offer 
practitioners and community partners an opportunity 
to come together and identify and cocreate essential 
resources. The Ulysses Syndrome videos and info 
sheets are an outcome of an effective collaboration 
with community partners. This kind of collaboration 
was only possible through meaningful engagement 
and the creation of safe, stable, nurturing relationships 
and environments. For this reason, how we engage 
is as essential as the programming we offer. How we 
engage and receive those new to our communities can 
be either a risk factor or a protective factor (Achotegui, 
2015). Receiving someone with a welcoming heart into 
a welcoming community helps lay a foundation for 
healing, thriving, and effective community partnerships 

The following steps and tools can help organizations 
and individuals effectively welcome/engage immigrants 
and refugees and build relationships of trust and 
transformation.

Step 1: Identify Intention 
“What” we do is secondary to “how” we do it. 
Therefore, it is important to reflect on where we are 
as organizations and individuals in relation to trauma-

informed principles. Do these principles inform your 
work? Your program design? Mission? Values? The 
simple matrix below is designed to assist organizations 
and individuals with assessing their current approach to 
work and plan for where they want to be. 
 
 
 
 
 
 
 
 
The same type of matrix can be used to reflect on where 
we are individually and organizationally in relation to 
being healing-centered. The healing-centered categories 
in the following matrix are based on work by Dr. Ken 
Epstein. 
 
 
 
 
 
 
 
 
 
It is essential to incorporate trauma-informed principles 
and healing-informed practices internally before a 
group/organization can effectively apply the principles 
externally and effectively engage others. Deep sincere 
reflection often requires wrestling with difficult truths 
about ourselves and our institutions. Please remember, 
as you explore the following ideas, give and receive 
grace and avoid blame and shame. Everyone (colleagues 
and clients) needs to feel welcome and valued.  
 
The following practices developed by Parker Palmer 
and further refined by the Peace and Justice Institute at 
Valencia College in Orlando, Florida, can help create an 
organizational culture conducive to respectful dialogue 
and community building. The Principles for How We 

Transformative relation-
ships offer practitioners and 

community partners an opportunity to 
come together and identify and cocreate 

essential resources.

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Treat Each Other are practices that develop a trauma-
sensitive environment by inviting participants to slow 
down, suspend judgment, check assumptions, and 
speak one’s truth among other practices. When used 
consistently, the Principles support honest and open 
spaces for authentic dialogue, as well as a foundation 
for skillful conflict navigation. The Principles move 
individuals and organizations toward a trauma-informed, 

healing-centered culture where all individuals are 
welcome. Organizations can create their own set of 
principles and read them at the start of each meeting, 
post them in common spaces, and return to them when 
conflicts arise and tensions seep into discourse and 
relations. The following principles are from Valencia 
College’s Peace and Justice Institute.

With intentions set and a framework for engagement 



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agreed upon, it is easier to delve deeper into our ideas, 
attitudes, and work and address possible barriers to 
effective engagement with immigrants and refugees in 
our communities. 

step 2: reflect on... 

biases 
 
“The word welcome confronts us; it asks us to 
temporarily suspend our usual rush to judgment 
and to simply be open to what is happening. Our 
task is to give our careful attention to what is 
showing up at our front door. To receive it in the 
spirit of hospitality.”

— Frank Ostaseski, The Five Invitations. 

Everyone has biases. To have a bias is part of human 
nature. Though natural, biases can be harmful and 
can perpetuate individual, systemic, historic, and 
institutional trauma and create barriers to helpful, 
healing engagement. To effectively engage others 
in a trauma/healing informed way, we need to better 
understand the lens/biases through which we see the 
world and others and examine the impact of our lens/
biases on our relationships and interactions.  
 
Implicit Bias: Attitudes, stereotypes, assumptions that 

affect decisions in an unconsciously. 

Confirmation Bias: Ideas that confirm our existing 
beliefs and impair our ability to see another side of a 
story. 

Fundamental Attribution Bias: Creating contextual 
excuses for our failures and seeing failures in others as 
inherent to their race, gender, culture, etc. 

How might these biases impact your work? How can 
you address biases and increase a sense of welcome? 

intersectionality 
Intersectionality is a phrase coined by Professor of 
Law, Kimberle Crenshaw to explain the interplay of 
“isms” that create and perpetuate systemic, historic, 
institutional, and individual trauma. Understanding 
the interplay of “isms” will help organizations more 
deeply engage parents/caregivers, address and dismantle 
systems of oppression, and build systems of well-being 
 
Is your organization aware of and responsive to the 
intersection of “isms”? If so, how is this awareness 
reflected in your community engagement work? If not, 
how can you and your organization be more mindful of 
and responsive to the complexity of trauma experienced 

by individuals and communities?.

The Principles for How We 
Treat Each Other are practic-

es that develop a trauma-sensitive 
environment by inviting participants to 

slow down, suspend judgment, check as-
sumptions, and speak one’s truth among 

other practices. When used consistently, 
the Principles support honest and open 
spaces for authentic dialogue, as well as a 
foundation for skillful conflict navigation. 

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attitudes 
Transformative or Transactional? 
Is your organization transactional (compliance driven) 
or transformative (relationship driven)? Transactional 
organizations engage bureaucratically, policies, not 
people, are the priority. In transformative organizations, 
people/relationships are the priority. A transformative/
relational driven aim can be both policy and people 
focused but it is difficult for a purely transaction driven 
motive to be transformative. 

Invitational or Institutional?

This question is very much related to the aforementioned 
question of transformation vs. transaction. The former 
invites people into programming and opportunities and 
the latter is based on a more impersonal, institutional 
process. “I have learnt that when people feel supported 
by strong human relationships, change happens. And 
when we design new systems that make this sort of 
collaboration and connection feel simple and easy, 
people want to join in” (Cottam, 2018).

Collection or Inclusion?

Is your organization’s goal a collection of diverse 
people/voices or the inclusion of diverse people/voices? 
The former simply brings people to the table. The latter 
brings people to the table and creates an environment 
where diverse ideas and opinions are valued and 
sought. To demonstrate a voice is valued, listen and 
acknowledge and, if needed, act. To demonstrate a voice 

is sought, ask.

step 3: engage  
Effective engagement is responsive to changing  
circumstances and needs. As opportunities emerge 
to respond to needs of refugee and immigrants in 
meaningful ways, utilizing the aforementioned 
tools and framework can provide a foundation for 
culturally and situationally responsive, trauma/healing 
informed engagement and transformative work. 
Research indicates being provided with positive social 

connections and resources can mitigate the harmful 
effects of violence and improve the mental health of 
immigrant and refugee adults and children (Fazel et al., 
2011). For Hui International, effective engagement has 
led to creative collaborations like the Hui International’s 
Ulysses Syndrome Project. 

final thought  
As we search for solutions to help those who hurt heal, 
to assist those who feel lost find and fuel themselves, 
and to work toward untangling the systems of 
oppression in this world, we can start simple. Engage 
with intention and reflection, smile and listen. Kindness 
reminds everyone they matter, they are somebody, 
they are valued within our communities and are not, as 
Sharif described, “without.” Intentional engagement can 
mitigate stress experienced by refugees and immigrants, 
address migratory mournings, and the Ulysses 
Syndrome, offer ways to heal and, as Muzhgan, Martha, 
and Arezoo’s ideas and efforts demonstrate, our best 
ideas for engagement and solutions for healing often 
come from partnering with those in the communities we 
serve.



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Achotegui, J. (2002). La depresión 
en los inmigrantes: Una perspectiva 
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celona. 
 
Achotegui, J. (2015). The Ulysses 
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Bandura, A. (1986). Social founda-
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Coleman, J.S. (1994). Foundations 
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Cottam, H. (2018). Radical help: How 
we can remake the relationships 
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Fazel, M., Reed, R.V., Panter-Brick, C., 
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Ostaseski, F. (2019). The five invita-
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Roberts, L. & Bourne, G. (2020). 
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Said, E. (2002). Reflections on exile 
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Seligman, M.E.P. (1975). Helpless-
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