San Diego — 'Go to the border between 5:00 and 7:00 in the morning, and you can understand something about my patients' lives. At that time in the morning, the border is crazy. People honking, yelling, fighting for a place in line. These people are under tremendous pressure to arrive on time to their jobs in San Diego. They're afraid that if they're late, they'll lose their jobs. And the border's always unpredictable. You can never be sure how long it's going to take you to get across. So the day begins in a very stressful way, and then there's the usual stress at work. Usually, you get home at around 9:00 at night. Often, there's lots of traffic getting back into Tijuana. You have just a short time to eat, talk with your children, take care of family matters. You go to sleep early because you have to get up early to cross the border. Then the whole process starts again. Where I work in Colonia Libertad, a great many people work in San Diego. This is what their lives are like. People come home at night, and they're hungry, exhausted, and they argue. That sort of life is hard on marriages. It's not so surprising that such marriages end in divorce."

Olivia Aguirre is, to her knowledge, the only psychotherapist in Tijuana who deals primarily with children of divorced parents. ("There are certainly other psychologists and therapists who see children whose parents are divorced, but these kids make up the bulk of my practice.") Although she has no hard statistics on the incidence of divorce in Colonia Libertad, she does know that, according to statistics published last year by the Mexican government, the divorce rates in Tijuana, and Ensenada, are some of the highest not only in Baja California, but in all of Mexico.

"It's not only that border life is itself stressful, but Tijuana is less traditional than other cities in Mexico. People here have come from everywhere. In many cases, they've left their extended families behind. They don't have that support."

Aguirre's family moved from Guadalajara to Tijuana when she was six years old, and she returned to Guadalajara to attend a Jesuit university, where she studied psychology.

"The Jesuits have a very open-minded approach to psychology, with a great emphasis on serving the community. The most important thing they taught us was humility. They taught us that it wasn't enough just to study psychology. You studied psychology in order to serve people. Which is why I think my practice in Colonia Libertad is important. A lot of people there don't have many resources. I can really make a difference in their lives.

"In some ways it's an unusual community. It's one of the oldest that was established outside downtown Tijuana. It has a reputation for being a poor neighborhood. People in Colonia Libertad feel a strong tie to the place. They may go to San Diego to work, but they don't venture much into Tijuana. They say, 'Why leave the neighborhood? We have everything we need right here. Bakeries. Butcher shops. Hospitals. A hotel. When I drive around Tijuana, I get lost.'

"My uncle, who's a pediatric surgeon, has a clinic in Colonia Libertad, and another, just a short distance away, in Zona Rio. Sometimes when he can't see patients at his Colonia Libertad clinic, he suggests they go to the one in Zona Rio. They say, 'No, thank you. I'll wait until you can see me here.' They have a very different mentality."

In the early 1990s, Aguirre interned at the AIDS Foundation San Diego. One of her closest friends had died of the disease, and she felt her work at the foundation was a way of honoring her friend. Her experience, however, prepared her for her work in Colonia Libertad.

"At the time I was at the foundation, there were very few Latinos working with AIDS patients and their families. What I learned was how important it is for a patient to have someone who speaks his language. In reality, there are very few people in the United States who are truly, 100 percent bilingual. There are professionals, of course, who speak good Spanish, who are quite fluent. But there are many cultural references they don't understand or fully appreciate. Simple things, like the importance of the Virgin of Guadalupe in Mexican culture, or references to food, or even Mexican sports teams.

"I know these things sound insignificant, but in order for therapy to be effective, in order for it to truly help, there has to be a sense of empathy between therapist and patient. Humor, for example, is an important way that people become more comfortable with each other and establish empathy, a rapport. Mexicans are very playful in Spanish, and there are lots of Mexican puns. It's extremely rare to find a non-native speaker who understands and appreciates Mexican wordplay. Without that sort of understanding, an important element of communication between therapist and patient is lost.

"There's also the issue of slang, which is very elaborate in Mexico. There are also Mexicans who don't speak Spanish all that well. For indigenous people in Chiapas or Oaxaca, for example, Spanish is their second language. If you haven't been raised hearing all the slang, all the variations of Mexican Spanish, you can have a hard time understanding what a patient's trying to get across.

"Language is one reason that some of my patients come from as far away as Los Angeles and San Jose to my clinic in Colonia Libertad. They need to see a therapist who truly speaks their language and knows their culture. Often they've sought counseling or therapy in the United States, but they didn't feel they were really being understood. Another reason is money. They can't afford to see a therapist in the United States. I charge only $20 per session. In Tijuana, some family therapists charge as much as $75. In Colonia Libertad, no one could afford that. Another reason they come from so far away to see me is that they're afraid that if they go to a therapist in the United States, either their children will be taken from them, or they'll be deported, or both.

"Let's say you have many members of a family living together. The father has been abusing the children. The mother wants out. She wants a divorce. But she doesn't want to go to an American therapist because she's afraid the therapist will tell the authorities about the abuse. The authorities will come to the house, and everyone will be arrested. So, they feel safer making the trip to Tijuana to see me.

"I usually see 14 to 20 children a week. I also teach. And I hold weekend workshops for families who are divorced or going through divorce. When I ask the children how they feel about their parents' divorce, the first thing they tell me is that they feel embarrassed. By the time their parents bring them to see me, the children are often withdrawn, depressed. They're having learning problems or problems with aggressive behavior. There's a lot of bed-wetting. I encourage the parents to speak to their children's teachers, to let them know what's happening in their children's lives. In Mexico, there's still shame attached to divorce. The children feel that shame, and so do their mothers. In Mexico, a divorced woman has a difficult time finding another relationship. In general, men are interested only in sexual relationships with divorced women. Families discourage their sons from marrying a woman who's divorced. Mothers say, 'She's had a marriage that ended in disaster. Don't go looking for trouble.'

"In my workshops, I try to encourage parents to be as honest as possible with the children. The important thing is that the children understand that they are not the cause of the divorce. So, I encourage the children to ask all the questions that they need, even if the questions are difficult or painful for the parents. 'Daddy, you left Mommy because you fell in love with another woman?' 'Daddy, do you ever miss me when you're at the other woman's house?' 'Daddy, did Mommy divorce you because you were beating her?' It's a very difficult process. I usually hold these workshops on Saturdays over two weekends. The questions and answers can be very tough. Sometimes the parents don't attend the second workshop.

"Marriages fail here for the usual reasons -- infidelity, abuse, drug and alcohol addiction -- but there are other reasons that are particular to Mexican culture. Often, extended families live together, and there can be tensions between mother-in-law and daughter-in-law. Sometimes marriages fail here because the husband's family and the wife's family just don't get along. Mexicans have a reputation for being very close to their children, for having close families, and that has its good points and its bad ones. When a child forms a very close relationship to his parents, he sometimes has difficulty establishing close relationships in the outside world...with a spouse, for example. It's almost an issue of competing loyalties. And when a very close family falls apart, it can be very hard for everyone. My job is to help the children. I can't reunite their parents, but I can try to help the children understand what has happened. I can try to help them understand that it wasn't their fault."