Women, mental health and grassroots education. (The Malaise of Gender).

Salud y Genero, A. C. (Health and Gender) (1) focuses on public policy, education, research and dissemination of information in Mexico through involvement in various national and international networks dedicated to health, sexuality, women and population policies, and sexual and reproductive rights.

In 1986, we joined in a new mental health initiative involving health promoters in several Mexican states and a community health network for Mexico, Central America and the Caribbean. (2) The work involved grassroots education in central and southeastern Mexico, with special attention to needy populations in marginal zones. We began with prevention, detection and basic management of the mental health problems most frequently encountered in places with little access to even basic health care, much less to psychological services.

Before 1986, health education in this area was carried out by health monitors who focused on primary care in the context of comprehensive health. This work emphasized organizational approaches to improving women and men's lives. But despite the comprehensive approach, we soon realized that important aspects of people's emotional and subjective realities were being left out which limits our ability to make an impact.

With an interdisciplinary team, we submerged ourselves in the world of emotions, pain, fear, sadness and malaise. These responses to social problems manifest in people's minds and bodies emphasize the fact that our individual experience is at the same time part of a collective story. Today, our efforts have evolved into a mental health program from a gender perspective with an emphasis on relationships. We now work in both urban and rural areas. (3)

The Roots of Our Experience (4)

We understand social participation to be a process of transfer and appropriation of power and knowledge in health that operates on at least four levels:

* The appropriation of knowledge and analytical tools that are necessary for people to prevent and confront the underlying problems.

* Self-care for simple problems and access to adequate services for more complex ones;

* The growing level of grassroots involvement in the way institutions respond to the aforementioned problems; and,

* Concrete opportunities to improve the living and working conditions that give rise to the majority of health problems. (5)

In Mexico and in other countries of the region, there are few opportunities for transfer of knowledge and tools to the public for the prevention and self-care of mental health problems. The complexity and breadth of mental health makes it difficult to tackle psychological problems through grassroots work. In addition, the area of mental health is not exempt from the ideological and professional barriers that continue to impede all advances in social participation--the idea that health is the exclusive domain of professionals (i.e., doctors, dentists, psychologists or psychiatrists).

Resistance to working with subjective realities exists even within social organizations and health programs themselves. We also face a shortage of educational materials and techniques for addressing different mental health problems.

Grassroots education and participation is a central theme in all of our work. We have therefore incorporated some principles of grassroots education into our work in the area of mental health.

1. The method is of primary importance:

* Start from the participants' current practices;

* Use these concrete realities as the basis for theoretical explorations: and

* Develop a new, enriched practice

We begin by using the problems experienced by our subjects as the basis for building knowledge, then suggest practices that will allow them to begin to overcome these problems.

2. This process involves participation through dialogue in which the subjects find their voices and learn from each other.

3. We aim for our work to have a multiplying effect: the participants should creatively adapt what they learn; share it with others; and/or apply it in other local contexts.

4. A central element of the educational process is starting from or using popular culture, incorporating popular images and practices in our work.

In this way, we seek to approach the mental health problems more openly and to understand the complex interrelationships the participants face, without trying to make their reality fit our models. Indeed, we see mental health as a non-linear process that is constructed individually and collectively on a daily basis by each person in relation to her/his feelings, body and environment.

Many adults who seek care in health centers suffer from psychosomatic illnesses, problems of emotional origin that manifest themselves physically. Indeed, practically all illnesses contain an emotional or mental cause and/or effect. Experience has shown us how inseparable body, mind and emotions really are.

It seems obvious, then, that an educational process based on these principles can contribute to mental health, to the growth and development of the participants. We have seen this clearly in our work in marginal populations, such as native peoples and rural women. We witness these people regaining their voices as they participate in groups, define their problems and seek solutions.

Mental Health: Women's Feelings and Experiences

It is often difficult to start talking about what is happening in our bodies, to share our experiences, our feelings, our wounds and our health problems. We are just not used to it. We can talk about what is happening with our children, our husbands, our friends or anyone else, but we only begin to talk about our own problems when they have become chronic. When we finally do work up the courage to break our silence, it is like opening a Pandora's box from which emerge many different manifestations of pain, exhaustion and discouragement.

What do women say when we dare to break our silence?

--I am sad. My bowels are upset. I sometimes feel depressed. I have problems with my 19-year-old daughter, and I've just broken up with my second partner.

--I am sad. I feel a weight on my chest. I need air.

--I feel worn out. My back hurts. I went to the doctor, and he gave me some pills that make me sleep. My husband has another woman, but he tells me that he's going to be good so that I can get better. I tell him that when you break a mirror, even though you glue it back together, it is never the same again.

--I am angry, but I feel embarrassed when I show it.

--I have skin problems that began when my mother died. I am tense, anxious and nervous. I have high blood pressure and a fear of falling.

--My boyfriend gets angry with me, and I get a knot in my stomach. I feel angry and sad, and I isolate myself.

--I am too self-sufficient. I'm a perfectionist. I am critical, and I project an image that doesn't allow me to get close to others.

--I am a good-for-nothing. I don't do anything worthwhile. I waste my time, and to top it all off, I am a woman.

--If I do what I want, they stop loving me.

--My head hurts.

--I am pregnant, and my husband left me.

The testimonies that bear witness to the problems that affect women's health could go on forever. Many of the women's personal stories are related to sadness, depression, lack of sleep, loneliness and lack of affection. The women also refer to high or low blood pressure, aching necks, frequent need to urinate, STD/HIV/ AIDS-related problems and termination of pregnancies, as well as tumors, cancer, gastritis, anorexia, bulimia, irritable bowel syndrome, migraines, nervous tics, anxiety, flu, nausea, hair loss, diarrhea, contusions, humiliation, sexual abuse, rape.

A study on the health of reproductive-age rural, indigenous and shantytown women was carried out in 1994 and 1995 by the Red de Mujeres (Women's Network). (6) Of the 142 women interviewed:

Ninety-nine (67%) indicated that they were experiencing or had experienced sadness in the last year.

* Ninety-one (64%) expressed feeling anger.

* Eighty-six (60.5%) said they suffered from joint pain and rheumatism.

* Seventy-one (50%) stated that they felt anxiety.

* Sixty-eight (47.9%) said they had the flu, tonsillitis or a cough.

Our experience working in women's mental health allowed us to comprehend the relationship between the socialization processes these women experience and their health. We also observed that their health problems are linked to the lack of opportunities they have to develop themselves and to live a full life.

Applying a gender perspective in our work allowed us to work on problems at different levels. Indeed, understanding the situations that affect women throughout the course of their lives clearly highlights the need for preventive work which would foster the development of the personal and collective resources women need to take ownership of their sexuality, their reproduction, their health,--in short, of their lives.

This need has encouraged us to design an educational method to construct new individual and collective identities that promote gender equity.

Emotions, Well-being and Daily Life

How can we speak of women's mental health if we do not first refer to the conditions that have made them the way they are?

The daily lives of women reflect all our gender values, socialized and reproduced over generations, as well as in our everyday lives. In order to understand our present, we must review our past for it is the past that can show us how the values, ideals and standards of behavior that impede our development were constructed and perpetuated.

The ideology of inequality is constructed and reproduced in daily life. The collective imagination and the symbolic universe of meanings are formed and organized and they become rigid creeds and mandates. Indeed, daily life is the setting for the development of the personal (intra-subjective) as well as the social (collective) consciousness, from which arises the idea that women need to be protected and that men have rights over them.

Concepts of what a woman "should" be are legitimized and reinforced in the organization of the home, the relationships of production, the processes of education and the social, economic and political systems. Hegemony takes root here in the form of unconscious attitudes through the mute internalization of social and gender inequality. These attitudes are written upon women's own bodies, in the organization of time and space, and in the ideas of what is possible and attainable. These internal processes even gain the active or passive acceptance of many women who then help to perpetuate such unequal relationships.

Garcia Canclini explains how society organizes the unequal distribution of material and symbolic goods and, at the same time, determines how individuals and groups relate to those goods in terms of their aspirations and awareness of what each one can or cannot have. (7)

In addition, there is an interwoven network of hierarchies, powers and dominions that determines what is acceptable and what is not, what is worth more and what less, what is superior and what inferior.

In this way, identity is constructed from our daily lives with the internalization and appropriation of specific models, rules and requirements of behavior. Women are faced with dilemmas that are sometimes difficult to visualize or recognize, and they must decide between living for themselves or living for others. In the face of the constant disassociation between what one is and what one wishes to be, these dilemmas ultimately express themselves as illnesses. Women believe they do not have the right to feel, think and act without labeling themselves as "selfish" or as "bad" women. This is especially true for mothers, who see themselves as responsible for the well-being of their families. A vicious cycle which wears women down is created between demands and guilt, between actions and being.

Women can react to these situations in a variety of ways. However, they tend to channel their responses into discomfort, illness and, in extreme cases, death.

In Mexico, increased life expectancy supposedly reflects advances in our country's development. But we should ask ourselves why should we want to live longer if we are not given the means to do so with dignity and integrity?

What is Mental Health?

"Mental health is a tool with which each person traces their own path."

--Juanita, health monitor.

Despite recent advances, Mexico's health system still has serious gaps. Mental health is one of them. In our country, mental health care has lagged behind other areas of medicine and continues to lean more towards a psychiatric focus. This medicalized perspective hides the problems women face in their daily lives. The common practice of prescribing sedatives silences women's feelings and legitimizes the culture of silence.

As health care providers, we usually are trained with a biologically-oriented perspective. When we identify and treat health care problems, we tend to ignore socio-cultural aspects and, paradoxically, psychological elements.

New concepts are needed that can be translated into new practices, especially in preventive work with women. We need to promote and channel new knowledge and techniques that will allow women to take ownership of themselves and the world around them.

According to the World Health Organization (WHO), mental health is a person's ability to identify and carry out their life goals. This definition reveals mental health as a complex process in which human beings are engaged daily, both individually and collectively, and which involves their feelings, bodies, sexuality and environment. Mental health is the source of well-being, in the sense of "being well" with one's way of living, thinking and feeling. Mental health refers to the subjective dimension of individuals, the place from which emotions arise, dimensions such as identity and our image of the world which facilitate our interaction with "the other" and generate inter-subjectivity.

Mental health implies the ability to identify one's own needs and desires, to recognize one's own feelings. These perceptions allow each of us to make and express decisions without harming others or ourselves, fully aware of our own dreams and desires. This means:

--Connecting with one's own center of power (empowerment), in order to act individually and collectively, from the discovery of one's own will and the individual and collective desire to build new female identities. These new identities will foster abilities and talents for transforming the socio-cultural, political and economic environment. We see power from a positive and proactive perspective.

--Valuing our history, redefining our problems and transforming them into opportunities for self-affirmation.

--Contributing to and/or facilitating flexible socialization processes that help to transform women's self-image.

--Promoting decision-making and a critical vision in the search for and strengthening of knowledge, power and resources for self-affirmation, dialogue and active participation.

--Broadening our horizons within the process of building self-awareness. in order to establish our own spaces and to build the confidence and self-acceptance we need to take charge of our lives, our bodies and our health.

--Promoting the active participation of women as citizens and collaborating on the construction of new relationships between civil society and the State.

All of the above involves fostering abilities and talents for:

--transforming impotence; turning the "I can't" into "I can"; identifying what we need individually and collectively in order to mobilize ourselves to achieve; learning to listen to the messages of our bodies and to act upon them;

--turning voluntary servitude to others into relationships of solidarity and reciprocity; learning to ask for help at the right time and not being over-responsible; identifying what we do and do not want for ourselves in life;

--overcoming insecurity and paralysis arising from fears about security; learning to recognize and not to suppress our fears since fear is a basic emotion that alerts us to potential risks; and

--exchanging an identity built around "others" for an identity built around oneself; learning to identify our own desires and expectations instead of concentrating on those of others, as this can lead us to lose sight of the meaning of our lives.

Our focus on mental health has thus been nurtured by a gender perspective. Indeed, every day new studies document how many of the illnesses and troubles of women are directly related to socially-constructed gender expectations.

In this respect, through Salud y Genero's educational work with different groups of women, we have frequently observed how the process of female socialization promotes high-risk behaviors. Recognizing the links between the different aspects of women's lives is important in understanding and explaining these problems.

Because of this, gender education (8) can make a significant contribution to stimulating and deepening the construction of new ideas of female identity and women's self-image based on new values and interpretations.

In preventive work with community women's groups, we must place a greater emphasis on health and education rather than illness and deficiency. This more positive approach will lead us to a more profound study of the conditions that promote, resillent behaviors (9) and move our work beyond the mere provision of information and messages.

From Malaise to Well-being: Listening to and Acknowledging Our Bodies

And you? How do you inhabit your body?

Reflecting more deeply on how we inhabit our bodies--whether we care for or neglect them, whether we listen to them and care for their needs or ignore them--can be a key for transforming malaise into well-being, and for enjoying our physical and mental health and integrity.

We do not often listen to our bodies, and so do not recognize in our discomfort or malaise a complaint, a cry for help or a call for attention away from the myriad demands in our lives to ourselves and our own needs.

We engage groups is an introspective exercise called "What is my body telling me?" (10) In this activity, the participants concentrate on themselves and become aware of needs that they have been ignoring.

--My body is asking me to eat better.

--My body is asking me to exercise more.

--My body told me to stop looking down on it, to love it more. My vagina told me to accept it and to stop seeing it as something shameful.

--My body is thirsty; it wants me to drink water and to be more patient with it; to control my outbursts and anger. It is asking me to defend, respect and value it.

--My body is telling me to look at it, to feel its presence, to admit that I've taken it for granted. It is asking me to make it slimmer, not to wear so many clothes, to touch it, to consider it.

--It is telling me that I need more discipline and to release my feelings because suppressing them is bad for my circulation.

--It is asking me not to feel anxiety, to learn to say no.

--It said: "Enough of this foolishness." I am hurting it with my prejudices.

In order to re-appropriate our bodies, we must get to know them, acknowledge them and tear down the negative ideas we have about them. We need to identify problems, illnesses, pains and/or conflicts embedded in them. We must also learn to identify our feelings to pursue what makes us happy.

A key element in this process is responsibility, literally the ability to respond, to take action and to be aware of what is happening. Most of the time we confuse responsibility with obligation and distance ourselves from our own needs and desires, in order to fulfill the expectations of others.

Moreover, when these expectations are not met, we internalize our guilt and seek external reinforcement and validation. This leads to a loss of self-confidence and a need for acceptance from others, which is based upon how well we conform to what society expects from us as women. (11)

Our socialization forces us to adopt belief systems rather than act from our own experience of reality. It is not easy for most women to question ideas that we have been taught. We must examine our histories and identify when a concept influenced our way of viewing and interpreting reality.

Guilt is a control mechanism that inhibits each real or imagined transgression of the model that has been forced upon us. This culture of control will continue to haunt us, until we question these fixed models and discard everything that limits us.

Fina Sanz, the creator of re-encounter therapy, (12) explains that our culture is based upon a Judeo-Christian vision which creates two subcultures--the masculine and the feminine--that are permeated with hierarchical, asymmetrical practices. To eradicate them, we must not place others above ourselves or allow ourselves to be placed below. This involves assuming both an individual and a collective responsibility.

To paraphrase Paulo Freire, women should occupy positions everywhere power is wielded, no matter to what degree. Otherwise, the dominant power will fill the vacuum. Women can recreate, regenerate and reinvent the world.

Body, Power and Change

"Springs will only be found where our desires cause them to flow."

--Andre Gide

Becoming aware of our history as women and as men in the present socio-historical, political, economic and cultural context involves broadening our analysis to a more comprehensive perspective. From this new viewpoint we may then reach an understanding of how the process of gender construction and the mechanisms of power can leave such a profound impact on our identities. This perspective may also help us understand how gender affects our health, wearing us down, making us tired, and causing pain and other physical problems.

Our experience at Salud y Genero has shown us how important it is to foster processes of consciousness-raising and appropriation of our bodies when working with women. In this effort, we must:

--Provide an opportunity for theoretical and experiential reflection upon the different ways of viewing our bodies and the effects of these perspectives on women and men's identities;

--Deconstruct and analyze the ways in which the exercise of power sets the standards for our bodies and facilitates the expropriation of our being and our ability to make our own decisions;

--Recognize the importance of expressing emotion as an element that connects all the aspects of our lives; work with expressing and managing feelings as a tool for achieving our goals and intentions;

--Identify gaps, dissociations and contradictions in the process of appropriation;

--Foster the awareness of our bodies as a way of channeling the process of giving new meanings to our own histories and of promoting decision-making.

By identifying how we see our bodies, we can see how we have internalized social mandates, standards, discourse, beliefs, representations and symbols, and how these externally-imposed values dictate our ways of feeling, thinking, acting, looking at, valuing, accepting and caring for our bodies.

It also uncovers the hidden loyalties and secret pacts that we have made, both individually and collectively. These unspoken agreements structure our subjectivity and make us accomplices in protecting and reproducing power relationships.

The way in which we think about our body assigns it a certain value, directs our behavior and determines our reality as women or as men. Moreover, it reflects the ideology and the culture that surrounds us, which in turn shapes how we describe our personal and collective histories.

Language is modulated in hundreds of different voices; it is a privileged realm of powerful signs, symbols, meanings, gestures, positions and inflections. But is also a place of numbers and measurements, of densities and lengths, of adornments and nakedness, pathologies and pleasures. (13)

Encouraging other perspectives on and choices for our bodies, our reproductive capacity, our sexuality and our lives, has to do with knowing and interpreting "the subjectivity of the subjects." This allows us to understand the individual's the point of view in relation to the system of symbolic representations and meanings in their specific context and to identify and understand the meaning individuals assign to their own experiences, practices and actions. Human behavior is determined by a construct of relationships and meanings that comprise our reality in a specific social, cultural and ideological context. Although this reality is constructed by individuals, it also structures their behavior in turn. (14)

Our belief systems and the social structures to which we belong permeate female and male identities: they mark individual and collective ranges and limits. Taking ownership of our bodies, reproduction, sexuality and health depends on access to education, information and health services. It also requires appropriate conditions for exercising our proactive power to make decisions that are free of coercion and founded on respect for human diversity and equity.

Working from a gender perspective implies a personal effort. We cannot engage in these processes without identifying our own tensions, pains, ideas and beliefs, without knowing where we are in our own process. This includes viewing our own personal history systematically and learning to identify our needs, feelings and emotions in order to free ourselves to act, to re-evaluate, to rediscover, to let go of old practices, to assign new meanings, and to make conscious decisions.

In order to deconstruct the social mandate that validates the use of their bodies only for others, women must begin to care for their own bodies. In this respect, it is important to reflect upon where we invest our well-being, and how this decision limits us and generates conflicts with powerful repercussions for our bodies, our reproduction, our health and sexuality.

Well-being involves:

--Living in conditions of warmth, security, support, respect and freedom;

--Divesting female sexuality of the definition handed down by our culture throughout history;

--Recognizing that we have learned to live with a type of sexuality that has been imposed upon us. From birth, we are inculcated with the fear of living full sexual lives. We are polarized, torn between this threat and the desire to live our own lives based upon our desires, our passions, our yearnings and our needs;

--Using fantasy as a tool for representing different aspects of our own developing sexual awareness without having to act it out. Fantasy is not subject to the limits of our bodies or our awareness. It allows us to recover long-forgotten physical sensations. Fear of our own desires deprives us of the ability to act;

--Knowing that our sexuality is more complex than we have been led to believe; (15,16)

--Enjoying freedom from the risk of unwanted pregnancy;

--Ensuring that motherhood does not mean abandoning or postponing other possibilities;

--Having control over our words; freedom of expression;

--Destroying the myth that women only have power in the intimate or private areas of life;

--Demonstrating new ways of exercising power based on wisdom, the ability to act individually and collectively for our own well-being;

--Visualizing the costs that the traditional model of woman has on our health and integrity.

By recognizing the nuances in our lives we can take back our own life histories, recognize landmark events and recall important things that we have learned. We can become aware of the different options and opportunities for personal and collective transformation. There is no single method or concept for advancing and becoming whole; it depends upon the place, the circumstances, the time and our goals.

Overturning the present order involves a conscious commitment to boost the position of women and increasing their opportunities for exercising their civil, political and cultural rights and powers.

Final Note

In a novel by Sara Sefchovich, entitled "The Lady of Dreams," the protagonist has a conversation with Ghandi about how to follow the right path.

When she says, "Perhaps what is lacking is knowledge," Ghandi replies: "What is important is not accumulating knowledge, as is believed in eastern educational systems, but in forming character, the culture of the heart."

According to Ghandi, human nature dictates that the impressions received in childhood take firm root, and are difficult to change. However, he also believed in the strength of the will: "One becomes what one thinks, and the most important thing is to have the strength to fulfill one's own commitments."

I believe that anything is possible, if we make contact with our own willingness to champion our own truth and integrity. Finally, to the extent that these practices are reproduced, both individually and collectively, we will share this awareness with women, and ensure that our work will continue.

The Burden of Stereotypes

Cultural stereotypes define women as passive, submissive, obedient, devoted and socially inferior. Accepting the challenge of constructing and assuming an individual identity different from the stereotype may be a painful and conflictive process. Women have internalized the stereotypes of femininity imposed by culture, mass media and fashion. We try to fit the model in order to feel attractive, good ... normal ... we become slaves of fashion, diets, etc., disconnecting ourselves from our true and unique beings. We disassociate ourselves and agree to do things against our will, things that make us feel confused, empty, depressed, insecure and guilty. All of this has a serious impact on women's autonomy and emotional and economic independence. To change this situation we must revise our family roles and socio-cultural stereotypes and learn about alternative roles that women are constructing in different parts of the world.

Source: Cartilla Mujer y Salud Mental. Montevideo, Casa de la Mujer de la Union, n.d.

Notes

(1.) Salud y Genero is an civic association founded in Mexico in 1992 by women and men from a variety of professions and work backgrounds who came together to develop innovative proposals for education and social participation in the areas of health and gender. We have offices in Xalapa, Veracruz and in Queretaro, Queretaro.

(2.) In Mexico, Produssep A. C. (Promocion de Servicios de Salud y Educacion Popular, Promotion of Grassroots Health Services and Education) was responsible for coordinating the mental health team and jointly responsible --with the Comite Regional de Salud Comunitaria (Regional Community Health Committee)--for coordinating the women and health team (today the Red de Mujeres, Women's Network) and in the work in Central America.

(3). This experience has benefited greatly from our close relationship with the Equipo de Mujeres en Accion Solidaria (EMAS A. C., Women's Action in Solidarity) through the training programs for leaders in women's health (1994-1996) and community development for indigenous women (1997-1999).

(4.) For more information, see B. de Keijzer, E. Reyes and G. Ayala, "Salud mental y participacion social," in Participacion social en salud: experiencias y tareas para el futuro, Haro and de Keijzer, eds. (Mexico: PAHO/ Colegio de Sonora, Hermosillo) 1998; R Herrera, B. de Keijzer and E. Reyes, "Salud mental y genero: una experiencia de educacion popular en salud con hombres y mujeres," in Genero y salud femenina: experiencias de investigacion en Mexico, S. Perez-Gil, et al., eds. (Mexico: CIESAS/U. de G./INNSZ) 1995; E. Reyes and B. de Keijzer, "Organizaciones, redes y salud mental: una experiencia de construccion social en Mesoamerica," in Redes: el lenguaje de los vinculos, E. Dabas and Najmanovich, eds. (Buenos Aires: Paidos) 1995.

(5.) Benno de Keijzer, "Participacion popular en salud: logros, retos y perspectivas," in E. Menendez and J. de Alba, Practicas populares, ideologia medica y participacion social (Mexico: U. de G./Ciesas) 1992.

(6.) For more information, see M. Garcia, A. Calleja, E. Reyes and R. Castellanos, "Violencia intrafamiliar, violencia de genero." in Ser Mujer: ?un riesgo para la salud? Del malestar y enfermar, al poderfo y la salud, G. Sayavedra, and E. Flores, eds. (Mexico: Red de Mujeres, A.C.) 1997.

(7.) Garcia Canclini, Cultura y Organizacion Popular. Cuadernos politicos, no. 39 (Mexico: Ed. ERA) 1984.

(8.) For more information, see R. E. Reyes, Nuevos Horizontes: Nuestra salud y los derechos sexuales y reproductivos: Manual de Metodologia Educativa desde la Perspectiva de Genero (Mexico: Solidaridad Internacional/EMAS A. C./Salud y Genero A. C. and Spain: Instituto de la Mujer) 1999.

(9.) Resilience is the ability to bounce back in the face of adversity, to adapt, to recover, and to build a meaningful and productive life. See M. Kotliarenco, I. Caceres and M. Fontecilla, Estado de arte en resiliencia (Washington, DC: PAHO) 1997.

(10.) In this workshop exercise, the participants make bodies out of modeling clay. This hands-on, creative expression allows them to access other levels of thought and perception and encourages a special level of intimacy and dialogue with their own bodies.

(11.) In EMAS A. C. Memoria proceso Escuela Capacitacion de Dirigentas. Salud y Mujer. Modulo: Sentimientos, cuerpo y sexualidad (Mexico, mimeograph) 1996.

(12.) Author of Psicoerotismo femenino y masculino.

(13.) Mario Ruz, "El cuerpo: miradas etnologicas," in Para comprender la subjetividad: Investigacion cuafitativa en salud reproductiva y sexualidad, Ivonne Szasz and Susana Lerner, eds. (Mexico: El Colegio de Mexico) 1996.

(14.) Susana Lerner, "La formacion en metodologia cualitativa, perspectiva del Programa Salud Reproductiva y Sociedad," in Para comprender la subjetividad: In vestigacion cualitativa en salud reproductiva y sexualidad, Ivonne Szasz and Susana Lerner, eds (Mexico: El Colegio de Mexico) 1996.

(15.) Amber Hollibaugh, "El deseo del futuro: La esperanza radical en la pasion y el placer," in Placer y peligro de la sexualidad femenina. Seleccion de textos, Carole Vance, ed. (Madrid: Ed. Revolucion) 1989, pp. 191-204.

(16.) Fina Sanz, Psicoerotismo femenino y masculino: Para unas relaciones placenteras, autonomas y justas (Barcelona: Editorial Kairos) 1999.

(17.) Ibid.

The author is a biologist, a community health educator and a gestalt therapist for adults. She is a co-founder of Salud y Genero, A. C. (Health and Gender) and currently directs this Mexican organization's work on public policy and lobbying. The following article shares the experiences of Salud y Genero in the area of women's mental health.