3 Indo-Caribbean Mental Health Counselors Talk About Community’s Stigma

mental health indo caribbean community

Although the world is full of suffering; it is also full of the overcoming of it.” – Helen Keller

Mental health and mental illness are topics of great international debate, and within the Indo-Caribbean community, the stigma attached to mental health issues still strongly exists. Typically unveiling itself in snide remarks, veiled insults, and ignorant comments.

She mad.”

“He not an alcoholic, he just like drink plenty now and again.”

“Depressed? No, you just lazy and don’t want do nothing.

These are just a few common examples but we’ve all probably heard much worse, either in reference to ourselves or someone we know.

The Indo-Caribbean community has higher than average rates for suicide, alcoholism and domestic violence, which is more than likely because of the prejudice our community has placed on mental health and mental illness. People either have nowhere to turn to for help or may believe they shouldn’t seek help because other people will think something is wrong with them. 

In order to get to the bottom of this issue, we spoke with three Indo-Caribbean mental health counselors to hear their insights on the Indo Caribbean mentality regarding matters of the mind.
 

STEPHANIE N. 

stephanie nandoo

Stephanie Nandoo is a Licensed Mental Health Counselor based in New York City, she is half Guyanese and half Trinidadian. She understands the stigma from two Indo-Caribbean perspectives, revealing that it sparked her interest in psychology. She said didn’t have an easy time convincing her parents about her choice of profession. Her mother told her she would only work with psychotic people and didn’t understand why she would willingly want to do that. Her parents, like many Indo-Caribbean people, subscribe to the notion that people with mental illness are ‘crazy’ and ‘dangerous.’

Yes, her father unknowingly drove her toward the field. He was always the person she saw family and friends turn to for advice, she said. And, in a way, he was the first counselor she encountered.

Now, Nandoo is focused on early childhood mental health. She works with children and their parents but doesn’t see many Indo Caribbean clients regularly. But, when she does, she understands what it may have taken for them to make the decision to seek her services to begin with.

An integral part of her counseling concentrates on how the parents of her clients were raised and how they have evolved their parenting style, she said.

I’m hopeful for the future of our community because the new generation has seen the effect of the cycles of trauma often endured by members of the Indo-Caribbean community and are trying to parent differently.” Nandoo added. “We have to be more empathetic and normalize empathy. We’re a social people and we need to socialize around more than just alcohol. We have to reach outside of what we know and educate ourselves to find support.

Through her work, she hopes to:

Encourage people to break the cycle and to not be afraid of mental health services. It’s not just hospitalizing people or performing lobotomies. It’s building a relationship to help with healing and growth.

SHAFEENA K.  

Shafeena Khan-Salim is an Indo-Guyanese, Licensed Mental Health Counselor based on Long Island. Growing up, she enjoyed watching “Law and Order” and was a big fan of Dr. Wong, the show’s psychologist. She always thought what he did was interesting and respected the way he helped people on the show. After momentarily pursuing a career in cosmetology, where she found people really enjoyed speaking to her about their day to day problems, she decided she should do what she truly loved and follow in the footsteps of Dr. Wong. 

Throughout her education and career, she worked with patients of all ages, who run the gamut of mental health illnesses. She runs her own private practice where she works with adolescents to adults, who suffer from depression, anxiety, adjustment disorders, etc. She admitted that she doesn’t see any Indo Caribbean patients specifically, but has seen some South Asian patients.

She said Indo-Caribbean patients are not yet accepting the option of mental health services because it’s not yet open to seeking help. She also noted that those who are open and seeking help may not be willing to see a fellow Indo-Caribbean psychologist because of how small the community is; word spreads. 

As a society we [Indo-Caribbeans] don’t take care of our mental health because we’re not educated on the matter. It’s not just a matter of formal education, it’s being open to small things to help us educate ourselves, like Dr. Wong on Law and Order or Dr. Phil or any other shows with a psychology focus; they’re more accessible now than ever.” Khan-Salim said. “Education is how we heal. In the time you take to scroll through Facebook, you can read an article in Psychology Today or some other source that may aid in attaining better mental health.

Through her work, she hopes to promote more self-care because:

Physical and mental health connect; you have to be healthy for yourself before you’re healthy for someone else.” To the Indo-Caribbean community, she asks, “What are you doing for yourself? Especially the Indo-Caribbean moms. Are you leaving the kitchen? Getting your nails done? Taking care of yourself, for once? If not, ask yourself why? Where’s the balance?

SHAINNA A. 

SHAINNA A.

Dr. Shainna Ali is an Indo-Caribbean Mental Health therapist, educator, and advocate, based in Florida. She works as a therapist within private practice, runs a Psychology Today blog, and has published a workbook entitled the “Self Love Workbook.” Her areas of research and practice include identity, culture, and how the two affect our mental health.

Culture is a really influential force,” she said.

Ali is excited about the growth she’s seen of mental health awareness within the Indo-Caribbean community but noted that there is a generational gap in those seeking help.

There is still a lot of room for improvement within the community at large. Developmentally speaking, the older you are the longer you have had to become entrenched in stigmatized beliefs.” Dr. Shainna said.

To raise awareness within the older generation we can begin by reaching them in places where they are comfortable, such as places of worship and trying to educate them about mental health.

One of her goals is to create a Caribbean mental health directory, in New York and Florida, to help the community move away from the stigma it has attached to mental health, she said.

“I want to shift the paradigm, it’s helpful to consider thinking about mental wellness proactively. We all have mental health and all have a responsibility to nurture it,” Ali said.

By Vijaya Singh

Vijaya was born in Guyana but moved to Long Island as a child and has yet to visit Guyana since. … Read more ›

‘The Black Rose’: British Asian Shweta Aggarwal Voices her Truth Against Colourism and the Battle to end her Skin Whitening Cream Addiction

Black Rose

I was a mere 14-year old on the fateful night of 22 April 1993. The night that witnessed black teenager Stephen Lawrence brutally murdered in a racially motivated attack as he waited for a bus. The night that cemented my fear, that the colour of my skin does matter. The same night that confirmed my indifference as a British Asian in the United Kingdom — were we really united? Fast forward to May 25 2020, the murder of African-American George Floyd by a white policeman was the turning point for British Asian author and my lovely friend, Shweta Aggarwal to finally break her silence and narrate her story of colourism, in her new book, “The Black Rose.” 

Aggarwal’s gripping memoir emits so many emotions; that of an awakening, a voice that has been suppressed for years, filled with anger, mistrust and guilt. But most importantly, “The Black Rose” successfully disrupts the narrative that consistently allows society to box someone as indifferent based on a visibility factor. For Shweta, this factor was the colour of her skin. The injustices she consistently endured via some family members and fellow South Asian peers throughout her life, was as a result of her skin tone failing to qualify as ‘acceptable’, or as she often quotes in her book, not ranking high enough on the ‘fairometer.’ Whether she was in India, Japan or London, the scale was never too far behind. 

[Read Related: Liam Neeson’s Week of Rage is Every Person of Colour’s Truth]

Within the first chapter, she recalls as a child in India, the distinct lack of subtlety displayed by certain family members through direct taunts of her duskier appearance in comparison to her parents. She realised that she wasn’t in complete isolation from this prejudice, as her maternal aunt and uncle were also harshly nicknamed on the basis of their skin colour — Kaali (black) and Savla (wheatish). Aggarwal was left mortified by what many South Asians sadly still continue to casually exercise. Echoing similar incidents within my social proximity, it’s infuriating witnessing the recipients of such remarks surrender to laughing at themselves too. 

Except it isn’t funny. Born into a culture where conversations on religion, caste and hierarchy in India are still so prominent, the comparison of Aggarwal’s skin colour being as dark as that of the domestic help (often from poorer families), prematurely planted seeds in her mind that she simply didn’t belong with her family, especially  when she was sent to boarding school. Her lack of self-worth coupled with these taunts, gave her a whole new vocabulary for the letter B, that grew in parallel with the ongoing prejudice and anxiety. B for blackie, beggar’s child, bedwetter! Not funny, but derogatory. Post her book launch that Brown Girl Magazine attended, she tells me,

I personally feel we are way behind when it comes to understanding the importance of mental health. Name-calling was normalised and if you objected, you were ridiculed further with remarks such as ‘So sensitive! Can’t you take a joke?’ Body and colour shaming can lead to a feeling of inadequacy in the victim, which can further lead to depression and much worse mental illnesses.

During the 1984 Hindu Sikh riots in India, where over 3000 Sikhs lost their lives, Aggarwal recollects the frightening moment when she and her classmates fled into hiding to escape the violence during a school trip. As a means to save all the students from harm, the Sikh boys were forced to remove their turbans and long hair — their visible identities stripped to keep them alive. Yet, ironically, even in this horrifying situation, Aggarwal felt least at risk, attributing this self-assurance to her darker appearance. 

The crux of her self-loathe was the love-hate relationship she formed with skin whitening creams. The birth of Fair and Lovely, India’s most renown brand (now known as Glow and Lovely following a backlash) was notorious for selling the damaging message that fairer skin equated to a happier and fulfilling life. For it was fairer skin women that would qualify for marriage — clearly their only sole purpose! 

Tactfully using famous fair-skinned Bollywood actresses in television ads and posters, their so-called perfection would scream out to vulnerable young girls. (Men were targeted much later on, but the importance seemed less). Akin to the wretched beach body posters plastered on every corner in January — because apparently bikinis only look good on a certain body type —  the damaging message remains the same. Social acceptance comes at a cost, and that cost is to look a certain way. 

[Read Related: Dear Priyanka Chopra, Endorsing Colorism and Discrimination is not ok. It Never was and Never Will Be]

It’s an extension of the dated methods imposed on women from the womb, where mothers are lectured on drinking milk with saffron to ensure the baby is fair, traditional matrimonial sites asking women to specify skin colour, and women being told to stay out of the sun. These socially ingrained views are eventually developed into modern day methods in the form of cleverly marketed consumables. Aggarwal admits, 

Most people only use the cream on their face just as I did. At that time, I didn’t even think about the rest of the body. I felt that if the face becomes fairer, that will be enough for acceptance. My mum noticed the difference for sure and I was lighter by the time I met my husband, Amit. I must admit the addiction is a combination of three factors: the justification in your own head, the strong marketing message that ONLY fair is beautiful, and the ‘compliments’ from those around you. 

I admired Shweta’s honesty on admitting what essentially was a dangerous obsession that she remained faithful to throughout her teenage and adult life. A ritual that, whilst prompted gradual results in her appearance, was never going to eliminate the insecurities she felt within herself. Moments of joy with her husband and children on holidays abroad, would be broken up by the need to ‘fix’ any damage the sun may have inflicted i.e. reverse her tan. The booming tanning industry in U.K., her now home, and admiration of her ‘sun-kissed’ look by Brits initially surprised Aggarwal — as if her colour had now gained acceptance. 

But who are we seeking acceptance from? A society that is still deep rooted in patriarchy forcing women even now to adhere to dated rites of passage that holds no relevance? Or a society that seeks to point out one’s indifference because of how they look — their skin, their religious attire, their weight? Or a society that passes judgement on a woman’s self-worth, and continues to abuse that same woman behind closed doors under the eyes of Goddess Kali? Aggarwarl goes on to explain,

The more damaging perceptions of colourism, are that ‘fair is rich’, ‘fair is successful’ and ‘fair is better educated’. Essentially, ‘fair is supreme’ in every sense. And if that’s the case, where does that leave dark-skinned people? In Ukraine, for example black and brown people were discriminated against and  not given a fair chance to save their lives. Is it fair to be denied a basic human right — survival — based on your colour? 

I personally was curious to know from my family what the definition of prejudice in the Hindi vocabulary is and how it is/was applied to in India. “Pakshappat” (taking sides) or “poorva dhaarna”, were the closest pure Hindi definitions known to my cousin, yet rarely used. However, my dad stated that “hum bedh bhau nahin hai” was the common term used to state amongst family and friends when someone was not biased and believed in equality. Somehow, colourism never really came under that category. A sentiment echoed by some of my Chinese and black friends . Even in parts of China and Africa, the belief that darker skin is perceived as inferior, is accredited to stereotyping certain groups of people as manual labourers working under the sun, and therefore of a lower class or caste. Does Shweta believe we can change this attitude?  

A couple of my aunts are still reluctant to help me with my mission. One even said ‘it’s pointless fighting it’, while one said, ‘everyone has the right to define beauty for themselves and being fairer is what beauty is for some.’ The problem with this is that people then start to look down on people who aren’t. Colourism, casteism and classism divide people, creating more unrest in society. If we continue to aspire to be fairer, we’re still encouraging white skin privilege, and encouraging colonial values. The more we allow ourselves to succumb to these social constructs, the more enslaved we feel internally. Melanin is crucial for protecting our skin against the harmful radiation of the sun. Feel blessed that you have it and wear it with pride! 

I wonder how we can dare to walk shoulder to shoulder with our black friends in the Black Lives Matter movement, if we refuse to face up to our own biases against colour? We seek equality in the U.K., but deny our deep-rooted prejudice, whilst a white privileged man lectures the world on the difference between racism and unconscious bias (yes Prince Harry, I’m looking at you!). “The Black Rose” has paved a way for many more voices to speak out against the damaging impact of colourism, and in my view, rightly belongs under the definition of prejudice in the collective South Asian vocabulary.

“The Black Rose” is available to purchase on Amazon.

 

Photo Courtesy: Shweta Aggarwal

By Sejal Sehmi

Brown Girl Magazine’s U.K. Editor Sejal Sehmi is an IT consultant by day, whose passion for writing stemmed from challenging … Read more ›

South Asian Masculinity and Mental Health: Can we Find a new way Forward?

toxic masculinity

What is South Asian masculinity?

Masculinity and mental health have come under greater scrutiny by researchers, particularly as traditional masculinity is often cited as the reason why men are less willing to reach out for support regarding psychological issues. However, the influence of masculine norms on well-being has been insufficiently viewed through an intersectional lens and is understudied within South Asian mental health. From a South Asian context, traditional masculinity can include focusing on material success while displaying suppressed emotionality, which can be manifested through anger or practicing other harmful behaviors.

[Read Related: Brown Boys Do Cry: How Toxic Masculinity Screws With Us, Too]

In order to understand its influence, it is critical to examine the impact of traditional paradigms of masculinity across the diaspora. For instance, some traits associated with traditional masculinity among South Asian men include displaying control over others. A Sri-Lanka-based study found that most male participants “associated manhood with dominance…” A Forbes India article asserted how boys in India are “taught to … apply themselves to the task of growing up to be a strong, unwavering support system for their families,” which in turn forces them to be silent about topics that may make them seem weak. This pattern of behavior becomes manifested in a particularly harmful way because boys grow up with the inability to handle their emotions or formulate healthy coping strategies during challenging circumstances. 

These norms can have drastic implications and harm other community members. For instance, a focus group conducted among Nepali men found that failure to deliver for their household economically as breadwinners eventually resulted in heated disputes, which escalated and led them to engage in domestic violence. The presence of domestic violence can also be observed through media stories on the pervasiveness of gender-based harm within South Asian communities, as seen in the murder of Sania Khan. 

Traditional masculinity also hides the wounds that South Asian men may be battling within themselves. One paper asserts that for a sizable number of Indian men, “…sadness and despair find a distorted manifestation in destructive behaviors that deny their emotional pain to themselves and to others.” Thus, performing conventionally masculine behaviors can mask deeper mental health issues. 

Repercussions of South Asian masculinity on mental health

Because of the pressure to adhere to such strict standards of conduct, traditional masculinity has significant, greater repercussions for mental health and well-being. For instance, because of the narrow ability of men to compartmentalize their feelings, this restrictive emotionality can result in an inability for others to recognize their mental health issues, thus failing to target the deeper causes of men’s behavior. Furthermore, men themselves might engage in fewer help-seeking behaviors. This is also further complicated due to gaps in culturally competent services that can serve South Asian men when they do utilize support systems. 

Additional social forces experienced by South Asian men might explain mental health outcomes, particularly when considering the role of immigration. Among South Asian American men in the United States, one study noted that “a lower social position” within their community was linked to higher distress, indicating how critical it was for first-generation men to be leaders and actively participate in their ethnic community’s organizations. Thus, social expectations of men within South Asian communities influenced their well-being, as did their social status and relative power. 

What we can do to change the status quo on South Asian masculinity and mental health 

In order to ensure that men in South Asian cultures can embrace their mental health, it is important to formulate a prudent, welcoming paradigm that encourages greater help-seeking behaviors. Greater attention to this topic can also contribute to theories on feminist and sociocultural therapeutic frameworks, which both offer the following includes suggested remedies:  

Challenging gender stereotypes and encouraging mental health care as a means to discuss issues about well-being

It is imperative to encourage South Asian men to show more emotion, thus changing the existing narrative and social pressure they face to limit the expression of their feelings. Fortunately, there is a platform, known as @BrownManTherapy, that posts content about the struggles South Asian men experience. Furthermore, therapy ought to be recommended as a means to deal with mental health concerns, which should be combined with support from the community. 

More South Asian male clinicians

In addition to instituting changes in community norms, there needs to be more diverse representation in the mental health field. In doing so, there will be greater platforms to have conversations about the negative repercussions of traditional masculinity that are unique to South Asian men. Furthermore, it is critical to challenge the social stigma that mental health is a female-dominated profession or that seeking therapy is emasculating. 

More research studies examining cross-cultural differences in masculinity across South Asian cultures

The connection between masculinity and mental health ought to be investigated much further. Studies should particularly assess masculinity within non-white contexts in order to examine the standards of manhood across several communities and truly understand the unique stressors men face across different cultural backgrounds.

[Read Related: These 5 South Asian Men Are Opening up About Their Mental Health and Toxic Masculinity]

While the connection between South Asian masculinity and mental health is not discussed among psychology professionals, it is critical to study the association since it plays a role in South Asian gender inequities and in mental health behaviors among South Asian men. More broadly, given the prevalence of intimate partner violence within the Asian American and Pacific Islander communities and the role of patriarchal norms in inflicting this harm, it is now more important than ever to reimagine expectations surrounding men’s behavior. 

By further examining the problems caused by adherence to traditionally masculine norms and implementing certain solutions, these ideas can be challenged and dismantled to create a progressive and more inclusive model of manhood. Above all, identifying and eradicating toxic ideas rooted in traditional South Asian masculinity will lead to liberation for all people.

If you need additional resources, please visit:

Photo: Shutterstock/Roxanne 134

paritosh joshi
By Paritosh Joshi

Paritosh Joshi is a graduate student in Clinical Psychology at Teachers College, Columbia University. His background includes a Master of … Read more ›

Painful Sex is More Common Than you Think

Close up on couple having intimacy moments

Ten to 28% of the world’s population of women experience painful sex. Keep in mind, that this is just what is reported. As embarrassing and as vulnerable as you may feel, you are absolutely not alone. The good news is that in addition to your traditional medical care to treat painful sex (also known as dyspareunia) such as medication, injections and surgery — a conservative approach is effective and long-lasting. Conservative care ranges from pelvic floor physical therapy, chiropractic care and acupuncture which are beneficial in treating the root cause of painful sex, as well as symptoms, for long-term healing. 

Some of the signs to look out for if you experience pain are:

  1. Deep pain/burning during or after sex
    • Pain descriptors: sharp, stabbing, deep, dull, burning
  2. Vaginal Dryness
  3. Low Libido
  4. Tightening at the vaginal opening

[Read Related: 12 Beliefs About Sex That South Asians Need to Throw Out the Window]

Treatment Options 

Treatment options for painful sex such as pelvic floor physical therapy, chiropractic care and acupuncture provide a long-lasting and profound effect on the pelvic floor and address your entire physical well-being.

The pelvic floor is a layer of muscles that range from the pubic bone to the tailbone. The purpose of these muscles is to assist in bowel and bladder control, support a baby during pregnancy and contribute to sexual sensations. Just like any other muscle in your body, these pelvic floor muscles can become tight or weak which can be a contributing factor to pain.

Pelvic Floor Physical Therapy

Pelvic floor therapy can assist by strengthening and relaxing the muscles which is necessary to relieve pain during sex. 

[Read Related: My Awkward First Time at the Gyno]

Chiropractic Physician

Chiropractors can be extremely beneficial with assisting in helping relieve pain. Associated pain and discomfort can originate from the lower back and buttock muscles. Chiropractors are trained in taking a history and performing a neurological, orthopedic and soft tissue examination to identify treatment options. Deep tissue massage, skin rolling, Active Release Technique, muscle energy technique, ice, heat and electrical stimulation are just to name a few.

Acupuncture

Acupuncture can activate the human dopamine system which helps regulate hormone levels and can assist in psychological factors. Acupuncture can improve mood, decrease pain and can be vastly beneficial in managing pain and mental health symptoms. 

Ask for help

“Everyone is having pelvic pain and no one is talking about it”

  1. Start with seeing your gynecologist who you trust for a history and examination of current symptoms to rule out any other medical conditions that could be a contributing factor to symptoms. 
  2. Locate a pelvic floor physical therapist through Apta Pelvic Health or Pelvic Rehab.  
  3. Locate proper chiropractic care that is trained as a licensed acupuncturist; look for credentials such as DC, LAc. 

[Read Related: Not Your Auntie’s Tips: 5 Sex Myths Busted]

How to talk to your partner about this in a safe/healthy way

Being open with your partner about your symptoms and painful sex may seem like a difficult conversation. Intercourse should never be painful and learning when to stay ‘stop’ is important in communication. Talking about pain before, during and after sex is important also in your own health diagnosis to see if pain symptoms are improving or becoming worse. Having open communication does not only benefit your relationship but most importantly, your own health.

To experience these symptoms may seem taboo or unheard of but quite frankly, they are common in many women. Women deserve to be directed to proper healthcare. 

Disclaimer: These are based on recommendations from a board-certified chiropractic physician and licensed acupuncturist. If symptoms become new or worse, consult with a primary care physician and or OBGYN to co-manage symptoms.

 

Reference: Tayyeb M, Gupta V. Dyspareunia. [Updated 2022 Jun 11]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK562159/

 

Photo by anushkaniroshan stock photo ID: 2071991336

jasmine bhoola
By Jasmine Bhoola

Jasmine Bhoola DC, LAC - A chiropractic physician and licensed acupuncturist in Midtown East Manhattan. A graduate from the University … Read more ›