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[et_pb_column type=”4_4″][et_pb_text admin_label=”Text”]I felt a lump randomly in my left breast. At that moment, my thoughts were,
Okay, there’s a lump. Rosh, you are only 22. You can’t possibly have cancer.
I convinced myself it was breast tissue and left it alone.
Two months went by and as someone who cannot sit still, I did not make connections to any early symptoms. I had some bruising near my armpit and some pain, but I was hit by the subway doors earlier in the month so I naturally associated the pain with that incident. I noticed there was blood on my sheets but I just thought it was from my period. I did not realize that there were bloodstains on my nightshirts as well – until I noticed blood on my bra. It was red, brownish discharge. When I put pressure on my breast it would come out.
This was late April. All these thoughts of possibly having cancer were racing through my mind. I was freaking out. At the time I didn’t have an OB-GYN in the city, so I went on Zocdoc to look for the earliest appointment. I found one at 10 AM the next day.
It was a rainy Saturday morning, I rushed to Chinatown from Brooklyn to find the waiting room packed with women waiting for their checkups. When I met with the OB-GYN, I expressed my concerns and felt a strong sense of “are you sure about this? Why didn’t you come in sooner?” type of hostile environment.
She asked all the routine questions: “when did you feel the lump?”, “is there a family history of breast cancer?” I have no family history with it, which was another reason why I didn’t get the lump checked when I first noticed it. It did not make me feel better that the OB-GYN didn’t validate my concerns. She judged me for waiting and based my quality of care on my age. I remember the remark she made while I sat on the medical table and she did a breast exam: “oh, it’s really bleeding,” after she put pressure on my breast.
To be completely honest, I did possess a lack of self-awareness. I didn’t have any inclination to getting breast cancer before the age of 40. It was recommended that I get a sonogram so I ran to the nearest place to do so on Canal street, and it was quite busy. I expressed my urgency to the woman at the reception desk. She, thankfully, took my concerns seriously and I was done within the hour.
As I was getting the ultrasound done, I sensed the sonographer looking worried. She moved from my left breast to my armpit and did this repeatedly for a couple of minutes. I was facing away from the screen so I couldn’t see what she was looking at so I kept asking her questions but she kept deflecting them.
I got dressed and took the CD of my images and ran back to the OB-GYN with the images so she could take a look at them. Once I got there, my OB-GYN informed me that the sonographer expressed concern and recommended I get a breast biopsy. The radiology place that was recommended doesn’t do biopsies over the weekend, so I tried to get the earliest date. The earliest date was a week and a half later. I sat in a random café in Chinatown, crying and filled with anxiety. I called the gynecology office again and left a message for my OB-GYN. In that moment I did not want to be alone, so I met with a friend to try to calm myself down as I tried to get the situation figured out.
My OB-GYN got back to me an hour later, I explained to her again that I needed to get an earlier date for a biopsy. She victim-blamed me and said something along the lines of,
You already waited so long, you can deal with waiting a little longer.
I was irritated and anxious – this was not something you want to hear from someone who is supposed to take your medical concerns seriously and help you.
I cried to her and yelled at her to start taking me seriously. If you know me personally, I have never yelled at someone over the phone but in that moment, I knew that this was my life I was dealing with so I needed to know as soon as possible what was going on with my body.
Yes, I waited. Yes, I was naïve. But prior to this I have never had any serious medical conditions or had surgery of any kind. After multiple back and forth phone calls I was finally able to get my OB-GYN to get me an appointment later that week.
On April 24th is when I got my breast biopsy done. I was the youngest person in the waiting and it was nerve-wracking. I absolutely hate needles and was about to get one through my breast. If you aren’t aware, a breast biopsy consists of sticking a needle through the side of the breast and collecting samples of any sign of tumor or lump to check for signs of cancer.
I laid down on the table facing the monitor. I could see my worst nightmare on the screen. Not only were they taking samples of the lump I could feel but also two other places in my armpit (my lymph nodes).
I was terrified—I had three lumps. I went home and binge watched Sex and The City to get my mind off the pain and the idea of having cancer.
The next day I got a phone call towards the end of the day from my OB-GYN to come into the office the next day—I almost fainted.
The next morning, I showed up at 9 AM with my cousin and one of my good friends. I tried to convince myself I could go alone (it’s a good thing I didn’t). We waited in the waiting room for two hours—two agonizing hours. So many thoughts were running through my mind. I was going to be sick.
Finally, I was called in. My OB is sitting at her desk. I was making my way to sit on the examining table as usual but to my surprise, she asked me not to. I sat on a chair facing her and she looked me straight in the eyes and said, “I don’t know how to tell you this.” When she said this, I got a little angry with her because I knew she didn’t know how to tell me I had cancer because she ruled out my concerns when I stepped into her office that weekend.
“You have breast cancer,” she said. And then she started to state the cancer statistics that 1 in 6 women get diagnosed with breast cancer each year. On the outside I wanted to yell that I was 22 years old. But I listened to her and her recommendations – she gave me oncology recommendations on, get this, a Post-it Note. My life’s fate, scribbled on a Post-it Note. I was beyond furious. I wanted to give her a piece of my mind but I didn’t. Instead, I went into the bathroom and cried my eyes out.
A cancer diagnosis is not the easiest thing to hear or cope with. I’m sharing my story because I made the decision to advocate for my health. I want other women who have ever been put into this situation to know their concerns and feelings are valid. We know our bodies, what feels normal and what doesn’t. My breast cancer journey has not been easy but by sharing my story, I hope to not feel so alone.
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August 15, 2023September 10, 2023 10min readBy Nimarta Narang
BGM literary editor Nimarta Narang is honored to publish this short story by the brilliant writer Ria Mazumdar. This story delves into very deeply important and timely themes of assimilation, family, mental health, and familial obligations.
Trigger warning: Self-harm and suicide.
America just didn’t have the right supply of spices, Neel thought as he scanned the towering aisles of the grocery store for the third time. White fluorescent overhead lights illuminated the vast shelves, which contained over three different brands of ground black pepper. While cardamom, let alone coriander powder, was nowhere to be found. On a daring day, Americans would venture to purchase paprika, which was about as seasoned as their cuisine would get. Although he had spent years in this country, the aroma of his home — an exquisite blend of turmeric, cumin, and freshly monsoon-drenched earth — still haunted Neel’s memory as he sighed into the dry, stale, air-conditioned atmosphere of the American supermarket. The same land that was supposed to grant him more constitutional rights had also robbed him of his sensory joys.
Resigned, he loaded up the metal shopping cart with ground pepper and paprika, wheeling it toward the cash register. A foreboding premonition rose to the front of his mind: without the right spices, his cooking just wouldn’t turn out right, and his wife Rana would break into tears, launching into her routine tirade. Paprika was one of many triggers of homesickness. She would rage against the frigid winters of Massachusetts and lament the absence of her family, telling him how much she regretted ever meeting him. Neel mentally prepared himself for this reaction as he braced himself to exit the store, walking headfirst into the harsh New England chill.
The pristine plains outside the supermarket stretched endlessly, as silent flakes cascaded down like sunbeams in the moonlight. As he clenched the thin plastic bags with his gloved hands, Neel proceeded toward his used Toyota Camry. The wind snarled mercilessly, tearing through the night like a whip, bearing no consideration for Neel’s circumstances. It did not recognize that he was a foreigner who had not seen snow until the age of 30, when he was tossed headlong into this abrasive climate, greeted by raging frost on a frigid December dusk. Though the walk was short, Neel trembled to the bone, pulling the diaphanous fabric of his navy blue Big Lots jacket closer to his skin. He was well aware that the flimsy, six-dollar garment was completely inadequate protection, but every penny he earned had to go toward a soft, down jacket for his small daughter.
The thought of his daughter gave him the adrenaline he needed to prevail against the hissing wind. One foot in front of another, he trudged cautiously along the snowy path, seeing nothing but a flat expanse of white before him. In the distance, a streetlamp cast a bluish glow. Finally, he reached the car and opened the door hastily, leaping inside to preserve every drop of heat. Arranging the groceries carefully on the seat beside him, he put the key in the ignition, immediately turning on the cassette player.
Barely any cars had cassette players these days, but Neel had gone out of his way to install one specifically so that he could listen to his old tapes from home. Familiar melodies were his only company on these long, solitary drives, providing stolen moments of tranquility. He emptied his mind, following the undulating roads from muscle memory, erasing any obligations to the outside world. The lyrics of his mother tongue washed over him like lukewarm water.
Sinking into a familiar tune lined with the rising drone of a harmonium, Neel came to a stoplight, drifting in this rare state of mental peace. Suddenly, two loud knocks rammed on the car’s rear window. Neel rolled down the window, seeing two men in the shadows. They were pale-skinned, dressed in extra-large gray hoodies and baggy black sweatpants, rapping at the car rambunctiously — the vapor of their breath emerging in wispy, smoke-like clouds. “Hey, sand n****r!” one yelled. “We don’t need another 9/11, go back to where you came from!”
The light turned green, as though it wanted to let Neel escape, and he stepped firmly on the gas, leaving the men’s laughter trailing in the distance. A small American flag ruffled halfheartedly on the dashboard, just above Neel’s brand new U.S. passport stowed in between the seats.
Neel drove on, feeling more resignation than anger. Such incidents were nothing short of expected for someone coming into this great country, where life, liberty, and the pursuit of happiness were granted to all, as long as they read the fine print. Racism and liberty — it was a package deal. Neel internalized each of these encounters as an exam, an opportunity to prove his stoic nature. He had adapted to his new life. Anyway, with whom could he share such experiences? The last real conversation he had with Rana occurred even before their wedding when he still lived under the euphoric illusion that his parents had discovered the right girl for him. Now, he dreaded seeing his daughter if he knew Rana would be around as well. Maybe someday the little girl could help shoulder some of this burden. Until then, he kept his chin up and moved along, expressionless.
He pulled into the garage, grabbed the groceries and steadied himself before stepping into the doorway. Old photos of his parents greeted him; the only fixtures on the white walls. His daughter, darting through the simply-furnished living room, ran up to hug his calf. He smiled and picked her up, twirling her around a couple of times.
“Want to help me unpack the groceries?” he asked. She nodded and skipped into the kitchen, her fluffy pink slippers thudding solidly with each landing.
As Neel followed her into the kitchen, he caught sight of Rana watching television, slouched on a couch, wearing her stained purple bathrobe as though she hadn’t moved since the morning.
“Ey,” she called out by way of greeting, her eyes still transfixed on the screen. “Did you bring the fish?”
Neel scanned the items laid out on the kitchen table. “No,” he said with a sigh. “Just chicken — I thought fish was for you to buy next week.”
“I wrote it on your list,” she retorted, her eyes still unmoving. “Why do you never listen to me?” Neel remained silent. As Rana’s tone grew icy, the daughter continued to prance around in the kitchen, unperturbed. Not oblivious, merely accustomed.
Neel poured the paprika onto a plate with some salt and prepared to turn on the stove. Suddenly, Rana got up from the couch and ambled into the kitchen.
“I want to take her to India next month,” she said, gesturing at her daughter. “We haven’t been back in over two years, it’s time.”
“We barely have enough saved up to get her a proper jacket,” Neel said, continuing to prepare his cooking.
“If she had been brought up in India, she wouldn’t need this ‘down jacket.’”
Ignoring this counterfactual, Neel smiled dejectedly. “Well, maybe you could bring back some cumin. God knows this house is missing some.” He regretted these words as soon as they left his mouth. His half-hearted jokes these days simply hung suspended in the air, dissipating and leaving quiet trails of resentment lingering in their wake.
“So, you’re saying we can go? You need cumin. I need my family.”
“No,” Neel said firmly. “We have to wait some more.”
His words seemed to flip a switch in Rana’s eyes. Previously drooping and groggy, her pupils alighted with sparkling embers.
“I always wait for you!” she shouted. “I don’t want to live in this godforsaken place. We don’t even have a proper store nearby. We can’t even eat proper food. You dragged me here!”
His ensuing silence only served as an additional provocation. Rana raised both hands to her head, grabbing her hair in tufts. “I HATE you!” she screamed, yanking out hair in chunks while wincing at the pain she was inflicting upon herself. Neel, all too familiar with this show, silently continued to chop tomatoes. Right down the seam in the middle, a clean slice, taking great care not to let them burst and lose juice to the cutting board. He clicked his tongue in exasperation as one lone seed came away from the whole, breaking the fruit’s pristine symmetry.
Neel’s lack of attention infuriated Rana further, while the daughter continued to sit serenely near her father’s calf. Glancing around the kitchen, Rana seized a small white ceramic plate from the Corelle set her parents had given them for their wedding. Scrunching up her face, she hurled it at the wall in a sudden burst of energy.
“I wish I were dead!” she yelled, her voice breaking and her breathing quickening, growing shallow. Neel kept his gaze on the tomato before him. He mustn’t lose any more seeds. Dice the half down the center, turn and dice again. Rana turned, running out of the kitchen, while her daughter stared confusedly at the shattered ceramic.
***
Indian cooking is a methodical process. In some cuisines, people throw everything in a pot and let their concoctions simmer. Not so here. One must first sauté the onions, and then gently lower the heat. Only then can the spices be added, coating the onions in a thin layer. After hitting a certain level of fragrance, the remaining ingredients are added, one by one. These steps are like a formula, nothing short of mathematical. Neel approached the stove, following these motions, seeking solace in his own muscle memory as he did during those peaceful, solo drives. The daughter skipped happily out of the kitchen.
Once everything had been added to the pot, Neel bent down to pick up the shards of ceramic Rana had left on the floor, sweeping them as far away from his daughter as he could. He felt a distinct lack of loss looking down at the broken pieces, remembering the day her father had presented them with the Corelle set and a pack of gleaming silverware. He really did like his father-in-law. He recalled smiling and laughing, putting his arm around Rana and envisioning the setup of the Americanhome they would call their very own. Although he could replay these memories in sharp focus, he now felt a strange emptiness in his chest. The knifelike pangs of the past seemed to have left him, just as his fury abandoned him when those two men tapped on his rear window. Part of him wished he could muster up that rage. Rage at the men, rage at himself for allowing the societal taboo of divorce to keep him trapped in his crumbling marriage. But instead, numbness enveloped his heart like a thin sheen of ice, simultaneously sheltering him from the polarity of emotion and inhibiting him from release.
Suddenly, he heard a loud thud outside the kitchen. Alarmed, he stepped out, running to the bathroom. The long glass mirror, stained with the debris of the past few weeks, interrupted his reflection as he stood at the door. Three glass dolls that were also once wedding gifts guarded the basin, once pearly white, now discolored in splotchy, uneven patches, grime lining their foreheads in faded streaks. Inside the basin lay twenty sleeping pills, clumped together, just fallen from reach. The open pill bottle lay sideways by the faucet. On top of the toilet lay a razor stained with fresh blood, the scarlet liquid slowly trickling onto the porcelain. Rana lay weeping on the floor, a lone pill in her hand and three long gashes tearing open her shin. The daughter watched.
“I couldn’t do it,” Rana sobbed. “I have to live, for her.”
Rana knew, but could only admit in her own mind, that she did not want to die. She did not believe in a life after death, only in blankness. But what she wanted was the opposite of blankness. She wanted a release from life as an immigrant. No fresh start can numb the pain of a tree that becomes uprooted from the place it has always stood. Suddenly, it is commanded, not merely to adapt, but assimilate. To shed old leaves and camouflage amid a new, foreign forest. To survive in sub-zero temperatures after being kissed by humid tropics its whole life. To withstand a snowstorm with nothing but a six-dollar Big Lots jacket.
So Rana did not want death. She wanted her hometown, the vibrant island of joy that lay on the opposite end of the planet. She wanted the fragrant monsoon rains that pelted the soil with scent, the same soil from which her own roots sprouted for years before being cut. She wanted a place where English was subservient to her mother tongue, the latter emblazoned everywhere from street signs to soap bottles. She wanted the spices, those long-lost aromas that the “ethnic” food aisle could only dream of capturing. Her body ached to take a dip in the Ganga River. What some, to this day, call the “Third World,” was always her first and only. This place she had landed in was not home. Regardless of what animal inhabited the cover of her passport, it would never be her home. While her body had crossed the circumference of a planet, her heart had stayed back. She knew that her family was a casualty of her pain. Yet it consumed her in clutches so tight, she felt like a puppet of her own longing. Her actions were no longer her own, driven by an unquenchable thirst, the desire for return. So she lay helplessly on the bathroom floor, rocking silently to the rhythm of her sadness.
The daughter looked on, hips akimbo, her head slightly tilted to one side. She was ignorant of her future as a sacrificial hybrid tree, one that grows uncertainly, unsure of its own existence between two lives, two anthems, two tongues, two allegiances, and even two parents.
As the daughter observed the scene — the glaze of innocence veiling her sight — Neel watched her with a dull sense of regret. He approached the bathroom sink without looking down at Rana, who remained curled up at his feet. He reached in with those hands, worn beyond their years, and picked up the pills one by one. This was one routine he hoped he would never have to teach his daughter.
Taking the little girl by the hand, Neel guided her to his own room, handing her some toys and turning on the DVD player.
“Just wait for me to finish making dinner, okay?”
She plopped down on the bed, already distracted.
Rana stayed on the floor, bearing the distance of an ocean in her empty chest. The daughter, playing with a Barbie doll in the other room while watching a Bengali cartoon, was already bearing the duality of a world she could not yet understand. And Neel, impassive, carried the weight of a thousand retorts buried deep within his heart. He and Rana had crossed a sea together but failed to cross the impasse that lay impenetrably between them. Neel stood at one end, unwavering, while Rana lay at the other end, drifting amid her own salty tears.
Neel finished cleaning the sink and set the pill bottle back inside the medicine cabinet. He returned to the kitchen, as though the entire incident had been just another task on his to-do list. As he sprinkled more paprika onto the food and resumed his work at the cutting board, his vision clouded. Onions had always made his eyes water.
When you grow up seeing blood stains on your shampoo bottles, your sense of normalcy shifts as mine did. You don’t cry when you trip and fall on the playground, because you had just seen blood the night before when your mother took a clothespin to her forearms. You watched the blood leak slowly down her clothes and onto the floor, where it left a dark brown shadow for you to see the next day too. You are unfazed when your classmates roughhouse and toss pencils across the room because a pressure cooker was hurled right past your head on your fourth birthday. You rip out pieces of your hair when you get stuck on a math problem because you are following the example of the biological role model that the world assigned to you. You hate this biologyfor making you what you are: a living reminder of your parent’s suffering, of the hurting of immigrants worldwide. You have escaped that pain simply because of the soil you were born on. And so the burden on your shoulders is inexplicable, as you carry the weight of a parent’s mental health, her suicide threats, the weight of her entire life, day in, day out. Your heart slowly starts to contort inward, its once fiery heat chilling over time like that cold Massachusetts night, for the only love you have ever known is wrapped in tears, sleeping pills, and razor blades.
Born and raised in Bangkok, Thailand, Nimarta grew up devouring Hindi movies, coming-of-age novels and one too many psychology textbooks. … Read more ›
September 13, 2023September 13, 2023 8min readBy Manali Deolalkar
Photo by: Yeexin Richelle
Traditionally, psychotherapy has let women down. This is not to say that women and other minority group members have never received help, but rather that the therapy they received made little attempt to address the root causes of their problems. In focusing narrowly on the personal and individual, which a lot of mainstream approaches focus on, they ignore the big picture and miss the point. An alternative approach — feminist therapy — can help challenge the norms and support South Asian women in a more comprehensive way.
A therapy which fails to address power issues in people’s lives automatically reinforces oppression. Feminist therapy is a way to look at people as part of society and not merely as individuals. As more people of marginalized identities realize that the cause of their mental and emotional difficulties are not individual factors but structural, they are seeking more thoughtful therapists and counselors. Feminist therapists are aware of the cultural dynamics that uniquely affect women and keep these at the center of their practice.
Feminist therapy has a lot to offer to women of color, particularly South Asian women. It is formed on the assumption that social forces impact, and these forces include the many identities that a South Asian woman holds — including race, ethnicity, caste, etc. Feminist therapy can help support our clients and us as therapists to conceptualize the client’s difficulties, as not just stemming from internal sources, but as an outcome of the deep-rooted patriarchal system.
Feminist therapy is the key to a progressive approach towards mental health care. There is a lot of awareness about feminism nowadays and women encourage feminist approaches to therapy. Feminist approaches look at how social and political forces interact with our own identities. Feminist therapy especially puts in a lot of emphasis on how our intersectional identities such as religion, family dynamics and social class plays a role in our own gender identity. Feminist therapy can help support our clients and ourselves as therapists to conceptualize the client’s difficulties as not just stemming from internal sources, but rather face the impact of the deep rooted patriarchal system.
Here are some important aspects of a feminist approach to therapy, whether you are a therapist or someone who wants to start therapy themselves:
Therapists’ own biases
Therapists, while working with South Asian women, as with any other client, need to put in their own personal work in understanding the assumptions and biases that they may hold towards these identities. If a counselor holds bias that a South Asian woman is timid, or doesn’t know what she wants, it may cause the counselor to take in a more direct approach rather than a collaborative one.
South Asian women are often being told what to do. Hence, therapists who may choose to be more directive rather than collaborative, may often reinforce the position of power and authority onto a South Asian woman reflecting what she faces in the world. South Asian women, especially who may have not been exposed to therapy, may look at counselors from a view of receiving advice or guidance. It is through our own ability to explore and process our biases that we can help challenge this narrative for the client, and help take a more collaborative approach.
Exploring identity work
It is important for a therapist to be aware about gender, sexuality and the intersectional aspects of feminism; about how sexual minorities, caste, religion impact gender in influencing the kind of experiences that women face. The counseling relationship is a space for clients to process the identities that are the most salient to them. We can start off with providing some context and psycho-education around the purpose of understanding these identities. Helping the client process different identities that are important to her can help take a more holistic approach to understand her difficulties. We can help provide information around how every identity that we hold impacts us in some way or the other, because of its interaction within the social context. This can also be a time when a client may self-disclose about their own identities, if comfortable and appropriate, to model this understanding.
Ask instead of assume
It is considered best practice with every client to ask their preferred pronouns; as well as identities they would like to highlight at the beginning of the counseling relationship.
Asking, instead of presuming, can help clients hold their voice from the beginning of the counseling relationship and create a safe environment. Processing identities that are salient to them and opening up space to share other identities can help clients share openly about how they choose to identify with their gender/sexual identity. It creates space for clients in the process of exploring their identities, to get curious about their identified gender/sexual identities for the first time.
One of the initial and ongoing processes of feminist therapy is educating women from a collaborative aspect. Providing psycho-education about their rights, consent, impact of patriarchy and other systemic factors promotes empowerment. While providing psycho-education, it is important to process the power dynamics in the relationship and model consent within the relationship by exploring the question: “What is it like for you to hear this information from me?”
We as therapists can be considered as guiding forces, but we should also be mindful that we are providing this guidance and information from a collaborative aspect rather than enforcing authority or being direct. South Asian women are often asked to respect people in authority and not defy them. We, too, as therapists may end up reinforcing these patterns, and instead need to do our own exploration by engaging in psycho-education with collaboration and continuing to check in with the client’s internal process.
Hold context around starting therapy
A South Asian woman puts a lot of thought into seeking therapy. The cultural stigma towards mental health can have an imperative impact on her recognising that therapy could be a potential need to take care of herself. Along with the courage that it takes to reach out to a therapist, either openly or whilst keeping it hidden from her family, there may also be a potential element of what kind of therapist do I want to see. Especially for South Asian women living in the US/UK or other Western countries, there may be a significant deliberation that goes into seeing a white therapist v/s a person of color therapist v/s a south asian therapist.
Can we think of potential factors that may prevent a South Asian woman from reaching out to a therapist who may hold similar cultural identities ?
Can we think of potential factors why a client may want to work with a South Asian therapist?
Explore reasons that led them to choose you
When a client comes in for therapy, she has probably considered the therapist’s background. She may choose to see a non-South Asian woman because of past and internalized fear of being judged by other South Asian women in her life. Or a client may deliberately choose to work with a South Asian woman therapist for perceived similarities in identity. For therapists, it’s important to create space at the beginning of the relationship to ask the client what led them to choose you as their therapist. For clients, it’s important to ask questions about your therapist that are important to you.
Fostering environment for all their identities
Clients are fully seen and valued for all aspects of their identity, background and experiences. It also means that we ground our interventions from a systemic and anti-oppressive approach.
We constantly learn and evolve to provide responsiveness, humility and respect to our clients and really redefine the standard of care based on the identities and background of South Asian women.
Background of the client
Particularly while working with South Asian immigrants, it is important to know the background of the client we work with in order to design culturally-appropriate interventions. As a lot of research has asserted, not all Asians are alike and group differences within Asian groups is often overlooked.
There’s a lot of information and knowledge around Indian groups that tend to be generalized across other communities from South Asia such as those from Pakistan, Sri Lanka, Bangladesh, etc. It is important for counselors to be aware about similarities and differences across these cultures, and create interventions that are more specific to the client’s cultural background.
It is important to check in about how the interventions land with the client. We may use certain strategies from a Western perspective that go into exploring a client’s relationship with her parents or caregivers. This can particularly bring guilt or shame for the client as it may be in conflict with her cultural value of holding respect for her parents.
A lot of the deep respect and regard towards family comes in the form of loyalty and not speaking “ill” about the family with strangers. Reflecting on family, based on Western interventions, can sometimes make it challenging for clients based on their values. Checking in with clients on how these interventions feel, and making space for the guilt and shame to surface can once again help clients to hold value in her own voice.
Examining values and beliefs
Therapy can support South Asian women in differentiating between their own values and society’s expectations. Even though collectivism is a value within South Asian culture, it may not necessarily be an individual value to our clients.
South Asian women very often bear the burden of the value of collectivism where they have to meet family’s expectations, be in touch with other family members and engage in other collective activities. It is an expectation that has been imposed upon them. A therapy space can be a space for clients to explore what their own individual values look like. It can be a space for counselors to collaboratively work with clients in choosing what matters to them, even if what matters to them is to take care of the family.
In this essence, she now has had a voice in choosing how she wants to move forward as v/s feeling stuck in expectations set by others. When the client recognizes that she has a choice in exploring her own values and beliefs, there can be support around how to engage in behaviors that are based in these values. Sue and Sue (2008) has recommended discussion about values, beliefs and behaviors of their family and culture, so that clients can discover those that are for them, those with which they identify and those with which they are ambivalent.
The reason why a South Asian woman may choose to work with a South Asian therapist is to feel understood and not hold the burden of having to explain different cultural norms and expectations. When working with a therapist from a different racial background, clients may feel the need to explain and defend their own culture. It may feel difficult to hear about certain norms being toxic or problematic from someone who doesn’t share the same background as you.
When we as South Asian therapists work with South Asian women clients, we have the unique opportunity to validate the importance/meaning of these cultural norms, as well as challenge its problematic impact on our mental health. We have the context and ability to hold the community and cultural system accountable. It is important to hold the value of one’s desire to have a community and fellowship, as well as hold the impact of this collectivism on the mental health of South Asian women.
It is important to pause and explore: What about the culture feels impactful? How does this impact self-esteem and the way they view the world?
South Asian women are bound by the cultural value of adjustment and acceptance. Accepting our culture the way it is and moving on is what they have been taught to do across generations. The therapy room can be a good space for us to pause and help them choose what aspects of the community are helpful and what feels unacceptable.
This, in turn, can help with increasing their voice and control on their own value system. When they come to you looking for that cultural connection, you can hold space to both empathize with their cultural upbringing and to be able to challenge it. There’s more likelihood that they need it to be challenged and from someone who understands what they are going through.
Manali is a licensed psychotherapist based in California. Manali has completed her Masters in Mental Health Counseling from Columbia University, … Read more ›
I’m at the gym. I’m on my grind. I keep telling myself that if I keep doing ‘X, Y, and Z,’ I’ll get results. Which is true — all the fitness gurus say so. The personal trainer I once had said as much. Yet, I forget to take a breather. I’m hoping for instant gratification, when I know the results I want — better energy, endurance, and metabolism — take time. I have to be patient with myself. So why do I feel pressured?
When I sit down to take a breath, I notice this idea of instant gratification weaves a common thread. I put pressure on myself to complete projects, quicker and faster. As a licensed therapist, my clients also talk about how they feel the pressure to do more work in a shorter amount of time, leading to longer work days and burnout. Some new clients ask, “How long does therapy take? Will I feel better after three sessions?” It’s like those junk tabloids with headlines like, “how to lose 10 lbs in 10 days!” In an ever-changing, fast-paced world, there are expectations to do things faster and better. On top of that, a relationship with our body, our career, our mind, and yes, our therapist, takes time too. To wait for results can create an uneasy feeling. We can’t trust the process if we don’t see results right away. We’re focused on the destination rather than the journey.
I believe the same idea is being applied to dating and relationships too. I cringe and roll my eyes when I hear, “Dating is a numbers game.” While it’s true that you might have to meet many people before finding your person, this has caused some of my clients to ‘gamify’ dating: swiping right on every dating profile and trying too hard on the first date in the hopes of landing “the one.” This prevents them from slowing down, truly seeing the person in front of them for who they are, and being vulnerable. My South Asian American clients feel the cultural pressure to settle down quickly and think they need to “catch up” with their friends who are getting married. They’re working very hard in the South Asian dating market, hitting up all the singles they meet, and finding instant chemistry with “the one.”
But just like a fad diet, once you get the results, you’re back at square one. You gain all the weight back, and the person you fell in love with falls out of love with you. You start to feel demotivated and hopeless all over again. Relationships that build quickly tend to fizzle out quickly too.
Here’s how South Asian American singles should stop shaming themselves for being single, this Valentine’s Day season, and try dating with intention. At the same time, this therapist has some thoughts on how we South Asian singles could be dating better. If you’re single this Valentine’s season and wondering, “when am I going to find my person?” you’re going to have to challenge some long-held, societal beliefs about dating, marriage, and relationships, both within and outside of our culture. It means:
Being okay with not going on a ton of dates
Dating is not a game to win! Forget about the “numbers” game. You are also not trying to “trick” anyone into being with you. That shit is not cute. Show up authentically and don’t be afraid to be “caught off guard.” After changing their perspective, some of my clients tell me, “I haven’t found a decent quality person!” Yeah, that’s kind of the whole point. You could go on a ton of mindless dates and have your time wasted, or you can have one or two quality dates and feel fulfilled. Pick one.
Stop love-bombing
Because some South Asian cultures have a much faster timeline with marriage, you might find yourself trying way too hard to impress your first date in the hopes that it will rush the chemistry high. Dating scenarios that start this way burn out once things get serious. Looking for chemistry too soon is like chasing a temporary high. Be patient and take your time getting to know someone because chemistry takes a long time to build.
Paying attention to what your date says and how they say it
We’re all putting our best foot forward on a first date. What do they talk about? How do they talk about other people? Does the conversation feel superficial? Does it feel like a performance? Do they take an interest in you? Are they sharing anything about themselves?
Remembering what you want from a long-term partner
Superficial qualities aren’t an indicator of how good of a partner they’ll be in the future. Having a high income doesn’t mean they’ll contribute to your relationship or the family you both build. However, their financial decision-making can indicate what they prioritize and what they value. And while physical attraction is important, there is no fountain of youth. Will you still want to share your life with this person when they are 60? Or will they annoy the shit out of you?
Taking your parents’ opinion with a grain of salt
Marriage is not just a blending of two families; it’s a ‘business contract’ between you and your spouse. Would you go into business with this person? Would you want to share physical space with them? Share a bed with them? Your parents are not the ones who are going to bump uglies with them, and at some point, your parents will no longer be around. Whose decision do you want to be stuck with?
Remembering no one is perfect
There is no such thing as “Mr/Mrs. Right.” Let go of the idea that there is someone better out there. Dealbreakers are important because they indicate what you have tolerance and patience for, and this can affect intimacy, but don’t write someone off for something workable. Think about the things that give you the “ick” versus things that don’t give you the “ick.” If someone’s qualities are only mildly imperfect but overall don’t give you the “ick,” then it shouldn’t be a dealbreaker. If it’s something that can be changed, then maybe it’s worth being flexible. If it’s something that can’t be changed and you can’t get over it, then you’re wasting your time and their time too.
As a South Asian American who is also single, I am pressured by my family to get married quickly too. I know that many people in my situation would either give in to their demands or take matters into their own hands. They might date to appease their parents that they’re “working on it.” But I refuse to give in to the pressure. When I date, I date to enjoy the person in front of me. I see the person for who they are, not some idea I cooked up in my head for the outcome I’m trying to achieve. I put my most authentic self forward. If this doesn’t result in a relationship quickly, I’m okay with that.
If this therapist can be patient with her process, then why can’t you? Like exercise, relationships take time, and you could be doing everything right and still not getting exactly what you want. You won’t be a good fit for everyone, and likewise, not everyone will be a good fit for you. But don’t close yourself off from the world. This Valentine’s season, learn to trust the process. Tune out the noise; the idea of “instant gratification,” Be patient, be honest, and be yourself. And don’t forget to take that breather.
