I Think you Should Start Therapy: Processing Trauma as a South Asian

woman of color reaching into space surrounded by puzzle pieces

“I think you should start therapy.”

“I’m fine.”

“I think it would be good for you. Here, see this guy. He loves seeing my patients.” Before I could argue, my psychiatrist writes a number on the back of a business card and hands it to me. I run my thumb along the name raised from the ink.

I had been suffering from intractable depression but had been convinced that my pain was simply the sign of my wound healing. Therapy wasn’t something that I wanted to do; I’ve had mostly bad experiences with it. It was only once my boyfriend broke up with me that I called the number on the back of the card. I figured it wouldn’t hurt to have someone to talk to.

A few weeks later, I sit across from a man dressed in black and white. His legs are crossed and I can see that his socks bunch up at the ankle. I will spend a lot of time looking at his socks in the coming months, an easier place for my eyes to rest than his face when I talk about the things that have ripped me in half. He is a plain man who does not bring himself into the room, a far cry from my psychiatrist.

She is a black woman, an immigrant, and a force of nature. She wears bright clothing and as she throws her head back to laugh, I can see the taxi cab pendant on her necklace. I am familiar with the glint of her wedding ring as she fills my prescriptions and I’m always comforted by the wristwatch she wears, one so similar to mine.

Therapy begins modestly; I am recalcitrant at best. I firmly believe that I do not need help but keep coming to sessions to fulfill my psychiatrist’s wishes. He is patient, although I sense that it is wearing thin. My feelings towards this new therapist teeter and then totter. While I do not quite dislike him, I do not quite like him either.

“Am his only Indian patient?”

I don’t want to be some specimen representative of an entire subcontinent. Skewered like a butterfly and observed under glass. So, I leave my culture outside of the clinic room, hang it on a coat rack as if my identity was so easily separated. I am an American in sessions; I like American things, make American references, and have American problems. I make no effort to talk about my life as a person of color, and he never asks. My American Life becomes performative. I’m not sure how to explain to him that my parents’ wishes for me are steps toward our American Dream. Here I am translating relationships; frustration boils inside me that my Nani must be referred to as ‘grandma.’

I have found myself in spaces of conflicting hermeneutics before. I had sought out therapists of color previously but had little luck. Psychology Today is filled with a sea of white faces and I have felt the acetic sting of cultural redaction. When I ask my white friends what therapy feels like for them, they say it feels like coming home. I’ve never really felt at home, and in many ways, I’m made to feel like an immigrant, sitting in the discomfort of a liminal space.

It is June of 2020. I march alongside a dear friend. The crowd chants, “Hands Up, Don’t Shoot!” The ground is dusty and the dirt we kick up settles in my socks. Our feet fall in time with the rhythm and other groups join us, tributaries pooling in Franklin Park. Monica Cannon Grant is on the microphone but I can scarcely see her; instead, my eyes are drawn to the wall of riot police that has lined up in front of Shattuck Hospital. I slip away from my friends and filter through the dense crowd toward them. I don’t know why, but I feel that it is necessary to look in the eyes of these men. They are all white. The line of police stretches on past sight. I am chilled by the thought of it, just as I have been since George Floyd’s murder.

When I ask my white friends what therapy feels like for them they say it feels like coming home. I’ve never really felt at home, and in many ways I’m made to feel like an immigrant, sitting in the discomfort of a liminal space.

How many white people were I now fearing? I ruminated on this question as I joined the dispersing crowd. Back through Franklin Park, the cops had blocked the entrances, past police lines on motorcycles, who revved their engines to agitate us. In how many spaces in my life were white people in control?

My mind turned, as it often does, to disparities in mental healthcare. What do you do when the people who are supposed to care for you look like the people that are hurting you? While I tried to separate the protests from myself, the reality of what occurred was such an affront to the senses that I was forced to reflect on my life and my therapy as well.

Suddenly My American Life was juxtaposed with a racial reckoning. I realized that it had not been about being American because America had been synonymous with white, and here amongst my Black and brown siblings was the real America. The pieces of me that I had left out of therapy came sharply into focus as if the lens had finally sought the finer details.

My identity as a South Asian woman had always been altered. Even my name is abbreviated. My full name, Sukhmani, translates to peace of mind. In Punjabi, my name is soft and fragrant; it is borne from our scripture and is sung in our hymns. But between the teeth of white doctors, it tastes metallic and the weight of it as it falls from their mouths threatens to break my spine. If my name, the first and most fundamental aspect of my being, has to contort itself in your clinic room, how can you ever expect me to feel fully embraced?

My therapist would often joke that if I wanted easy therapy, then I should go down the hall. I pictured him now, smiling, lips pulled past his teeth, as protesters raised their signs around me. A line of police barricaded Blue Hill Ave shields up, creating an area of restricted diffusion. To keep the peace, they step aside. We spill into the street and begin marching toward the Boston Police Headquarters.

The therapy itself is brief, an hour a week. All of the hours surrounding it are when the work is put in. I know ‘easy therapy’ was meant as a joke but I thought about it often. Was I consistently showing up? Was I committed to my recovery?

I couldn’t stop thinking about how many white doctors I had seen who made me feel as if the wounds were my fault: The snide comments in the ER, the ignorant statements in sessions, and the insistence that I must say India when asked where I’m from. As much as they simultaneously centered and erased my culture, so had I. There were divisions in this country and my identity, and I wondered if I had been choosing the easy therapy.

A few days have passed. Because of the pandemic, I had to move back in with my mom. It is her driveway I am now parked in, hands gripping the steering wheel as I watch the drunken flight of a honey bee on her hydrangeas. I have not slept in three days. At night The Man in the Hat stands over my bed and The Girl in the Closet scrapes her nails against the door, begging to be let out. Even now, in the corners of my vision, there are shadows. It feels as if someone has gone into my head and scraped my brain from my skull. I am hollow and I am nauseated from sleep deprivation. Despite this, there is a pronounced electric hum emanating from my core.

My body is whirring and clicking and begging for movement. My skin is too tight and I have to fight the urge to peel it off. Bipolar disorder, despite what the name implies, actually has four unique states. There is the euphoric mania, the productive hypomanias, the crushing depression, and the place I now reside: a mixed state. When I was younger, I saw a YouTube video where a man put a goldfish on a hot skillet. The fish launched itself back and forth, burning on both sides until it died. That is what a mixed state is like. I felt that way now, my knuckles turning white as they wrapped themselves around the leather.

My phone is ringing, buzzing loudly in the center console. It is my therapist returning my call. I pick up and tell him about insomnia, the hallucinations, the electric hum. He listens and reassures me. The air as it leaves his lungs, the soft ‘oh’ that it makes, is like a salve.

“Let’s get you feeling better,” he says as I begin to cry.

I am used to being by myself in altered mood states. My friends know not to call and my abrupt absences are expected. I prefer loneliness to the shame and disappointment that comes from trusting myself with others. In the past, the providers that I relied on for my care had left me wanting, not returning calls, rescheduling sessions; they had made me feel like a burden rather than a human being in crisis. I had carried those memories with me when I called my therapist that morning. I had not expected him to care.

My whole life, I have met the darkness alone, never daring to place my weight on another person. It would be days before the medications brought me back to baseline. Red pills slowly percolating into my bloodstream, little hits of dopamine. I would have suffered, but I would not have suffered alone for the first time in my life.

Therapy still does not feel like home. What is home to the child of immigrants? To a girl who spent her school breaks shuttling across oceans, spending sweltering summers in Punjab, hands sticky from the mangos she consumed. Therapy did not feel like my Nani’s house or my Masi’s house or our village in Talanian. Places whose inhabitants laughed and quarreled on worn wicker chairs. Where barefoot women packed kitchens and drank piping hot masala chai. No, therapy took place in a small room with blue chairs.

The only art on the walls was a stock photo of the lighthouse on Cape Elizabeth. The only tea that was consumed was from a 16oz mug that had “Welcome” written across the rim. Now that I finally sit in a place of healing, I see that therapy is like a compass, the center from which I can chart my course. Each week, we venture forward toward a better self. Though landscapes change in the sun and shade, a compass always guides you north. It is through the processing of trauma that my strength is returning. All of the bits and pieces of me that are scattered across continents can finally settle into place.

Now that I finally sit in a place of healing, I see that therapy is like a compass, the center from which I can chart my course. Each week, we venture forward toward a better self.

I look forward to therapy now. Thursday mornings as the sun slowly makes its way across my bedroom. My therapist sits against an exposed brick wall, his white collar tucked neatly into his black sweater. He wears glasses, often black but sometimes brown. Because this is a pandemic and because this is Zoom, things are chaotic, but the chaos lends itself to a different type of intimacy. There is no longer a performance, how can there be when he meets me in my home, hair askew, a cat meowing loudly into the microphone?

Now, when I cry, I do so without reserve; no one can hear me, and there is no waiting room for me to bear my face. My therapist is not a plain man at all; in fact, he’s quite funny. We find out we’re both from San Francisco and he tells me he used to be a writer. I get nervous when I share my essays with him. Fragile, imperfect things; what would a real writer make of the words I’d written on the back of a napkin? I am embarrassed that I ever doubted him, upset with the time I wasted with my stubbornness. As our time together enters a new season, I find myself nostalgic for my moods, wishing to start over, to be better, to recognize what I had.

I have learned that it is not the passing of time that we notice, though it has now been two years. It is all the markers that come with it. There has been gentle, inevitable progress in therapy that can only be likened to the rising sun’s quiet spill over the horizon. Before therapy, I had long retreated from the world, lost in my books and journals. But now, I have found myself intensely alive, whole in a way I never imagined.

By Sukhmani Bal

Sukhmani Bal, MPH, serves as Director of Community Outreach at the Massachusetts General Hospital’s Center for Cross-Cultural Student Emotional Wellness, … Read more ›