Ten years ago, I sat in a doctor’s office completely lost and confused about the thoughts that had overcome me. I went into that office looking for an easy solution to my problem but I ended up leaving with a six-month plan including therapy and medication. Although I heard her say that bipolar disorder was a lifelong disease, there was a part of me that hoped in six months I would be better or even cured.
The plan was extended to a year and then that was extended to a focus of graduating high school. Once I had graduated, the new plan was focused on acceptance, coping and learning to live with my disorder.
This was the part of the plan that I had struggled with: what did it mean to live with bipolar disorder?It took years before I actually had the answer to that question and to be completely honest, 10 years later the answer is still changing.
There are days that sadness takes over my body in a way that even my medication can suppress; there are days that the voices in my head prevent me from hearing my own thoughts; there are days that my mania is so exacerbated that racing thoughts fuel the games my own mind plays on me. So yes, nothing has really changed when it comes to my symptoms. I would even say that my symptoms have increased and intensified but I have changed. And because of these changes I have made in my life, lifestyle and even relationships I have survived.
During the course of my ten-year journey, there are three main lessons I have learned: contentment, acceptance and realism. Life doesn’t always give us choices: I didn’t choose to be bipolar that was bestowed upon me but I did have the choice to decide how I was going to handle my disorder.
For the first three to four years, I choose to pretend it didn’t exist. That was one of the worst choices I have ever made; as a result my symptoms intensified. At that point I had a choice: accept my disorder and take care of myself or bury myself in misery and self-pity.
Acceptance has been my greatest gift. Accepting yourself, your flaws, weaknesses and capabilities allows you to be happy. Contentment works hand in hand with acceptance. Learning that life isn’t always perfect and that not every decision will make you happy allows you to be at peace. That is what contentment has taught me: inner peace, with my choices, decisions and most of all with my illness.
The hardest lesson has been realism. For years, I lived in a pretend, very naiive world. Being bipolar forced me to face reality; I was given no choices in this regard. I say often that it was reality that slapped me in the face on October 26, 2006. For months, maybe even years I knew something was wrong but I never wanted that to be my reality so I pretended. I thought, I would “fake it till I made it.” Each day, I bore a fake smile and a shared anecdote from a life that I imagined was mine, but it was never mine. My reality was hiding in my closet to shut out the voices in my head; my reality was paranoia, anxiety and sleepless nights. October 26, 2006 forced me to accept this reality and by doing so I have survived.
These ten years have been the worst and best of my life. I have graduated high school, college and graduate school but at the same token I have had to deal with the murder of my sister, suicide attempts and three hospitalizations. I have been forced to make difficult decisions, while trying to focus on my best interest. It hasn’t always been easy but I have gained a sense of confidence in myself as result.
There are some days that I absolutely hate my disorder. There are moments that I am so overwhelmed and upset that I still wonder, “why me?!” But then I remember, that I have survived, thus far and the only way that has been possible is because I have been given strength. This is when I remind myself that it has been my disorder that has given me strength.
Being bipolar has taught me strength, tenacity and perseverance. Had I not been bipolar, I don’t think I would have been able to survive the loss of my sister. But most of all, bipolar disorder has taught me the meaning of survival. I would be hesitant to say that I have conquered my disorder and that I am completely prepared for what is to come, but day by day I am surviving and if I have learned anything over the past 10 years is that survival is the first step.
I still worry about the years to come; I worry if I will grow weak; I worry if I will always be as high functioning as I am now; I worry about the uncertainties of life. I will always worry and who knows what will come in the next 10 years. But for now, I choose to live in the present, relish in my accomplishment and enjoy the journey.
Subrina Singh is a passionate young writer. After completing her degree in all things Indian at Stony Brook University, she is now pursuing her Master’s Degree at Columbia University. More recently, she has become committed to using her experience with mental illness to help better the mental-health awareness within the South Asian community. Subrina enjoys writing, reading and drinking Starbuck’s Passion Tea Lemonade while singing Bollywood hits of the Golden Era. Follow Subrina on Twitter for her reactions to Pretty Little Liars every Tuesday night!
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 ›
Mental health is quite the subject these days, its troubles affect everyone; it knows no gender, orientation, race — it strikes upon one’s inner journey. But specifically, what have not been put in the same sentence are men, mental health and vulnerability. Too often it is seen that men are not allowed to show their emotions. But the aftermath shows that this repression of emotions bleeds into relationships, substance abuse, domestic violence, and more. It is seen time and time again in films, books, art — it’s all too familiar.
And it is beyond the point of “let’s talk about it.”
Time for action.
Mental health hits close to home for me. As a filmmaker, I will always share my journey with others. – Jacquile Singh Kambo
Men, mental health and vulnerability often aren’t talked about enough. “Embrace” is a short film that seeks to change that. It is a short animated film about Arty, a well-dressed man who has no face, gets ready for his date until he meets a younger version of himself. Arty and this younger version of himself delve into a surreal world where he learns to embrace himself. It’s him versus himself.
The façade self; the feeling of wanting to be somebody — are all things people are dealing with especially in adult life. From the dating world to the social media world — it feels like different masks are worn only to make us feel faceless, feel numb or a nobody. Too many masks could make people feel like a lost identity amidst everything that is going on in this crazy world. Out of touch, and out of life — with others and with themselves. The masks are metaphorical, the story is internally about men and mental health. Arty learns to ’embrace’ himself and to overcome his internal struggles.
Not often is it discussed that men should have a safe environment to be vulnerable, amongst others or even other men. Perhaps this is because men are wired to put on a façade when things go wrong, when things get difficult, or when true emotions are not expressed. If these are not dealt with, it can lead to other relationships, including romantic relationships. Further it becomes a cycle: suppression could lead to aggression, substance abuse or self-sabotaging behaviors and could create a toxic environment. Many of these arise from childhood trauma. Quite often childhood is repressed or ignored, and one may take their troubles along with them into adulthood. Perhaps revisiting the roots of the past can help one become successful in a better tomorrow. “Embrace” is an example of how important it is for men to embrace their past.
“Embrace” was meant to be a live-action film — until animation was considered. Seven years of re-writing, re-working, and digging down deep with the characters for the story to better fit the message at its core. Animation is an underrated avenue for a universal story that became the key pillar for “Embrace”. What many do not know about animation is that you can create a serious subject matter in a light-hearted way that is universally acceptable. Men and mental health are heavy subjects for some, but animation allows the exploration to become innovative, creative and fun. Animation allows the experimentation of entering surreal worlds.
For example, in “Embrace” Arty enters a surreal world where he has to go up against a younger version of himself — to unmask the root cause of his internal struggles and give himself the “big hug” he needs. This heart-throbbing metaphor is captured in animation that a live-action film couldn’t have captured. The freedom of animation helps tackle tough subject matters about self-love, and how we must embrace the soul, the child, the person within.
The Story Behind The Story
There are many inspirations behind “Embrace”. Film noir, the silent film era, surrealism and the works of Christopher Nolan and David Lynch — the film is able to articulate something far more special. This is more than just a mental health piece for educational purposes. This is a classical narrative from beginning to end; a story of important themes and beloved characters that needed to be shared with the world.
It is not often the words mental health and men and vulnerability are discussed under the same umbrella — especially with growing hypermasculinity, and the likes of social media where facades are put up and the vulnerable parts of ourselves aren’t as expressed. It is here where the film encourages men to look within themselves, and allows them to be vulnerable to themselves. Perhaps this is an important step to better themselves on the journey to have successes (whatever success means to them), and to enlighten and lift those around them. The first step should always begin with “you.”
It’s tough to find places where men have access in ways of improving their mental health without feeling like a patient or a victim in the institutionalized realm. It’s tough to find places where men can talk to other men about their struggles among peer groups, educational groups, and more.
The “Let’s Talk” phase and awareness is long overdue; it is indeed time for action. Perhaps creating seminars or group-related events and activities to help create vulnerable environments. Art or art therapy can be a great way of producing something stemming from the inner journey. Or maybe it is time to look at “sick days” as “mental health days” as well. Perhaps more can be done to simply just talk about it. It’s time to give ‘doing’ a chance to start in our close-knit communities.
Maybe if one learns to ’embrace’ themselves, only then, perhaps one can fully understand others and their pain — and have the vision of empathy for others. “Embrace” took seven years to write and a year of animation for a four-and-a-half-minute short film. The film is about self-love, embracing one’s self before one can see empathy for others. It is produced by Raman K Fenty and Jayesh Kodwani and his team, directed and written by Jacquile Singh Kambo, co- written by Sidartha Murjani and stars Jenna Berman. “Embrace” has received numerous international accolades including Best Audience choice at the Emerging Lens Cultural Film Festival of Halifax, Nova Scotia, as well as acceptances in hometown Vancouver, Canada; Goa, India and Chicago, United States.
If you are struggling with your mental health, please call your regional crisis hotline. These are a few non-crisis mental health resources for men’s mental health.
Mental health in the South Asian community has long been stigmatized, and South Asian individuals who experience psychological issues might feel hesitant to express their concerns due to the shame they may encounter. Nevertheless, while there has been progress made in studying and openly discussing South Asian mental health, several topics remain in need of further examination; these include studying the relationship between mental health and gender, specifically the role of masculinity on mental health outcomes.
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.
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.
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.
Paritosh Joshi is a graduate student in Clinical Psychology at Teachers College, Columbia University. His background includes a Master of … Read more ›
Subrina Singh is a passionate young writer. After completing her degree in all things Indian at Stony Brook University, she is now pursuing her Master’s Degree at Columbia University. More recently, she has become committed to using her experience with mental illness to help better the mental-health awareness within the South Asian community. Subrina enjoys writing, reading and drinking Starbuck’s Passion Tea Lemonade while singing Bollywood hits of the Golden Era. Follow Subrina on Twitter for her reactions to Pretty Little Liars every Tuesday night!
