When I mentioned it to my friend, her eyes bulged a bit. She said:
Oh my god, why? Is everything okay?
And then, quickly:
That’s good, though. I mean, we all probably need it.
Her response was the clumsiest I had received to my admission about not being available to go out:
Sorry, I can’t. I have therapy.
There was a time when I would have debated telling her, a family friend whom I have known since I was three. Our mothers, despite being friends for decades, are as likely to volunteer that kind of information to each other as they are to seek out therapy in the first place. Which is to say, not at all likely.
In my experience—and, I assume, that of so many South Asians—going to therapy is a shameful thing. It is indicative not of temporal difficulties, chemical imbalances of serotonin outside of our control or, you know, just wanting someone to talk to, but instead of an inherently damaged person. And it’s a question of image, as most things are.
People will think I’m abnormal. People will question my parent’s parenting. They will be wary. Uncomfortable. They will speak in hushed tones when I leave the table at a dinner party and with loud, disdainful authority on phone calls afterward. That my frustration with the stigma around seeking therapy took up a few sessions with my therapist is some cruel irony.
I never had to tell my mother about this; one of the greatest privileges I’ve acquired as an adult is my own health insurance plan. When I did casually mention my weekly sessions, she was upset. She asked how and why, despite her best efforts at raising me, I was “still unhappy.” She said:
When we were upset, we talked to our family.
I figured it wouldn’t help to point out that our family members go to painstaking lengths to hide unpleasant details from each other.
I have always known that I can talk to close friends about it. Most of them either go to therapy, used to go, or have considered it. When I worry out loud to my best friend—about the existential dread of Sunday nights, the looming threat of complacency, the latest boy to wrong me, etc.—she’ll say:
I can’t recommend SSRIs enough.
And I laugh because it’s funny, but it’s also reassuring. We won’t waste any time pretending everything is fine.
Openness from my friends is what encouraged me to seek out therapy when I needed it in the first place. Eventually, I stopped going out of my way to make up some other excuse for why I am busy on Tuesday nights or wondering whether it’s a good idea to talk about it.
(Spoiler alert: It definitely is a good idea to talk about it.)
Now, in conversation I’ll say without ceremony or taking a deep breath:
Well, my therapist says…
Yes, it is personal, but it has nothing to do with wanting to air personal information. It has everything to do with giving visibility to something that feels as ordinary and necessary for me as shopping for groceries. The process of normalizing a topic by just talking about it is the simplest concept, and yet so frustratingly rare for mental health.
So when I told this Pakistani friend that therapy helps me make sense of my feelings towards people and situations, helps me avoid burdening friends with emotional baggage, and in general, teaches me about myself, she said:
You know, I always wondered whether I should talk to someone, and I have no idea where to even start looking.
I gave her some tips. I don’t know if she will follow through on it, but I do know that there is lightness in discovering that you aren’t alone.
May is Mental Health Awareness Month. If you would like to contribute to our #TherapyTalk series, please email us at Staff@0mq.349.myftpupload.com with your submission.
Komal Kazim lives in Brooklyn, NY and works in advertising. She likes anemones and Kanye West and is a diehard poptimist.
February 28, 2023February 28, 2023 4min readBy Sara Qadeer
Hi! I am Sara and I am a mom to a beautiful, neurodivergent child. This piece explores some challenges of parenting an atypical child in a typical world.
It is a sunny day in the summer of 2020 and I am trying to enjoy the only entertainment that has finally been “allowed” by our province. Parks. Sunshine was always free; scarce but free. I have eyes on my daughter, running and somersaulting, with that untethered quality they say she gets from me, while socializing with two girls her age from a distance.
All of a sudden, the distance called ‘social’ gets smaller and as I run and call out in vain my child has the kid in a tight and loving but forbidden hug. I understand that pandemic or no pandemic, physical space is a basic right but for my daughter, it falls under the ‘but why?’ category.
The next 15 minutes are spent apologizing to an exasperated mother asking me why my kid was not taught the dangers of COVID-19 and personal space. She is four, I tell her, she just got excited. At some point, I zone out and just let her say her piece. Some of it is in a language I have never heard before, complete with hand gestures and melodrama as if it was not a preschooler but Bigfoot.
Maybe later I will do the thing we all do; oh, I should have said that. Maybe I won’t. This is not the first time my kid has drawn public attention and it is not the last.
Six months later, we received a diagnosis for Autism Spectrum Disorder (ASD). After the reaction time (read stress eating and ugly crying) ended, we began our journey of raising an atypical child in a world that insists on the typical.
Textbook wise, neurodivergence includes Autism, ADHD, Asperger’s Syndrome, Dyslexia, Dyscalculia, OCD, hyperlexia and Tourette Syndrome.
I could write a book on my journey as a mom raising a child who is neurodivergent (ND). I will in due time and the first chapter would be, “Fighting for inclusion in a world insisting on exclusion.” If you ask any parent with a neurodivergent kid, they will tell you that it is not finances or the fear of the future bringing them down, it is just people. But that’s been the case since the dawn of time anyway.
If you are someone who is kind and inclusive but are confused by the jargon, read on for some guidance that will make you an ever-favorite ally and, well basically, just decent. It is just basic decency after all to be inclusive and kind.
If you have a kid on the spectrum for ASD or ADHD or any other neurodivergence in your social circle, the first step is to not stop being friends with their parents. Yes, that happens. Parents can get super isolated and alienated because their kid is a certain way. Give ND families a chance to breathe. Invite them to BBQs, ask them what their kid will eat, encourage your kids to include them — the whole nine yards.
There will be meltdowns, at birthday parties, at the mall, in restaurants. Sometimes the best thing to do is to look the other way. Ask the right questions. Rather than asking “what happened?” or “why are they doing this?”simply say “how can I help?” Maybe you can help with another sibling or give the child some space.
Do not equate a sensory meltdown or otherwise to a parenting failure or a lack of discipline. ND parents face a lot of judgment on those grounds. That is one of the top reasons they scoop up their kids and leave before dinner is even served.
The biggest challenge in our community is acceptance. There is a dire need to accept that around 30 percent of our population is neurodivergent. This includes adults and undiagnosed individuals. You and I might not even know if we are atypical, the world is just getting to know this word and what it entails. As for the South Asian community, neurodivergence is practically stigmatized and seen as ‘spoilt’ child behavior or ‘mom spending too much time at work, on social media, Netflix, sewing, knitting, kayaking…’ The list goes on.
It is 2022 and we are all trying to make space for people at our tables. This includes people who might not look or act or perceive the world like us. As a parent I have fears that all parents have, but somehow those fears have been heightened to exponential limits ever since my kid’s diagnosis came through.
How is she doing? Did someone bully her? Does she have friends? Is she included in activities? What if she says something silly and they laugh at her? What happens when she is older? Will she go to college? I should not be thinking that. I want to think about how much she is learning at school, what game they played today, what she and her friends talk about and all other typical mom things.
Except I am not a typical mom. And that is okay.
My child has wonder; she has innocence. I see things from her lens and her computation of the world is unique. The biggest misconception people have is of intelligence. A child with autism finds difficulty in processing social cues (like sarcasm) but otherwise they are as smart as you and me, if not more. Probably more.
Some days are hard but not all days are hard, and not every moment of that rough day is difficult. We, parents of ND children, do not keep obsessing over the fact that our kids are atypical; we binge watch the same shows, we have hobbies and interests and date nights and ‘me-time.’ Some days are magical and the most important thing for people to know is that Autism families are not looking for pity parties, just kindness and inclusion with a healthy sprinkle of understanding— an understanding of the atypical in a world only rooting for the typical.
Valentine’s Day is here, and my calendar is fully booked on February 14th. It’s not what you think. My calendar is fully booked with therapy clients who will most definitely be reflecting on their singlehood this year. And so will I. Most of them are just like me — single South Asian Americans, between the ages of 22-40 who come from moderately conservative cultures. The adult children of immigrants, who had arranged marriages, wondering when we will ever find “the one,” and why we won’t settle.
I’m a therapist in therapy, and I’ve had a lot of family trauma and baggage to unpack with my therapist. Through my training and personal therapy journey, I learned to question a lot of the things that I’ve been told about marriage and relationships.
At the same time, it’s not easy. No one wants to be lonely. Brené Brown talks about how detrimental loneliness can be for humans in “Braving the Wilderness.” We all want to belong to someone or something bigger. And there is a difference between being lonely, without intimate companionship, and being alone in our experiences. As we get older, everyone we know in our age group is on a different life trajectory, and we start to feel both alone and lonely.
We straddle the line between two cultures — the one that we were born and raised in, and the one our parents and family tried to teach us. Many of us might live double lives. But being single is not an anomaly. In fact, according to the Pew Research Center, about 31% of adults in America are single. About 32% of American women, between ages 18-29, and 29% of women, 50-64, are single. This means that roughly about a third of American women are single, regardless of age or developmental stage.
Results vary by sexual identity and race. 56% of adults who identify as lesbian, gay, or bisexual, between the ages of 18-29, are single, compared to 29% of their straight counterparts. Black adults are more likely to be single than White or Hispanic adults. However, no statistics included Asian Americans. Some studies show we are more likely to get married due to strong values placed on marriage in Asian cultures, and less likely to get divorced. There is also a huge stigma against divorce. For Asian American women, there is a cultural pressure to not only get married, but stay married.
For many South Asian Americans who are first or second-generation, we have no blueprint for the modern world of dating. A lot of us don’t know what a healthy dating experience, let alone a marriage, is supposed to look like if it is even at all possible. In the South Asian diaspora, marriage is taken very seriously, but counter-intuitively; we are not given the opportunity to spend time on making the decision — we are expected to decide very quickly. For most of us, who are children of immigrants, our parents more than likely had an arranged marriage — that was a decision made by our grandparents, aunts and uncles. And the wedding and engagement happened fairly quickly. That is our blueprint
There are many mixed messages about how to approach marriage and dating. Many of us were told to not start dating until after we graduate from college and get a full-time job, which left a lot of us with very little dating experience, and then, Poof! We’re magically just supposed to settle down. There are many desi people who stay single because they know they have issues to work on. A lot of us are aware of how messages about marriage and dating in our communities are sometimes not realistic, if at times rooted in colorism, internalized colonialism, patriarchal and misogynistic values,and racism.
Dating is uncertain because you can’t control whether or not someone wants to date you, let alone if someone wants a relationship with you. And sometimes that has nothing to do with you and everything to do with that person’s preferences or baggage. But is it possible you have some baggage too?
Staying single because of personal baggage is not uncommon for South Asian American millennials. Because of this, many of us believe that something must be “wrong” with us, especially when people ask why we’re still single and unmarried. While we should address underlying issues for why we’re still single, that doesn’t mean anything is necessarily “wrong” with us.
As a licensed therapist, I see many single South Asians Americans who believe that something must be wrong with them because they’ve never been in a relationship before, or because they’re not in a serious relationship yet. If you’re one of these people, I want you to consider:
Who taught you how to date?
Who taught you how to socialize with other genders?
When were you allowed to date?
How often were you allowed to socialize with other genders?
What is your model of a healthy marriage or relationship?
Who taught you free will and how to exercise choice?
How were affection and romance modeled for you?
When we unpack the answers to these questions, we start to realize that there are actually very good reasons for why we’re still single.
If there are that many South Asian Americans who are afraid of dating because they don’t want to repeat toxic relationship patterns, that means that many of us are…meant for each other. So why can’t we find each other?
Our parents had an easier time finding each other because they lived in a homogenous society. My parents came from a community where everyone was of the same or similar Malayalee-Indian background and the same religion. My parents hope that I can find someone from our culture, but they forget that we live in a heterogeneous society, where finding someone who is South Asian, let alone of our specific culture, background, community, and religion, is few and far between. There is pressure on many South Asian Americans to find someone within their specific communities. Not to mention that meeting someone through a mutual connection doesn’t necessarily mean they’re a good fit for you. It makes it feel like our options are limited.
This creates a ‘scarcity mindset.’ Scarcity mindset is the belief that there aren’t enough resources or opportunities out there. When you feel there aren’t enough singles within your community that you can meet, it can cause you to become hyper-fixated on these limited ‘resources’ and even heighten anxiety. And to some extent, there is some truth to that fear — some of my clients are joining dating apps to meet South Asians out-of-state. As the people around you start to settle down, you might start to feel the pressure of settling down quickly to “catch up.” You may have tried to go on a bunch of dates or entertain the idea of certain people in your community, but they eventually fizzle out, fall flat, or end in rejection. You might start to feel discouraged. This kind of pressure can result in:
Avoiding dating in the culture or dating altogether to prevent being hurt or feeling rejected, or having to confront the social anxieties of meeting new people and being open and vulnerable.
Latching on to the idea of someone we meet, working too hard to impress them early on, and attempting to force chemistry to guarantee an outcome (marriage).
When you feel this kind of pressure, you might underestimate or overestimate how to interact with potential partners. This pressure might come from messages you’ve heard in your community that you’ve internalized. For instance, if you’ve heard someone say, “we don’t get divorced in our culture,” you might start to believe that divorce is the worst possible outcome. That might put pressure on you to find the “perfect” partner in order to prevent divorce, but the future of your marriage is not something that you can guarantee. Another example — if you hear your parents tell you to “just compromise,” you might start to believe that your expectations are not realistic; therefore, that’s why you’re not married or in a relationship yet. You might start to lower your expectations and get attached to any potential partner in the hopes that you can guarantee a relationship, but changing who you are does not necessarily mean you’ll attract what you want.
How we approach dating, especially when under this cultural pressure, can have an impact on how we bond emotionally with people. One theory based on psychological research, called Attachment Theory and Styles, describes patterns of how we create and maintain emotional bonds with others and where we fall on the attachment style spectrum or circle. Cultural pressure to settle down and marry someone from your specific culture or community can influence how we date and why, but it prevents us from being mindful and enjoying the process of dating. Your attachment style might be the result of your family dynamics, your parents’ style of emotional connection, and cultural messages you’ve been taught about what a relationship or marriage “should” be like. For example, if you’re under cultural pressure to get married quickly to appease your family, you might develop an anxious attachment style because it triggers thoughts and behaviors that fall under that category. If you question the cultural pressure, you might associate marriage with negative connotations. You might push away dating and marriage and act in the way of an avoidant attachment. Your attachment style is not genetic or something you are born with. It is a pattern of behavior that is about how you relate with others, especially in relationships. It can change over time and vary based on your anxiety or the person you’re seeing. If you want to learn more about attachment style, seeking a therapist is a good resource.
Regardless of what your attachment style is, it can prevent you from being patient, truly vulnerable, and having quality dates or quality relationships. It might keep you in unhealthy dating situations or relationships too long out of fear that you won’t find anyone else “in time.” You might be jumping to conclusions about what should happen next when you date someone. When you really like someone, you might be asking, “What if things go wrong?” But what if things go right?
Valentine’s Day has never been something special for me, and while it would be nice to be in a relationship, I’m not going to let the cultural pressure of what I’m “supposed” to do, as a South Asian American single woman, dictate my life. I have my reasons for being single, and it’s no one’s business but mine (and my therapist’s). If someone in my family or my culture doesn’t approve of my singlehood, then I sincerely hope they’re awake at night thinking about why I’m single. What they think of my life is none of my business. At the same time, I’m not going to shut myself off completely from dating and relationships. Dating will be on my terms. While rejection hurts, I have accepted that people will come and go and I wouldn’t want someone to feel forced or obligated to stay with me if they have emotionally left the relationship. Ultimately, I’m looking for someone who will fit the lifestyle I already have, but if I don’t find my life partner, I’m okay being with myself too.
You don’t have to follow your parents’ blueprint to marriage and relationships. You’re allowed to follow your own. If we adopt an abundance mindset, a mindset of knowing that there are enough resources for everyone and accepting what resources are available to us — along with practicing healthy relationship habits — we might develop better, more satisfying relationships. There are enough single South Asian Americans out there who would love to be with you. Stand firm in who you are and what you want, and be open to what comes your way.
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 ›
