So your parents don't believe in therapy...

“I think my mother has undiagnosed depression. I’m overwhelmed by her emotions”

“My father is an angry old man. We have to walk on eggshells around him and never know when he’s going to blow up”

“I wish my parent would go to therapy, but they don’t believe in it. They would never do it.”

When I hear some version of these statements from my clients, I sense the feeling of helplessness and despair from wanting a parent to heal from trauma, understand themselves better, be able to take difficult feedback, or at the very least learn to just listen.

If you are similar to my clients, you might start therapy not for yourself, but for someone else. By being in therapy, you can say to one or both of your parents, “Look, you’re the reason I am going to therapy…if I’m doing the work, why can’t you?”

Starting therapy this way would be a mistake. I see how frustrated you are, how your parents mental health impacts you, how desperate you are for them to change, so you can be released from the psychic burden of managing their destructive behavior and feelings. Sometimes, clients are seeking a therapist’s “expert” opinion on their parents condition, diagnoses, etc.

In my opinion, your parents are allowed to live their life however they see fit.

Culturally, your parents have probably thought therapy was only for people who were extremely ill, or that talking about your problems is shameful, useless, and a waste of time and money.  They’d prefer to brush things under the rug as they always have, one sacrifice among many they’ve had to make. They would never, ever, go to therapy. That very well may be the case.

Meanwhile, if you have grown up in the US, you have likely been learning that it’s good to express your feelings, to not bottle things in. You have learned about intergenerational trauma, attachment theory, internalized oppression, and the body-mind connection. You’re proud, rather than ashamed, to be in therapy.

Neither of you are right. It’s a difference, informed by your life experiences, upbringing, and surrounding influences. The fact that your parents don’t believe in therapy will not diminish your investment in it. This difference does not have to divide you, either.

So, instead of hoping that you can heal your parents, go to therapy to find out what’s there that can be just for you.

When Asian American Men Seek Therapy: The Invisible Struggle

“It was getting so bad I couldn’t hide it.”

When his friends and family members started noticing his unusual behavior and expressions, Ryan*, a Korean American man in his thirties, realized he needed to seek help for his feelings of depression in his late teens and twenties. He says his starting place was shame, an admission of defeat.

While research shows that individuals in the Asian American community suffer from high rates of mental illness, this is a population that has largely gone untreated. As an Asian American therapist in San Francisco, I have worked with too many clients who suffered in silence for years before they finally sought help for their struggles.

According to a 2011 study from the National Institute for Mental Health, Asian Americans are less likely to reach out for help with emotional difficulties than white, Latino, and Black ethnic groups. In fact, only 17% of all Asian Americans have sought professional help, and only 6% sought this help from a mental health provider.

It became my mission to find out why. To this end, I’ve conducted a series of interviews with Asian American men in order to understand why this trend exists.

“My family was split, and you couldn’t reach out [for help] in my community. There were so many hot topics you couldn’t talk about. You don’t want to show your cards.”

Ryan tried to keep his suffering to himself. He said he would seclude himself alone for days, unreachable by any mode of communication. He found himself sending bizarre, cryptic emails to friends, and engaging in risky behavior like talking to random strangers in the middle of the night. Still he could not bring himself to open up about his suffering with friends or family and things grew worse, not better. Eventually he decided it was time to talk to a counselor.

Ryan’s story is common. Seeking therapy is generally not the first consideration and often the last ditch effort. Many of my clients grow up believing “Asians don’t go to therapy unless there’s something wrong with you” or that Asian men are not interested in their emotional life. They speak about the avoidance in their families of origin when it came to verbalizing thoughts and feelings, where the option of going to therapy was never even brought up.

The stigma of mental illness in Asian cultures can make it unsafe to express feelings of overwhelm and vulnerability, let alone talking openly about your symptoms of depression. For men adhering to traditional masculine gender roles, it often means that you keep your pain silent. I’ve heard many guys describe how they tend to bottle it up, hoping it will just go away. One wants to do whatever they can to “save face,” which means to avoid mention of any issue that could potential bring shame and humiliation to themselves, their family, and the greater community.

Unfortunately, these efforts to hide are precisely what can cause psychological symptoms and maladaptive behaviors to emerge.

For Mark, a Korean American who grew up in the Midwest, the emotional struggle was visceral.

“I would have pretty bad panic attacks and was having a really hard time falling asleep…I was in a ‘rabbit hole’.” He tells me of his difficult time working for an advertising company.

He was wearing himself thin, spending hours overtime into the night, and dreading going to work. The stress started to become unmanageable.

Mark, who is now in therapy, said he didn’t know what it meant to be depressed when he was growing up. But as he looks back on his childhood, all the signs were there. “I feel like a lot of things I’m experiencing, if I had voiced them then, I might have found different coping mechanisms.”

Because of the popular stereotype around being “model-minorities,” Asian Americans are under immense pressure to exemplify what it means to succeed in America, and are, in turn, denied lives that also include temporary setbacks or failure — lives that are also frustrating, conflicted, historically influenced, and subject to the pains of loss and death like any other person.

The lack of nuanced portrayals of Asian American perspectives in the media contributes to a belief that Asians are not complex people, although there have been major signs of progress with the emergence of television shows like “Fresh off the Boat,” “Dr. Ken,” and “Master of None”. When an Emmy-award winning episode of “Master of None” showed us two Asian American men exploring their relationship to their immigrant parents, it captured an experience that many have often felt alone in. More importantly, it made it okay to talk about, sometimes for the first time.

Mark* says being in therapy has greatly helped relieve his stress and anxiety. When I asked him about the shame factor, his answer surprised me.

“I don’t hesitate to say that I go to therapy. I’m not ashamed at all.”

Share your story, get in touch: nicole@nicolehsiang.com

All names and identifying information have been changed

What Happens to You When You Don’t Want to Suffer?

“You can hold yourself back from the sufferings of the world, this is something you are free to do and is in accord with your own nature, but perhaps precisely this holding back is the only suffering you might be able to avoid.” -Franz Kafka

It’s curious that most humans do everything they can to avoid suffering- it’s only natural, right? Yet the results of these actions can lead to graver discontent and even deadly consequences.

Consider everything you’re not doing when you attempt to not suffer:

You’re not asking that person out.

You’re not asking your boss for a raise.

You’re not sharing your art or writing.

You’re not speaking your mind in school or at work.

You’re not standing up for what you believe in.

You’re not calling your friend to hang out.

You’re not leaving your house.

Take Franz Kafka’s simple words seriously, and you may see how the avoidance of suffering leads to an un-lived life.

The Shadow Side to Being an Asian American Over-Achiever

Andy* a 34 year old Taiwanese American living in San Francisco, could easily be seen as a person who has “made it”. A UX designer at a prominent company, he spent 7 years steadily climbing the career ladder, receiving much praise and acknowledgement for his artistic talents and focused work ethic.

But shortly after he became promoted to a senior position, he realized that he was completely miserable.

Amazed, I asked him, “How did this happen?”

Andy took me back to his childhood. As a teenager, Andy hardly had any spare time for a social life because he was too busy with school and extracurricular activities. His parents, who were worried when they saw too many B’s on his report card, put him through hours of after school Kumon tutoring, SAT prep courses that started in the sixth grade, violin lessons, Mandarin lessons, and sports. He was given math textbooks to read over the summer. He became a hardworking perfectionist, conditioned to strive for the best.

Andy’s story is common for today’s young people in an increasingly competitive society. We see a lot of concern in the media about whether we are putting our youth through too much stress in school without enough consideration for their emotional wellbeing. Parents are encouraged to look for warning signs of excessive anxiety in their children, and many schools incorporate “socio-emotional learning” within their curriculum.

But if you ask an Asian American family, you might hear that it’s entirely appropriate and necessary to push our kids to excel and reach high goals with a hearty dose of "tough love. On the recent hit show “Glee”, there was a memorable episode called “Asian F,” where Asian American character Mike Chang is scolded by his father for getting an A- on a chemistry exam.

That’s right, an A- is equivalent to an Asian F.

Despite the exaggeration, the story resonated with many former Asian kids. They remember what it was like to be reminded of their immigrant parents’ struggle and sacrifice, so that they could have a better life. Even if they didn’t receive the messages overtly, immigrant children are likely to feel that their family’s future weighs on their shoulders. Being smart, hardworking, and studious is the only way to a bright and secure future.

As a result, Asian American college enrollment and academic achievement has surpassed that of any other race including whites, demonstrating the immense value of this type of parenting. The media has highlighted the phenomenon of Asian American success as either a sign of great accomplishment, or a threat to American security.

But lately, people have started to pay attention to its emotional cost. Research shows high instances of depression and suicide among Asian American high school and college students, a fact often masked by their achievements. A recent study at Cornell University found that among 21 on-campus suicides between 1996–2006, 13 were Asian American. A task-force and outreach center was created at the school specifically to address the needs of their Asian American students.

In 2002, San Francisco’s Lowell High School lost 16-year old Thomas Hoo , described as a “seemingly untroubled” teen, whose hidden depression led to his suicide. Lowell High School is the most competitive public high school in San Francisco that selects its students based on merit and academic performance. Their student body is predominantly Asian American. More recently, Palo Alto experienced a spike in suicides among upper-middle class high school youth, many of them Asian.

Being good at school doesn’t mean you’re good at life, and we often overlook this fact. Asian American students frequently fall under the radar when screening for mental health issues in schools.

Andy said that he never questioned what it was that he wanted for himself. In complying with his parents’ demands, Andy developed the strengths he needed to meet similar high standards in college and graduate school, although always driven by a perpetual feeling of inadequacy.

It wasn’t until he started his career when his mental strategies started to fail him.

“When you’re in school, there’s a sense that you’re stressed out now, but at least there’s an end in sight. But when you apply that same mentality to work, you realize there is no end. The way that you’ve always done things, it’s not sustainable. You look into the future and think, ‘Am I going to do this until I retire?” And that’s when the hopelessness sets in.”

Like Thomas Hoo’s story, Andy’s perfectionist battle with himself went unnoticed. Feeling disconnected from his colleagues, he became irritable, resentful, and even developed serious physical symptoms, including tendonitis from computer-related repetitive stress.

One day, he finally decided he had to do something about it.

“I realized that all of the rewards in the world won’t make me feel good about the work I was doing.

“I had this feeling that I’m missing out on a whole world of emotions that I don’t know how to express,” Andy explained. He decided to begin personal therapy and career coaching to think about what it would mean to live and work for himself and not others.

His journey to find himself began, and he now works in a different field.

Beneath the image of the hardworking, successful Asian American, people like Andy have complex and nuanced desires and feelings that are a part of what makes them human. A lifetime of avoiding failure and disappointment can prevent one from ever sharing who they are inside- and as we’ve seen, the consequences can be deadly.

The truth is, if we don’t allow ourselves to make mistakes and disappoint others, we won’t be able to ever know who we are beyond what people expect us to be. And that is never a sustainable way to live.

Perhaps a better way to thank our parents for all that they’ve done for us, is to show them that we’re not afraid of failing. Every once in a while, that is.

*Name has been changed to protect confidentiality