Culturally Responsive Therapy for Chinese Individuals (Part One)

Photo credit: Chelsea Warren

I have often wondered why there aren't more Chinese individuals seeking therapy given how complex the dynamics that are faced by this population. I have been supported by competent mental health professionals in my own journey of healing and self discovery but have felt that they weren't giving me everything I needed. I have sought out different therapists specialized in a number of therapeutic modalities to sample but still felt as if something was missing. I had an epiphany this year when I had a session with a female Chinese healing professional and finally felt something click into place that I have not experienced before. This is no criticism towards any of my previous therapists, but they have always been Caucasian and either cisgender women or men and their words have never quite landed when they've encouraged me to set healthy boundaries in my life.

The missing piece for me; the part that has been unexplored or underacknowledged are the cultural dynamics that are inherent in my identity; of being an immigrant, female, growing up with Chinese parents who passed along cultural traditions that reflected a collectivist belief system but grew up around primarily Caucasian people who follow North American individualistic values. Living in Canada, I have felt as if I was stuck between two extremes without a place of belonging in the middle as it felt like there was pressure to choose a side. I lived in a traditional Chinese household but attended elementary school in a Caucasian neighbourhood and I remember being told that my food and clothes "smelled weird". How I had envied the other kids' lunches that were sandwiches, juice boxes, apples, and granola bars, when I had baos, leftovers with rice in a thermos, and scallion pancakes. I wasn't invited to birthday parties or sleepovers, never had my own, and was introduced to Santa Claus in elementary school. We were told to write him a letter as a class assignment and I was left devastated to not find a present left for me on Christmas Day from him, believing that I was a "bad" child as to why I didn't get one. All of this typical of a North American childhood but that immigrants are likely not aware of or seek out for their children, not understanding the importance to socialization that it offers. I would include individuals who are biracial in potentially experiencing similar challenges of acculturation or integration when their parents are from two different backgrounds at odds with each other in traditions and societal expectation but I speak from my personal experiences.

Chinese cultural values emphasize a focus on maintaining social harmony, avoiding conflict, and a strong adherence and responsibility for each member of the family "to honour the family", always with the unspoken rule to always "save face". The concept of a person's "face" is focused on each individual being a representative of their entire family and ancestors and it being of the utmost importance to maintain dignity, respect, and to uphold a honourable reputation. It can be seen in behaviour as a tendency to give compliments, people-pleasing, being self-deprecating, and making excuses to protect someone else from "losing face". This can be experienced as avoiding criticism and conflict, not giving a direct "no", and using a more indirect communication style which is at odds with the North American emphasis of needing to be direct, finding, and using their voice to assert their individual needs with the emphasis on individual needs over the collective. Inherent in Chinese culture is an emphasis on conformity, having a firm control over emotions, the promotion of the family through each individual, being disciplined, the pursuit of success, and humility. Chinese females are especially encouraged to be demure, self-sacrificing, feminine, and if not decorative, highly intelligent in a demonstrative way (awards, grades), obedient, and submissive.

This concept of Asian women in general has been fed by the North American media to fetishize and objectify them to the point where I have encountered a number of Caucasian men in my life who claim that they only date Asian women and joke about having the "yellow fever". Additionally, Chinese men have often been portrayed as nerdy and socially awkward in media, common tropes portraying them as the side kick or comic relief, presented as the nerd, physically inadequate, weak, or unathletic, and emasculated, most commonly, not part of a romantic storyline. Examples of this are Long Duk Dong in Sixteen Candles and Han Lee in the TV show 2 Broke Girls. I have been vocal of promoting the Netflix series Physical 100 as I had never before seen Asian men presented on screen in such a manner promoting their athleticism, strength, and physique. This seems to be changing with the popularity of K-pop bands and the global nature of music, and an increased presence of Asian stories being presented in North American settings, i.e. XO, Kitty, Fresh off the Boat, Crazy Rich Asians, Shang-Chi and the Legend of the 10 rings, which has been promising, much needed, and long overdue.

I hold a great deal of respect and admiration towards my parents who left China as they were implementing the one child policy and decided that they wanted to give my older sister and I a chance at better opportunities in life and decided to come to Canada where they didn't know the language and had only $200 in their pockets. It has felt disloyal to not honour their sacrifice with my own, to follow what they wanted for us, to succeed in school, to work hard, to help out at home, and above all else, filial piety, which is an immense respect and devotion to parents, elders, and ancestors. This combined with their cultural and societal practice having grown up as a collectivist where it was expected that the needs and goals of the family/community were seen as more important than individual ones, and that there is a shared responsibility and expected decision-making to bring honour to the family.

Photo credit: Fanny Dunagan

Chinese meals are always served family style and in Chinese restaurants, a number of dishes are put onto lazy Susan in the middle of the table and all the dishes are shared. Etiquette dictates that those younger should serve their elders as a sign of respect and that they should eat first. Woven into everyday meals are the implicit rules of respecting your elders, ensuring that everyone gets an equal share, and the ever present expectation to be aware of what everyone else around you is doing. If an elder's plate is empty, they should be offered more food before they need to ask for it, and that too much food is the appropriate amount of food, as there is the necessity of being able to care for everyone. Another example being played out internationally is how Japanese fans who have been in attendance at North American stadiums to watch FIFA World Cup games have stayed behind after the game to clean up as they wanted to offer respect to the host country, and the Japanese players have left their change rooms in immaculate order. This is a demonstration of a collective of people following the tenets of their society even when away as an acknowledgement and commitment to their values of respect, leaving things as they were found, and not burdening others.

Part 2 to follow.