Treating mental health in the Asian American community through old traditions
S1: It's time for Midday Edition on Kpbs. Today , we explore all the ways you can reach a state of wellness. I'm Jade Hindman. Here's to conversations that keep you informed , inspired and make you think. Talk therapy.
S1: What is and isn't working when it comes to your mind , body and soul. Since the pandemic , it's become increasingly common for people to turn to therapy for help. But traditional one on one talk therapy is falling short for communities of color , particularly Asian Americans. So they are turning to ancient cultural practices. As Asian American Pacific Islander Heritage Month and Mental Health Awareness Month come to a close , we want to take a closer look at mental health in the community and the challenges Asian Americans face in getting the care they need. Here to tell us more is Dr. Nelly Tran. She is a community psychologist and associate professor at Sdsu Department of Counseling and School Psychology. And , Dr. Tran , welcome.
S2: Thank you so much for having me.
S1: So glad to have you.
S2: So like any other professional relationship , it comes down to whether the client feels comfortable to share the truth of what they're really going through. And it also depends on whether the clinician or the therapist is able to relate to the client and is able to communicate back. So sometimes a therapist , you know , one on one talk therapy is a very Eurocentric practice. And so it doesn't always align well with individuals from cultures that have not traditionally used a one on one communication , you know , talk therapy format. So I think therapy can be really useful if a therapist can really tap into cultural practices and cultural ways of being that resonate for their clients , especially Asian American clients. Yeah.
S1: Yeah. And you know , as we mentioned earlier , sometimes therapists fall short for that. It's , you know , especially people of color , as you said. So I want to talk about the Asian American community in particular. Studies show that Asian Americans who seek therapy are more likely to drop out early , one third drop out before intake sessions even start.
S2: I think you can think of this in two different ways. You know , we often talk about the stigma of seeking mental health services from the Asian American community. And I think it's twofold. One is that there is a stigma within the Asian American community to reach out for therapy. And so you often see Asian American clients reaching out when they are in crisis mode , right ? They waited so long that they need they're desperate for help. And so when they go into therapy , they need something that is going to relieve some of the stress and pain that they're in and they need it immediately. And clinicians don't always offer that right away. You know , I think in my training of counselors , we often tell folks that it'll take a while , right ? It'll take six weeks , six sessions in order for you to start to see an improvement. And that simply doesn't work for a lot of the clients right there in crisis mode. They need something quickly. And I also think it's the other end of the spectrum as well , which is that , you know , a lot of clinicians haven't been taught how to meet clients where they're at , right ? That there may be an ideal that , you know , you build up to change slowly , but if a client isn't going to return , then there's no point in going slowly , right ? The training has to teach clinicians , trained clinicians on how to meet clients , where they're at , and if they need crisis intervention on day one , then we have to offer it. So clients who don't return after the first session because it wasn't helpful , then that creates a stigma about going to therapy because therapists don't understand what clients need , what Asian American clients need and what they need quickly. So I think we're seeing a problem on both ends of the spectrum that therapy isn't working for Asian American clients , and clinicians don't always know what to do about it.
S1: And , you know , you talked about Asian Americans finally coming to therapy when they're already in crisis mode.
S2: Right. And , you know , at the start of the pandemic , there was also a rise in visibility of anti-Asian hate. And think a lot of folks don't realize that the trigger , the seeing of these images brings up memories in your body that aren't new. Right. That these are feelings that perhaps our bodies have carried with us through many. Generations and certainly through , you know , wartime and migration experiences. And so coming into the US now dealing with a pandemic where we're being isolated from the very community that has kept us sane and kept us whole and healthy and also seeing and being triggered , right , seeing images that are conjuring memories , body memories of pain and hatred and a feeling invisible and unwanted in this country. It's bringing up feelings of isolation , depression , loneliness and heightened anxiety. So I think we're seeing kind of the bringing together of all of these different factors at this very moment. And we're also seeing that Asian Americans don't know what to do about it. Right. So they're not sure what's happening to their bodies when they feel this pain that's coming up because of what they see in the news and what they're reading about in the media and not being able to link it to external factors. Right. That there is Asian American racism in this country , that it comes from perhaps feelings of colonization and war from earlier parts of our our heritage.
S2: And because we don't have you know , we don't have enough Asian American therapists to go around and we certainly don't have enough therapists who have been trained to be Asian American centric , we have a problem. And so I think a lot of practices therapists are now turning to ancient Asian practices to incorporate into their own practice. And I think that Asians ourselves can turn to those practices to do them in our kind of more traditional ways. For example , mindfulness has been a practice that has become very popular in America. But those , you know , roots are in ancient Asian practices. Tina Han is kind of credited as a Vietnamese Buddhist monk who popularized mindfulness practices. And , you know , he trained and taught mindfulness in his temples. And you can get mindfulness training , meditation , training for free at any of our many temples here in San Diego and certainly in Southern California. And so I think it's turning back to that. It's turning back to community. It's beginning to come back into community with our families and our friends and being able to talk about what has happened in our history , what we're all feeling now and validating one another in those experiences. I also find that it's really helpful to , you know , not all of us have the the privilege of having family here or having the relationship with our family to be able to have those conversations. So also having conversations with other communities of color who are going through the same thing really , and finding solidarity in being able to cross those racial lines and talk about what it's like to be a minority or to be , you know , a racial minority in America , and finding solace in our solidarity and our camaraderie in that.
S2: I think it simplifies things. It makes sense in some ways that if we treated everyone exactly the same , that maybe the task would be easier. Right. But I think that's just not true. Right ? It doesn't make any sense that our cultural upbringings , the things that make us different , have produced these different outcomes for us , right ? Different feelings , different mental health outcomes. But yet we don't use that same information to tailor our treatment plan. Right ? It's the same way as medical doctors who are prescribing medicine without thinking about whether the individual , you know , will have the time of the time in their schedule to take , you know , many medications or if perhaps using one that is simpler to schedule into one's day is easier. I think it's it makes sense , right , to consider individuals as individuals who come from different cultural backgrounds and have different practices. And I think that's where the , you know , psychology and mental health practices are moving. It's to really think about how can we treat people as whole humans who have had different experiences and who require different kinds of therapeutic treatment. And some of them may be in one on one therapy and some may be elsewhere and some may be some combination of the two. And that that's perfectly okay. We all deserve resources that meet our needs and help us to stay well in an otherwise chaotic world. You know.
S1: We'd love to hear from you all about your wellness journey or experience with talk therapy. Give us a call at (619) 452-0228. You can leave a message or email us at midday at pbs.org.
S2: Coming up. Tai Chi Martial Arts , Qi Gong Meditation. These are all practices that we should incorporate into the plethora of practices that we engage in to stay well and sane.
S1: You're listening to Kpbs Midday Edition. You're listening to Kpbs Midday Edition. I'm Jade Hindman here with Dr. Nelly Tran. She is a community psychologist and associate professor at Sdsu Department of Counseling and School Psychology. We are continuing our conversation about wellness and well-being. Dr. Tran , as you mentioned , many of these ancient practices are centuries old and even pre-date therapy. Can they be seen as alternatives to talk therapy ? Absolutely.
S2: I think there they kind of live in the same realm as talk therapy that they must go hand in hand. They can be good alternatives because they've always existed. Right. I think we forget that mental health existed in Asia and other parts of the world before talk therapy became a practice , and that talk therapy has actually always existed within our communities , right ? We talk to our religious leaders one on one for consultation. We talk to our family members , we talk to aunties and uncles , and we talk to our respected elders. And all of those traditions are forms of talk therapy , right ? It's just a conversation that helps us to heal and to move forward when we're stuck. And I think the ancient cultural practices that we're often talking about are things that , you know , Tai Chi , martial arts , Qi gong meditation , that these are all practices that we should incorporate into the plethora of practices that we engage in to stay well and sane. And I think talk therapy in and of itself must be part of that conversation. We must be allowed and capable of using all of the different resources that are in our world , in our realm. And I think Asian Americans forget sometimes that , you know , as we try to assimilate or culturally bring in these American practices , that mental health services like talk therapy hasn't been hasn't always been made for us. But we can insist that it come into collaboration with some of our practices like ancestor worshipping that we've always participated in. Yeah.
S2: It's it's verbal. And that's not the only way that we can heal , right ? We can heal also , you know , through the use of medicine , whether that be kind of Western use of pills or Eastern use of Chinese herbs , We can also think about our bodies as needing to move energy , right ? Sometimes we use the language of feeling stuck , right ? I feel stuck. And that could be that you feel physically stuck. But it can also be that there is energy that is stuck , that needs to be moved. And so you have practices such as Reiki and Qi Gong and Tai Chi that really help to move energy through your body , right ? Yoga also another practice mindfulness and helping us to slow down our fast thinking , our anxiety and helping us to find clarity , but also meditation and helping us to figure out what movement needs to happen. Right ? Once I have mindfulness and clarity , I can also figure out what is right in the world. And , you know , a reminder that activism has been a part of wellness and mental health training within Asia , that our Buddhist monks are kind of our original activists of Asia , and that those practices help us to move our world forward. Ancestor worshipping is about looking back towards our elders and seeking guidance. And many of us have traditions that look back towards our ancestors and learning about our history , both personal and societal. And that too helps us to move energy and move our thoughts forward.
S1: It sounds like there's a lot to be said for sometimes just sitting still and meditating and also looking back and remembering and giving honor to the ancestors.
S2: Yes , absolutely. And that we know that we don't have to go to therapists to learn these traditions. Right. I think a lot of therapists now are trying to incorporate these traditions , but really many of us have these traditions and these , you know , the wise masters and elders who hold these traditions in our families and in our communities. And we should really privilege those people to teach us and train us on how to use them , rather than folks who've gone to a webinar to learn it. You know , once or twice.
S1: You mentioned yoga earlier. You know , when when these practices are used outside in. Asian cultures. Is there a concern about the line between cultural appropriation and cultural appreciation or anything like that ? Absolutely.
S2: I think , you know , we get so afraid of cultural appropriation these days , and I think that that's a legitimate concern. And my biggest concern around this with our mental health practices is that when we take traditions out of their cultural origins , we are missing the full picture , right ? Like yoga is not just a physical practice , it's a spiritual practice. And so we're missing the opportunity of the spiritual component if we take it out of its traditions. And same with meditation , that meditation , when practice outside of Buddhism , you end up typically with a one sided version of meditation where you only slow down your thinking or try to empty your mind. But within the Buddhist tradition , meditation is not just about emptying one's mind. It's actually many meditation practices are about fixating on certain concepts so that we can gain clarity and that that leads us to doing what's called right mind , which is morality. And then it helps us to do what is right in the world , to be in community , to take care of one another and to be activists , you know , to create positive change in our communities and for one another. So when you take it out of its cultural practices , you never know what you're missing. You never know what you're losing. That could be the most beneficial component of the practice.
S1: When you say , I hear you say that. And I'm like , boy , it's like we've gentrified well being.
S2: We've monetized it , too. And , you know , my my colleagues and I have written a lot about this and talked about it , but it makes sense that in America , we are a capitalist country and making money from things that people are expert at is part of our American cultural tradition. But I also feel like , you know , we've moved away from things being free , right ? That we'd rather go to a mindfulness retreat led by some new young person rather than going to a temple that offers meditation retreats for free and is brought to you by , you know , an old Buddhist monk who has been trained for , you know , their entire life. For this practice. It doesn't seem as cool and simple and easy , right ? Yeah.
S2: It helps us to see ourselves as , you know , small entities. Our problems seem smaller. And I think for a lot of Asian Americans , travel meant getting to go home. Right ? So , so many of us get to go to our kind of home countries or countries of origin to see ourselves as part of the majority. And that there's there's good history , there's good connection to the land and to the people of different cultures in that way. And Covid really took that away from us , these things that used to be fun , even though it took us out of our comfort zone and is difficult , has become terrifying and fearful experiences now. And I think we need to return to some of these things that we enjoyed because they were hard. So yeah , I would highly encourage travel , doing things , you know , being with people again , returning to community to the extent that it is possible to do so , right. I know that many people are still very much in need of protecting their space and their bubble and their their health in that way , and I think that's fair too. But also thinking about what is lost when we don't come into community , and especially for people coming from more collectivist cultures and origins. Yeah.
S1: Yeah. And I would think also it would be important to sort of , you know , get an authentic idea of how yoga works , for example , or meditation , you know , to to get that unique and authentic perspective on that. Absolutely.
S2: Absolutely. I think learning about traditions in their place of origin is very different , right , than learning about traditions that have been learned in a different context. That even if you're learning about yoga from a guru in the US , it's different than being in a place where it is fully embraced and accepted. I think a lot about Muslim cultures and how prayer , when prayer is done collectively , all together on schedule , it becomes a very powerful experience throughout one's day versus needing to hide away and find a space that feels safe in order to do prayer. Right ? Think there's something that happens when you can do things collectively and it feels normal , right ? And celebrated as something that's just part of our everyday being that can be very healing and that we can learn a lot from.
S1: And I have to go back to something that you said , which is that yoga is in many ways very spiritual.
S2: And in many Asian cultures , it's difficult to separate out what is cultural and what is religious. So if you talk to especially many second generation immigrants , folks who have been born in the US but whose parents immigrated to the US , it's often difficult for them to parcel out , right ? Is this practice spiritual or is this practice cultural ? And think that when we think of it as intertwined , right , that my culture and my spirituality all kind of coexist in our enmeshed with one another ? Then when I do the physical exercises involved in prayer and yoga and meditation , that it's all very meaningful , right ? Each pose , each breath carries with it meaning and ritual. And that that helps us to then be with our spirituality , to be with our mental health. In the US , we often don't think about spirituality as part of our mental health. You know , we think about kind of psychological mental health and then our physical mental health , but we don't always. Clude our spiritual. And it's so important , I think , for the vast majority of us to think about our spirituality and whether we feel grounded , right. Connected with our spiritual beings , whether that may been a God or many gods or a higher purpose or a higher calling , that those pieces of us are real , they're meaningful , and when they are validated , become a very important piece of our healing journey.
S2: So the Asian American Psychological Association has launched a directory of mental health providers who can bring in an Asian centric mentality into their therapeutic practices. So I would check there. So , you know , psychology Today , you can now filter by folks who are catering towards different racial ethnic groups. And I would check there as well. Check with your local spiritual providers as well. You know , think becoming reconnected with our spiritual selves would be a really good way becoming involved in our local communities. You can , you know , really look towards your employee resource groups at your workplaces and your local communities. If there is an ethnic enclave , that would be a place to check. But also , you know , meeting people where people are. I have found that many people become reconnected with their cultural groups through grocery stores , hair salons , nail shops. Right. Like doctor's offices , that those are all places where we have community. So if you're looking for ways to connect , right , think the most important thing is how do we find connection with other human beings and with other professionals who might be able to offer us referrals , resources , that that becomes the most important thing. It doesn't matter where you go to get it as much as that , you are going out to seek it. And here in San Diego , you Pack is kind of our local agency that offers the most services in language for our Asian American folks.
S1: I've been speaking with Dr. Nellie Tran. She is a community psychologist and associate professor at Sdsu whose Department of Counseling and School Psychology. Dr. Tran , thank you so much for your insight and for joining us.
S2: Thank you so much for having me. It's been a pleasure.
S1: We'd love to hear your thoughts on today's show. Give us a call at (619) 452-0228. Leave a message or you can email us at midday at pbs.org. You may hear your thoughts on the radio. I'm Jade Hindman. Thanks for listening.
Traditional one-on-one therapy is falling short for communities of color, particularly Asian Americans. Many are turning to ancient cultural traditions like yoga, qigong, martial arts and tai chi to seek healing; therapists are starting to incorporate these into their own practices.
KPBS looks closely at the challenges Asian Americans face in getting the care they need and the importance of these centuries-old practices to Asian cultures and mental well-being.
Dr. Nellie Tran, community psychologist, associate professor at San Diego State University’s Department of Counseling and School Psychology