Filial Piety and Mental Health in Asian American Families

Filial piety is a virtue in East Asian cultures defined as respect for one's parents or elders that may lead to unhealthy familial relationships ... Skiptomaincontent FrankChenM.D. ThePsychMic FilialPietyandMentalHealthinAsianAmericanFamilies Envisioningtheinvisibletentaclesaffectingminoritymentalhealthtreatment. PostedAugust17,2021 | ReviewedbyJessicaSchrader Share Tweet Email Keypoints FilialpietymayplayaroleinmentalhealthdisparitiesforthosewhoidentifyasAsianAmericanorPacificIslanders(AAPIs). FilialpietyisavirtueinEastAsianculturesdefinedasrespectforone’sparentsoreldersthatmayleadtounhealthyfamilialrelationships. Incultureswherefilialpietyorothersimilarvaluesarecommon,apersonmayfeeltheyareunabletoconfronttheirparentsevenintreatment. Overthelastfourmonths,Ihavesupportedmymotherandextendedfamilyincaringformyfatherjustbeforehisrecentpassing.Inthattime,I’vetakentheopportunitytoreflectonmyfamilyandmyidentityasaTaiwanese-Americanandpracticingpsychiatrist,andparticularlyhowthatidentityhasimpactedmyownrecentexperienceswithgrief.Thiscontemplationhasilluminatedformehowculturaltraditions,expectations,andvaluescansignificantlyimpactone’smentalhealth. IwasborninTaiwanandcametotheU.S.whenIwas10yearsold.Givenmyagewhenmyfamilymoved,Igrewupstraddlingtwoverydifferentworlds—traditionalAsianvaluesandWesternculturalnorms.Itwasn’tuntilIstudiedChineseincollegetofulfillalanguagerequirementthatIlearnedofmanyAsiancustomsandtraditions.AndnowthatI’mmarriedtoawhitewoman,we’vecometorealizetheimportanceoffamilytraditionsandarelookingtoraiseourchildrenwiththebestofbothcultures. Source:cottonbro/Pexels InJulyweobservedNationalMinorityMentalHealthAwarenessMonth,andIfoundmyselfevenmoreawareof,andinterestedin,abetterunderstandingofsomeofthereasonsbehindunderlyingdisparitiesinmentalhealthamongmulticulturalcommunitiescomparedtoCaucasians.Inmyopinion,themostsignificantdifference,especiallyforthosewithasimilarculturalbackgroundtomine,istheimpactstigmaandculturalnormscanhaveonaperson. IntheU.S.today,23.8millionAmericansidentifyasAsianAmericanorPacificIslanders(AAPIs),makingupmorethan7%oftheU.S.population.[1]AndthatnumberisonlygrowingasAsianAmericansaccountedforthefastest-growingracialandethnicgroupinthecountrybetween2000and2019.Despitethecommonuseof‘AsianAmerican,’itisimportanttonotethatthetermreferstomanycommunities—approximately50subpopulations,whichvaryintermsofculture,religion,history,andlanguage.However,onethingisconsistent:AAPIshavethelowesthelp-seekingrateformentalhealthservicesofanyracialorethnicgroup. AndIbelievethatformanyAmericansofEastAsiandescentlikemyself,thisisrootedinfilialpiety,thefundamentalvirtueintraditionalChineseandotherEastAsianculturesdefinedasrespectforone’sparents,elders,andancestors.Thisconceptisrootedinacommitmenttomaintainingahierarchicalpowerstructurewithinfamiliesandsociety.Itcertainlyhasitsplaceinourculture,butiftakentotheextreme,filialpietycanbeconsideredauthoritarianandcancreateafamilialculturethatisn’thealthy. Byexpectingchildrentopaydeepreverencetotheireldersandparents,childrenmaydevelopunconsciouschallengesasadultswhenrelatingtotheirownfamily.Ratherthancreatingopenlinesofcommunicationbetweengenerations,childrenaretoldtoobeytheirparentsatalltimes—it’sasignofrespect.Ifachilddoescorrectanelder,theyareoftenseenasungratefulandmadetofeelashamedforupendingthissystem. InmanyAAPIhouseholds,childrenareexpectedtocontrolorhidetheiremotionstopreventbeingperceivedassomeonewhocomplainstoomuchandcan’tsolvechallengesforthemselves.Thiscantranslatetofamilyenvironmentswheresilenceisasignofstrengthandfeelingsaren’tlikelyshared. ItcanalsoresultinalackofcommunicationwithinAAPIcommunitiesaboutanykindofemotionalormentaldistress.Inparticular,youngergenerationsmayfeelmisunderstoodandevenbecomeatoddswiththeirownemotionsorsufferingtoliveuptothefilialideal.Inthishierarchicalsystem,anydecision-making,includingthedecisiontoseekcareformentalillness,isdeterminedbytheinterestsofthefamilyasawhole.Sincementalillnessisstilloftenperceivedasaflaw,failure,orweaknessforthewholefamily,accessingtimelymentalhealthcaremaynotoccur,potentiallyexacerbatingtraumaorcrisesforallinvolved. Whenmyfatherwasdiagnosedwithpancreaticcancerin2018andlatertookaturnfortheworse,IcouldneverhaveanticipatedtheintrafamilialstrugglesIwouldhavewithmyownmotherasIupsetourtraditionaldynamics.Evenasadoctor,mymotherwantedtoremainincontrolofmyfather’scareanddisregardmyprofessionalopinion.Shefrequentlydisregardedmyopinions,because,assheseesit,Iamstillthechild. InsimilarculturesbeyondAAPIcommunities,apersonmayfeeltheyareunabletoconfronttheirparents,setappropriateboundaries,orengageinfamilytherapy.Assuch,whenindividualsfromnon-Anglo-Saxon-Americanbackgroundsreachoutforsupportfromamentalhealthprovider,itisimportanttoconsiderthesetraditionsinviewoftreatment. Physicians,psychologists,socialworkers,andnursepractitionersworkingcloselywithpatientsshouldeducatethemselvesonhowthenuancesofaperson’sidentitymightaffecttherapeuticapproachesandtheiroutcomes.Thereareeducationalresources,fromorganizationssuchastheNationalAllianceonMentalIllness,thatdiscussidentityandculturaldimensionsacrossraces,ethnicities,disabilities,orsexualorientationstolearnmoreaboutcertainconsiderations.Whileawarenessofmulticulturalbarriersalonewillnotsolvethechallengesofcaringforpeopleacrossculturalcommunities,itisacriticalfirststepinunderstandingwhyitmaybesohardforsomepeopletoseektherapeuticapproachesthatmakesenseforthem. Formany,belongingtoafamilywithcloserelationshipsacrossgenerationscanbeasignificantsourceofpersonalstrength.Butitcanalsobeasourceoftraumawhenbondsortraditionalvalueslikefilialpietyaredisrupted.Importantly,formanyAmericanswhoarecaughtbetweentwocultureslikemyself,thepressuretoupholdfamilyexpectationswhilestayingtruetooneselfcancausereal,significantmentaldistress. AlthoughIconsideredmyownupbringingaslargelyWesternandnon-traditional,I’veseenhowdeeplyrootedandevenunconsciousfamilyvaluesandculturalnormscanrun.Openinguptoafamilymembermaynotbeanoptionformembersofsomecommunities,andmentalhealthprofessionalsshouldbeconsiderateofthisissue.Mentalhealthprovidersshouldeducatethemselvesoncross-culturaldifferencesandhowculturaltraditionsorvaluesmayimpactthepatientstheyaretreating.Eachindividual’scareshouldbetailoredtoallthenuancesoftheiridentity—beitculture,gender,orsexualorientation—totreatthepersonasawhole.Itisimportanttorememberthatanyoneshouldbeabletoreceivehelpfortheirmentalhealthorillness,especiallyforthosewhoovercomeculturalstigmasbyseekingassistanceatall. References Tanqueco,R.,andPatel,S.(2020).MentalHealthFactsforAsianAmericansPacificIslanders.AmericanPsychiatricAssociation.Accessedathttps://www.psychiatry.org/psychiatrists/cultural-competency/education/… More references Share Tweet Email advertisement AbouttheAuthor FrankChen,M.D. isa practicingpsychiatristinHouston,Texas,whospecializesinAdultPsychiatryandthechiefmedicalofficerat HoustonBehavioralHealthCareHospital andHoustonAdultPsychiatry. Online:HoustonAdultPsychiatry,LinkedIn ReadNext CrazyRich,Multicultural,Asians Long-TermManagementofBipolarDisorderTakesTeamwork advertisement MostPopular ADivorceTrendThatMayReshapeMarriageForever 7SignsofMentallyStrongPeople TheGrey,GrittyDetailsofLong-TermMarriage ASimpleTechniquetoFeelMoreLoveforYourPartner TheEffectsofGaslightingonSomeoneWithBorderlinePersonalityDisorder 3EasyThingstoTrytoImmediatelyImproveYourMood advertisement FindaTherapist Getthehelpyouneedfromatherapistnearyou–aFREEservicefromPsychologyToday. 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