Understanding Mental Health in a Cultural Context

Living in the United States, the diversity of our cultures is an everyday experience. However, that does not mean that we fully understand others’ experiences in their cultural context. Multicultural humility is the best concept that I have learnt in recent years. Although it does not give me answers, it provides a guideline to always remind me to stay open-minded, curious and humble when meeting with clients from different cultures. People find strengths and resources from their cultures, enjoy a sense of belonging, yet we also carry baggages and even trauma (either individual or collective) that are part of our culture’s legacy.

1. Cultural Stigma and Mental Health Disclosure:

Growing up believing that mental health struggles don’t exist or shouldn’t be talked about, many people from the Chinese culture (where I come from) found it challenging to open up about their vulnerable experiences in therapy. The fear of judgment and the weight of societal expectations made it hard to share their struggles to someone their barely know.

2. Communication Styles and Therapy Engagement:

In some cultures (including my own culture), indirect communication is very common. When the therapist doesn’t get it, the client can get frustrated and/or feel disconnected. Yet, it can be a challenge for the client to learn to communicate and clarify in a more open and direct manner. It is a learning process for both the client and the therapist to get around this mismatch. Luckily, I found out that paying more attention to verbal communication has been really helpful. My clients also benefit from noticing and using non-verbal communication in relationships outside of therapy.

3. Cultural Identity and Self-Esteem:

One’s journey of embracing their cultural identity can be a rollercoaster. Balancing the traditions and values with a sense of agency is not easy. A lot of self-esteem issues are found in immigrant families who try to preserve their traditions while adapting to other cultures. Therapy helped clients explore their identity and learn to build a relationship with their cultures so that they grow and thrive.

4. Cultural Trauma and PTSD:

The historical trauma deeply embedded in one’s culture can affected their mental health more than they realized. Wars, disasters, political conflicts, oppression, etc. are not uncommon in therapy. Therapy became a space to unravel and heal intergenerational wounds, understanding the effects on people’s mental well-being.

5. Family Dynamics and Cultural Roles:

Navigating family dynamics and traditional roles is often challenging. The pressure to conform to these roles sometimes clashed with personal aspirations. In therapy, we explore ways to balance cultural expectations with clients’ desires and boundaries, fostering healthier family relationships.

6. Cultural Norms and Gender Identity:

For those who identify outside of traditional gender norms within their culture, acceptance and understanding are critical for their mental well-being. Therapy sessions became a sanctuary to discuss the unique challenges they face and work through the cultural aspects of their gender identity.

7. Cultural Resilience and Coping Mechanisms:

Embracing the resilience ingrained in one’s culture can be empowering. Therapy allowed people to tap into these strengths, helping them navigate challenges and build emotional resilience based on their cultural foundation.

8. Cultural Beliefs Impacting Treatment Preferences:

Considering one’s cultural background and beliefs, finding a treatment approach that respected and incorporated both traditional beliefs and modern psychological practices has become a collaborative effort. Respecting clients’ unique journey in their culture not only empowers clients, but also lead to a holistic healing journey.

I often feel privileged to have the opportunities to explore cultures in my personal and professional life. Having travelled across over 20 countries, working with people from different cultural and social economic backgrounds, my multicultural experience made me more humble and more curious about the complexity of intertwined human experiences on the individual, group, and universal levels.