The Growth Guide: How to talk to your (skeptical) family about therapy

US Government poster relating to mental health. PHOTO: Twitter @samhsagov

As a daughter of Indian immigrants and granddaughter of refugees, “mental health” didn’t exist in my family’s vernacular growing up. Not even when I experienced a traumatic incident or was navigating a subsequent depression. Instead, I was encouraged to focus on the positive, cry only when someone dies and consider how “complaining” was making things worse.

It wasn’t until many years later that I learned that many millennials from different cultural and racial backgrounds had gone through similar experiences. We are taught that something needs to be extremely wrong to seek professional mental health care, or that going to therapy is a betrayal to one’s family. We may feel as if our struggles with emotional and mental health are unworthy in comparison to our parents’ hardships.

When I did finally seek therapy in my 20s, my immigrant parents perceived it as their failure. What did it say about them that their own daughter needed to turn to a complete stranger for help?

Often, millennials in different racial and cultural communities are still unlearning the narratives that have been passed down from their elders. Additionally, there may be larger issues at play that make one’s family resistant and distrusting of therapy – such as the “model minority” myth, intergenerational trauma, religious discrimination and structural racism.

But at what cost? Asian Americans are one-third as likely as their White counterparts to seek mental health care. Only 1 in 3 Black people who need mental health care receive it. Latino and Hispanic people access mental health care 50 percent less often than non-Hispanic White people. And Indigenous people have disproportionately higher rates of mental health issues compared with the rest of the population, yet they have low rates of insurance coverage and their geographical locations can make it difficult for them to access care.

Even when it doesn’t cause a tragic outcome, the inability to address mental or emotional health can be disruptive to our own personal growth journeys. After all, therapy is not just a resource for when someone is in crisis; instead, it can be a tool for self-exploration, allowing us to gain confidence and grow healthier relationships.

Normalizing therapy and mental health care is critical, but how do we actually talk about it with our family members in a way that reaches them? Here are seven strategies:

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Consider why you are bringing this up

Take some time to consider why you want to have this conversation. Is it because you are looking for acceptance of a struggle you’ve been experiencing? Is it because you are concerned about a family member’s well-being? Did something happen within your family that needs to be addressed?

Reflecting on what you hope to achieve can help you start preparing for how to have the conversation, what you can expect and responses for different scenarios.

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Be mindful of how – and what – you share

Consider your word and language choice when talking to family. Saumya Dave, a board-certified psychiatrist, suggests using “I” statements, which can decrease the likelihood of blame, shame or defensiveness felt by the other party. You should also be mindful that the clinical language you are learning in therapy can be distancing. If “depression” or “therapy” aren’t used in your household, consider other words.

Being compassionate and reminding family that you are having this conversation out of love can also help set the tone. You may want to bring in another family member to join the conversation as an ally.

Additionally, discern what you need to share. As Han Ren, a licensed psychologist, explains, millennials “don’t need to justify or explain [their] reasons for taking care of [themselves].” You may want to avoid discussing your own experience with therapy in front of certain family members.

“Keeping this part of your life separate from the judgment and opinions of unsupportive family members can be protective and necessary,” Ren says.

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Be prepared to address common arguments

Stigma is real, especially because therapy and mental health care are steeped in history and vernacular that don’t feel culturally apt for many communities. Consider preparing for some questions that may arise during your conversation:

-“Therapy is for White people; it’s not for us.” You can acknowledge that therapy is not the only way toward healing or meant to replace other cultural forms of care. While the field is predominantly White, there are more and more resources for culturally sensitive care. Consider printing online resources that address your family’s specific background, or – depending on how receptive your family member is – highlighting how therapy has benefited you.

“Sometimes when our elders see how our quality of life has improved from these steps, they become more open and accepting of the idea,” Ren says.

-“You just need to pray more.” For many folks who grew up in religious households, discussing mental health struggles can be met with criticism of their devotion to their faith. Remember: Therapy is not meant to be a replacement for practicing religion, and practicing religion is not a replacement for professional care. Areeba Adnan, a clinical psychologist and neuropsychologist, suggests citing the rise of religious and spirituality research in the mental health field, or pointing to wellness and self-improvement references in religious teachings.

-“Don’t air our dirty laundry.” You may have to educate your loved ones on the logistics of therapy – like confidentiality and how therapists are trained to help people process their experiences.

-“Mental health care is a waste of money.” Natalie Y. Gutiérrez, a licensed marriage and family therapist, suggests highlighting how therapy can be seen as an investment comparable to things like a gym membership. You can also consider having information handy on how to find lower-cost options.

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Draw on popular culture and shared interests

Sometimes we have to be creative in how we discuss mental health with our families. It may be helpful to utilize a shared interest to create an inroad for larger conversations.

For example, you can watch a movie that has a mental health storyline, or perhaps find a celebrity interview or pop culture reference to destigmatize the idea of discussing mental health. If you can find someone who is from the same culture or country as your family, even better.

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Connect mental health to physical health

Mental health issues may be somaticized as physical symptoms in Asian communities. And Latino/Hispanic people are more likely to seek help from a primary care provider than a mental health professional.

So making the connection between physical symptoms and emotional health may be key to having these discussions with family. This may sound like, “Dad, you’ve come home every day with a headache. I wonder if you’re feeling stress at work.” By validating our relatives’ struggles with a focus on physical health, we may be able to broach conversations about mental health.

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Focus on the collective impact

Many communities of color are rooted in collectivism – the act of prioritizing group harmony and community. While this is important, and can even be a protective factor toward our mental health, these values may come at the expense of our own well-being. To address this, consider focusing on the familism value to explain your concerns or struggles.

One example Dave shares is: “I really want our relationship to be stronger so our family has a better time when we’re together, and I see this as one way to get there.” By focusing on a mutual goal, you create a dynamic where you are collaborating with your loved one rather than asking them to change, which could make them feel isolated or defensive.

Alternatively, if you are on the receiving end of a family member’s struggles, you may have to consider speaking up about how it’s affecting you. This may sound like: “I know this has been painful for you, but it’s taking a toll on me to be your only source of support.”

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Take care of yourself

Being vulnerable and broaching this topic can be incredibly difficult for many millennials from different racial or cultural backgrounds. It’s important to have support when doing so.

Consider role-playing your conversation in advance with a trusted friend and putting a plan in place for how to handle an escalating conversation. You may also want to make plans to de-stress afterward.

Remember: When talking to family, it’s important to recognize that not everyone may be supportive, no matter how kind, earnest or prepared you are. The truth is, we can’t do the work for our loved ones, and sometimes we have to accept that two things can be true: Going to therapy is a healthy choice for ourselves, and our family may not be supportive.

“We can share how we talk about mental health,” Dave says, “and we are also limited in our ability to change someone’s mind.”

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Sahaj Kaur Kohli. Photo Twitter @SahajKohli

Sahaj Kaur Kohli is a mental health professional and the creator of Brown Girl Therapy and Culturally Enough, communities focused on people with bicultural identities and immigrant parents.




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