Nightmares, flashbacks, and anxiety: these symptoms can be debilitating and make one feel powerless and hopeless. It is important to understand the depth to these symptoms and the various factors that can impact them in order to understand how trauma shows up in South Asian communities.

Trauma refers to an emotional, psychological, or physical response to a distressing or harmful event. The impact of trauma can be long-lasting, affecting mental health, relationships, and one's ability to navigate everyday life.  For those in the South Asian community, trauma can be experienced on both an individual and collective level. Physical, verbal, and sexual abuse are experienced on a personal level, whereas, historical events, such as wars, partition, colonialism, discrimination, and racism all contribute to the cumulative burden of trauma.

Another form of trauma which is not often discussed is vicarious trauma, also known as secondary trauma, when an individual experiences physical, emotional, and psychological turmoil by witnessing another person’s suffering. This is often seen in front-line workers, such as counselors, social workers, and emergency responders. However, family, friends, and community members can also experience this form of trauma. For example, a sibling can experience vicarious trauma after being exposed to their sibling being physically or verbally abused by a parent.  A social worker or counselor hearing the aftermath of a war from a veteran, can also experience vicarious trauma.

Vicarious trauma is prevalent because our brains and bodies are not equipped to handle traumatic events. For instance, our bodies release cortisol and adrenaline when we are under a lot of stress. When trauma is stored in our bodies for years, our bodies will feel unsafe and unsettled, and may stay in a prolonged “fight, flight, or freeze” state. This can result in chronic tension, fatigue, and startle responses. Furthermore, trauma can present itself through emotional dysregulation such as mood swings, irritability, and depression. 

Since the symptoms and attributes of trauma are multifaceted, it needs to be addressed through a holistic lens. However, this is not always the case. Collective well-being is often emphasized at the expense of individual mental health, which can discourage open discussions of trauma. Additionally, the emphasis on family honor, reputation, and maintaining harmony makes it difficult for individuals to address and acknowledge that they need support.  The notions within South Asian families of “what will people think?” and “just push through” are barriers to individuals seeking the appropriate resources and help.

Furthermore, mental health has historically been stigmatized in many South Asian communities. UCLA Health found that Asian Americans are 50% less likely to seek therapy than other racial groups. Studies among  South Asians living in the United States suggest that personal stigma may be greater than public stigma, and that this stigma can extend to family. Additionally, biological explanations of mental illness may further increase stigma (South Asian Public Health Association, n.d.). In South Asian communities, those in the older generations tend to think mental health issues are “just in your head.” Instead of being supportive, they often use statements such as: “come on get up, get going, we never had this in our era” (Virdee, n.d.) Anxiety, depression, and PTSD tend to be misunderstood or dismissed as signs of weakness. Seeking therapy or counseling can be seen as shameful and considered a disgrace, especially in conservative households.

Suppressing emotions instead of engaging in healthy, therapeutic practices such as mindfulness and therapy can make individuals feel isolated. With nowhere to turn, they continue to suffer in silence without appropriate care and support.

Although trauma can be overwhelming, there is hope that healing can take place. It starts by raising awareness through reducing stigma and overcoming the shame and fear that often comes with seeking help. Safe and comfortable spaces need to be created so individuals can voice their concerns without receiving judgement or experiencing shame and guilt. It can start within families, where parents can create welcoming and warm environments for children to express themselves. At a larger scale, however, we need more culturally competent physicians, therapists, psychologists, and social workers, especially those who understand South Asian cultures.

Culturally sensitive therapy involves a provider who understands and respects their patient’s cultural background, creating a comfortable environment for them to receive care. Culturally sensitive therapy is meant to create a welcoming and warm rapport between the clinician and client, enhance communication, improve treatment outcomes, address social and systemic issues, and empower clients.

More broadly, community dialogue and activism can also enhance understanding, empathy, and support.  For example, educational workshops, seminars, and non-profit organizations whose mission is to provide quality mental health services can all open up spaces for dialogue around mental health, instilling confidence and empowering individuals to seek the help that they need.

With appropriate resources, social support, and community healing, immense transformations can take place. To find a provider that fits your need, check out the South Asian Care directory.

About the author:

Naziat Hassan received her Bachelor of Arts from Queens College of the City University of New York and Master of Science in Education in Mental Health Counseling from Hunter College at the City University of New York.  Naziat is a Licensed Mental Health Counselor at the Counseling Center of Queensborough Community College in Bayside, New York, where she sees students for personal and academic counseling, coordinates health events for students, and teaches Introduction to College freshman seminar.  She is also a Licensed Professional Counselor in New Jersey. She is a National Certified Counselor and has extensive experience working with diverse, underserved populations, especially families, adolescents, and young adults affected by trauma, abuse, substance abuse, and various other issues.  Aside from being a counselor, Naziat is an avid advocate for access to quality mental health services in underrepresented and underserved communities.  She has hosted and presented on various mental health topics at workshops and educational seminars.

References:

South Asian Public Health Association. (n.d.). Retrieved from https://sapha.org/resources/mental-health-facts/

Virdee, G. (n.d.). The Centre for Addiction and Mental Health. Retrieved from The Centre for Addiction and Mental Health: https://www.camh.ca/en/camh-news-and-stories/lets-talk-about-mental-health-in-south-asian-communities