The Ugly Duckling: Unearthing the Beauty Within

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The Mental Health of Asian Americans

• When Two Cultures Collide

Josephine M. Kim, Ph.D., LMHC, NCC Harvard
Graduate School of Education H311
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The Current Social and Emotional State of Asian
American Children
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Stereotypes and Myths Herrick Brown
(1998)

• Asians do not experience emotional difficulties
  and do not need help.
• Asians are the model group because
• One of the most educated racial groups.
• Higher paying jobs compared to other minority
  groups.

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Model Minority
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What are the damaging effects of being considered
the model group?
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What else does the media say about Asians?
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Truths about Mental Healthof Asians
Herrick Brown (1998)

• Greater mental health needs found than in the
  general population.
• Rate of mental illness is underestimated.
• Culture-bound factors place Asians at higher risk
  for many emotional problems.

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Behind the Stereotypes Myths Herrick Brown
(1998)

• Many emotional disorders are expressed through
  physical symptoms (somatic)
• Less stigmatizing (e.g. panic attack vs. heart
  attack)
• More culturally acceptable (e.g. low self esteem
  vs. not feeling well)
• Asians simply do not talk about mental health
  issues

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Intergenerational Conflicts Kim
(2003)

• Western Culture
• Individualism I
• Independence
• Self first
• Asian Culture
• Collectivism WE
• Interdependence
• Family first

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Intergenerational Conflicts Kim (2003)

• Parents
• Feel overwhelmed when children adopt western ways
  and reject traditional values.
• Fear losing control when children grow in
  self-assertions, independence, and self-reliance.
• Make superhuman sacrifices to give their children
  the American Dream yet never expect their
  children to become Americans in the process.
• Use psychological control to control children

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Intergenerational Conflict Kim (2003)

• Children
• Face the challenge of resolving issues between
  two differing worldviews.
• Must juggle differing identities.
• Must learn to negotiate between cultures
• Must learn to code-switch
• Suffer identity role confusion.
• Feel love and reverence for parents is not enough
  but must sacrifice dreams and ambitions to
  satisfy parents expectations.

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Depression Otsuki (2003)

• Asians disproportionately suffer from depression.
  
• Adolescent sample reported more depressed mood
  symptoms.
• High correlation between depression and suicidal
  ideation and attempts.

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• What are symptoms of acculturative stress?

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Perfectionism Castro Rice
(2003)

• Shame-based guilt induction
• Perfectionism is associated with
• Anxiety depression
• Suicidal ideation
• Procrastination
• Low self-esteem poor adjustment
• Extreme worry about
• Concern over mistakes
• Parental criticism expectations
• Self doubts about actions

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Perfectionism Castro Rice
(2003)

• Competitive friendships
• Dichotomous thinking
• Fail vs. Asian Fail

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Body Image Eating Disorders



(Haudek,
Rorty, Henker, 1999)

• Asians report
• More body dissatisfaction
• More concern about their shape
• Stronger drive for thinness than Whites
• Bulimia more prevalent in Asians than in Whites
• Ethnic people tend to use Western standards as
  mirror

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Attaining the Perfect Physique

• The core psychological themes reflected in
  disordered eating are pursuit of identity, power,
  specialness, validation, self-esteem, and
  respectthemes (that are) significant in the
  lives of all oppressed people.
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  (Root,1990, p526)

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Distorted View of Body Weight

• In a study on body weight of Asian females
• 18.2 of females were underweight
• 79.2 were of normal weight
• 2.6 were overweight
• The majority perceived themselves as having a
  weight problem.

Source Cummins, Lillian Lehman, J. (2007).
Eating Disorders and Body Image Concerns in Asian
American Women Assessment and Treatment from a
Multicultural and Feminist Perspective.
Eating Disorders, 15(3), 217-230.
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Cultural Factors that Lead to Body
Dissatisfaction

• Social stereotypes of Asian men and women in the
  media
• Perfectionism
• Cultural values of what an ideal woman or men
  look like
• Culture focused on embellishments and outward
  packaging

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Asian vs. White (Kaw, 1993)

• Ethnic women tend to compare themselves to White
  Western standards of beauty and feel inadequate
  after this comparison.
• Popular surgeries for White clients do not change
  the conventional markers of racial identity
• Surgeries for Asians tend to change stereotyped
  genetic physical features.

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• WHO AM I?

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Low Self-Esteem Otsuki (2003)

• Asian women display the lowest of both public
  self esteem and core self-esteem compared to the
  general population and other racial groups.
• Asian men display the lowest core self esteem and
  the second to lowest public self esteem
• What factors contribute to low self esteem?

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Substance Abuse Otsuki (2003)

• Rates of binge drinking are increasing.
• Short-term and instantaneous coping strategies
  are sought.
• Substance abuse involved in most suicidal
  attempts.
• What is it like, living with an alcoholic parent?

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High Risk for Suicidality Jernewall, Lau,
Myers, Zane (2002)

• Suicide ranked as the second leading cause of
  death in many Asian subgroups.
• Highest suicide rates amongst females 15-24 y.o.
• A push to achieve leads to suicidal ideation and
  attempts
• Lack of coping strategies, delay in seeking
  treatment, and suffering in isolation and silence
  contributes to high suicide rates

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Suicidality Intergenerational Conflict
Jernewall, Lau, Myers, Zane (2002)

• 30-fold increase in risk when there is high level
  of intergenerational conflict within family.
• 76 of Asian youths who received emergency
  medical attention for suicide attempts reported
  cultural conflict with parents as a major
  contributing factor.
• Reported conflicts over
• Style of dress
• Dating
• Relationships with Caucasian peers
• Rules governing communication

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• How do we help immigrant
• children and adolescents?
• How do we increase tolerance of difference?

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References

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• Haudek, C., Rorthy, M., Henker, B. (1999). The
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  eating and weight concerns of Asian-American and
  Caucasian college women. International Journal
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• Herrick, C. A. Brown, H. N. (1998).
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