Hwa-Mei (not her real name) is an Asian American woman who is highly educated and works at a high-paying high-tech job. On one hot summer day, when a co-worker asked her why she was wearing a long-sleeved turtleneck, she answered that her father-in-law had beaten her because he was angry with his son. This was a normal occurrence for Hwa-Mei who had grown up in a traditional Chinese family that had taught her to obey her in-laws unquestioningly. Like many survivors of domestic abuse, Hwa-Mei suffered from feelings of hopelessness and helplessness, but unlike many, she sought therapy. In Hwa-Mei’s case, therapeutic work centered on supporting her as she made tough decisions. In the end, she asked her husband to choose between divorce and having his parents move out. He asked his parents to leave.

Like Hwa-Mei, traditional Chinese women typically live with their in-laws after marriage and are vulnerable to familial gender abuse. In some cases, family members collude against the woman. One website reports a case in which a mother-in-law and sister-in-law restrained a woman to allow her husband to brutally beat her, almost to death (See end note 1).

Familial gender abuse is a prominent and historical part of Asian culture. In China, each year, thousands of female fetuses are aborted and families routinely abandon female infants for adoption while reserving food, medicine and other highly valued resources for their male children. Young girls are often forced into prostitution or child labor or sold into marriages outside their native countries. The low self-esteem and feelings of devaluation which result from this marginalization could explain the high rates of depression and suicide among Asian women. In fact, Asian women over the age of 65 have the highest female suicide mortality rate among women across all racial and ethnic groups. Among women age 15 to 24, Asian American girls have the highest suicide mortality rates across all racial and ethnic groups. Asian American adolescent girls have the highest rate of depressive symptoms of all racial, ethnic and gender groups (See end note 2).

The high rate of depressions and suicide heavily impact the Asian community because it is not uncommon for suicidal women to take the lives of their children along with their own. These women believe that they will be re-united with their children in heaven, but they also believe that by killing them they are saving them from abuse by husbands and in-laws.

Because there is a stigma against seeking mental health services in the Asian community, victims of domestic violence are hard to reach. This stigma is comprised of language and cultural barriers, lack of resources and alternative perspectives on mental illness. Perhaps cross-cultural awareness and sensitivity could prove the most useful therapeutic skill in supporting this population; specifically, clinicians being mindful of significant cultural and historical dimensions that impact clients’ experiences. This awareness would include honoring belief systems that do not separate the body and mind, recognizing cultural norms, understanding risk factors and probably most importantly, recognizing clinicians’ bias and limited understanding (See end note 3). It is equally important to be aware that these experiences do not apply to all Asian people. Thorough and accurate assessment within the context of cultural norms is paramount to understanding the client’s experience. Perhaps through this multi-faceted awareness, clinicians can increase the quality of therapy offered and increase access to mental health services across cultural divides.

1. Asian & Pacific Islander Institute on Domestic Violence: www.apiahf.org/apidvinstitute/GenderViolence/analyze_a.htm
2. Asian Americans: Women of Color Health Data Book-Factors affecting the Health of Women of Color: www.4women.gov/owh/pub/woc/asian.htm
3. The ADS Center: Addressing Stigma in Culturally Diverse Communities, August 20, 2003. www.adscenter.org/StigmaCultural.ppt

Helen Yang, MS. MFT Intern, is a bilingual, bicultural Marriage and Family Therapist Intern who speaks fluent Chinese (Mandarin) and understands Asian Culture. Ms. Yang serves as the chair for Diversity Committee of EBCAMFT and is a member of AAPA (Asian American Psychological Association).

Note: This article reflects the opinions of the author and not necessarily those of
East Bay CAMFT.