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Between Two Cultures

Family therapy for Chinese Canadians

Dan Zhang, MD, MSc, PhD

Reprinted from "Treatment for Young People" issue of Visions Journal, 2006, 3 (1), p. 19, 21

The process of immigration requires learning to live in a culture different from one’s native culture. This process involves a large number of life changes and lowered well-being over a period of time. People often experience changes both individually and in their families—and family is very important in Chinese culture. Normal family conflicts and confusion are likely to be made worse. Issues such as cultural value differences and family structure changes are the major source of problems people in immigrant families may need help with.

Competing demands on Chinese youth

In North American culture, new family structures and practices have been emerging, and traditional values and assumptions have often been called into question. As a result, there aren’t clear guidelines to help immigrant families as they experiment with different ways of relating and adapting to a new—and changing—social world.

During cultural transition, children often experience increased demands on them. Placed in a strange culture about which they had no choice, children are overwhelmed by the numerous obstacles confronting them. They are constantly reminded by their parents that the parents invest their future in their children. The children are expected to do well in an English-speaking school, even though they cannot speak English at the beginning.

When Chinese children enter the Canadian school system, they learn new social values that conflict with those of their parental culture. When the children become skillful in the English language, they also learn to accept and assimilate the culture and values that come with the English language. The children’s assimilation into Western culture then makes them strangers in their own homes. Their newly learned assertiveness and freedom of choice and speech create increased conflict and physical and emotional distance between them and their parents. Should children disobey the parents—especially the father, who is the disciplinarian in the family—the parents will feel threatened and may demand more respect and deference from the children.

The children’s rapid acculturation (i.e., shifting to the values of the new culture), however—including greater proficiency in the English language—can cause role reversal in the family. Because of their skill in English, the son or daughter may be asked to translate or speak for the family in situations and relationships outside the family. This status, newly acquired by children, may cause them to have less respect for their parents, who remain traditional, rigid and less educated in English.

Chinese youths thus tend to experience anguish due to the dilemma of competing demands: 1) cultural role expectations at home, and 2) survival in the larger society. This involves not only conflicting pressures from other people, but personal con? icts within the individual Chinese youth, who is oriented to both sets of norms.

Some suggestions for cultural sensitivity in family therapy

The wide acceptance of the family-centred approach to problem solving has generated many treatment theories and models. In working with Chinese Canadian families, Chinese cultural and family traditions must be considered. The following suggestions may be useful:

  • Use of symbols. Symbols—words, objects, actions, gestures, images and sequences of interaction—can represent a client’s way of communication , personal metaphors, culture and life stories in a familiar and comfortable manner. Instead of asking Chinese clients to directly express themselves in feelings or comments, symbols can be used as an indirect way of having clients present personal needs and meanings, as well as emotions. Asking Chinese clients to bring their favourite pictures to the session, for example, can change the focus from the person to the objects.

  • Re-labelling. By using a concept the client is familiar with—for example, their own way of labelling a problem or issue—therapists can not only help clients understand their difficulties, but also alleviate the anxiety about exploring their problems in a therapeutic situation.

  • Applying Chinese traditional medicine theory.This is highly recommended for working on depression with Chinese clients. Feelings are often not directly expressed by Chinese clients. According to the theories of Chinese traditional medicine, physical symptoms are very much related to one’s emotional well-being. Thus, descriptions of physical symptoms such as headache, sleeping difficulties or eating problems are easily used by clients in discussion of their issues and problems. Counselling will be more acceptable and effective if it can assist clients to talk about the symptoms of their excessive anger, worry and thinking. In terms of practice, questions like: “What happened to you?” Or “What did you do?” is preferable to “How do you feel?” The focus should be on helping Chinese clients express their distress in a way that they can maintain “face” by not talking about their emotions.

  • Involving family members. Traditional customs also influence Chinese clients who have difficulty opening up to an “outsider.” Most Chinese clients are very much concerned about not making direct statements to others, and worry about “losing face” for themselves and their families. Therefore, they are very careful about what and how to say things to a “stranger.” Family members whose English is more advanced can also help some clients overcome possible language and cultural barriers.

  • Respect clients: Avoid stereotyping. If you not sure, ask. Interpretation out of context and beyond the facts is inevitably limited, offensive and harmful, whatever the intent. The therapist needs to understand clients within the clients’ cultural context, to avoid generalizing beyond what is known, and to keep an open attitude without stereotypical assumptions regarding their clients and other people.

About the Author

Dan practised medicine in China before immigrating to Canada, where she obtained a doctorate in counselling psychology from the University of British Columbia. In addition to her counselling at Vancouver Community College and teaching at Kwantlen University College, she volunteers with the Canadian Mental Health Association, Vancouver Burnaby Branch

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