I Started Brown Girl Therapy to Make Mental Health Care Better for Second Generation Immigrants Like Me
Yana Iskayeva
In this op-ed, Sahaj Kaur Kohli, MA, LGPC, NCC, explores going to therapy as the daughter of Indian immigrants, and what spurred her to start Brown Girl Therapy.
When I sought therapy 10 years ago, I had no idea what to expect. I wasn't fluent in therapy speak, and there wasn't an influx of information or education at my fingertips since Instagram was then just a place to post and consume sepia-toned photos. I went in blindly as I navigated the fallout of a long-term relationship, triggers from a traumatic experience I had a few years prior, and low self-esteem.
Going to therapy for the first time can be tough for anyone, but as a daughter of Indian immigrants, and the first person in my family to be born in the West, it was particularly hard for me. In my family, and often in my culture, therapy is thought of as taboo and most issues surrounding mental health care get grouped into a pile labeled “white people stuff.” In fact, taking care of yourself can be considered selfish. After all, I grew up in a collectivist culture where I was expected and encouraged to prioritize family and community over everything else – including myself. I was raised with values, norms, and expectations at home that were diametrically opposed to those in the American environment I was socialized in.
This push and pull between who I am around my family and who I am alone with my friends was difficult to reconcile. I now know this is a feeling ultimately rooted in something called bicultural identity straddling, which is defined by researchers as an “ongoing process of adaptation resulting from living within two different cultural influences.”
Instead of getting therapy to process those feelings – because it was inaccessible and simply not on my radar – I grew up seeking self-help and personal development books and content only to have my feelings of inferiority reinforced —in turn increasing my feelings of shame and making me believe that I was not enough or that it was a me problem. Like me, many children of immigrants are left out of these wellness spaces because only parts of our bicultural identities are reflected. This is despite the fact that as of 2021, one in four children (eighteen and under) in the U.S. is a child of an immigrant or that children of immigrants or that second-generation immigrants—or children of immigrants—in the U.S. have almost a twofold greater prevalence of psychological distress than their immigrant parents.
Therapy was the first time I had a professional, confidential space to talk about myself and my feelings without worrying if I was taking up too much space, or boring the other person, or worse, if they were judging me. I didn't have to worry about my family finding out or ruining their reputation, a fear rooted in a cultural value of saving face, mostly because I had gotten the physical and emotional distance from my parents – by moving away – that allowed me to pursue this mental health care without them having to know.
Dr. M, my middle-aged white therapist, helped me build language around my own experiences and feelings; she was a sounding board as I sifted through these values and expectations and really interrogated how they impacted my sense of self. I learned that I didn’t have to hold myself hostage to everything I had ever done or said, and I could forgive myself for the mistakes I had made. I started to make connections between why something activated me and what relational blueprint I may have been replicating in present-day dynamics. I stopped expecting others to absolve my pain or to manage my emotions for me, and I started to learn how to do these things for myself. I practiced and brainstormed with Dr. M about how I wanted to communicate my feelings or needs, expanding into a gray area of outspokenness and strength – traits that are often discouraged for Indian women because they are perceived as “disrespectful” or “difficult.”. I was learning to discern between my thoughts and reality. And though I often found myself caught between my parents’ expectations and the choices I wanted to make, it was through my work with Dr. M and my pursuit of healing and self-examination that I learned to root into my own values and needs – without foregoing the relationships important to me.
I worked with Dr. M for about four years and it was a life-changing experience. Yet there was one specific way the work we did came up short.
Several months before my last session with Dr. M, my parents came to visit me in New York. As an unmarried daughter, I was expected to stay with them in their one-room, two-bed hotel room in order to maximize our time together. It didn’t matter that I was in my late twenties, or that I had my own apartment a mere 20 minutes from their hotel, or least conceivable of all, that I didn’t want to., I was expected to do as they asked — they were visiting from so far away, after all.
I ultimately decided to set a boundary, one in which I still spent the whole weekend with them but refused to stay in their hotel with them. I told Dr. M about the psychological discomfort I felt over not staying with them and not abiding by my parents’ expectations, and she instinctively made a face.
I don’t know for sure what she was thinking, but her immediate response – You’re an adult. You shouldn’t have to stay with them – immediately made me feel small. Though I didn’t say anything, I felt judged and invalidated. In my case, this didn’t negate the significant work we did together, but for others, it might. When the mental health care system does not reflect your experience, it can be easy to feel like you do not deserve quality care unless you can fit yourself into a small box. This prevents so many people from wanting to seek help.
My experience with Dr. M reinforces an underlying tension so many marginalized folks experience in the West – join in and point out everything that is wrong with your other culture or identity group, using it as a scapegoat for mental health struggles, and completely turn your back on where you come from; or defend everything about your culture/identity, even when some of its expectations and values are contributing to your struggle. This perpetuates the all-or-nothing mindset that holds us back from being able to acknowledge multiple truths at the same time. Therapy should be a refuge where we can remove our armor, explore being who we’ve never dared to be, and sort through our issues — not have them exacerbated.
These feelings of cultural frustration were brewing in me long before I even realized, and I didn’t have the language then that I do now to explain cultural humility or to stress how individualistic, Eurocentric and colonial Western models of therapy are. I didn’t know that, to some degree, Dr. M was pathologizing my culture of collectivism, only that it didn't feel right to me.
Being a culturally sensitive therapist is not necessarily about needing to share an identity or a language with your clients. Instead, it’s about creating space that gives clients permission to speak their truths without assuming that the way you think things should be is the “right” way. After all, what is right? What is normal? It’s not normal for some to stay with your parents in a shared hotel room as an adult. It’s not normal for others to pick and choose how often you will see your parents who traveled to visit you.
A year after ending my time with Dr. M, I started graduate school to become a therapist. The mental health profession was created by, and normed for, white people, those who historically were members of communities and that abide by individualism. According to 2019 data from the American Psychological Association, about 83% of the U.S. psychology workforce is white. Hispanic Americans represented the second-largest group at 7%, while Asian Americans represented 4% and African Americans just 3%. And in 2023, the Bureau of Labor Statistics found that 70 % of U.S. social workers and 76% of mental health counselors were white.
Counseling and mental health are not one-size-fits-all, yet this individualistic perspective was embedded in the training I received and the tools I learned. It was obvious to me how many of us are left out of the narrative. Mental health cannot be understood in isolation from identity and culture and I quickly became impassioned to bridge the gap between Western psychology and cultural nuances for immigrant-origin folks.
Stigma and fear around mental health care in immigrant communities often stem from a feeling of something “not being for us” and from a notion of it being harmful rather than helpful. Even more, there’s cultural stigma that seeking mental health care means you’re “weak” or “crazy.” Discussions about mental health or therapy are often steeped in misunderstanding because of a lack of knowledge or access.
This is represented in support-seeking behavior: Asian Americans are three times less likely than their white counterparts to seek mental health care (and are the least likely of all ethnic groups to do so). Only one in three Black adults who need mental health care receives it, and only approximately 35 % of Hispanic/Latine adults with mental illness receive treatment each year, compared with the U.S. average of 46%.
I wanted to add our voice to the conversation. Our growing pains, as children of immigrants, look different from our Western counterparts. We aren’t just learning how to be individuals, but rather we are learning how to make room for ourselves while maintaining relationships that are important to us. “Feeling good” is culturally situated. Research suggests that in collectivist cultures, we may measure our self-esteem based on the groups (family, community, and so on) we participate within and the roles we play in those groups.
I experienced the tension between these differing cultures firsthand, and that’s why, in 2019, I founded Brown Girl Therapy – a community that spans across six continents and has members whose heritages are from more than 100 countries. It grew out of my attempt to find community and to bridge the gap that Western self-care methods and discussion had been unable to traverse. It blossomed quickly into the first and largest mental health community for adult children of immigrants living in the West.
Seeking therapy and working as a therapist has been instrumental in helping me create a tool kit to communicate and explore my own experiences—overlapping and differing cultural factors and all. I strongly believe that everyone deserves personal growth, healing, and the option to explore what taking care of oneself means, even if they’ve never been encouraged to do so—whether because no one modeled it for them or because they didn’t have access to the resources.
For many of us, it’s hard to believe that we deserve quality care when the care doesn’t figuratively or literally speak our language, or when the people providing care are unable to see us wholly within the multiple systems in which we exist. We are not a monolith, but we are collectively experiencing similar struggles and hardships, regardless of where our families are from. We deserve healing, too.
Originally Appeared on Teen Vogue
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