East and South East Asian People on Why They Started Therapy This Year

As we sit down outside a restaurant in London’s Chinatown, Weiliang* takes a moment to soak in the sea of mostly East and Southeast Asian (ESEA) faces. “This is one of the rare times I’ve felt safe outside,” he admits. The last time he came to Chinatown was over a year ago; the intervening year has not been kind to his mental health. 

As news of a novel virus spreading in China first appeared in British media, the 793,000 or so ESEA people estimated to be living in the UK were quickly cast in new roles as the diseased. “Before the pandemic, I was already quite an anxious person,” Weiliang, 26, recalls.

Anti-Asian sentiment had already been on the rise worldwide. When it arrived in his corner of the world, it came in the form of a group of teenagers who shouted “coronavirus” as he walked home in north London.

Though he was physically unhurt, the incident triggered a perpetual fight or flight mode. During lockdown, he’d walk to the supermarket – his sole excursion out of the house every week – and frequently got panic attacks. As restrictions lifted, stepping outdoors for the first time in months made him wary of everyone around him, prompting Weiliang to seek out a private psychotherapist. 

When he asked his parents if they could shoulder some of the financial cost, he was instead met with victim-blaming. “My dad just said, ‘You’re Chinese, you shouldn’t have left the house’, and that was the end of that conversation. I never got the money.”

For ESEA communities in Western countries, the mental health cost of the pandemic has extended far beyond the effects of lockdown. Rachel An Vu, a South London-based psychotherapist of Vietnamese heritage, says she’s seen an increase in the number of ESEA people enquiring about and engaging her services in the past year. 

“[These clients] were already dealing with issues related to race and identity, but didn’t have the courage to enter therapy then, or weren’t ready,” she says. “The media [coverage demonising ESEA people] likely gave them the push to contact someone to address these issues.”

For many, seeking help is tough. Mental illness is still heavily stigmatised in the diaspora; according to the Mental Health Foundation, people who identify as Asian are one-third less likely to be in contact with mental health services in the UK than those who identify as white. 

“In Vietnamese, there is a phrase which roughly translates to: ‘you should only disclose the beauty and hide the ugliness, otherwise you bring a lot of shame to the family’”, says Vu. “[My East Asian clients] were raised in a culture where they were told, you know, you can’t speak about ‘bad’ things; you’ll be seen as being weak. Or, they were raised in a way where they were told that ‘you can’t cry’, or ‘you should toughen up’ – that they shouldn’t complain, basically.” 

Carly*, 24, an international student from Hong Kong, reflects on a year she describes as “nightmarish”. Having moved to London in September last year, Carly has spent most of that time in her small student bedroom. She developed depression and anxiety, and decided to start counselling in February after staying in bed for three days straight.

“In [East] Asian society, we tend to prioritise our families’ feelings over ourselves: Would they feel betrayed? Would they be ashamed?” she explains. “So I would never tell my family and friends back home that I don’t feel mentally well, so I don’t burden them. I put this pressure on myself to pretend that I’m OK, or even enjoying myself in the UK, when I’m talking to them.”

Carly once hinted at her mental health troubles on the phone with her mother, mentioning vaguely that she might need to go and see a counsellor. Her mother’s response was to deposit £200 in her bank account and tell her to go shopping. 

“She meant well, but completely shut down when I tried to be honest,” Carly says, which added to her low mood. She ended up putting that money toward her therapy sessions. “Mental self-care is not a real concept in East Asian cultures. We’re supposed to be resilient. If you seek help, you’re admitting you have a problem.” 

Vu believes that this vicious cycle only inhibits people who actually want to be helped. “In Vietnamese this word ‘mental’ is translated as ‘tâm thần’, and it sounds like ‘crazy’ in English. People who are considering therapy are sometimes hesitant because they don’t want to be seen as crazy or mad, or that there’s something wrong with them,” she says. “But actually, in therapy, we focus more on the question of ‘what happened to you?’, instead of ‘what’s wrong with you?’”

Vanessa, 28, went to therapy after experiencing a burnout-induced breakdown at her role at a media company. But no one in her family truly believed she had a problem that warranted mental health intervention. “My parents were saying, ‘You have a well paying job, you have a boyfriend. Are you sure you’re depressed?’, as if success in life only depended on these things,” she says. 

“When I told my family that I was going to therapy, there was a lot of skepticism. They make it out to be a generational thing, like, you know: ‘Kids these days, oh, they’re too soft. Vanessa is so dramatic.’ When really, all I’ve done is identified how I can stop feeling so down.” 

It’s also a distrust of what’s seen as a therapist’s hold over a client that has Vanessa’s family worried. “Therapy is also seen as threatening,” she says – both to her family and herself. “They often say, ‘don’t let them get to your head’. If I change something about myself, they think, ‘that’s not who we raised you to be’. And things like learning how to set boundaries – especially with them – is considered talking back and disobeying.”

Vanessa adds: “Everything about me reflects on my family, so mental illness becomes a failure on their part which they don’t understand. They think, ‘I gave you everything you needed to succeed in life. Why would you have any problems?’”

For many ESEA people undergoing therapy, mental health is often intricately intertwined with cultural nuances. Everyone I spoke to emphasised the importance of having an ESEA therapist to help them navigate their problems empathetically.

“It was very important to me that my therapist was of the same heritage as me and understood the pain that I felt,” Vanessa says. She once saw a white therapist years ago for just two sessions: “She would gaslight me into believing things like racial microaggressions weren’t as bad as I thought, and all my insecurities were immediately boiled down to racial stereotypes like ‘tiger parenting’.”

“I know not all therapists are like that, but talking to someone of the same racial experience has definitely helped to minimise these misunderstandings.” 

Rachel, likewise, understands the appeal that draws ESEA clients to her service. “There is an assumption that I can understand some cultural norms (i.e. losing face) that Westerners might take longer to get fully,” she says. “There are things that are unspoken but easily understood or shared.” 

Despite familial resistance, Weiliang ended up downgrading his gaming laptop in order to afford his therapy himself, and has no regrets. He dreams of the day he can talk about his sessions openly with his family. “I’ve gained so much from it, I can only imagine [what could happen] if my repressed family goes too,” he laughs.