Written by Abigail Romero and edited by Clarissa Kim
Have you ever heard of the term AAPI? Maybe you’ve seen it surrounding the census and other national data, or maybe you’ve even seen it sprinkled in scientific studies. The acronym AAPI stands for Asian Americans and Pacific Islanders. From Laos, to India, to China, AAPI covers many people from all over Asia and the Pacific Islands, with different cultures, ethnicities, nationalities, and lifestyles. Though the AAPI community is vast and diverse, there are important mental health topics that apply across the board: specifically, culture’s impact on stigma and somatization.
Given the scope of the AAPI community, it would be almost impossible to cover all the major mental health issues with the entire community, however we will cover important topics that relate to mental health: specifically culture’s effects on stigma and somatization.
First of all, what is somatization? The answer relates to the connection with mind and body; for every emotional experience, there is a physical response. When people are sad, they cry. When people are afraid they begin to breathe harder. Somatization is the word that people use to identify physical expressions of stress and emotion through the connection of mind and body. If a student takes a maximum course load and multiple extracurriculars, the strenuous condition of working so hard might cause them to faint multiple times in a day. Similarly, a person with a pre-existing medical condition, such as an inflammatory bowel disease, might see their symptoms worsen because of stress. And vice versa, if a person with a pre-existing mental disorder gets a physical injury, symptoms of the physical injury may return even after it heals due to somatization. These people could possibly be diagnosed with Somatic Symptom Disorder or Conversion Disorder. Somatization is normal, however people with somatic disorders don’t have this connection between mind and body. But what does the idea of somatization have to do with the AAPI community specifically?
A lot actually! Culture plays a huge part in mental health, as it shapes the expression and recognition of mental disorders. Essentially, the way people treat others and themselves is influenced by their culture. In Western cultures, a distinction is made between the treatment of mind and body. However in Asian cultures which are influenced by Confucianism, there is no such distinction, which leads to Asians seeming to display much more somatic distress than white Americans. This is where stigma comes into play, though it will be expanded upon until later in this article. The distinction between mind and body is thought to be because of the influence of Confucianism on many Asian cultures. Confucian philosophies are very traditional in the way that they discourage any show of emotion, as it is a sign of weakness. Because of these traditions, Asians are predisposed to either unconsciously or consciously repressing their emotions or feelings. The repression of these emotions is thought to cause stress to be exhibited in a physical way, rather than a mental way. As a result, Asians are more likely to experience disorders with somatic symptoms over white Americans. This is specifically true in Chinese Americans over any other Asian or Pacific Islander community, since Chinese culture is more influenced by Confucious more than any other Asian culture. Though Chinese Americans make up the largest group of people affected by somatic symptoms than any other culture, other cultures that are heavily influenced by Confucious tend to have similar issues. Some of these countries are Japan, Korea, Taiwan, Vietnam, and Singapore and the Chinese territories of Macau and Hong Kong.
However, somatization isn’t the only issue which is shared across the AAPI community; The bigger issue is stigma. SAs mentioned earlier, stigma is part of the reason somatic issues occur in most of the Chinese population, however stigma’s impact is broader than only China. Stigma is a word that means “a mark of disgrace or dishonor”, so in terms of mental health, it means that someone will view you negatively as a result of your mental illness and not your character. Discrimination is when you are treated differently as a result of this.
In the AAPI community especially, stigma and discrimination is a huge problem. This, as aforementioned, is largely due to culture. Confucius’ teachings promote the idea that emotion means weakness and that asking for help is foolish. Because of this perspective on life, and how integral this ideal has stayed over many generations (typically the ideology lasts 3 generations) in AAPI cultures, there is a stigma around mental illness. As a result, most people who suffer are too afraid to reach out or go to therapy, because they are afraid of being rejected or humiliated. Buddhist teachings have a similar impact, as they say that problems in a person’s current life are because of sins one has committed in a past life. The idea of this life cycle can be damaging to people, as they believe that their issues are their own fault, and makes them less likely to reach out for help.
However, it is not only Confucianist and Buddhist teachings that affect stigma around mental health. Traditional views of mental health are also a large factor. Chinese, Japanese, Korean, and Vietnamese cultures specifically have a traditional idea that mental illness is caused by evil spirits or a lack of harmony within oneself. Table 1 will help to separate these ideas between different cultures.
Besides religion and traditional views, the level of acculturation in the AAPI community is important to take into account. Acculturation essentially means how well or how much someone has assimilated to a new culture and lifestyle. Scientific studies say that it takes around three generations for immigrants to accept or adopt parts of the lifestyle they have moved into. So typically first generation and second generation, sometimes even third generation, individuals have a hard time accepting modern medical care and mental health treatment.
To conclude, all of the issues that impact the mental health of the AAPI community are difficult to fit into a single article. There are several cultures and lifestyles that have probably been brushed over in this essay. There are other factors that negatively affect AAPI mental health too; some examples of that being post traumatic stress from war torn areas, anxiety and resent over colonizers, and stress within specific immigrant or refugee groups. However, somatization and stigma are huge issues that span across cultures and countries in the entire AAPI community.
Sources
Cover Photo by Tim Mossholder on Unsplash
1. Kramer, E. J., Kwong, K., Lee, E., & Chung, H. (2002, September). Cultural factors influencing the mental health of Asian Americans. Retrieved August 15, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1071736/
2. Office of the Surgeon General (US). (n.d.). Chapter 5 Mental Health Care for Asian Americans and Pacific Islanders. Retrieved August 12, 2020, from https://www.ncbi.nlm.nih.gov/books/NBK44245/
3. Somatization and the Mind-Body Connection. (n.d.). Retrieved August 13, 2020, from https://keltymentalhealth.ca/somatization
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