Family Expectations and Men's Mental Health

People living in South Asia, mainly in India, Pakistan, and Bangladesh, often live in extended families. An extended family is a joint family system where children, parents, grandparents, uncles, and aunts live together, and one has little to no privacy in such a setting. Individuals have to abide by family traditions and values, making it quite challenging to make independent decisions. As a result, many people end up having mental health issues because they cannot align with their true selves.

Mental health in South Asian communities is considered a taboo topic. In such a family system, the head is usually a patriarch who must act tough to provide for the family, protect them, and keep his emotions buried deep inside, to mask it from the world, often leading to increased aggression.

The pressure to maintain a positive image in society is so high that it has led to a culture of silence around mental health in South Asia. Both men and women often maintain a facade of happiness and contentment to satisfy societal expectations and respect their elders.

In South Asian families, the respect of elders is paramount; elders are considered infallible, and children and young adults are discouraged from speaking their minds or discussing the struggles they face regarding mental health. Mental health awareness is looked down upon in many South Asian families because questioning traditional beliefs and practices is seen as going against family or community norms.

When mental health issues escalate, they are often misunderstood and sometimes believed to be caused by supernatural forces or moral failings.

Those who become self-aware often seek therapy, but not all South Asian therapists are capable or certified to handle such delicate issues.

I remember one of my clients complaining about his previous therapist, who told him, "Children should listen to parents," disregarding the whole concept of empathy and unconditional positive regard.

While women in these communities often suffer more from domestic violence, toxic marriages, and other stressors that lead to anxiety, depression, and other neurotic behaviours, it’s important to remember that men face similar issues too.

Society often tells men to conform to ideals of masculinity, not express vulnerability or emotions, and keep everything inside. The concept of therapy for the South Asian diaspora, especially men, is so vague that it prevents many from seeking help or opening up about their struggles.

Recently, it has come to my notice that there has been an increasing number of therapy sessions from individuals living in the United States and Australia. These clients are primarily South Asians who have migrated to these countries and are facing significant challenges in their marriages.

Both men and women are experiencing immense trauma and abuse, which has led them to seek professional help to address their mental health needs and save their relationships.

However, there is an obvious reluctance among these individuals to seek therapy from local therapists in their host countries. They often feel that therapists who are not from their cultural background may not fully understand the unique experiences and complexities of the South Asian diaspora.

Such clients show concern that Indigenous therapists may lack the cultural sensitivity and awareness needed to effectively address issues rooted in South Asian cultural contexts, such as familial expectations, gender roles, and societal pressures.

As a result, many South Asians living abroad are turning to online therapy services provided by therapists based in India and Pakistan. They believe that South Asian therapists are better equipped to understand their cultural background, their values, and the specific challenges they face as immigrants.

These therapists can offer culturally competent care, which not only resonates with their clients' experiences but also helps in building a therapeutic alliance based on shared cultural understanding.

This trend underscores the importance of culturally sensitive mental health services for the South Asian diaspora and highlights the need for more accessible and culturally aware mental healthcare options globally.

In many South Asian households, men are seen as the primary breadwinners and key figures in the family system. They are often expected to provide financial stability, make key decisions, and protect the honour of the family. This responsibility can be a significant source of stress, especially in places where economic conditions are challenging, and job security is uncertain.

The stress from balancing work and family can lead to feelings of being lost and overwhelmed. Qualities like toughness, stoicism, and emotional reserve are highly valued in South Asian communities, which might make it difficult to recognise and treat mental health problems.

Men are frequently taught from an early age to repress their feelings and refrain from showing vulnerability, which can result in the development of unhealthy coping strategies such as substance abuse, aggressiveness, or social withdrawal.

Men are more likely than women to experience the stigma attached to mental illness because they may perceive getting treatment or acknowledging psychological suffering as a betrayal of the ideals taught by society and their elders.

This stigma is exacerbated by the fact that many communities do not have open conversations about mental health, as it is typically frowned upon to talk about feelings and mental well-being. Some men may even feel guilty or ashamed about their mental health struggles, believing they have failed in their familial or religious duties.

Therefore, Mental health professionals in South Asian communities need to be culturally sensitive and understanding of the cultural norms, values, and beliefs of their clients. They must be qualified to provide culturally competent therapy for South Asians.

Men are often discouraged from displaying vulnerability or expressing their emotions in South Asian communities, which can result in repressed feelings and poor coping techniques. Mental health support for South Asian men is necessary to encourage them to explore and express their emotions healthily.

This could include using therapeutic approaches like mindfulness-based activities to promote emotional awareness and regulation or cognitive-behavioural therapy (CBT) to assist them in recognising and challenging harmful thought patterns. Mental health professionals in South Asia can provide tailored programs that may include a combination of psychotherapy and other interventional techniques, allowing these men to be themselves, express their emotions, and learn how to regulate them effectively.

It is also crucial to educate oneself and others about mental health. Men suffering from mental health issues can educate themselves about mental health and, in turn, assist others in de-stigmatizing mental health issues by reading articles, and books or listening to podcasts and videos on social media.

Lately, it has been observed that more men have started seeking therapy. This noticeable change has occurred due to the awareness created by social media and mental health professionals who are working in South Asia.

The stresses of modern life, such as financial strain, family obligations, and work-related stress, have made many men aware of the need for mental health services. Men are more likely to seek therapy as a proactive measure to manage their mental health as they become more conscious of the effects that stress, burnout, and other mental health issues can have on their overall well-being.

A significant number of men sought therapy for the first time as a result of the COVID-19 pandemic, which particularly highlighted the importance of mental health and the need for a therapeutic approach more aligned with South Asian culture and traditions.

Word of mouth is playing a significant role in reducing the stigma on mental health and therapy that has been around in this part of the world. It encourages men to speak up too. Hearing about the benefits of therapy from friends, family, or colleagues can be a significant motivator for men who may be on the fence about seeking help.

Therefore, Personal stories and testimonials about how therapy helped someone have inspired men to take the first steps towards improving their mental health.

As awareness about mental health grows and cultural norms evolve in the South Asian diaspora, there has been a gradual shift towards recognizing the importance of emotional well-being and mental health awareness for both men and women.

Families need to create environments that create an open communication environment, provide emotional support, and challenge long-standing societal norms that have contributed to neuroticism and psychosis in South Asian communities.