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Chinese Culture and Psychopathology 中華文化与心理病態學 Melvin W. Wong, Ph.D. 黃偉康博士 Licensed Clinical Psychologist ChristianMentalHealth.com ACTS: Associated Canadian.

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Presentation on theme: "Chinese Culture and Psychopathology 中華文化与心理病態學 Melvin W. Wong, Ph.D. 黃偉康博士 Licensed Clinical Psychologist ChristianMentalHealth.com ACTS: Associated Canadian."— Presentation transcript:

1 Chinese Culture and Psychopathology 中華文化与心理病態學 Melvin W. Wong, Ph.D. 黃偉康博士 Licensed Clinical Psychologist ChristianMentalHealth.com ACTS: Associated Canadian Theological Schools, Trinity Western University, Langley, British Columbia, Canada April 30 - May 4, 2001

2 David ChowMark VeghMelvin Wong Pablee Wong Gayle MacNab Rosamond Chan Loretta Luk Teresa Leung Vera Ma Alice Yu Chinese Canadian Culture and Psychopathology (Class of 2001)

3 Course Description This is a two unit graduate introductory course in the relationship between Chinese culture and psychopathology It is designed to help mental health professionals and ministry leaders in discerning the counseling needs of a client, patient or a congregation member Students will be expected to know the strengths and pitfalls of the Chinese culture in helping someone with a family problems or a disorder. The pastor will know when to make a referral

4 Course Requirements Each student is expected to complete either one of the following two paper assignments Paper 1: A Case Study or Paper 2: A Theoretical Study-presentation

5 Paper 1: A Case Study Paper 1: A Case Study Paper 1: A case study of the impact of culture on one aspect of a psychological symptom (of a person; a client, a congregation member or family member). Students are required to present a study of an individual (someone that you have counseled, someone that you know as a friend or relative) will suffice. Give an introduction, a family history with a genogram, a description of the one-symptom that marks the pathology, a formulation of the cultural correlation and some suggestion for a brief treatment recommendation.

6 Paper 1: A Case Study (No differential diagnosis is required.) A BRIEF written (not more than 10 pages) summary is to be presented to the office by June 18, 2001 (deliver to Mary West). Do not give paper to the instructor. While paper presentation in class on Friday is not required, extra credit could be earned and students are encouraged to sign-up (by indicating to the instructor) to make their presentations

7 Paper 2: A theoretical study- presentation Paper 2: A theoretical study-presentation of the impact of Chinese culture on psychopathology as manifested in the clinical population (or church-based communities): The Intervention recommendations: Students are required to present a more detailed theoretical study of the effects of the influence (subtle or obvious) on the development of psychological disorders, depending on the work environments of a student, such as a clinician or a minister.

8 This paper is intended to facilitate the understanding of the student in formulating a prevention response towards a wellness approach in their line of work. A BRIEF written (not more than 10 pages) summary is to be presented to the office by June 18, 2001 (deliver to Mary West). Do not give paper to the instructor. While paper presentation in class on Friday is not required, extra credit could be earned and students are encouraged to sign-up (by indicating to the instructor) to make their presentations

9 Class Time 08:30 to 10:00 AMInstruction session 1 10:00 to 10:10 AMBreak 10:10 to 11:15 AMInstruction session 2 11:15 to 11:25 AMBreak 11:25 to 12:30 PMInstruction session 3

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17 River Culture

18 Chinese is a “River Culture” Fate Fate of survival depends “nature’s ways” –Need –Need for rain, sunshine, no flood, no pests Communities Communities are important for survival –During –During harvest time, floods and famines Harmony Harmony is important for survival –Smooth –Smooth interpersonal relationships facilitates work Non-aggressive Non-aggressive (contrast with “Island Cultures”) Dependence Dependence on nature and conditions for crops Position Position of village-house critical to survival

19 River Culture and Customs

20 Water Management & Chinese Culture

21 Chinese Cosmology: Triadic Forces Balance: Relationship-Emotions Goal Goal in life is to master the eternal balance of the three relationships between heaven, earth & men. Heaven-Earth-Person: Heaven-Earth-Person: Relationship & Love Based There There is a God in Heaven : Heaven : Sense Sense of Justice Justice & Fairness Parent-Child: Parent-Child: Love analogous to heavenly love Ethnocentrism Ethnocentrism (Sinocentrism):

22 Chinese Pictograph 狂 The “animal inside” becomes “king” (taking over our self-control and made us do “crazy” “wild” and irrational things)

23 China: The Central Kingdom 中 國

24 Chinese Cosmology: Triadic Forces Balance: Relationship-Emotions Goal in life is to master the eternal balance of the three relationships between heaven, earth & men. Goal in life is to master the eternal balance of the three relationships between heaven, earth & men. Heaven-Earth-Person: Relationship & Love Based Heaven-Earth-Person: Relationship & Love Based There is a God in Heaven : Sense of Justice & Fairness There is a God in Heaven : Sense of Justice & Fairness Parent-Child: Love analogous to heavenly love Parent-Child: Love analogous to heavenly love Ethnocentrism (Sinocentrism): “foreign devils.” Frame of reference: Idiosyncratic Ethnocentrism (Sinocentrism): “foreign devils.” Frame of reference: Idiosyncratic

25 Chinese Cosmology: Triadic Forces Balance: Relationship-Emotions Goal in life is to master the eternal balance of the three relationships between heaven, earth & men. Goal in life is to master the eternal balance of the three relationships between heaven, earth & men. Heaven-Earth-Person: Relationship & Love Based Heaven-Earth-Person: Relationship & Love Based There is a God in Heaven : Sense of Justice & Fairness There is a God in Heaven : Sense of Justice & Fairness Parent-Child: Love analogous to heavenly love Parent-Child: Love analogous to heavenly love Ethnocentrism (Sinocentrism): “foreign devils.” Frame of reference: Idiosyncratic Ethnocentrism (Sinocentrism): “foreign devils.” Frame of reference: Idiosyncratic –Familial-centrism: Family isolation & self-sufficiency

26 Chinese Cosmology: Triadic Forces Balance: Relationship-Emotions Goal in life is to master the eternal balance of the three relationships between heaven, earth & men. Goal in life is to master the eternal balance of the three relationships between heaven, earth & men. Heaven-Earth-Person: Relationship & Love Based Heaven-Earth-Person: Relationship & Love Based There is a God in Heaven : Sense of Justice & Fairness There is a God in Heaven : Sense of Justice & Fairness Parent-Child: Love analogous to heavenly love Parent-Child: Love analogous to heavenly love Ethnocentrism (Sinocentrism): “foreign devils.” Frame of reference: Idiosyncratic Ethnocentrism (Sinocentrism): “foreign devils.” Frame of reference: Idiosyncratic –Familial-centrism: Family isolation & self-sufficiency –At the expense of women: Martyrdom, sacrifice.

27 Chinese Cosmology: Triadic Forces Balance: Relationship-Emotions Goal in life is to master the eternal balance of the three relationships between heaven, earth & men. Goal in life is to master the eternal balance of the three relationships between heaven, earth & men. Heaven-Earth-Person: Relationship & Love Based Heaven-Earth-Person: Relationship & Love Based There is a God in Heaven : Sense of Justice & Fairness There is a God in Heaven : Sense of Justice & Fairness Parent-Child: Love analogous to heavenly love Parent-Child: Love analogous to heavenly love Ethnocentrism (Sinocentrism): “foreign devils.” Frame of reference: Idiosyncratic Ethnocentrism (Sinocentrism): “foreign devils.” Frame of reference: Idiosyncratic –Familial-centrism: Family isolation & self-sufficiency –At the expense of women: Martyrdom, sacrifice. – “Us-against-them” mentality: a win-lose paradigm.

28 The Triadic Balance ( 三 和 ) of Relationships and Emotion Heaven-Earth-Person: Relationship & Love Based – 天 地 有 情 There is a God in Heaven: Sense of Justice & Fairness – 舉 頭 三 尺 有 神 靈 Parent-Child: Love analogous to heavenly love – 孝 感 動 天 Openness & Acceptance of Errors – 人 誰 無 過

29 Fundamental Cultural Concepts Relationships of 3-Dynamic-Forces (三勢) –H–H–H–Heaven, Earth & Person: 天地人 Life goal: Master the balance of the three Powers –天–天–天–天地人:天時,地利,人和 (三和) Do not upset the spiritual balance in the relationships of these Triadic Forces (三和) Physical (Geomantrics) Feng-Shui (風 水) –I–I–I–Integrate People with nature & ergonomics (Yin-Yan) Spiritual Balance (陰 陽 變 數)

30 What is Asian-Canadian culture? Asian-Canadian Asian-Canadian (Asian: Ethnic Chinese) is an extremely diversed group of Asians ethnically from all over Asian with different cultural, religious, economic and political backgrounds. Koreans, Japanese, Chinese, Taiwanese, South-East Asians Asians (Vietnam, Laos, Cambodia, Burma, Thai, Singapore, Malaysia, Indonesia) As As diversed as we are : are : There are common threads: Rice, Chop-sticks, Family Values, Education, Arts, with diversed ethnic subcultures

31 Asian-Canadian Cultural Understanding Life is a stage: Role-play 人生如舞台 Being a Person: 做人=做戲 Life is about On-stage, Off-stage: 上台,下台 –I–I–I–In an interpersonal shameful situation, it is known as “hard to get off stage” 難下台 –T–T–T–To help, provide a graceful exit: 下台階 Detested Characters (animal-temperament) –H–H–H–Human-faced, Animal hearted 人 人 人 人面獸心 –W–W–W–Wild-animal put in a man’s dress 衣冠禽獸

32 Asian-American Cultural Understanding Filial Piety (most favored virtue): Education 老子,孝順,老子文=教 Favors sons over daughters:重男輕女 –子–子–子–子承父業 –女–女–女–女子無才便是德 Conformity & Self-Denial:克己服禮為仁 Gentlemen vs. the Conceited:小人君子

33 Day Two

34 Patterns of Immigration Bachelor laborer Laborer and his village (mail order) bride Children of laborer and village bride Bright scholar from big cities at ivy league Foreign students who stayed Pre-post 1997 political refugees –B–B–B–Bosses and professional Children of Shanghainese elites: ivy league

35 Asian-American Culture & Philosophies (* Local-Domestic Origins) *Confucianism 儒 Buddhism 釋 *Taoism 道 Western-Christianity 耶 *Self-Material-Pragmatism 錢

36 Buddhism An Indian prince’s response to human pain –P–P–P–Prince lived a life of pleasure within palace gate –N–N–N–Noticed pain of peasants when outside gate Pondered about the sad human condition –P–P–P–Personal guilt of pleasure that was for granted –S–S–S–Social sufferings: Birth, aging, illness, death Bad things happen to you because you have done something wrong: “Karma” Death: Reincarnation: Good deeds

37 Chinese Sexual Beliefs (Role of Women) (Adapted from Christian Ethics: Principles and Applications, Dr. Ping-Cheung Lo, Hong Kong Baptist University ‘92) Taoism Tenets: Longevity, Transcend to Become a god Methods: Methods: Diet, Qigong, Meditation By By Practicing Special Sexual Techniques –“Take –“Take from Yin to Compensate Yan” »Virgins »Virgins & Women used as means to an end to benefit the Men’s desire to have longevity –“Return –“Return Sperm to Compensate Brain” »Sex »Sex to benefit Men’s desire for longevity & stamina

38 Day Three

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43 The Five-Hierarchical Harmonious Relationships (The Five-Orders “Wu Lun”) 五倫 Copyright (C) Melvin W. Wong, Ph.D

44 Order 1: The King and his Subjects 君要臣死, 臣不死, 不忠也 If the king decrees death to his subject, if he doesn’t kill himself; it is not loyalty Authoritarianism: Authoritarianism: Do as the king says, obey –Reinforces –Reinforces dependency : dependency : “Emperor's new clothes” –Hypocrisy: –Hypocrisy: “Public self vs. Private self” “Self-identity” –Externalized –Externalized locus of control: Reduced personal responsibility The The all-powerful king: analogous with god Deified Deified king: Idolized-worshipped the king

45 Day Four

46 Order 2: Father and Son 父要子亡, 父要子亡, 子不亡, 子不亡, 不孝也 If father wants his son to die, if he doesn’t kill himself; it is not filial piety Fatherhood Fatherhood equals Kingdom government Generalized Generalized authority to the elderly : elderly : Wisdom Authoritarianism : Authoritarianism : Do as the father says, obey –Reinforces –Reinforces dependency: “Must please father” –Externalized –Externalized locus of control: Reduced personal responsibility

47 Filial Piety Resulting Resulting virtue of a harmonious relationship between father and child is Filial Piety First-born First-born son is most valued: first-born son is the first child that can carry on the family lineage Fathers Fathers have unquestioned authority over their children –have –have the right to the lives of their children –The –The reasoning is that, “They are my own.” This This virtue gave rise to patriarchy and nepotism Ancestor-worship Ancestor-worship (Idolization of ancestors) –Complex –Complex of respect and fear for the deceased

48 Reciprocity-Entitlement-Empathy Reciprocity Reciprocity (Family Culture Demands It) –Duty –Duty > Personal Desire = Sacrifice; Payback –Trauma –Trauma Re-Enactment of Mother-In-Laws Entitlement Entitlement (Takes It For Granted) –Do –Do It, Give It, Or Else! (Shame-Guilt-Injury) Empathy Empathy (Lack of) “Form > Will” –Do –Do It-Perform It-You Don’t Have to Like It –My –My Way > Your Needs (Self > Others)

49 Order 3: Older brother and younger brother 兄弟如手足 Brothers (older and younger) are like hands and feet (they are irreplaceable, blood is thicker than water) Older-brother Older-brother in command during father’s absence Facilitates Facilitates family operations: Internally-externally Authoritarianism : Authoritarianism : Do as the brother says, obey –Reinforces –Reinforces dependency: “Must please brother” –Externalized –Externalized locus of control: Reduced personal responsibility

50 Order 4: Husband and Wife 夫妻如衣服 Relationships between husband and wife is similar to clothing (change them at will) Women’s Women’s identity begins after marriage 三從 : 三從 : 在家從父 在家從父 出嫁從夫 出嫁從夫 老來從子 Authoritarianism: Authoritarianism: Do as the husband says, obey Reinforces Reinforces dependency : dependency : “Husband-pleasing” Externalized Externalized locus of control: control: Reduced personal responsibility Faithfulness Faithfulness in marriage: Wife must be chaste

51 Husband and Wife Relationships Women Women suffer and sacrifice silently She She becomes a martyr-sacrificial lamb of the dysfunctional family & inflicts the same pain upon her daughter and in-laws copes by Denial and Resignation: “fate” Poor Poor husband-Wife relationship is the norm Extra-marital Extra-marital affairs, Informal Mistresses, Concubines, Polygamy

52 Seven Facets of Chinese Face Work After Bond and Hwang “Six types of face work“ © Melvin W.Wong, Ph.D.2001 LevelDescriptionManifestation Chinese pinyin 1 Enhancing your own face Etiquette consciousness yao mianzi 2 Enhancing other’s face Reciprocity gei mianzi 3 Losing your own face Shame, humiliation diao mianzi 4 Hurting other’s face Retaliation for shame felt shang mianzi 5 Saving your own face Avoid shame, be proper baocun mianzi 6 Saving other’s face No criticism, give apology mian mian qu yuan 7 Tearing your own face Relationship destroyed mou mian

53 Biblical Order of Relationships “The New Five-Orders” 新五倫 Copyright © Melvin W.Wong, Ph.D Christ 1. Christ the King and His Children Children (Isaiah (Isaiah 9:6-7) Love and Sacrifice 2. Father 2. Father and Mother (Exodus 20:12) Love and Honor (Leave, Cleave becoming one flesh) 3. Husband 3. Husband and Wife (Ephesians (Ephesians 5: :21-25 ) Love and Commitment 4. Parents 4. Parents and Children (Ephesians (Ephesians 6:1-2 6:1-2 ) Love and Acceptance 5. Fellowship 5. Fellowship of Believers, Friend-Foe (1 (1 John 4: :11-12 ) One another love, Hospitality & Forgiveness (Mat 22:39)

54 Day Five

55 Guilt True guilt: Biblical guidelines & mandates –A–A–A–Absolute: Objective (conscience) False guilt: Imposed family-social values –S–S–S–Subject to change: Subjective (conscience) –O–O–O–Overly-harsh conscience vs. “relaxed” conscience Over-control vs. Under control Compulsives vs. Psychopaths Perfectionists vs. Anti-social narcissists

56 Effects of Migration on Psychopathology Social Social up-rooting, destruction of network –Increases –Increases isolation and loneliness –Timing –Timing is when support is needed the most –Pre-mid-life –Pre-mid-life crisis: May hasten crisis: Divorce Migration Migration requires personal adjustment –Polarize –Polarize the gap between the well and the sick Increases Increases coping demands: Breaking point? –Exacerbates –Exacerbates pre-existing marital problems pre-existing parent-child issues

57 Effects of Migration on Psychopathology Men’s adjustment problem of ego & identity –U–U–U–Underemployment causing self-doubt, prestige Women’s new found freedom & power –T–T–T–Threatens “unhealthy balance” of marriage Intergenerational conflicts of values Role-reversal: English proficiency = Power –F–F–F–First-born daughter controls the family –F–F–F–First-born daugther made to doubt self-worth »E»E»E»Ensure the authority of parents (mother)

58 Codependency Love Love is Possessiveness: Suffocating, Controlling, Secrets, Feel-as-I say, Ego- Enmeshment-ID, Materials = Happiness. loss: Separation trauma, Life’s threatened, Individual-Family-Destructiveness, Filicide Poor Poor Communication Skill “Cross-Talk; Over- Talk; Cover-Talk” Limits, Intrusive Boundaries, Violations Gratefulness Gratefulness

59 Origin of shame The lack of a personal identify: Who am I? The lack of a personal identify: Who am I? External vs. Internal shame mechanisms External vs. Internal shame mechanisms –Parents against their children: Name calling –Children’s cruelty against their peers: Name calling –Personal handicaps: “Imperfections” –Compares & Contrasts: Athletes, models & stars –Physical features: Aging, race, skin color –Need for acceptance & “measuring-up”

60 Shame & Blame Projection is a defense against shame: anxiety Blame Blame is externalizing of an internal conflict The The person does not take ownership for shame –“It –“It is easier that shame is on you & not on me” –“I –“I will be a no body when I am not perfect” am not worthy, to be rejected when I am wrong’ –This –This is a homeostatic approach to balance anxiety There There is little introspection: No learning-maturity Self-Defeating, Self-Defeating, tragic outcomes: Hiding Secrets

61 Boundary & Limits Physical-Personal Physical-Personal Boundaries aids Efficiency –MTR, –MTR, Queues, Zebra Lines Fuzzy Fuzzy Psychological Boundaries –Dire –Dire need to stay connected-complete identity –Fusion –Fusion of identity: Security Based –Needs –Needs For Vicarious Meaning through your life –Intrusiveness –Intrusiveness Invasiveness Lack of privacy –Power –Power Play: Omnipotence

62 Guilt Sigmund Freud & others (1930, 1961) saw guilt as the more worthy emotion Arealistic & growth-facilitating emotional response to wrong-doing (deals with doing) Resulting Resulting from transgression against the superego Is Is central to the conflict theory of analysis Results Results from more advanced Oedipal conflicts in doing-performance: Recompensation

63 Christianity Prominent only in intellectual circles only Prominent only in intellectual circles only –Common values among repatriates from the West: USA, Canada, Australia and the UK Not common among blue-collar or laborers Not common among blue-collar or laborers Personal responsibility Personal responsibility Long-term investment Long-term investment Moral restraints based on Biblical laws Moral restraints based on Biblical laws

64 Christianity Philosophy of Forgiveness, Repentance & Redemption Provision for correcting wrongs through confessions & forgiveness: Repairing relationships. Building trust & genuiness Self-Reflection, Introspection possible Suffering & pains are real and to be faced Win-Win Paradigm

65 Self-Material-Pragmatism Winning Winning & Success Driven (Greed): Can’t Fail Practical Practical Measurements Measurements (Concrete Materialistic) –Whoever –Whoever has the most toys wins –Symbols –Symbols of prosperity and achievement Risks Risks Takers: Short-Term focused Personal Personal aggrandizement: Narcissistic bend There There is no Moral Restraints: Self-focused Individualist-Hedonistic: Individualist-Hedonistic: Post-Modernist

66 Diagnostic criteria for Narcissistic Personality Disorder A pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy, beginning by early adulthood (1) has a grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements) (2) is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love (3) believes that he or she is "special" and unique and can only be understood by, or should associate with, other special or high-status people (or institutions)

67 Diagnostic criteria for Narcissistic Personality Disorder (4)requires excessive admiration (5)has a sense of entitlement, i.e., unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations (6)is interpersonally exploitative, i.e., takes advantage of others to achieve his or her own ends (7)lacks empathy: is unwilling to recognize or identify with the feelings and needs of others (8)is often envious of others or believes that others are envious of him or her (9)shows arrogant, haughty behaviors or attitudes

68 Common Female Disorders Somatization Disorder (Neurasthenia) –A–A–A–Anxiety-Repression: –S–S–S–Socially acceptable disorder: Concrete Vs. Abstract Hysteric-Borderline Personality Disorder –F–F–F–Features Vs. Full-Blown Disorder –O–O–O–Object Relation Type of Disorders: Trust Issues –A–A–A–Attachment Deficits: Trust Issues –A–A–A–Attention Deficits: Narcissistic, Expansiveness

69 Common Male Disorders Anxiety Related Disorders Conforming (Over-Control) Disorders Obsessive-Compulsive Disorder –C–C–C–Control-Mastery Issues (Compensational) –T–T–T–The Perfectionistic-Intellectualization Disorder –T–T–T–Trauma Response Syndrome –S–S–S–Shame-based cycle adjustment constellation –W–W–W–Workaholism vs. Pathological Gambling

70 Impulse (Under-Control) Antisocial Disorders –I–I–I–Intermittent Explosive Disorders: Profanities –F–F–F–Family violence: Physical and Verbal Subtle Impulse Dyscontrol Symptoms: Lying, Porn Attachment Deficits Disorders: Trust Issues –P–P–P–Poor relationship with males (Father-Son) –L–L–L–Lacks meaningful & intimate male friendships –F–F–F–Friendship themes are rivalry-based (Win-Lose)

71 Common Marital Disorders Angry Husband - Depressed-Hurt Wife Angry Wife - Withdrawn Husband Avoidance of Emotional Involvements –F–F–F–Focus on the Concrete, Practical issues –O–O–O–Over-Rationalization, Over-Intellectualization –J–J–J–Judgment Passing: Reason, Right or Wrong Rigid Structure, Non-Cohesive: Stress prone

72 Common Parent-Child Disorders (Father)-Man Haters (Misogynist) –F–F–F–First-born son’s grudge against father –D–D–D–Daughter mistrusts, despises father –N–N–N–No relational conversations –N–N–N–No-win situations (Mother)-Woman Haters (Misandry) –F–F–F–First-born son’s grudge against mother for being too involved with his life

73 Specific Disorders Impulse Impulse Related disorders –Rage –Rage and Destructive potential of Asian males –Workaholism-Gambling –Workaholism-Gambling (Winners ethics) Codependency Codependency Related Disorders –Emotional –Emotional dependency of the Asian females –Physical –Physical Punishment –Family –Family Secrets. Involuted No-Win Family Loyalties –Roles –Roles of martyr, rescuer, mascot, clown

74 Culture & Parenting Skills The Developmental Perspective The Developmental Perspective Parenting-Child rearing practices affect the personality of the child Parenting-Child rearing practices affect the personality of the child Parenting Skills are “Hand-Me-Down” beliefs that parents do not question until much later in life Parenting Skills are “Hand-Me-Down” beliefs that parents do not question until much later in life The First-born Child: The First Experiment The First-born Child: The First Experiment

75 Culture & Parenting Skills Beliefs or Myths about Children affect Discipline Beliefs or Myths about Children affect Discipline Attachment Conflicts: Over-dependency Issues of Child upon care-givers Attachment Conflicts: Over-dependency Issues of Child upon care-givers Mother-daughter conflicts Mother-daughter conflicts Father-son conflicts: Physical abuse Father-son conflicts: Physical abuse

76 Culture & Parenting Skills Other-Centered: What will they say about me as a mother? Other-Centered: What will they say about me as a mother? Unquestioned Obedience is expected Unquestioned Obedience is expected Shame based: Get at the Self-Image-Esteem Shame based: Get at the Self-Image-Esteem Fear-Dread: Anxiety provoking Fear-Dread: Anxiety provoking Pain-Hurt: Inflicting pain to oppress child Pain-Hurt: Inflicting pain to oppress child Divisiveness-Splitting: Sibling Rivalry Divisiveness-Splitting: Sibling Rivalry

77 Historic-Social-Psychological Perspective: Hong Kong Refugee Refugee Mentality: “Survival for the fittest” Refugee Mentality: “Survival for the fittest” Don’t Mind My Rudeness: Show must go on Don’t Mind My Rudeness: Show must go on Must Make it “Big”: At all costs & sacrifice Must Make it “Big”: At all costs & sacrifice Raise Perfect Children: “All for the love of you” Raise Perfect Children: “All for the love of you” Education is the End: “Compensates my ego” Education is the End: “Compensates my ego” Colonist vs Colonized: Identifying with aggressor Colonist vs Colonized: Identifying with aggressor –Trauma Bonding, Trauma Re-Enactment

78 The Narcissistic Individualist in Disguise When My face is torn, anything goes When My face is torn, anything goes You Will never see me so cruel (words & deeds) You Will never see me so cruel (words & deeds) What do people do in the dark? When no one’s watching? What do people do in the dark? When no one’s watching? “Strong Family Tie” vs “Self-aggrandizing” “Strong Family Tie” vs “Self-aggrandizing” Empathy Void: If any primitive vestiges exists Empathy Void: If any primitive vestiges exists

79 Games Chinese Play Everything Must Go My Way (Or I would be devastated). Even If you don’t like me, please pretend, I will pay. Everything Must Go My Way (Or I would be devastated). Even If you don’t like me, please pretend, I will pay. When I Go to Shenzhen, My Problems will go away. When I Go to Shenzhen, My Problems will go away. Hypocrisy: “Do as I say vs Do as I Do” Hypocrisy: “Do as I say vs Do as I Do” –Haggling For a Bargain: Leave! Beg! Friendship! –Sexual Relationships: “No is Yes” Babel –“I Emigrate and sacrifice all for you”

80 Boundary & Limits Physical-Personal Boundaries aids Efficiency Physical-Personal Boundaries aids Efficiency –MTR, Queues, Zebra Lines Fuzzy Psychological Boundaries Fuzzy Psychological Boundaries –Dire need to stay connected-complete identity –Fusion of identity: Security Based –Needs For Vicarious Meaning through your life –Intrusiveness Invasiveness Lack of privacy –Power Play: Omnipotence

81 Family ¼Ò×å¹ÛÄî Familial-Centrism ¼Ò×åÖ÷Òå Familial-Centrism ¼Ò×åÖ÷Òå Family Isolation ¸÷¼Ò×ÔÃÅÇ°Ñ©, ĪÀíËûÈËÍßÉÏ˪ Family Isolation ¸÷¼Ò×ÔÃÅÇ°Ñ©, ĪÀíËûÈËÍßÉÏ˪ Lack of Community Care, Community Indifference: Public spitting, littering, poor public sanitary facilities. Lack of Community Care, Community Indifference: Public spitting, littering, poor public sanitary facilities. Family heritage & creed (family policy: Obey): ¼Ò½Ì Family heritage & creed (family policy: Obey): ¼Ò½Ì Specific positions ¹Ãĸ, ¹ÃÂè, ¹Ã½ã, ¹ÃÕÉ, ÒÌÂè, ÒÌÕÉ Specific positions ¹Ãĸ, ¹ÃÂè, ¹Ã½ã, ¹ÃÕÉ, ÒÌÂè, ÒÌÕÉ Perpetual in-law rivalry: Ç×¼Ò±äÔ©¼Ò Perpetual in-law rivalry: Ç×¼Ò±äÔ©¼Ò Business “one-man bands” Nepotism ×ӳи¸Òµ Business “one-man bands” Nepotism ×ӳи¸Òµ –Sibling rivalry over inheritance & business

82 Husband and Wife Relationships ·òÆÞ¹Øϵø Husband-wife relationship is only the third of the 5-cardinal orders. Where women’s role first appears Husband-wife relationship is only the third of the 5-cardinal orders. Where women’s role first appears Father-son, Older-Brother Younger-Brother relationship more important than husband-wife ÐÖµÜÈçÊÖ×ã ·òÆÞÈçÒ·þ Father-son, Older-Brother Younger-Brother relationship more important than husband-wife ÐÖµÜÈçÊÖ×ã ·òÆÞÈçÒ·þ Wife expected to sacrifice herself to maintain a happy family balance (Eating Bitterness) Wife expected to sacrifice herself to maintain a happy family balance (Eating Bitterness) ³Ô¿à ³ÔµÃ¿àÖп෽ΪÈËÉÏÈË ³Ô¿à ³ÔµÃ¿àÖп෽ΪÈËÉÏÈË Perpetual tension and strife between mother-in- laws and daughter-in-laws Perpetual tension and strife between mother-in- laws and daughter-in-laws

83 Husband and Wife Relationships ·òÆÞ¹Øϵø Women suffer and sacrifice silently ÎþÉüСÎÒÍê³É´óÎÒ Women suffer and sacrifice silently ÎþÉüСÎÒÍê³É´óÎÒ She becomes a martyr of the dysfunctional family & inflicts the same pain upon her daughter-in-laws. Թż Cope-Denial ÈÌ She becomes a martyr of the dysfunctional family & inflicts the same pain upon her daughter-in-laws. Թż Cope-Denial ÈÌ Poor husband-Wife relationship is the norm Poor husband-Wife relationship is the norm Extra-marital affairs, Informal Mistresses, Concubines, Polygamy ÍâÓö СÀÏÆÅ ¶þÄÌ Extra-marital affairs, Informal Mistresses, Concubines, Polygamy ÍâÓö СÀÏÆÅ ¶þÄÌ

84 Gender-Bias (devaluation of Women) ÖØÄÐÇáÅ® Women’s Identity: only part of relationship with a husband Women’s Identity: only part of relationship with a husband Wives to discharge duty to husband: Give birth to sons Wives to discharge duty to husband: Give birth to sons Worth and identity of wives are threatened when the first- born is not a son. Worth and identity of wives are threatened when the first- born is not a son. –Daughters become the big let-down of mothers –Blame first-born daughters for their misfortunes –Superstitious beliefs are at work: Bad-luck-daughter A virtue for a girl to have no scholarly achievements Å®×ÓÎ޲űãÊǵ ×ÓÔ» ΨŮ×ÓÓëСÈË ÎªÄÑÑøÒ² A virtue for a girl to have no scholarly achievements Å®×ÓÎ޲űãÊǵ ×ÓÔ» ΨŮ×ÓÓëСÈË ÎªÄÑÑøÒ²

85 Dependent Identity of Women Dependency vs. Independency Tasks Seasons of Dependency Developmental Dependency of Women Three stages of Identity formation 三從 Depends on parents when young 在家從父 Depends on parents when young 在家從父 Depends on husband when married 出嫁從夫 Depends on husband when married 出嫁從夫 Depends on son when old 老來從子 Depends on son when old 老來從子

86 First-Born-Daughter Complex ³¤Å®Çé½á( ñ±) Precipitating factors: Belief values males over females & the mother’s increased worth on having a first-born son (ÖØÄÐÇáÅ®,ĸƾ×Ó¹ó ) Precipitating factors: Belief values males over females & the mother’s increased worth on having a first-born son (ÖØÄÐÇáÅ®,ĸƾ×Ó¹ó ) FBD Mothers are usually FBD’s themselves (rejection, abandonment) FBD Mothers are usually FBD’s themselves (rejection, abandonment) –Enmeshment, Projection of their fears & insecurities ontoFBD’s. –Role-reversal:They are their mother’s confidant & counselor. –Lack a childhood: FBD’s siblings’ surrogate mother & care-giver. –Gross experience of splitting, abandonment: Perfectionism, B/W. –Shame, divisiveness, splitting, favoritism, nepotism and fear of separation and dread are commonalities in their upbringing. –Lower functioning FBD’s: Suffered multiple interpersonal traumas, losses and rejections. Full borderline personality disorder. Reduced impulse control, running away from home, chronic suicidal ideations. Self-mutilations and suicide attempts. –Disappointed & betrayed by their fathers and unfairness with brothers. They have been emotionally and physically abused. –FBD’s:Organized & “capable.” Hyper-sensitive to fairness, justice.

87 Shame & Guilt ³ÜÈè¸Ð ×ï¾Î¸Ð Li Àñ ÓÐÀñ ÎÞÀñ ʧÀñ Shame-Social Guilt- Familial Li Àñ ÓÐÀñ ÎÞÀñ ʧÀñ Shame-Social Guilt- Familial Social Rituals, Protocols, Ceremony, Etiquette ÀñÒÇ Àñ½Ì Social Rituals, Protocols, Ceremony, Etiquette ÀñÒÇ Àñ½Ì Four National Virtues 禮 義 廉 恥 國 四 圍 Four National Virtues 禮 義 廉 恥 國 四 圍 知 恥 近 勇 知 恥 近 勇 –Knowing shame is the beginning of courage –Knowing shame is almost the same as courage –Knowing shame is as close as having courage

88 Codependency ÒÀÀµµÄ°® ¼ÄÉúµÄ°® No western concept of autonomic and interdependent love. No western concept of autonomic and interdependent love. People: Asset of China, a key of the 5-cardinal relationships, people become +, - reinforcers of behaviors. People: Asset of China, a key of the 5-cardinal relationships, people become +, - reinforcers of behaviors. –Older mothers like their children to be with them. It is not what they do but who is with them & how many. –Mother’s respect and honor depends on the presence of children’s as symbol of paying respect and honor. –In-law problems are standard struggles in this codependence family dynamic. Faking compliance is common to please.

89 Codependency ÒÀÀµµÄ°® ¼ÄÉúµÄ°® Love is Possessiveness: Suffocating, Controlling, Secrets, Feel-as-I say, Ego- Enmeshment-ID, Materials = Happiness. Love is Possessiveness: Suffocating, Controlling, Secrets, Feel-as-I say, Ego- Enmeshment-ID, Materials = Happiness. Love loss: Separation trauma, Life’s threatened, Individual-Family-Destructiveness Love loss: Separation trauma, Life’s threatened, Individual-Family-Destructiveness Poor Communication Skill “Cross-Talk; Over- Talk; Cover-Talk” ÓÐÎÒ½²ÎÞÄã½² ¼¦Í¬Ñ¼½² Poor Communication Skill “Cross-Talk; Over- Talk; Cover-Talk” ÓÐÎÒ½²ÎÞÄã½² ¼¦Í¬Ñ¼½² Poor Limits, Intrusive Boundaries, Violations Poor Limits, Intrusive Boundaries, Violations Gratefulness ÎÞ±¾ÐÄ Òûˮ˼ԭ Gratefulness ÎÞ±¾ÐÄ Òûˮ˼ԭ

90 Anger & Rage Å­·ß ·³ÑáԹŭ ·ßºÞÔ÷±É³ð Ô©Çü Dependency & anger are 2 prominent features Dependency & anger are 2 prominent features Anger is not an acceptable feeling, happiness is. Anger is not an acceptable feeling, happiness is. –Weakness to cry, suppression is norm ÎÞÃû»ðÆðÈýǧÕÉ Anger when express is usually passive Anger when express is usually passive Manifestations of Ragefulness is common Manifestations of Ragefulness is common –Child-abuse “Discipline” –Family Violence “Family Discipline” Dominance & PredationÔ©Í÷, Ô©Çü, Ô©Äõ, Ô¹ºÞ,Çü Dominance & PredationÔ©Í÷, Ô©Çü, Ô©Äõ, Ô¹ºÞ,Çü

91 Self-Identity Development/Personhood Éí·Ý Self not a key concept in the Asian-American’s personality development. Not only is the self is de-emphasized, it carries a negative connotation. Self not a key concept in the Asian-American’s personality development. Not only is the self is de-emphasized, it carries a negative connotation. The self is to be denied to meet the social mores of the elders. ¿Ë¼º·þÀñΪÈÊ, The self is to be denied to meet the social mores of the elders. ¿Ë¼º·þÀñΪÈÊ, Self-Denial is first of 4 cardinal virtues ÈÊÒåµÀµÂ Self-Denial is first of 4 cardinal virtues ÈÊÒåµÀµÂ Personal identity is derived out of relationship, usually a part of family order or social status. Personal identity is derived out of relationship, usually a part of family order or social status. Social identity is extremely important: Ãû·ÝExtreme shame when salutation is improper. Social identity is extremely important: Ãû·ÝExtreme shame when salutation is improper.

92 Confucianism: The Drawbacks Professor Fu Wei-Feng, UC San Diego 94-Nov-14 Harvard Divinity School –Community relation is not emphasized or developed. Focused too much on the individuals & family 各 家 自 掃 門 前 雪 –Lacks social responsibilities –Not critical enough of negative characteristics of men 人 初 性 本 善

93 Common Family Disorders “Give-Face” “Save-Face”: Overly Concrete “Give-Face” “Save-Face”: Overly Concrete Codependency Codependency Over-Dependency Over-Dependency –Sons are favored financially & overly protected –Daughters are overly-protected Over-Protectiveness: Children controlled Over-Protectiveness: Children controlled Under-Protectiveness: Children neglected Under-Protectiveness: Children neglected

94 China’s Boy Bias China’s 1979 “One-Child” Policy to slow population growth: Resources Management vs. management of people China’s 1979 “One-Child” Policy to slow population growth: Resources Management vs. management of people Most Chinese families concur “If they can only have 1 child, it’s better to have a boy.” Most Chinese families concur “If they can only have 1 child, it’s better to have a boy.” Jan 96: 1.7M fewer female babies on birth records yearly compared with worldwide rates. Jan 96: 1.7M fewer female babies on birth records yearly compared with worldwide rates. by 2000: Surplus of 70M single men in China. by 2000: Surplus of 70M single men in China. Boys are investment in the future, prestige, genealogy. care for aging parents. Boys are investment in the future, prestige, genealogy. care for aging parents. A nation of adult but immature “Little Emperors” (Brats) A nation of adult but immature “Little Emperors” (Brats)

95 Male Bias’ Impact on Women Women are attaining more value in China, but as commodities than human beings; the New Trade: Women are attaining more value in China, but as commodities than human beings; the New Trade: –Kidnapping and Trading women for marriage –Trade, Prostitution –More serious in the rural areas Monica Das Gupta, Harvard University (Weiss, Washington Post) Monica Das Gupta, Harvard University (Weiss, Washington Post) –1 Mil + girls “Lost”: Selective Abortion –4 Mil “Disappeared” During first 4-6 yr of life –“Selective abortion is not substituting for female infanticide, but supplement it”

96 Treatment Considerations Match Client - Therapist Expectations Match Client - Therapist Expectations Must be Concrete-Practical to the Clients Must be Concrete-Practical to the Clients –Just attentive listening is not enough –Advise-giving is often expected(Concreteness!) Focus on Short-Term, Achievable Goals Focus on Short-Term, Achievable Goals Clarify expectations at mid-point to avoid disappointments later & unrealistic goals Clarify expectations at mid-point to avoid disappointments later & unrealistic goals Therapist Self-Disclosure expected Therapist Self-Disclosure expected

97 Culture & Treatment Revisited Bridge Culture & Psychology by dialogues Bridge Culture & Psychology by dialogues Involvement of cultural factor into parenting practices to prevent rebelliousness of teens Involvement of cultural factor into parenting practices to prevent rebelliousness of teens “Experts” Provide training of a variety of parenting skills based on the psychological principles that are compatible with culture “Experts” Provide training of a variety of parenting skills based on the psychological principles that are compatible with culture

98 Short-term Pastoral Intervention Establish Establish Realities of Pain & Suffering –Believe –Believe the Person with Pain: Victim? »Develop »Develop Empathy: “Beyond my own Pain” –Pain-Pleasure –Pain-Pleasure Polarity: “Recalibration” –Acknowledge –Acknowledge Hopelessness & Helplessness Prayers Prayers and Visitation: Accountability Encourage Encourage Networking with Cell Groups Prevent Prevent Drop-out: Reduce Shame

99 Long-term Professional Counseling After After the Crisis has Resolved but Conflicts continue: Frequency & Intensity –Physical-Sexual –Physical-Sexual Intimacy is reduced/absent When When “The Affair” stays (mental-physical) Personality Personality Disorders are Characteristics Depression Depression & Anxiety are Serious –Suicide –Suicide Prevention, Medication Management “Problem “Problem Child” Issue that persists

100 How to Make a Referral? ChristianMentalHealth.com Thoughtfulness Thoughtfulness makes Referral Succeed –“You –“You are too messed up so I can’t help you” –Problem –Problem is Chronic & You Ran out of Solutions After After the Referral: Your Care Continues –How –How did the week go? –Counseling –Counseling Helpful? Learned Anything? Establish Establish Link with Professional

101 Working with a Professional Issue of Confidentiality: Trust & Disclosure Issue of Confidentiality: Trust & Disclosure Issue of Fees: “Worth & the market place” Issue of Fees: “Worth & the market place” Issue of Dual-Relationships: Destructive Issue of Dual-Relationships: Destructive List of Three Names: What is “Christian”? List of Three Names: What is “Christian”? –Expect Doctor shopping & Blaming Making a Very Good Match: Making a Very Good Match: –Similarities: Spiritual-Cultural-Language –Gender-Matching: Case-by-Case


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