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Chinese Culture and Psychopathology 中華文化与心理病態學

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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 Purpose To Understand the correlations between culture and the common psychological disorders that are manifested in immigrant, Chinese-Christian Ministries. (1-hour general session) © Melvin Wong, Ph.D. Goals 1. To bring about awareness of Christian leaders & missionaries in cross-cultural work, noting the strengths and the pitfalls of Chinese-Americans culture to reduce problems with interpersonal relationships in ministry to further the Lord’s kingdom. 2. For lay-leaders and pastors to know how to address the inherent problems arising out of culture with Chinese-American ethnic churches in North America. 3. To equip and increase the cultural competency of counselors. Contents 1. An introduction to the specific psychological problems that Chinese immigrants face in America. 2. Husband and Wife Relationships: The Disorders involved with romantic relationships in Chinese families pre-maritally and post-maritally will be included. 3. Shame and guilt are some primary emotions most people have. How do these become the basic causes of codependency and dysfunctions in Chinese immigrants? 4. Specific Disorders of the Chinese families will be discussed including: Common Female Disorders Common Male Disorders Common Parent-Child Disorders 5. Some recommended treatment strategies will be used to conclude this seminar.

2 David Chow Mark Vegh Melvin 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 Paper 2: A Theoretical Study-presentation
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 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 (No differential diagnosis is required.)
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 Paper 2: A theoretical study-presentation
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 AM Instruction session 1
10:00 to 10:10 AM Break 10:10 to 11:15 AM Instruction session 2 11:15 to 11:25 AM Break 11:25 to 12:30 PM Instruction session 3

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17 River Culture

18 Chinese is a “River Culture”
Fate of survival depends “nature’s ways” Need for rain, sunshine, no flood, no pests Communities are important for survival During harvest time, floods and famines Harmony is important for survival Smooth interpersonal relationships facilitates work Non-aggressive (contrast with “Island Cultures”) Dependence on nature and conditions for crops 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 in life is to master the eternal balance of the three relationships between heaven, earth & men. Heaven-Earth-Person: Relationship & Love Based There is a God in Heaven: Sense of Justice & Fairness Parent-Child: Love analogous to heavenly love Ethnocentrism (Sinocentrism):

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

23 China: The Central Kingdom

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. Heaven-Earth-Person: Relationship & Love Based There is a God in Heaven: Sense of Justice & Fairness Parent-Child: Love analogous to heavenly love 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. Heaven-Earth-Person: Relationship & Love Based There is a God in Heaven: Sense of Justice & Fairness Parent-Child: Love analogous to heavenly love 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. Heaven-Earth-Person: Relationship & Love Based There is a God in Heaven: Sense of Justice & Fairness Parent-Child: Love analogous to heavenly love 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. Heaven-Earth-Person: Relationship & Love Based There is a God in Heaven: Sense of Justice & Fairness Parent-Child: Love analogous to heavenly love 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) Heaven, Earth & Person: 天地人 Life goal: Master the balance of the three Powers 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) Integrate People with nature & ergonomics (Yin-Yan) Spiritual Balance (陰 陽 變 數)

30 What is Asian-Canadian culture?
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 (Vietnam, Laos, Cambodia, Burma, Thai, Singapore, Malaysia, Indonesia) As diversed as we 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 In an interpersonal shameful situation, it is known as “hard to get off stage” 難下台 To help, provide a graceful exit: 下台階 Detested Characters (animal-temperament) Human-faced, Animal hearted 人面獸心 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 子承父業 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 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
Prince lived a life of pleasure within palace gate Noticed pain of peasants when outside gate Pondered about the sad human condition Personal guilt of pleasure that was for granted Social sufferings: Birth, aging, illness, death Bad things happen to you because you have done something wrong: “Karma” Death: Reincarnation: Good deeds

37 Tenets: Longevity, Transcend to Become a god
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: Diet, Qigong, Meditation By Practicing Special Sexual Techniques “Take from Yin to Compensate Yan” Virgins & Women used as means to an end to benefit the Men’s desire to have longevity “Return Sperm to Compensate Brain” Sex to benefit Men’s desire for longevity & stamina

38 Day Three

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40 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: Do as the king says, obey Reinforces dependency: “Emperor's new clothes” Hypocrisy: “Public self vs. Private self” “Self-identity” Externalized locus of control: Reduced personal responsibility The all-powerful king: analogous with god Deified king: Idolized-worshipped the king

45 Day Four

46 Order 2: Father and Son 父要子亡, 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 equals Kingdom government Generalized authority to the elderly: Wisdom Authoritarianism: Do as the father says, obey Reinforces dependency: “Must please father” Externalized locus of control: Reduced personal responsibility

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

48 Reciprocity-Entitlement-Empathy
Reciprocity (Family Culture Demands It) Duty > Personal Desire = Sacrifice; Payback Trauma Re-Enactment of Mother-In-Laws Entitlement (Takes It For Granted) Do It, Give It, Or Else! (Shame-Guilt-Injury) Empathy (Lack of) “Form > Will” Do It-Perform It-You Don’t Have to Like It 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 in command during father’s absence Facilitates family operations: Internally-externally Authoritarianism: Do as the brother says, obey Reinforces dependency: “Must please brother” 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 identity begins after marriage 三從: 在家從父 出嫁從夫 老來從子 Authoritarianism: Do as the husband says, obey Reinforces dependency: “Husband-pleasing” Externalized locus of control: Reduced personal responsibility Faithfulness in marriage: Wife must be chaste

51 Husband and Wife Relationships
Women suffer and sacrifice silently She becomes a martyr-sacrificial lamb of the dysfunctional family & inflicts the same pain upon her daughter and in-laws She copes by Denial and Resignation: “fate” Poor husband-Wife relationship is the norm 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 Level Description Manifestation 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. 1999-2001
Christ the King and His Children (Isaiah 9:6-7) Love and Sacrifice Father and Mother (Exodus 20:12) Love and Honor (Leave, Cleave becoming one flesh) Husband and Wife (Ephesians 5:21-25 ) Love and Commitment Parents and Children (Ephesians 6:1-2 ) Love and Acceptance Fellowship of Believers, Friend-Foe (1 John 4:11-12 ) One another love, Hospitality & Forgiveness (Mat 22:39)

54 Day Five

55 Guilt True guilt: Biblical guidelines & mandates
Absolute: Objective (conscience) False guilt: Imposed family-social values Subject to change: Subjective (conscience) 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 up-rooting, destruction of network Increases isolation and loneliness Timing is when support is needed the most Pre-mid-life crisis: May hasten crisis: Divorce Migration requires personal adjustment Polarize the gap between the well and the sick Increases coping demands: Breaking point? Exacerbates pre-existing marital problems Exacerbates pre-existing parent-child issues

57 Effects of Migration on Psychopathology
Men’s adjustment problem of ego & identity Underemployment causing self-doubt, prestige Women’s new found freedom & power Threatens “unhealthy balance” of marriage Intergenerational conflicts of values Role-reversal: English proficiency = Power First-born daughter controls the family First-born daugther made to doubt self-worth Ensure the authority of parents (mother)

58 Codependency 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, Filicide Poor Communication Skill “Cross-Talk; Over-Talk; Cover-Talk” Poor Limits, Intrusive Boundaries, Violations Gratefulness

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

61 Boundary & Limits Fuzzy Psychological Boundaries
Physical-Personal Boundaries aids Efficiency MTR, Queues, Zebra Lines 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

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

63 Christianity 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 Personal responsibility Long-term investment 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 & Success Driven (Greed): Can’t Fail Practical Measurements (Concrete Materialistic) Whoever has the most toys wins Symbols of prosperity and achievement Risks Takers: Short-Term focused Personal aggrandizement: Narcissistic bend There is no Moral Restraints: Self-focused 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) Anxiety-Repression: Socially acceptable disorder: Concrete Vs. Abstract Hysteric-Borderline Personality Disorder Features Vs. Full-Blown Disorder Object Relation Type of Disorders: Trust Issues Attachment Deficits: Trust Issues Attention Deficits: Narcissistic, Expansiveness

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

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

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

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

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

74 Culture & Parenting Skills
The Developmental Perspective 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 The First-born Child: The First Experiment

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

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

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

78 The Narcissistic Individualist in Disguise
When My face is torn, anything goes You Will never see me so cruel (words & deeds) What do people do in the dark? When no one’s watching? “Strong Family Tie” vs “Self-aggrandizing” 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. When I Go to Shenzhen, My Problems will go away. 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 Fuzzy Psychological Boundaries
Physical-Personal Boundaries aids Efficiency MTR, Queues, Zebra Lines 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 Sibling rivalry over inheritance & business
Family ¼Ò×å¹ÛÄî Familial-Centrism ¼Ò×åÖ÷Òå Family Isolation ¸÷¼Ò×ÔÃÅÇ°Ñ©, ĪÀíËûÈËÍßÉÏ˪ Lack of Community Care, Community Indifference: Public spitting, littering, poor public sanitary facilities. Family heritage & creed (family policy: Obey): ¼Ò½Ì Specific positions ¹Ãĸ, ¹ÃÂè, ¹Ã½ã, ¹ÃÕÉ, ÒÌÂè, ÒÌÕÉ Perpetual in-law rivalry: Ç×¼Ò±äÔ©¼Ò 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 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) ³Ô¿à ³ÔµÃ¿àÖп෽ΪÈËÉÏÈË 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 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 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 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. 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

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 husband when married出嫁從夫 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 ) 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 ʧÀñShame-Social Guilt-Familial Social Rituals, Protocols, Ceremony, Etiquette ÀñÒÇ Àñ½Ì Four National Virtues 禮 義 廉 恥 國 四 圍 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. 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 loss: Separation trauma, Life’s threatened, Individual-Family-Destructiveness Poor Communication Skill “Cross-Talk; Over-Talk; Cover-Talk” ÓÐÎÒ½²ÎÞÄã½² ¼¦Í¬Ñ¼½² Poor Limits, Intrusive Boundaries, Violations Gratefulness ÎÞ±¾ÐÄ Òûˮ˼ԭ

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

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 Codependency Over-Dependency Sons are favored financially & overly protected Daughters are overly-protected Over-Protectiveness: Children controlled 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 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. by 2000: Surplus of 70M single men in China. Boys are investment in the future, prestige, genealogy. care for aging parents. 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: Kidnapping and Trading women for marriage Trade, Prostitution More serious in the rural areas Monica Das Gupta, Harvard University (Weiss, Washington Post) 1 Mil + girls “Lost”: Selective Abortion 81-91 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 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 Clarify expectations at mid-point to avoid disappointments later & unrealistic goals Therapist Self-Disclosure expected

97 Culture & Treatment Revisited
Bridge Culture & Psychology by dialogues 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

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

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

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

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


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