How to cope with racism-induced stress

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Jason Wu, PhD, is a psychologist with a private practice in the Bay Area.

Researchers have found that pandemic experiences of racial discrimination were associated with higher levels of anxiety and depression. This was certainly true for Asian Americans and Pacific Islanders during the past few years, who endured bigotry and racist attacks after President Donald Trump labeled the coronavirus the Chinese virus.

As an Asian therapist, I witnessed firsthand the effect xenophobia and racism had on my community. One client said they started to question whether moving to America was the right decision, as they hadnt realized that racism toward Asians was so prevalent. Another talked about the hours they would spend scrolling through videos of hate incidents, feeling angry, anxious and hopeless about the future and the potential for change. One client even said they started to carry a pocketknife when they went out in public.

Before the pandemic, about 20 percent of my clients were Asian-identified individuals. Now its closer to 60 percent. Bango Gancinia, a psychologist in Utah, said he has more such individuals coming to therapy and with higher levels of distress than his other clients.

Im seeing more Asian clients in my practice, but the reality is that Asians tend not to seek mental health help. The National Survey on Drug Use and Health showed that in 2019, 7 percent of Asian Americans sought mental health services, less than for almost any other racial group. By comparison, 20 percent of non-Hispanic White adults and 10 percent of Black and Hispanic adults seek mental health care.

Only 3.3 percent of psychologists are Asians, even though Asians make up 6.2 percent of the US population. This has left some providers, including myself, overwhelmed by the large number of patient requests and unable to work with everyone who contacts us.

Despite these issues, it feels like a watershed moment. Many Asian individuals, young and old, are opening up to therapy as well as explicitly addressing the mental health consequences of racism.

The long, ugly history of anti-Asian racism and violence in the US

Shuyun David Lo, director of psychiatry at the University of California, Santa Cruz Health Services, said that hes seen it, too. More Asian students are coming in to address the anxiety they feel about their safety and that of their elders, as attacks on Asian elders have been well-documented by the media.

In his practice, Gancinia said that not only have young people been more vocal about their mental health needs, their parents have been more responsive and are taking them more seriously. And adults have shared that they have been wanting to try therapy for a while, and current events have been so stressful that they finally decided to seek it.

Every person of color in the United States has experienced some form of bigotry. Here are some of the things I tell my patients to help them cope with racism-induced stress.

Be proud of who you are and where you come from its good for your mental health. Developing positive feelings toward your ethnic group, learning about your cultural heritage and history, and feeling secure in your ethnic identity can protect your self-esteem even amid high stress from discrimination. For example, one of my Asian patients feared seeming too Asian for their efficiently White community. They would accept being the butt of racist jokes to fit in, not bring certain foods to school, and would go to their White friends houses rather than invite them over, as they were embarrassed of what the friends might think of their familys behavior.

Once they began to embrace who they are more fully and develop a stronger sense of ethnic identity, they felt less ashamed and fearful, and more confident and assertive.

The power of reclaiming my Asian name

Cultivating a secure sense of ethnic identity can involve reading about Asian history, volunteering with advocacy groups, de-stigmatizing therapy in your community by talking about mental health, or even binge-watching Asian movies.

As a psychology nerd, I take pride in recognizing that the popular concepts of mindfulness and acceptance have roots in Asian and Buddhist traditions that have existed for thousands of years. Thats right, we were meditating before it was cool.

Some of my clients, after experiencing an act of racism, criticize themselves for not responding. One of my patients was called a racial slur and was shocked into silence. Later, they were frustrated with themselves at allowing racism to go unchecked. They discussed feeling pressured to represent the entire Asian community in that moment, especially in an effort to combat the stereotype that Asians are submissive and unassertive. Not saying something felt deeply disappointing and shameful to them.

I understand why some, like my patient, think racism should be confronted, but that places an unfair burden on the victim. There are costs to both confronting and not confronting a perpetrator of racism. If we dont confront the perpetrator, we may feel shame and guilt and ruminate excessively. If we confront them, we may face social and employment repercussions, or worse, threats and violence. Jeopardizing your safety is not healing.

Yue (Brian) Shi, a psychologist in Davis, Calif., was at a supermarket in the early days of the pandemic. A person stared at him in a way that made him feel targeted and unsafe. Shi then decided to shop online. Rather than beating himself for not confronting the threat, he recognized that there was resiliency in finding alternative ways to cope with racism that did not compromise his sense of safety.

In responding to racism, choose what feels right for you.

I remember walking with my dog, and, through my headphones, I thought I heard someone yell the lyrics to Gangnam Style, a South Korean song. I didnt see anyone. At first, I was confused, then angry. I even came back to the street on my way home to see if it would happen again.

I told my friends about it; some were similarly outraged, but others questioned whether I had misheard. I initially felt angry at those who questioned my experience. Later that night, I found myself lying awake, wondering if I was acting foolish.

Teaching Asian American history in its complexity can help fight racism

Learning about racism-related stress, however, has helped me contextualize the situation. In such moments, we are not responding to just one act of racism we are carrying a lifetime of being hurt by racism.

So don’t litigate what happened, but validate the feelings that were triggered. I might have misheard, but my feelings of anger and hurt are still valid.

Self-compassion can buffer the effects of racial discrimination on depressive symptoms. Individuals can also use culturally specific variations of compassion exercises that are consistent with their cultural backgrounds, as that can increase the effectiveness of the exercises.

One example is the Buddhist practice of metta meditation, often translated as loving kindness, which focuses on cultivating feelings of compassion and love for ourselves and others. Practicing regularly can reduce anxiety, depression and stress, and it doesn’t require much time; you can try a seven-minute metta meditation here.

Seek out a BIPOC therapist

Research shows that mental health services tailored to culturally specific needs can greatly improve the treatments success. Interventions targeted to specific cultural groups are four times more effective than non-culturally specific interventions, while interventions conducted in native language clients are twice as effective as interventions conducted in English.

There are even Asian-specific therapist directories to help clients find therapists who understand their culture, and fundraisers to support Asian individuals becoming mental health professionals.

Finally, remind yourself that change happens slowly and across generations. Most importantly, Asian therapists and clients are ready to talk now, so lets keep the conversation going.

We welcome your comments on this column at [email protected].

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