Umesh Joshi | Ep #46| Do Conflicts with Cultural Identity Affect Mental Health?

consultations or professional medical advice hey guys i’m tasha hey listeners this is gooney and we’re here to discuss lifestyle medicine welcome everyone to day of the podcast so today we’d like to speak about how having conflicting cultural identities can have an impact on our mental health and to broach this topic we have umesh joshi a qualified counseling psychologist who is a member of the british psychological society and health and care professions council umesh welcome to our show we are super super excited to have this particular conversation and to have you with us thank you for having me i’m really excited to be here so welcome umesh cultural identity has been really tricky because growing up in a household where inside of it the culture is you know south asian or sri lankan in this situation but when you step outside it’s an entire different culture and so forming your own cultural identity it has just been tricky and so is this something you see in your practice um when we think about some of the young people or some of the adults that i see in my private work it is often to do with identity and that can be conflicting identities to do with sexuality race ethnic background all of those different things what’s quite common is that there can be a conflict between how one’s family identify which aspects of your family that you identify with but then actually the aspects of identity and culture that are your own and maybe separate or different from your family and i think that can feel really tricky to navigate because i think as human beings it’s important for us to have a sense of belonging and to feel like we’re a part of something to feel like part of a group or part of a tribe and i think to feel like an aspect of us or all of us is going to be rejected it’s almost like well then where’s my tribe and where do i belong and who am i then if aspects of me or all of me isn’t accepted or acknowledged that’s a critical point that you you brought up being part of a tribe and so if you don’t have a sense of identity to something you you’d feel misplaced displaced and generally people are always born into a family right so then there’s a high chance that if you don’t connect your family then immediately that you’ll start feeling those those experiences as well yeah completely and i think when we think about what identity is if i have like more of a textbook definition that it’s kind of self-defined characteristics that can be like personal psychological or relational and not completely shared with another person and includes a range of social roles but then to me that immediately leads on to me thinking about well actually that is then self-defined completely right and then that makes me think about somebody’s cultural context and culture which is again if i look at like a definition like a formal definition from a textbook it would be like integrated patterns of human behavior including thoughts communications actions customs beliefs values institutions of race ethnic religious and social group which is so broad but essentially what that saying is is that you are your own individual um yes so this textbook definition sounds very overwhelming right because there’s like so many different aspects and as you said like there’s factors that influence identity and is basically very unique to the person um there’s a study that came up uh from the national library of medicine on cultural identity uh conflict and psychological well-being in bicultural young adults they concluded that elevated cultural identity conflict was positively associated with emotional distress and psychopathological symptoms and negatively associated with satisfaction with life which basically translated in lower self-esteem um is this something that you see psychologically speaking in in terms of your mental health in your practice it really depends on the individual’s experience what i’ve noticed not only within myself being second generation immigrant south asian background it depends on where you are at what time so for example for me personally there were experiences of being not brown enough for the brown spaces and not white enough for the whites faces which can feel really confusing and conflicting and i think what i’ve noticed within my client work as well without speaking about any client specifically is that it can be really easy to cherry-pick aspects of ourselves so okay which aspects of myself am i going to bring to this space and which aspects of myself am i going to leave behind for example for a gay or queer south asian man he may bring more femininity and more of that vibe to a gay space or in a space where he feels more safe or comfortable with friends or in a club whereas that may not necessarily be the case amongst family and friends so yeah i think that in itself can lead to anxiety shame stress internalized homophobia if somebody is a gay person um internalized transphobia for a trans person or even internalized racism where we actually end up hating or resenting the parts of ourselves that don’t align with what the society that we live in expects from us i think that can then actually also lead to physical health symptoms because that then leads to thinking about how we express stress and anxiety and shame in different spaces and different cultures but then so say for example someone was queer where you can express your femininity in a club and it’s accepted versus you can’t be that self at home because your dad might not like it so it looks like you have to be different in different settings right and that sometimes i have to do this because you have to like adjust yourself and become this chameleon without even noticing you you’ve changed right you sound different you carry yourself different that bit the fact that you’re you know changing those head which might sound a bit like a say bipolar somebody’s bipolar because you’re kind of changing personalities i used to call myself that when i was younger not knowing what that meant right when i was a kid i was like i think i’m bipolar because like i’m this person here and that person there right when i realized i was like uh that’s not the right term to be using yeah well i’ll call myself like a split personality it looks and it feels sometimes that way because there’s a whole part of your being or your personality that you hide or you ignore or you don’t want to show and you said like it’s internalized racism or it’s internalized whatever because you know that factor will not be received with honor and so that aspect of changing what is the what’s the impact on your body and your your mind yeah that’s there’s a notion in psychology called splitting where you can separate aspects of yourself where you might kind of identify in one way or more closely with one group at one point in time and reject the other and switch the other way which is also a possibility and when we do that what we do is we kind of split ourselves and we can feel quite torn and that can lead to frustration anger resentment that can then lead to difficulties within our interpersonal relationships that we have with family and friends and i think that can feel confusing for the people around us because actually they don’t necessarily understand what we’re contending with or what we’re battling with um and ironically they may be battling with those same things themselves right but i think when we don’t have the language or the vocabulary to think about actually what is the impact that this environment is having on me we start to then blame ourselves and think well there’s something wrong with me or i’m doing something wrong because i’m not aligning in the way that i should be with this space or that space and i think that then comes back to shame right i mean on that point i can completely relate to what you’re saying because i’m malaysian indian and in malaysia there’s like multicultural society right so growing up here and in the states for a bit so then i have this like other dimension to me right and so i have this conflict because there’s a very communal sense of like upbringing in my household and my family but when it comes to like the greater good for the community which is very much a south asian i guess theme that that we see right and you’re not doing something that is beneficial for the entire group then there’s this conflict you’re battling like how do i exert my independence and but still share the values that everybody else in the group shares with me right and the funny thing is i’ve noticed that the generation above me they struggle with that with the older generation but then they impose the same thing on the younger generation so i’m like where is the line how do you express that yeah if i revisit the notion of splitting and i think it’s more of kind of like a defense mechanism that allows a person to tolerate difficult and overwhelming emotions by seeing something as good or bad or idealized or devalued and it makes it easier to then manage those emotions and i think that like you said where’s that line between and how is that then passed down essentially on some level that’s what intergenerational trauma can be informed by is the maintenance of patterns and ways of behaving that are unhelpful or unhealthy for a family or a system but it’s continued because that’s what’s known to be normal or acceptable yeah and i think i’ve come to a point where i even wonder if the splitting bit is actually bad because people who are and success looks different from one person to another but say financially successful are people who know how to you know navigate those crowds in a way that are benefiting them in a financial sense uh so you’re able to build trust with like say you’re in a room with investors and say majority are a white male you being able to speak their language and and that will create a sense of trust but you’re not being your full entire self or you’re suppressing some of those sides and you’re as you said you’re splitting yourself but then you go at home and they’re having a discussion where there’s an accent that comes out and then you pull out that accent because you don’t want to stand out and they accept you for your accent i’ve come to a point where like it has benefited me to a certain extent or or maybe i chose to see it as a positive or i suppress the whole thing um it’s by having these conversations like with the podcast and and speaking to people who are from these similar backgrounds where you’re like actually is this really good or is there a positive aspect of splitting and or or is it only negative so have you heard of the phrase code switching before code switching please go ahead enlighten us so it’s sometimes referred to when people switch dialects or styles or registers and ways of speaking um and so people who speak like more than that one language for example multiple languages may switch the way they communicate when conversing with different people and i think i’ve noticed myself do that too so when i’m at work or when i’m in more of a formal setting i may speak more similarly to how i’m speaking now but when i’m speaking to my mom i’m probably gonna speak a mix of punjabi and english or when i’m speaking to my friends from like my hometown where i grew up i noticed myself slip back into that accent because it’s just so familiar and safe and i don’t do it consciously but then when those friends hear me speaking this voice it’s like oh who’s this guy right yeah and i think code switching is probably helpful and it makes sense because it would be it fits and it has to fit in different contexts like it wouldn’t be helpful for me to and i want to speak punjab you know i want to speak that language so if i was speaking in that way in other contexts it just wouldn’t really make sense so i think like in some ways it’s really helpful and necessary but then in other contexts i suppose what it the splitting aspect and the code switching aspect are two different things splitting is more of a rejection and trying to devalue something and value something else whereas the code switching is more logical like it makes a bit more sense it’s more of a kind of a survival mechanism i suppose yeah and i think that that’s that’s a great nuance to bring right code switching versus splitting because i do sense sometimes when i’m code switching a sense of splitting because i do feel like oh i know i’m not being my authentic self in this situation because i have to code switch and i know i’m dimming my south asian heritage because i know it’s not going to be accepted i hear about this a lot as a psychologist that works with clients for therapy but also as a human being outside of that and within that context when i think that other people who have similar experiences and backgrounds probably feel more comfortable code switching in front of those who get it versus those who don’t and that can then bring a sense of safety and community and that then informs the people we choose to spend time with then etc etc right and i guess to look at the flip side of this in the context of saying accents right how we switch accents the funny experience that i experience is when people put on an accent here right it’s my home base there’s a lot of judgment because people they’re like oh don’t put on your accent here because you’re not better than us and so there’s this like reverse that you experienced and as you said earlier on like you’re not quite brown enough for the brown community but you’re not quite white enough for the white community and it’s it’s strange because in malaysia for example you’re not seeing white people everywhere but it’s like in the brown community there are pockets of like oh you’re a bit more like exposed and you’re you’re more like a rural or like you know um village like if that if that’s the right term um and so do you see this as an experience that your clients maybe experience as well maybe in their home setting absolutely i think it’s such a big part of of that experience for second generation immigrants because some people who are second generation immigrants their parents may not even speak the language or know the language and then if you’re being educated in england for example which i’m based and academically you’re doing really well and then you go to you know let’s say somewhere like oxford the language and the way you present yourself and the way you speak is going to be completely different to the way that you do with that parent at home and then if you do come home with that accent how is that person going to then respond or perceive that what does that mean like will they be prideful will they be proud because actually you’re they’re seeing that growth and that change or are they going to be ashamed or frustrated like you know you just don’t know there’s so much judgment i feel and it’s side with shame because they like make you feel um ashamed for not embracing your culture and at the same time they don’t quite want to let you embrace the other culture either so it’s like where do you want me to be there’s also that sense of they want you to succeed they want you to do well they want you to assimilate and be successful but then to assimilate and be successful means that you on some level have to break free from the barriers and the constraints of the culture that your parents may come from yeah 100 and i think that that’s their own conflict that is then apparent in that dynamic right because they are going through their own cultural identity crisis or definition and then yours in the mix of it is just chaos testing them everyone’s tested i guess and then because like as a parent you want your child to be able to identify themselves with you and vice versa and then when there’s like these small elements your accent or the way you dress like the dress is too short you’re showing too much and and then you’re like well the thing is that i’m growing up in this culture where this is normal so get with the plan and in england is such a complex landscape to understand identity because there’s a lot of diversity it’s easier to sit comfortably with your differences because everyone’s so different whereas when you start going outside there’s more clusters and it’s about fitting in even like when you walk when the majority is white your identity as a british person or a swiss person in my context is always questioned yeah when i was younger i’d say i was seen as indian walking down the street either as british or which then also led to experiences of racism right but then as diversity increases i imagine i may be perceived as like a british indian person but then at the same time i may well not be depending on how old that person is and what their context is yeah so we covered like how the emotional symptoms that show up like anxiety shame guilt judgment and that’s that’s the stuff that comes from the mind right um do you see in your practice that these cultural identity issues showing up in the physical sense is there an impact on the body that you can spot mental health does have a impact on physical health and i think the way that that’s shown in even within a family system for example can look different and that again can cause conflict and confusion so for example in certain cultures people may be more likely to express emotional distress through headaches or saying they have a headache and physical symptoms such as you know some people end up developing ibs um because of how anxious they are and how much they struggle with their you know with managing their emotions some people experience nausea or sickness and but then if we think about more extreme manifestations of difficulty that might then be anorexia or you know which is more prevalent in western cultures than in other cultures but i think the physical symptoms of anxiety and stress are definitely present when i work with people and because the experience of that can be so different for each individual that’s not necessarily understood within family systems which can then lead to more conflict and confusion because again an older person or a parent might experience distress in a more physical way because that’s how they’ve learned to manage well that’s just how their body manages their psychological distress whereas a younger person might be crying out for support in a more obvious way to do with their psychological slash mental health but it’s not received well because it’s not through the same domain that that system is used to responding to distress definitely i and i completely relate to that in the observation in my own family as well and i mean i think all of us have grown up in a house where there was some sort of like background indian drama series playing and i can tell you one thing for sure that there will be a scene at some point where there will be like a disagreement with between family members and then the mom would fall and you know be bedridden basically because she’s so ill from the decisions of her children you know and it really encapsulates what it means to have physical symptoms that actually are on the mind right my blood pressure is rising like stop doing this it’s like i’m gonna have a heart attack because of you and and the thing is that sometimes it’s true it’s true and that’s quite a frustrating position to be in for the person on the receiving end because it’s like oh okay well i’m just telling you the truth and you’re about to have a heart attack and you’re gonna die because of me yeah and so you can’t express yourself i think that’s what’s so difficult as well because i think the difference between western cultures and like south asian cultures is that western cultures are a lot more individualistic and how they manage distress and how they look at differences even within families in a western context it’s like well that’s your problem not mine yeah whereas i think in eastern cultures and south asian cultures it’s a lot more like if someone is distressed that’s held by the family system and the family network what are we gonna do about this this is how we’re gonna handle it and whether that’s what you align with or not you feel like you have to and because your actions and your behavior have a direct impact on the on the mental health of everybody else involved and i think that’s a lot of pressure to hold and there’s pros and cons to both ways of existing within a system but i think at the same time it’s important that we’re able to acknowledge both and choose one that works for everybody but those those are really nuanced and difficult conversations to have that families often don’t even think about or have time for right it’s time and that’s the knowledge the right because the ignorance around it is is a thing um when you go in and say let’s have yeah let’s go and have a chat about this with my dad and you’re like what what nonsense are you speaking about like just have some water sleep a bit more and you’ll be fine and so it’s just even having those conversation with people who don’t even know that this is a thing is the added layer of complexity and i really like the fact that you are putting out this like individual versus community-based societies and so in a societal kind of way one person’s problem is everyone’s problem that complexity and how it creeps in into your mental health and how you navigate you know your life it’s like oh why are you worried why are you stressed oh because my mom is you know right and people an individualistic culture would say was well just like it’s not your problem like get with it and focus on your work this reminds me of a very important point in seeking mental health services from a psychologist or a counselor that the person is giving you the service they need to understand the context that you’re coming from and i have had caucasian or inexperienced counselors with cultural complexities and they’re just like well if you’re angry leave your household if you’re upset with your mom stop talking to her i’m like that’s definitely not on the table i’m not coming here to tell you that i don’t want to speak to them i want you to give me a solution to navigate this and they’re just like well it doesn’t make sense that you don’t want to leave a situation that’s difficult for you and i’m like that doesn’t make sense that you don’t understand where i’m coming from you know the fact that i was lucky to have like a family member who was a psychologist who gave me this context beforehand so i knew that i could fight for this you know but so many people go seek therapists in where they have this sort of complexity in their in their home and they get this sort of advice and i worry for all the south asian um younger generation i think it’s not just south asian it’s actually the bam communities yeah you’re right sorry they all can relate to this and that aspect of having access to a psychologist that gets this in england is basically if you get one who gets it then you’re really lucky it’s frustrating in the sense that if you want to find actually someone who gets it then you have to go on the private side and have to pay for it which is not really fair yeah completely and it just makes me feel really sad thinking about that because that actually adds to the conflict that we’re talking about of you know i’m in this white society with this white woman telling me that this is how i need to be responding to my family and you know maybe that does work for some people you know i can’t say it doesn’t because i don’t maybe it does but at the same time i think there’s like the conflict that you spoke about is so prevalent for so many people right and it’s like you know not talking to my mom isn’t an option but how do i navigate that situation or that relationship that still allows me to be authentic and truthful to who i am yeah whilst having enough boundaries within that relationship to protect myself right essentially that’s what i’m hearing from what you said and i think that often psychologists and therapists speak from the place in which they are in their own life in their own context and i think that’s important to mention because we’re human beings right and even though you may come to us for advice and support and perspective we’re trained in different modalities we prefer working through different therapeutic modes we have our own life and lived experiences our own life and lived experiences are diverse in their own ways and i think that it depends very much on that individual person there’s something there’s a theory called the social graces it’s a systemic theory which looks at all the different aspects of identities such as sexuality gender culture age socioeconomic status all these different aspects of identity and i think one of the advantages of thinking about that model is that actually it thinks about all these different layers and all these different parts of identity but then again one of the criticisms that i have for that model is that it doesn’t think about intersectionality and it doesn’t acknowledge that actually i might be this this this and this and then how do i navigate things according to that context could you just like briefly explain what intersectionality is for people who don’t know what that means yeah so intersectionality is when you belong to more than one group that may be marginalized so for example so intersectionality would include like multiple minority distress which means that you’re not experiencing distress just from one context of your identity it’s multiple contexts so not only the context of being a south asian immigrant but also the context of being a gay person and actually those are two different things that are bringing two different stresses that also then interact with one another and when you start adding all those different layers it becomes really complex right and that’s when we start thinking about microaggressions and you know those things that people may say that they may not mean to say but it’s actually well they may not mean to be offensive but it is offensive about culture and identity and it can be a lot to manage yeah it’s it’s heavy and like it’s multi-layered it’s complex and just to touch on your point the lived experiences of the counselors and psychologists that you see also impact the quality of the the service that you receive and so if they’re from a rural area and you’ve lived all over the world i don’t think that’s going to be a good match right now so now we’ve identified we’ve we know it’s a complex issue but how do we find solutions to navigate this dilemma and this complexity what would you say are three practical methods that one could like apply in in their lives as you’ve acknowledged it is complex and there’s so many layers to this so i think the first thing which isn’t necessarily an easy thing to do but it is doable is acknowledging what the conflict is and when you became aware of the conflict and a practical way of doing that would be either talking to someone you trust a therapist or even talking out loud to yourself to help you structure your thoughts um or even journaling about it i think that can be a really helpful way of making sense of conflict and not thinking too much about it i think when it comes to journaling people up feel like they have to be like dear diary this is how my day started whereas how i choose to journal is just free flow of thought like this exactly how i’m feeling in this moment i’m just going to write whatever comes out and then i choose not to read it back because when i read it back i feel like i go back to that place it’s like no i’ve got it all out i’m going to let it go i’m going to put it aside so i’m going to alleviate myself from whatever that was for me and then acknowledging when you became aware of it thinking about how that then impacted your mood and your body what did that conflict start to do to you in different contexts and in your different relationships and again this can be hard to do because this may have been present from a really early age but i think what we do when we do this for ourselves is we start to notice the nuances in our conversations and when we do code switch and how does it feel to code switch and when we are splitting and rejecting aspects of ourselves why are we doing that what does this mean how can i bring in the part of myself that i reject so it still has a space that isn’t necessarily as prominent as it needs to be but it still exists within me as i am i know that’s very absolutely yeah no no no i think it’s amazing yeah yeah and what would be your third one i know this is such a blase thing to say but just allow yourself to be yourself in a way that feels safe so if if you don’t have a community around you that you feel like you want to connect with but can’t connect with in a safe way have a look online like look on youtube look on other social media websites to develop that sense of connectedness and community and knowledge and understanding develop the language that you want to develop that can be hard to do when you don’t know what words to type in but i think if you think about your base experience so for example um managing stress as an indian person or just managing stress or you know how to accept aspects of your identity you might come across things that are unhelpful and potentially dangerous but i think make sure you’re looking at credible sources credible people think things with references from psychology or people who are versed in what they’re saying i think there’s so much false information out there it’s really important that you look at concepts and information from trustworthy and reliable people yeah i think that’s that’s a very important aspect to make sure you get your information from the right sources but also being able to label what’s happening with you or so that you don’t feel alone in that experience right because that can usually happen when you’re like maybe i’m crazy you kind of dumb down your experience and it’s like oh it’s yeah just you know one of these days and and you brush it off but actually it’s a thing and there’s a word for it most likely and so it’s just easier to cope as well right yeah completely because then you’ve got a rationale and a perspective that allows you to put things into context um but if you can like i also said like talk to someone acknowledge it find a way to acknowledge it think about the shift and that you’ve experienced in yourself since becoming aware and find ways to connect with people who may understand your experience put yourself out there go to festivals that you may not normally go to you know just do things great yeah that’s a great idea well thank you so much image that’s like practical tips that we can actually take away um and and as we always conclude our conversations we have a couple of rapid fire questions um and so the first one is what is the first sign that you notice when you are out of balance um not feeling content that’s deep yeah well it’s a deep question so you know and so what is the method of coping for you when you’re out of balance or feeling uh discontent i’d say i kind of stop pause reflect talk to people i trust journal meditate i just start doing all the things that i feel like my body and my mind needs because i there’s only one me so i’m going to look after me first yeah i like that um and the last one is what has been a book that impacted your approach to well-being or wellness this is probably going to sound like a cop-out but i’m going to say my journal because that’s really helped me a lot to put into perspective what my blind spots are and what the patterns of my behavior are and how frequently and i know i’m a psychologist so i’m able to think about it from that point of view but i think that also the more i journaled the more i became aware of what feelings i was bringing to the paper and so i think doing that first thing in the morning and just letting it all out and starting my day almost afresh allowed me to then put into context what i needed to do for myself that day or thereafter that’s very powerful yeah i love it well nobody would have access to it though but they can create their own they can right exactly i hope no one ever reads my i’ll meet you my god i would cringe so much yeah but it’s valid points and it’s just we shouldn’t it’s our process it’s a process right we’re not a finished product so yeah well this has been great image i think we could speak for days on end about topics like this with you and with you because thank you so much for inviting me it’s been an absolute pleasure i’ve loved every second of it and yes i would be more than honored to be back on another show thank you if you enjoyed this episode go ahead and select that follow or subscribe button for now stay safe and we’ll see you next week you