Trio of Discussant Responses to 2020 Lecture with David Eng
By Meiyang Liu Kadaba, Psy.D., Loong Kwok, Psy.D., and Sahil Sharma, Psy.D.
Background:
In the fall of 2020, NCSPP (Northern California Society for Psychoanalytic Psychology, the local affiliate of APA Division 39) invited David Eng to give its annual lecture. The event centered David Eng and Shinhee Han’s 2019 book, Racial Melancholia, Racial Dissociation, which delves into literary and psychoanalytic work with Asians and Asian Americans. For more information about the event, visit https://www.ncspp.org/events/annual-event-and-lecture-2020.
During the second half of the event, the three of us presented our responses to David’s lecture. Interwoven are our personal stories as Asian American psychologists, our work with our communities, and our varied experiences with psychoanalysis. The notes of our responses are included here, having been lightly edited for readability but largely remaining true to how these notes were presented at the time. They are shared here in alphabetical order of authors’ last names.
Meiyang’s Response
When I was preparing for this panel, I wondered if I should present a case, share my dissertation research, or talk about my current work as a teacher and supervisor. As an Asian American clinician who’s worked with numerous Asian American clients, research participants, and students, David and Shinhee’s ideas resonated across the spectrum of my experience and made it nearly impossible to know where to begin. For a time, all my beginnings led to dead ends. Then I realized that they all led me to the same place - the very theme that echoes throughout their book - which is my own state of melancholia and dissociation when I think about and work within psychoanalysis.
From my first class in psychoanalytic interventions, I was hooked. I marveled at how the ideas I was encountering could touch so deeply on the primal, vast, yet unified core of human existence. Between the lines, for the first time, I found a place where the love for Chinese language and history that my grandfather, my 姥爷 (colloquial Mandarin term used primarily in the Northeastern region of China for maternal grandfather, pronounced “lao3 ye2.”), instilled in me as a child growing up in Northeastern China could exist right alongside the thrill of discovery and experimentation I found as an adolescent 1.5-generation immigrant in the U.S. Ideas about play, spontaneity, creativity, and the unknowableness of the unconscious sparkled with promise in the potential space between people’s subjectivities.
But at the same time, these ideas never quite landed within me as they seemed to for many of my White American-born classmates. For them, it seemed that discussions just clicked into a place that felt fitting and comfortable, whereas the lenses that I was looking through always showed me two images, two interpretations, two possibilities - and through them, hinted at infinite more. I was encountering the “double consciousness” that W.E.B. Du Bois wrote about, in a space I was trying to make my home. The more classes and training I attended in psychoanalysis, the more questions piled up in the back of my mind, questions I’m still trying to understand and answer. Many of these wonderings are reflected in David and Shinhee’s book and resonate with what I’ll speak of today. I share these not as an academic, navel-gazing exercise, but to try to highlight the necessity of “reappropriation” in the way that David and Shinhee have done - of the very theoretical tools that we’ve chosen in our healing work, as well as how we acquire and practice them - and to emphasize:
…how the liberating potential of psychoanalysis must be freed from the chokehold of a too-narrow version of human experience that perpetuates social structures of racism, heteronormative patriarchy, and exclusion.
Some of these questions come up whenever I encounter a patient who shares my language or aspects of my cultural upbringing. The racial ambivalence within, and between, us is often immediately introduced into the room as we negotiate which language to use (or, more often, when and why to use each language), what imagery and metaphors can be shared and understood, and what different set of hierarchies and expectations may bind or blind us in important therapeutic tasks. As I sit with my Asian American clients, we float into a “psychic nowhere” (term by Eng & Han) together that at once feels like home, but also transgressive and migratory, like that of the young clients they describe.
We’re estranged from both worlds, the language of psychoanalysis making us strangers to our origins, and our Asian Americanness leaving us without anchor within psychoanalysis.
Other questions came up as I interviewed my dissertation subjects, whom I called “transnational left-behind children.” These were fellow Chinese American young adults who, like the parachute children described in David and Shinhee’s book, experienced prolonged separation from their parents during their process of immigration. I wanted to learn more about how these young people maintained important attachments across caregiving situations, cultures, and continents. What I heard didn’t fit neatly into familiar theories that assumed a constant nuclear family, successful development through separation, and letting go as healthy mourning. Instead, I found enduring and evolving narratives of selves-in-relationship. These narratives originated in the interviewee’s families and were often anchored in cultural ideals of sacrifice and duty. They were reinterpreted time and again far beyond what’s typically considered the interviewees’ “developmental years,” an ongoing process that both lent them strength and masked repeated losses.
The spaces in which we learn, teach, and consult with each other raised yet other questions for me, questions about what kinds of - and whose - legitimacy, labor, and subjectivity are privileged with rights of property. These questions feel particularly significant now, as we grapple with a destabilizing democracy, disease and destruction, and uprisings for racial justice that have rightly awoken us from our colorblind dream, including within our own field.
As an Asian American person of color in psychoanalysis, I’ve experienced “the problem” of deeply embedded racism. As a trainee, my countertransference to a female Asian American client was repeatedly faced with skepticism and blankness by an older, White, male supervisor. As a prospective applicant to a training institute, I’ve been told that my questioning of a psychoanalytic program’s lack of attention to racial harm was a symptom of my own anxiety and defensiveness. Most recently, our (i.e., NCSPP’s) ground-breaking course specifically for clinicians-of-color this past summer was forced out of our institutional Zoom space to make room for another event, a dismissal that I’ve felt more than once in my time within professional structures of psychoanalysis.
Each time, the wounds of being an alien - which was literally my label as a young immigrant, incomprehensible and dismissed - are picked raw again and felt anew.
I also recognize the ways in which I have been “the solution” to racial violence against Black and Brown communities by staying silent. Such was the case last year during this very event (i.e., 2019 NCSPP annual lecture), in a conversation about racism against Black men and boys. It was a silence I noticed was shared by many other Asian American colleagues in the room. After the event, some of us gathered to discuss feeling caught between our true selves and the false self of the traumatized and triangulated model minority. We continue to gather in order to break through this anxious wordlessness, resulting from what I see as an attempt to mimic a White male psychoanalytic superego.
We do so with the hope to stop reinforcing our own aloneness and invisibility and leaving the burden of speaking on the shoulders of our Black and Brown colleagues.
Author’s note: After the 2019 lecture, a group of AAPI-identified psychoanalytic clinicians, mostly based in the San Francisco Bay Area at the time, responded to my call to gather and examine our experiences at the event. We continued to meet monthly for about two years through the COVID pandemic, racial uprisings sparked by the George Floyd murder in summer 2020, and the wave of increased anti-Asian hate in 2021.
The Division 39 presidential trio wrote in a statement this past June, “As psychoanalysts, we acknowledge the ubiquity of unconscious influences in ourselves and others, including unconscious racial biases, in addition to conscious and overt biases.” Ever an immigrant, I feel both hope and weariness at this challenge ahead. I believe the urgent task we face is to turn toward psychoanalysis - including ourselves, our theoretical tools, and our systems of relating - as the troubled client, dissociated from and defended against its own history of marginalizing and harming the psyches of racial minorities. I believe that we racial melancholics in the community, in our “absolute refusal to relinquish the racial other - to forfeit alterity,” hold a key to psychoanalysis’s wholeness. But I want to see us invited into spaces that recognize their own inherent inequity and are committed to true transformation. David and Shinhee have asked us how it feels to be “the solution” and the “failure to be the solution.”
In turn, I want to ask, “How would it feel to refuse to be the solution?”
The choice to raise our voices in community about our field’s marginalization of entire ways of being may provoke fear, anxiety, or a sense of threat. But in doing so, we would be invoking the radical heart of psychoanalysis, an act more urgently needed now than ever.
Loong’s Response
My first sense of being Asian-American was when I was 23. I had moved to San Francisco for graduate school, and went to watch a movie. In the theater was a space that was being used to host a dance party that was attended exclusively, or so it seemed, by Asian-Americans. It was my first experience being in a crowd of people who looked like me in the US. I was unsettled.
Before that moment, I was not unaware of the fact that I was different, but it was a private difference. A personal one. In college, my nickname (among one group of friends) was “Asian.” It was said with love and I felt no harmful intent. It was my name in the sense that it is a word that pointed to me and only me. I was not actually the only Asian person in New Orleans, where I went to college, but it felt like I was. Like if someone was to shout “Asian” in a crowd, I would be the only person to turn around.
It was an inverse interpolation; a word that applied to over a billion people only referred to me.
Coming to San Francisco, in a sea of black hair and epicanthic folds, I was no longer “Asian.” I lost something of who I was. For me, becoming Asian-American was losing myself in an identity that belonged to a larger group. It is for this reason that the term Asian-American -- and to some extent other broad categories such as people of color or LGBT -- took away meaning. It made me less than what I am.
What I am has always been a Kwok, a member of my family. I have never felt Chinese in a larger sense. In my work with the China American Psychoanalytic Alliance, I supervised a therapist in Beijing. About a year into our work together, she asked me what I thought about China. I gave a panicked answer about how I thought of China as the place where my family came from. She was very upset, and told me that she had been thinking of me as Chinese but now realized that I was not. I do not know what she meant, but I felt it as an affirmation that there was something missing in me, something Chinese, that I needed to cover up or fill in.
My paternal grandparents, Thomas and Agatha Kwok, lived in Hong Kong, and visits were marked by the fact that I do not speak Cantonese. The time I spent in China was in a British colony where I could get by with English, and the Chinese spoken was a language that I did not understand.
I do speak Mandarin, though I’m not particularly fluent. My accent can fool people, but I jokingly ask people to speak to me as if I’m 12. The Mandarin I speak is the Mandarin my family speaks, not putonghua, the common language of China. It is a different version of Dr. Han’s presentation of Nelson, whose mother was tasked with giving up her native Japanese to speak in broken English, and Nelson had to make sense of the loss of his maternal tongue and the impossibility of mastering the colonizing replacement.
My mother tongue is present, but frozen in time.
A funny illustration, in my internship, I had the rare experience of being around four people who also spoke Mandarin. One of them was Adam, who was not of Chinese descent, but had lived for many years in China. Adam was telling a story of funny misunderstandings as he was learning the language. One such misunderstanding involved the difference between xiao pien and da pien, which are terms for going to the bathroom, number one and number two respectively. Xiao means small and da means big. Suffice it to say that there was a humorous confusion about what small pien and big pien meant. Now, I had no idea what xiao pien meant. It was the first time I had heard the term. Confused, someone asked me what word I used, and I responded niao niao. All the Mandarin speakers in the room immediately burst into laughter. Niao niao is analogous to “wee wee,” a term reserved for small children. I was so embarrassed and furious that I called my mother to yell at her for letting me out into the world telling people that I had to “wee wee” whenever I was excusing myself to use the restroom. When she stopped laughing, she explained that it was just what we said in our family. A language that only we spoke.
Let me share another story about language. Two years ago, at the Division 39 Spring Meeting in Philadelphia, I had the opportunity to attend a panel by three Asian-American clinicians, Flora Chan, Christine Wai, and Grace Yan, with whom I had worked at RAMS, Inc. (e.g., Richmond Area Multi-Services in San Francisco). They spoke about their mutual consultation on biases about their work with Asian-American clients, as they each had a different configuration of Asian and American. It was a lovely panel, and I believe they have or will publish a paper from their work. In the discussion, I started to make a comment about my struggle in my work as the child intake coordinator at RAMS, trying to speak to concerned parents in my 12 year-old Mandarin.
As I was describing that experience, I began to cry. I don’t know why. I don’t have the words to describe the sadness that I felt. I can’t tell you the shape of it, where it lives, or why it comes out.
If I step out of that place, if I think about it and don’t feel, I can tell you that it is related to being a singular existence. To not be truly Chinese, to not have the language to talk to people who came from my father’s land or my mother’s land, feels profoundly lonely? Disconnected? Lost? Melancholic might be the right term. A pain that cannot be felt, a loss that cannot be mourned.
Instead of exploring what I was or where I came from, I focused on just being me. I elaborated on being the new kid in town. In high school and college, I developed multiple friend groups that I would move between. I came out in high school, but I had my gay friends and my straight friends. I studied pre-med like my father wanted me to, but went into clinical psychology. I became involved with the psychoanalytic community, but have always had multiple committees and jobs. Currently, I’m down to two jobs and 3 groups.
Having multiple demands helps manage my experience of racial melancholia because it replaces a sense of identity with a sense of worth.
I use time and work as a replacement for something I’m missing. Payment for a place in this world that I should have just because I’m here, but has been taken from me. I don’t know how to reclaim that lost place, but I feel that this conversation -- with hopefully more following -- is a part of that.
Sahil’s Response
To See or Be Seen: Reflections of an Immigrant Therapist
Initially, upon immigrating to the United States, I was plucked from my narrow, but warmly confined scope of the world extending from my street to my school and back. At the age of five, I found myself in a foreign place surrounded by people who did not look like me and spoke an unintelligible language. Coen and Penn (2013) share a quote by an immigrant colleague that resonated with me:
“I attended my first day of Kindergarten as if it were a visit to a new country.” (p. 1203).
Upon reflection, I suppose my response to this was to quickly work towards reestablishing that sense of familiarity I so missed. This meant unzipping myself out of the suit of my Indian identity as soon as I stepped outside of my home and frantically stitching together a new, American suit that would allow me to seamlessly blend in.
Or perhaps this American suit was thrust towards me by this newly engulfing sense of anxiety and alien-ness with the simple instruction, “put it on.” Regardless of the origin of this suit, I wore it.
I wore it proudly and disparaged the other costume that I begrudgingly put on whenever I entered back into my Indian home; the home that viscerally reminded me that I am different, with its sensory assault of intense smells and sounds that I became ashamed of and ridiculed. I attempted to toss aside anything that tied me to my Indian identity and quickly adopted a new American identity, going from “Sahil (sa-HILL)” to “Sahil (sa-HEEL).” I now wonder how my parents viewed me undergoing this process. Did they have regrets about immigrating to this place that caused me to strip myself of anything tying me to what was left behind?
It is only in recent years that I have begun frantically searching for those parts of me that I stripped off and cast aside, retracing my steps but returning empty handed. Perhaps those things cannot be retrieved, but instead a new identity must be developed, one that integrates the complex feelings of loss, longing, and regret that come with immigrating, with the life I have created here and the American that I have become. Boulanger (2015) describes immigrants as living double lives; both dwelling in the world they have left and in the world they live in now, all while trying to avoid the “alienating experience of being ‘other (p. 287).’” Now I strive to recreate those once hated smells and sounds in my own home, experiencing them now as comforting rather than assaultive. I search for ways to reinvigorate that part of me deep inside that lies dormant, cut off from what gave it life in India. Can it be reawakened as it once was or do I need to mourn that it will never be alive again in the same way. Probably the latter. I find myself hesitating when introducing myself, fighting the reflex to call myself by my Americanized name. I find myself thinking, “call me by my name. Sahil (sa-HILL).”
Perhaps this new embrace of my Indian-ness is in fact the beginning of the reincarnation of that dormant being in me, the birth of a new sense of no longer simply wanting to survive and assimilate, but instead wanting to live more completely.
As I reflect on this process of doing, undoing, and reintegrating following the early parts of my acculturation, I notice how applicable it is to the nature of my professional identity development. The same adaptive qualities that allowed me to quickly blend in and adopt Americanness, have allowed me to be a successful student in the field of psychology. I learned how to “effortlessly privilege one self-state for another,” (Boulanger, 2015, p. 291). By donning my American suit, Sahil (sa-HEEL), I learned how to do psychotherapy as it is most commonly taught, for and by White people. Boulanger (2015) describes this privileging of self-states and goes on to explain that in doing so, there is always an “echo, a life not being lived,” (p. 291) for me, that was Sahil (sa-HILL). Sahil (sa-HEEL) has been successful in America and now in psychology because he left Sahil (sa-HILL) at the door. Mehta (1998) describes a phenomenon in which if children are not specifically helped to develop a bi-cultural identity, they are at risk for developing a “sense of cultural alienation, not feeling bonded to or comfortable in either culture.” (p. 134). While adopting an either/or cultural identity has allowed me to fit in and navigate White spaces more seamlessly, it has left me incomplete. So now I turn to finding how to cultivate a bi-cultural self as a clinician, how to find a way to integrate these various aspects of identity into one cohesive therapist. In this paper I will attempt to reflect on the costs of my cultural dissociation on my clinical identity (Boulanger, 2015, Oguz, 2012).
In working with immigrant patients, I have found myself drawn towards them in a different way than my other patients. For example, with some patients, earlier this year, I found myself automatically introducing myself as Sahil (sa-HILL) when I have never previously done so before.
What is it about these patients that allow Sahil (sa-HILL) to feel comfortable putting on the therapist suit for once?
Where does he all of a sudden have the audacity to be in the room with Sahil (sa-HEEL)’s patients?
I ask these questions facetiously, but also from the understanding that they are generated from the internalized sense that I must fragment and compartmentalize my identities in order to thrive, to be seen as legitimate in predominantly White spaces. I believe the very same conditions in immigrant patients that draw them into the work with immigrant therapists is activated in those therapists to draw them more deeply into their treatments with these patients. These strong feelings evoked in me while working with immigrant patients is derived from my own desires to be known. Bollas (2009) describes what he claims is a universal drive for humans, to see themselves represented in others. Combined with the idea of immigration as the third individuation (Akthar, 1995), it can be understood that just as humans in general have a drive for representation, the experience of immigration, perhaps especially as a child, reinvigorates this hunger to be represented and leads to the immigrant child, even in adulthood, seeking some semblance of representation in all aspects of their lives.
Just as the immigrant patient is often drawn to work with a therapist who they believe can understand their experiences, I believe the immigrant therapist is also motivated by a deep desire to be seen, reflected, and known by their patients.
For me, the feeling of being seen or reflected in another is powerful, given that I sought this kind of representation as a child, mostly fruitlessly. In the realm of my professional work, where the experience of navigating the culture of psychology training programs as a non-Western immigrant has been akin to the obstacles faced in assimilating into the dominate culture of a new country, the feeling of being seen, known, and reflected in another is especially gratifying. But it is in this notion that I find myself conflicted. How much personal gratification is allowed in our clinical work? Am I pursuing a particular direction with a patient for them, or is it for me? Am I so strongly engaged in this treatment to see, or to be seen? Boulanger (2015) describes her work with an immigrant patient, Miriam, who expresses,
“I want to be seen by you and I want to see you seeing me…I need to connect with you in order to connect with myself…but I feel so alone, I have done so much alone. I do want to keep the boundaries, but I strive to be fully seen, I feel such desperation to be someone in the eyes of another person…” (p. 298).
When I read this quote I thought to myself, “Shit. This is me. But this is the patient talking and I’m supposed to be the therapist here.” What do I do with that?
One of the most critical factors in determining the extent to which an immigrant child is enriched or impoverished by the immigration experience is the capacity of the parents to provide a good enough holding environment to protect the child from an excessive degree of loss (Bonovitz, 2004). The less developed a child’s internal apparatus for processing emotional pain, the more reliant the child will be on the capacities of the parents to respond empathically to engender a sense of safety within the child (Bonovitz, 2004). Perhaps this idea can be extrapolated to understand the experience of other immigrant groups as well. For example, it may be that adult immigrants therefore must be reliant on their own internal capacities for regulating the pain, loss, and confusion of their immigration experience, while children of immigrant parents are made to be the providers of this support and holding for their parents in their acculturation process through cultural ambassadorship.
As a result, it is important to understand immigration, not as a discrete event, but rather as a more complex, dynamic, and continuous process that has significant effects on one’s internal and relational worlds (Akhtar, 1999).
These ideas are undoubtedly essential to keep in mind when working with immigrant patients, but how the impacts of these experiences inform our work as immigrant therapists must also be understood. For me, my parents and three older siblings had to begin working almost immediately upon immigrating. I had a lot of family around, but at the same time I was a latchkey kid. In some ways I had five parents and in other ways I had none. Of course that has an impact on my way of relating with my patients, but to be honest, I don’t really know how to think about that.
While work with homoethnic patients allows some therapists to have a more attuned and refined empathy with the patients’ experiences, it can also place the therapist at risk of various forms of collusion (Coen and Penn, 2012, Akhtar, 2006). Various degrees of awareness of these potential collusions lead me to fluctuate in several capacities in my work with patients with whom I share identities. How much effort am I putting in? Am I getting too close? Am I imposing my own experiences onto this person as if I understand them? What is the optimal distance here and how do I figure that out? (Akhtar, 2006). Would I be responding in these ways with a White, non-immigrant patient? In certain ways, I feel that I keep a part of myself guarded from White patients. Or rather, I keep a part of myself out of the room, because I cannot justify it being there. I feel more compelled to put on this role of what I think a therapist is supposed to be rather than just allowing myself to be me, as a therapist.
Akhtar (2006) warns of overidentifying with the experiences of homoethnic immigrant patients, stating that we may be more tolerant of acting out, be more didactic in our process, and often are tempted to go the extra mile for these patients. In my work with an adolescent South-Asian female assessment client, I found myself immediately compelled by the extent of her trauma and pain. In considering having her mother involved in the feedback session, she became worried about her mother’s minimization of her symptoms and subsequent stigmatizing of mental health treatment as a whole. Drawing from my own understanding of the mental health stigma in our shared cultures, combined with my strong desire to provide this client with something special, I found myself pulled to reassure her that I have experience working with stigma in the South Asian community and promise her all kinds of ways that I will overextend myself to make sure her mother truly understands what she is going through. Despite noticing myself going out of my way for this client that I felt connected to through our shared cultural identity, her gratitude made it feel worth it and my clinical superego took a seat. Was I uniquely equipped to understand the nuance of her experience and offer an appropriate and necessary degree of holding for her in that moment? Or do I need to sort out my own stuff more to avoid engaging in cultural enactments? Maybe it’s not so simple.
With another patient whom I have related to strongly in various ways, there have been moments where I have been able to speak to parts of his experience in a way that seems to genuinely resonate with him. For example:
P: I know in the romantic relationships I’ve been in, sometimes they’ve ended because people complain that I’m too distant and not as emotional as them. When people have said I love you, I think, “I don’t believe you.” It’s weird, but I get suspicious of that. Why do you have to say it? I don’t know, maybe it’s cultural or something because of how my family is, but I don’t really believe it for some reason.
T: It feels like, if it were true, you wouldn’t have to say it.
P: Exactly! If it were true you wouldn’t need to say it unless you’re trying to convince yourself or the other person.
When I recounted this exchange to a supervisor, she was confused by why I had responded that way, and how it seemed to be exactly the idea my patient was trying to explain. I suppose it is in small moments of understanding like this that we see that immigrant therapeutic dyads, especially homoethnic ones may benefit from this distinct sense of relatedness. The potential parallel implication of this exchange with my patient also does not escape me here. We are referring to his experience in his relationships with others, but I wondered how our ability to relate to one another also grants us the privilege to understand each other without needing to say it. In moments like these, do we each feel seen by the other without needing to hear, “I see you.”?
There is undoubtedly a holding function that seeing people that look like you, hearing your language, tasting your country’s food, and smelling familiar scents provides for immigrants (Bonovitz, 2004). Naturally, this holding also occurs for both patients and therapists in which each member of the dyad has similar features, speaks the same “othered” language, and has an understanding of the same cultural experiences. An Indian patient of mine was recounting her experience of not having her mother attend her gay wedding. In response we, seemingly in unison, stated sarcastically, “ because what will people think?” and laughed together at our shared understanding of the power of image and saving face in South Asian families. It is in moments like these that a certain sense of aliveness is cultivated. These moments seem to shatter the feeling of routine monotony or the sense of going through the motions our sessions can fall into at times, each of us playing our roles, therapist, and good patient.
In these brief moments of understanding, is the aliveness or sense of connectedness indicative of my client being seen? Is the welling up of brightness in me from myself feeling reflected in my client? Perhaps it is the product of a generative mutual connection being established; two immigrant children feeling known by each other.
In my work with this patient, and others with whom I strongly related to, I find myself needing to monitor my feelings in moments of feeling especially connected. In my excitement I sometimes want to respond impulsively, and have to remind myself to consider my motivation in responding a particular way. Will what I am about to say actually be helpful to the client or will it be simply be gratifying for me to share my own experiences with someone who I perceive would understand, as a means for me to feel seen by another?
On another occasion with this same patient, she was trying to find the right translation for a Hindi word, I know the word and it is both similar in Hindi and Punjabi. I found myself hesitating to even come up with the word and then in saying it. It was as if I was halting by the question, "wait. Is this allowed in here? Is this part of me allowed in this space, in my role as therapist?" It is illustrative of my own cleaving of these aspects of my identity. My cultural self in the role of an Indian immigrant and my professional self in the role of a therapist. Ultimately, I chose to say the word, zidi, and then provide the translation "stubborn." My client's face lit up and she said "yes! Exactly that's the word. Thank you." A part of me felt as if my client and I just had a secret interaction unbeknownst to the world of clinical or psychological discourse, but really it was exactly in the service of therapeutic interaction. A part of her felt seen and connected to her therapist that understood and could touch this part of her, and through this interaction, she helped me to be seen as well.
While I am able to understand that interactions such as this are actually therapeutic and in the service of my client, there is still a nagging feeling within me about whether I should let this part of me into the room with my patients. Because of this inherent drive to be represented and seen in others (Bollas, 2009), the feeling of connection with a client on cultural grounds feels particularly invigorating. In these moments, all of my defensive means of keeping my patients at a distance are circumvented and I feel truly connected to them, able to take them in more fully.
Maybe this frightens me to some degree. Maybe I feel like they must also be taking me in and I don’t know if I am ready for that. Maybe I fear that some kind of emotional floodgates will be opened and I won’t be able to return from it. Who am I seeking permission from? Why can’t I just let myself be?
In thinking about where my cultural identity belongs in my clinical work, I often begin to fantasize about what my office will look like some day. What objects, furniture, and art will I adorn it with? (Akhtar, 2015). I feel a sense of underlying anxiety and doubt and find myself struggling with distinguishing what feels true to me and what might be culturally performative (Smith & Tang, 2006). Conducting therapy via telehealth from home has afforded me a unique glimpse into my future. I get to conduct my sessions in an area of my choosing rather than in treatment rooms at a clinic that I had no part in decorating. Without being consciously aware, I realized that I have been conducting therapy in a room with an Indian tapestry behind me. But before I start each session I make sure to have only the bottom half showing in frame instead of the whole thing, as if wanting to reveal a part of myself but being weary of revealing too much. I guess this is as good a metaphor as any for my conflict about what parts of my cultural identity belong in the therapy room.
While the compartmentalization of my identities was adaptive and has allowed me to navigate social and professional spaces, it has left me with doubts about who I am in each of these roles and about where my cultural self has permission to exist. Through my reflection, I think what has become more apparent to me is not how much of myself I allow to exist in the room with immigrant patients, but rather how little of myself I am bringing into the room with my other patients. In all of these clinical vignettes, I can find theory to rationalize how I am feeling or how I am responding to my patients, but in the back of my mind I still ask myself, am I doing it for them or is this for me; am I seeing them or being seen? Maybe the answer is both, and that’s okay.
References
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Akhtar, S. (1999). Immigration and Identity: Turmoil, treatment, and transformation. Northvale, NJ: Jason Aronson.
Akhtar, S. (2006). Technical challenges faced by the immigrant psychoanalyst. Psychoanalytic Quarterly, 75(1), 21-43.
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Bollas, C. (2009). The evocative object world. London; New York: Routledge.
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Boulanger, G. (2015). Seeing double, being double: Longing, belonging, recognition, and evasion in psychodynamic work with immigrants. The American Journal of Psychoanalysis, 75, 287-303.
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About the authors
Dr. Meiyang Liu Kadaba, Psy.D. is a licensed psychologist in private practice in San Francisco (unceded Ohlone Ramaytush land). Deeply rooted in her bilingual, bicultural upbringing between China and the U.S., Dr. Kadaba dedicates her work to uplifting the perspectives of fellow travelers between worlds. She's profoundly grateful for the inspiration and strength offered by her BIPOC elders and peers in anti-oppressive psychoanalysis, Asian/Asian American psychology, and other liberational and decolonial pursuits. She is the founder of Coloring Psychoanalysis, an online publication/community by and for BIPOC in psychoanalysis. You can contact Meiyang at coloring.psychoanalysis@gmail.com.
Dr. Loong Kwok, Psy.D.: I’m a Licensed Clinical Psychologist, and I work with adolescents and adults. I believe in the uniqueness of each person’s experience, and in the value even of bad habits. Therapeutically, I want to help people understand and integrate different identities, with the goal of empowering them through greater self-cohesion and flexibility. I’ve written, presented, and taught classes on the influence of culture and ethnicity on identity, both locally and nationally. One of my interests has been exploring identities and meanings born out of “low culture,” artistic and creative genres that aren’t fully mainstream, such as comic books, video games, TTRPGs, and cartoons. You can contact Loong at drloongkwok@gmail.com.
Dr. Sahil Sharma, Psy.D., has a private practice in Oakland, is a clinical supervisor, and a faculty member at both the Counseling and Clinical Psychology programs at The Wright Institute. Dr. Sharma practices primarily through a relational psychoanalytic lens with adults, adolescents and couples, especially those suffering from chronic or early childhood trauma. An immigrant himself, he is particularly passionate about working with other immigrants and children of immigrants through issues related to identity development, acculturation, and navigating bi- or multi-cultural experiences. You can contact Sahil at sahilsharmapsy.d@gmail.com.