Expectations and Family Pressure

Many cultural traditions within Asian American Native Hawaiian Pacific Islander (AANHPI) communities emphasize “collectivist” values, where personal identity is defined by the interconnectedness and relationships with other community members. The needs and interests of the community often take priority over the needs and wants of each person.

This culture can create a burden of high expectations and family pressure, which can worsen, or even cause, mental health issues. Additionally, having mental health issues typically does not align with the expectations a person is supposed to meet — and too often, people in the AAPI community will try to hide their symptoms from friends and family in order to avoid the cultural shame and stigma that is so closely associated with mental health issues.

Expectations

Both internal personal motivations and external cultural values can create a high burden of expectation and pressure to succeed. Predominant stereotypes like “Asian advantage” and the “model minority” myth assume that AAPI individuals should be intelligent, affluent, obedient and living the “American dream.” Failure to live up to these stereotypes and expectations can be a source of significant stress, often creating feelings of inadequacy.

Different philosophies and religions — including Catholicism, Islam, Protestantism, Hinduism, Jainism, Sikhism, Buddhism, Taoism and Confucianism — also shape cultural values in the AAPI community. Many of these philosophies and religions include a strong emphasis on personal self-control to achieve internal balance or harmony in order to maintain peaceful and respectful relationships in the community. These traditions and practices can strongly influence community members across generations, regardless of how recently they have immigrated to the U.S., or how thoroughly they have integrated to the U.S. “mainstream” culture.

In many of these cultural and religious traditions, clearly defined roles and expectations for different family members are an important foundation for strong families and communities. For example, the concept of “filial piety” expects children to pay deep respect to their elders and parents. The interests and respectability of the family are of the utmost importance and depend on children obeying the authority of older generations and representing the family well in the broader community. To live up to this expectation, children often grow up with a strong emphasis on emotional self-control, loyalty, conformity to social norms, respect for authority and academic achievement.

AAPI individuals with mental illness may deny or hide their symptoms due to fear of rejection by their families or communities. Family-oriented interdependence and hierarchy often mean that any decision-making, including the decision to seek health care, is determined by the interests of the family as a whole. Because mental illness remains highly stigmatized, concerns about revealing a perceived flaw, failure or weakness to the community can lead to shame and avoidance for the whole family — creating a barrier for accessing timely mental health care.

Family Pressure

Belonging to a family with strong bonds and close relationships across generations can be a significant source of personal strength, providing a reliable network of support and compassion. But it can also be a source of significant distress and trauma when something disrupts these bonds — whether by a family member breaking away from shared traditions or from a personal crisis. The pressure to uphold family expectations can manifest in various ways.

Acculturation
AAPI youth may face a great amount of family and social stress from biculturalism, attempting to balance the expectations of belonging to two different communities at the same time without “failing” either. Traditional AAPI community and family values can often be at odds with the highly individualistic values of mainstream American culture, and individuals may feel that they face a choice between disappointing their family or remaining an “outsider” to non-AAPI friends, classmates and broader society.

Intergenerational cultural conflict (ICC)

Intergenerational cultural conflict (ICC) is a notable stressor for AAPI youth, especially in families with wide acculturation gaps between recent immigrant parents/grandparents and U.S.-born children. Although families from any cultural background experience conflict based on behaviors and expectations changing over time, Asian American families are more likely to experience intergenerational disagreements about fundamental core cultural values.

This type of conflict can also be motivated by intergenerational disagreement on religious principles. For example, Hindu Indian-American families may experience significant intergenerational conflict about commitment to dharma, which includes the duty and responsibilities to family. Because the source of this conflict is so deeply personal, affecting critical aspects of identity, it can cause serious friction between family members and worsen mental health outcomes for the younger generation.

Gender-related expectations
Gendered norms and expectations tied to cultural values can cause significant distress. Young women are often expected to provide care to younger siblings or elders, and experience more strictness and scrutiny of their social behaviors. This prescribed role within the family and community can be highly restrictive, leading to frustration, stress and limited options in choices of education or careers.

Achievement expectations
Children of AAPI immigrant parents often grow up hearing explicit or implied messages that their parents made a lot of sacrifices for them to be in this country, and that the family’s future depends on their hard work and achievements. This pressure to achieve can create a deep sense of obligation and burden, and ultimately have a significant impact on mental health – potentially contributing to a higher rate of suicidal thoughts among Asian American college students compared to their white peers.

Diagnosis severity
In some AAPI families, a psychotic disorder might be taken more seriously by the family because of its more severe and less relatable manifestations, while mood disorders may be trivialized. For example, parents might make statements, such as “How can you be sad when I worked so hard to bring us here?” or “No one is anxious back in our home country because they have other things to worry about. Be grateful”).

Trauma
In addition to personal mental health concerns, many AAPI individuals also struggle with the lasting impacts of stress and trauma experienced by their parents and earlier generations. For those who came to the U.S. as refugees or as immigrants from areas with significant conflict, experiences of violence, war or economic and political oppression can often be manifested as post-traumatic stress disorder (PTSD). One study found that 70% of Southeast Asian refugees receiving mental health treatment met the diagnostic criteria for PTSD. Refugees’ children, who never experienced the trauma firsthand, can internalize their parents’ psychological distress — a process known as intergenerational trauma.

Coping And Recovery

You are not alone. AAPI individuals and families contribute to NAMI’s collective wisdom in coping, healing and recovery. We are fighting to remove the systemic and cultural barriers to quality mental health care for all through awareness campaigns, education, support, outreach and advocacy.

There are many pathways to healing and the journey of recovery is individual for each person. It can be a long journey, but in an adage ascribed to Lao Tsu, “a journey of a thousand miles begins with a single step.” It is okay to reach out. Your mental health matters and there is always hope.

Testimonials:

• Listen to NAMI Ambassadors Diana Chao & Martin Hoang discuss the mental health experience of Southeast and East Asian Americans. These two inspiring peer advocates discuss the diversity of the Asian American experience, generational trauma and stress, the effects of stereotypes and racism, and how cultural stigma can play a role in mental health.
• Listen to Pooja Mehta’s story where she shares her mental health story as a South Asian American.
• Read Grace’s story on how as a primary caregiver to her adult daughter, she has risen from feeling helpless to becoming a mental health advocate and educator, offering fellow family caregivers “words of optimism and hope.”
• Read Elaine Peng’s sharing, “Hope is Within Reach.” As an individual with lived experience of mental illness and a family member, Elaine helps to promote mental health services and provide peer support within the underserved Chinese community.