Bringing up counseling?

temurlang

Is there a culturally palatable way to introduce the topic of counseling to fairly traditional Desi people?

My friend "S", who was my MOH, has been acting strange for about the past year.  She behaved oddly around my wedding and has not been returning my calls.  I really really can’t think of anything I did, so I’ve always thought there’s some other issue.

 

Some background on her:  She came to the US as a teenager with her parents, she finished her BA, and then she worked in her dad’s company.  She was always very active and hard-working and is quite intelligent.  In the past year, she stopped going to work, moved to her parent’s town, and sits at home all day in her pajamas watching TV while her mom does her housework.  She also doesn’t seem to “get” stuff she should be able to understand, and IDK if it’s laziness or what.

 

A couple of days ago I got a call from her (younger) sister, who was really upset.  She described a few incidents where "S" treated her badly to the point of verbal abuse.  I was really shocked because many of the things Sis said were just so out of character for "S".

 

Then I got a call from her brother.   He told me that:  1) she spends all her time at their parents’ house (she is married and has a son); 2) she doesn’t return his calls ever, and he only sees her because he lives with the parents; 3) he thinks she neglects her son… Sis and their mom do all the childcare for her and when the mom is out of town she can’t cope; 4) he thinks her husband might leave her and her husband’s uncle just passed away so he is going to his home country (he’s not Desi) to take care of things.  I don’t know about leaving her, but he was obviously deeply unhappy at our wedding.

 

I want "S" to get counseling, but I don’t know how to approach it.  She lives in a different state, so I can’t really take her myself.  I mentioned it to both Bro and Sis.  Sis basically feels completely powerless and is now afraid of "S".  Bro is very old-fashioned and thinks “between us we can fix this.”  I don’t think so.  I know her whole family, but I feel uncomfortable bringing it up with the parents just like that.

 

Any advice on getting her some help?

JH11

If I were you, I'd reach out to your friend directly, either through phone or e-mail. Tell her your concerns and let her know you're there for her if she wants to talk about whatever is bothering her. I'm American born and raised, so my mentality is not like the typical desi, but speaking from personal experience (my parents and their friends all came the US about 30 years ago), desis have this irrational concern about what people in their community think about them. It could be that her parents and/or siblings do want her to get counseling, but are afraid of people finding out and maybe gossiping about the family or thinking less of them. If you feel uncomfortable speaking to her parents, reach out to her siblings and let them know that there is nothing to be ashamed of by their sister going to see a counselor, and possibly a psychiatrist. Also, how old is your friend's child? From reading your post, your friend seems like she might be depressed. Is it possible she has post-partum depression?

temurlang

In Response to <a href="http://forums.theknot.com/Sites/theknot/Pages/Main.aspx/cultural-wedding-boards_south-asian-weddings_bringing-up-counseling?plckFindPostKey=Cat:Cultural%20Wedding%20BoardsForum:430Discussion:bd732547-9199-44ea-966b-35ddcf1718f6Post:b0dc05cf-2e7b-4f44-b05f-2b337b19bf39">Re: Bringing up counseling?</a>:
[QUOTE]If I were you, I'd reach out to your friend directly, either through phone or e-mail. Tell her your concerns and let her know you're there for her if she wants to talk about whatever is bothering her. I'm American born and raised, so my mentality is not like the typical desi, but speaking from personal experience (my parents and their friends all came the US about 30 years ago), desis have this irrational concern about what people in their community think about them. <font color="#0000ff"><strong>It could be that her parents and/or siblings do want her to get counseling, but are afraid of people finding out and maybe gossiping about the family or thinking less of them. </strong></font>If you feel uncomfortable speaking to her parents, reach out to her siblings and let them know that there is nothing to be ashamed of by their sister going to see a counselor, and possibly a psychiatrist. Also, how old is your friend's child? From reading your post, your friend seems like she might be depressed.<strong> <font color="#0000ff">Is it possible she has post-partum depression?</font></strong>
Posted by JH11[/QUOTE]

Yes, she seems depressed.  It started before having her son, actually now that I think about it, but is definitely worse since (he's about 1).  I felt when she had him she kind of didn't want him.  It was planned and everything, but somehow it seemed like she did it just to say she had a kid.

You're right about her family being concerned about what people think.  They also only like to deal with their own community.  I understand it's a tight community, but sometimes it seems a bit irrational.  Like I can see her mom saying she could only trust a Desi counselor, but then a Desi counselor might gossip, so no counselor.

I have a hard time talking to her directly because she doesn't return my calls.  When I have talked to her to ask if she's okay, she always says yes.  I don't think she even realizes there's something wrong.  I might try her brother again because he's the one I think maybe I could explain about counseling like you suggested.

JH11

The culture is starting to change, but my parents' generation definitely places a strong emphasis on having children. I've seen young, married women have multiple children and lose themselves. Any ambitions they had disappear, and they turn into bored housewives with the same daily routine. When I have children, I plan to teach them to pursue their dreams and have a fulfilling home life. Anyways, I'm starting to ramble.

I guess all I can tell you is don't give up. Keep reassuring her siblings and parents that there is help out there, and the ethnicity of the doctor/counselor is not important. Also, just for your information, any information that is exchanged between a patient and doctor/counselor would be kept confidential under law. So, if the parents were to find a desi doctor/counselor, he/she would not be allowed to talk about the daughter's case at all, and if the doctor/counselor did, he/she would lose his/her license. The only time patient/doctor confidentiality can be broken is if the patient gives permission to doctor to share information with family/friends, there is a legal matter, or if the patient is a threat to him/herself or someone else. If this information will help convince her parents to get her help, then use it.

mimosa1977

First off....you are an awesome friend to want to be pro-active about all of this!!  Second...you need to talk to your friend perhaphs in person if possible, but not in a confrontational way.  This is very difficult for all involved...our culture places a HUGE emphasis on physical health but not mental health.  It is very difficult for many in our parents generation to admit that their child may need to see a physician/counselor.  

There really has to be an intervention in helping your friend, can on of her siblings help to set up an appt with someone??

raangoli

In Response to <a href="http://forums.theknot.com/Sites/theknot/Pages/Main.aspx/cultural-wedding-boards_south-asian-weddings_bringing-up-counseling?plckFindPostKey=Cat:Cultural%20Wedding%20BoardsForum:430Discussion:bd732547-9199-44ea-966b-35ddcf1718f6Post:38b378bf-6891-408f-b8ce-2f8280b400a9">Re: Bringing up counseling?</a>:
[QUOTE]First off....you are an awesome friend to want to be pro-active about all of this!!  Second...you need to talk to your friend perhaphs in person if possible, but not in a confrontational way.  This is very difficult for all involved...our culture places a HUGE emphasis on physical health but not mental health.  It is very difficult for many in our parents generation to admit that their child may need to see a physician/counselor.   There really has to be an intervention in helping your friend, can on of her siblings help to set up an appt with someone??
Posted by mimosa1977[/QUOTE]

I agree that maybe it's best to approach the topic in person. I know you said she lives out of town (and state?) from you, and it might be some time until you see her, but that might be the best. I also agree that your best course of action is through her brother since he seems to be the most receptive to things thus far.

I wonder if it is post-partum related? Or that she is just unhappy that she had a child because that was what was "expected" of her and her life is not shaping up to be what she wanted for herself?

Either way, it's a tricky situation when discussing mental health with the desi community. I agree with mimosa that you are a fabulous friend for continuing to care and wanting to help her. We should all be lucky to have a great friend like you!

Good luck!

temurlang

Over the weekend I spoke very briefly on the phone with "S".  Based on that conversation, I think PPs are right that it will be better to bring it up in person.  It was like she was not really engaged on the phone (which I've noticed before) and trying to make excuses to get out of talking (another thing she also does with her brother).

She lives on the East Coast, so it's actually a really big trip for me, but one I will make sometime if not immediately.  In the mean time I'm thinking of talking more with her brother and looking for support groups for new mothers in her area.  I was thinking a "support group" might be easier to sell as a starting point.

Thanks so much for the support and suggestions!  I really hope I can get my friend back.