mental health

THE MORE TRUMP AND HIS SUPPORTERS REJECT & HARM DIVERSITY, THE MORE MANY OF US WILL EMBRACE & ADVOCATE FOR IT.

MY CONTRIBUTION OF THE DAY: A PROCLAMATION TO PUSH THE BOUNDARIES OF WHAT IS SEEN AS DIVERSE IN YA FICTION.

DEAR YA FICTION, NOT ALL DIVERSE TEENS CELEBRATE THEIR CULTURE(S) 

By: Sonia Patel

In June, my husband and I took our two half Filipino-half Indian teenagers and their three half Filipino-half white cousins to a Little Simz concert in Chicago. Little Simz, a black rapper from England, delivered nothing less than powerful, feminist bars. Her inspiring lyrics seemed to light up Lincoln Hall’s dimness and hypnotize the eager crowd. My family and I head nodded, deep in the zone. And when Little Simz spit the words “the Philippines” in a hook, our kids, nephews, and niece exploded with pride, their fists thumping their chests then pumping high over their heads. I stood behind pressing my hand on my heart and smiling, overcome with a mix of awe and happiness for them. But then a thin layer of sweat formed on the small of my back. I peeled my shirt as guilt and grief took turns trying to tug the corners of my lips down. 

Why can’t you be that proud of being Indian?

You know why.

Sure, but it’s not like you’ve ever been starving or had acid thrown on your face so get over yourself.

But things were bad in a different way.

I don’t celebrate my Indian culture. I never have. I don’t know how to because I was raised around it, not in it. Growing up, it was as if I was an outsider sitting in a dark theater watching our Indian relatives and family friends on the big screen like a Bollywood film. I studied the intricacies of my mom and grandmother’s daily Hindu worship of Thakorji. I noticed the way my mom lent a helpful ear and hand to everyone, despite some of her in-laws putting her down. I plopped down on the sofa next to my mom when she was engrossed in one of her pirated Indian movies depicting perfect, loving families. I was fascinated by the beautiful, intricate saris and gold and diamond jewelry Indian ladies wore to weddings and garba...the delicious, complicated food my mom and aunties made......the emphasis on hard work and education...the sacrifice to help my generation make it in America….

Still I didn’t feel Indian. I felt worthless. What no one knew was that at home, my family’s way of life, our secret culture, was that of isolation, conflict, and abuse. 

Now as an adult I recognize the elements of patriarchy, misogyny, and intolerance long present on one side of our extended Gujju network but the culture of dysfunction (COD) at home was its own terrible beast. Simply put, my dad was a charming tyrant. My role was his wife. My mom was his servant. My mom and I existed, voiceless, to accomodate my dad in every way. 

Instead of getting a shot at normal teen emotional development, I was in a perpetual state of anxiety to keep the peace at home, and then in my future relationships, even if that meant making poor decisions. Instead of having the opportunity to build my separate identity and self-worth, I learned that my only value was in pleasing my dad, and then men like him who similarly lavished me with attention in exchange for my emotional and/or sexual usefulness. And instead of developing skills to maintain healthy, nuanced peer relationships, especially with girls, I didn’t trust anyone.

Looking back I’ve come to understand that my family’s COD trumped any protective effects of my Indian background. Why? Because the COD was the lens through which I saw everything Indian. And since there wasn’t a single day of my youth that I experienced my Indian-ness independent of the COD, the two became inextricably linked for me. Being Indian was foreign to me yet I equated it with pain. 

I’m not alone. Many of the diverse teens I treat who live in COD don’t have strong connections to their birth culture(s) either. Let’s face it—COD is universal. In my office, when these teens reveal their agonizing stories of abuse, neglect, parental drug use, parental mental illness, and/or other severe adverse childhood experiences, their mental suffering is similar regardless of their backgrounds. It’s true that they may manifest some culturally specific variations in symptoms, but there are undeniable commonalities in their negative thoughts, feelings, and behaviors. That and the medically proven trauma-induced brain changes are the same. 

In order for youth to survive traumatic experiences that are out of their control, dysfunction can become hardwired in their developing brains. They can become stuck in survivor mode as COD clouds their vision and becomes the blueprint for future relationships, leaving them prone to an endless cycle of repeating and recreating what they’ve endured at home with others. This is largely why the buffering effects of their birth culture(s), such as positive relationships with extended family members or participation in traditional activities and religious practices, can remain out of reach.

It’s crucial to understand that these diverse teens are often alienated from their backgrounds because they never experience it apart from their COD. They are shoved onto different playing fields of development far apart from teens being reared in healthy families where culture isn’t shrouded in toxicity. So to expect all teens, particularly those from cultures stereotyped as nerdy and family-oriented immigrants, to rise above their struggles is unrealistic. More likely these vulnerable teens living in COD may have extreme difficulty making friends. Or, they may choose another family of  “bad kids.” They may not be able to set limits with people. They may engage in repeated risky, quick feel-good behaviors (sex, drugs, alcohol, etc.) not condoned by their birth culture(s).

Let’s take fifteen-year-old Kaya (not her real name), a part Native Hawaiian-Filipino-Japanese girl who I began treating recently. She wants to feel connected to her family’s blended way of life but can’t. She’s spent her youth battling recurrent negative thoughts, flashbacks, depression, suicidal thoughts, and worthlessness. Our talk therapy to this point has given her insight into why her neural circuitry hardwired with depression and anxiety—it allowed her to survive the abuse. Her symptoms told her that the abuse was her fault, thus giving her a sense of control in a situation that’s been totally out of her control. It’s my fault. I’m bad. I deserve it. Why else would the people who say they love me the most hurt me the most? Why else would the people who’ve taught me cultural values of family, respect, and honor treat me and each other like this? She wants to feel pride when her family participates in Native Hawaiian activism but ends up feeling disgust. Her profound emotional burdens have denied her the mental free time to be a “regular teen.” She hasn’t dreamt about her future or romance or hobbies or college or achievement or the next party. She can’t help but feel like an imposter at family gatherings and traditional ceremonies. She hasn’t had a fair chance to form strong female friendships. She hasn’t been able to set limits with boys—she’s allowed them to push her around and she hasn’t been able to say no to sex like she wants to. She also hasn’t been able to come out as lesbian though she identifies as one.

This brings me to YA fiction. Obviously teens read for different reasons. Some of my diverse teen patients enjoy escaping the hardships of their lives by immersing themselves in YA fantasy, dystopia, or paranormal. Some are drawn to YA romance. There are some, however, who seek to find themselves in books. But diverse teens being raised in COD have a difficult, if not impossible, time finding themselves in existing YA fiction. At this time most of it celebrates different cultures. Most of it includes at least one functional parent who protects against the occurrence of COD and therefore makes it possible for the birth culture(s) to be appreciated. 

Kaya hasn’t found herself represented. How can she when COD has prevented her from experiencing her birth cultures without bias? How can she when she feels distant and, at the same time, repulsed by her birth cultures?

When I was Kaya’s age, I couldn’t find any Indian or Indian-American YA novels. There are some these days but I can’t relate to any of them. That’s one of the reasons I wrote Rani Patel In Full Effect. It’s why I decided to keep writing (Jaya and Rasa: A Love Story, Bloody Seoul, and a fourth YA novel in the works). 

Teens living in the complex dynamics of COD may not be able to see themselves in diverse YA fiction, including realistic bestsellers, that happen to be by or about people of their same background. To think otherwise—from my point of view as a child and adolescent psychiatrist in the trenches with vulnerable teens—is short-sighted, minimizing, and insulting to those in the midst of survival and in the most need of empathy from sources outside of the family. 

YA fiction needs to expand its boundaries beyond safe, popular stories that affirm and praise different cultures. It needs to push past the expectation that all diverse teens can conquer adversity in a tolerable way. It needs to depict the ugliness of when COD hijacks birth culture. It needs to represent the unpalatable perspectives of teens who don’t have the luxury of enjoying their cultures and working through typical teen concerns. It needs to embrace painful reality, not just what’s convenient. It needs to champion these types of troubling diverse stories the way it does those stories that make people feel comfortable, content, and less guilty. Afterall, the Kayas of the world are worth it even if they themselves can’t feel worth it yet. 

 



I AM GRATEFUL FOR THIS BLOODY SEOUL REVIEW BY A READER WHO HAS EXPERIENCED BULLYING.

I couldn’t be more excited that Bloody Seoul’s official release is August! If you don’t know, I write in a way to show how teens who’ve been through severe adverse experiences really think, feel, and behave. I don’t write flowery prose meant to please. I write raw to show how these teens actually express their suffering. That’s why I’m especially grateful for the following review. Thank you, Dani, for taking the time to write your thoughtful, personal review. I appreciate it, and you! —Sonia

cropped-New-Perspective-of-a-Writer-Logo-2.png
BloodySeoul-w01.jpg

BLOODY SEOUL REVIEW

Dani - Perspective of a Writer's review Jun 21, 2019
Check out more reviews @ Perspective of a Writer...

The Buzz

Totally from that cover!! Isn't it gorgeous?! I could tell this was a gangster type of book just from the way this character was drawn and they aren't my favorite TBH. And I guess Sonia Patel novels always have a cover from this artist. It's a neat way to brand yourself as an author. I haven't read her before though I know she's an indie favorite.

So it was totally a matter of gorgeous cover and perfect title catching my eye! Because it's set in Seoul!! And I just couldn't pass up a chance to read about my favorite culture.


The Premise

Rocky is a real bully. Like a REAL bully. Not a girl hater who likes to push around the unfashionable nerd. A person who makes another person eat a cigarette butt. Yes, THAT kind of bully. It was hard to read but such a realistic portrayal that it's very relatable to those who have been bullied. It's pretty horrible and actually if you've been bullied at all Bloody Seoul may scar you even more (so read with care). But I really loved the way Rocky came to understand that bullying may be a way to live but it's NOT the way HE wanted to live.

it's hard. His dad is a gang leader. His two uncles who started the Three Star Pa gang are gone or dead. His mother abandoned him. Rocky has three friends who totally follow his lead. The school and neighborhood are frightened of who his father is. That neglect, example and power are quite heady. There is an in-the-moment way to Sonia Patel's writing that gives a lot of substance to the story. And I really felt like the brutality in Bloody Seoul rang true to gang life in Korea.

Then we have Hana. The girl Rocky bullies. I'm not sure that I could have reacted the way she did. It was about more than just the way Rocky treated her though. It's the dirty part of Korean teen culture and many other school age kids (no matter their culture). I did appreciate though for the story's sake that Rocky was able to move forward with hope for redemption. Bloody Seoul is one of those books that should rightly be in high schools today, so current teens can start working on disabling the bullying around them.


My Experience

Since I was bullied when I was in school at various times Bloody Seoul was really hard to read. I didn't find Rocky to be a sympathetic character at all. I started to regret giving this clearly gang centered book a chance. Then he started to remember his mother. That really intrigued me. Sonia Patel expertly showed how Rocky had been taught two different ways of being. One way was honest if not the moral high ground. The other way was brutal and disregarded other people's lives.

When he realizes what could be a consequence of his treatment of Hana... he quickly moves to change his immediate actions. And his motivation by this point is clear. While as a victim of bullying I doubt a bully's ability to change quickly I do think its possible. (Actually I met one of my bullies later and he'd found god and totally change!) The current actions of his father really come to play with this too. Rocky loves the family that he used to be a part of but he doesn't condone many of his father's ways now.

I loved that Sonia Patel explored a teen's need to separate himself from a parent whose beliefs and code he doesn't agree with. All teens have to make this transition as they move into adulthood. Bloody Seoul is well worth the read for this journey alone.


Why should you consider reading Bloody Seoul?

-An accurate portrayal of bullying!
Rocky will make you hate him right off... but stick with him and you'll be satisfied you did.

-Friendship and acceptance.
Rocky's friends are good friends to him even if they are mini-gang members in the making...

-Parental relationships + an uncle...
GAHHHH rich, complex and heart breaking. His uncle was my favorite!

-Korean gangs and life of a gang member.
These parts made me so queasy but gave the story punch.

-Physical and mental abuse. Mental illness.
Clearly his father is not mentally sound. And we get to see how that effects his family.

Bloody Seoul is a difficult situation but also a wake up call to bullying in school and its effect on others. Both in creating victims and egging on bystanders to become bullies themselves. I can totally see this becoming a must read in high schools today!


⋆ ⭐⭐⭐⭐ Authenticity
⭐⭐⭐⭐⭐ Writing Style
⋆ ⋆ ⭐⭐⭐ Plot & Pacing
⋆ ⭐⭐⭐⭐ World Building
A+ Cover & Title grade

Thanks to Edelweiss and the publisher for providing me with a copy in exchange for an honest review. It has not influenced my opinions.

______________________
You can find this review and many others on my book blog @ Perspective of a Writer. Read my special perspective under the typewriter on my reviews...

WRITING IS HEALING

I often assign homework to my teen patients as part of our ongoing talk therapy, because healing doesn’t just occur in the office. Sometimes the homework is writing. It can be a poem, or prose, or a letter. The format doesn’t matter as much as the eventual outcome-that writing can facilitate the processing of complex thoughts and emotions. Not only can writing lead to healing but it can be used as a positive coping strategy during difficult, triggering times in the future.

I practice what I preach. Here’s a poem I wrote this morning to help me resolve old wounds that opened up a little…

DOOMED

When it all fell apart

It was me, my heart

That was blamed

Tossed into the fires of women shamed

Yet I scratched and crawled, dragged

My soul up the jagged

Mountain of healing

Saved myself by kneeling

To insight, not your God

No fraud

That daughters of narcissists

Are primed to exist

Solely as objects for abusive men

Cloaked in normalcy, again and again

She’s vulnerable to predators

Recreating traumatic metaphors

She reeks of selfish lies

Groomed, doomed, to repeat father-daughter highs

Four decades later I reached the mountain’s peak

And learned to speak,

Roar, because understanding is my dominion

I reject your ignorant opinions

Your blind accusations

Making my own declarations

I DON’T CARE WHAT YOU THINK.









WHAT I'D TELL MY YOUNGER SELF REGARDING SUICIDAL THOUGHTS

I made this video for the Child Mind Institute. I’m grateful to be a part of their #myyoungerself project.

Child Mind Institute

Published on Apr 20, 2019

Sonia Patel is a physician and author. Patel is psychiatrist in Oahu and is passionate about helping teens work through emotionl obstacles. She is also the author of several books including, "Rani Patel in Full Effect," and "Jaya and Rasa: A Love Story."

#MyYoungerSelf by Child Mind Institute is an anti-stigma campaign. We are grateful to Sonia for her willingness to open up about her childhood experience with anxiety and depression.

ABOUT CHILD MIND INSTITUTE As an independent, national nonprofit organization dedicated to transforming the lives of children and families struggling with mental health and learning disorders, we deliver the highest standards of care, advance the science of the developing brain, and empower parents, professionals, and policymakers to support children when and where they need it most.

CHECK OUT THE HAWAII BOOK & MUSIC FESTIVAL! I’LL BE REPPIN’ YA LIT & MENTAL HEALTH ON 4 PANELS.

The Unrecognized Impact of Sexual Violence on Survivors

This essay was originally published in LENGUA LARGA, BOCA ABIERTA, edited by Isabel Quintero & Allyson Jeffredo, February 2017. I shared it on my blog soon after but took it down when I received threatening letters about the personal content.

Today, however, I’m reposting it. You see, I just finished watching the documentary LEAVING NEVERLAND and Oprah Winfrey’s AFTER NEVERLAND. I’m inspired by the bravery of Wade Robson and James Safechuck. As a psychiatrist who has treated survivors of childhood sexual abuse, this documentary does an excellent job of describing the grooming/seduction process, the immediate impact of sexual abuse, and the lifelong aftermath survivors must work through. Also, as a survivor myself, I will no longer be silent. No one in my life knows the entirety of my experiences except me. I didn’t think it was abuse. I flat out denied it or minimized it. It is still difficult to talk about it with those closest to me. But I can write about it. Writing is how I process my painful past. Writing is how I can dispel shame, secrets, and help myself move forward. I’m hope that my truth might aid someone.

The Unrecognized Impact of Sexual Violence on Survivors

by Sonia Patel

The truth of the matter is that “20 minutes of action” by men with privilege, power, and influence that “just kiss,” “grab ‘em by the p***y,” “don’t even wait,” and “can do anything,” can cause a lifetime of brain repercussions for their victims. And this is what is missing from the current discussion of sexual violence—that the effects on victims can be as biologically serious as brain injury induced by things such as concussions or crystal methamphetamine use.  

As a child & adolescent psychiatrist, I’ve spent over twelve years guiding sexual violence survivors on their paths to recovery. I’m also a young adult novelist and my debut, Rani Patel In Full Effect, details the negative impact of paternal covert and overt incest and date rape on a sixteen-year-old girl. My second novel,  Jaya and Rasa: A Love Story, addresses LGBTQ issues and one example of sex trafficking, including the profound damage that occurs to the development of a young girl when older men prey on her sexually from the time she’s twelve.

Sexual violence can damage a survivor’s brain at a cellular and physiological level. Time and time again medical research has shown that sexual violence can, for example, alter brain structure, change how the brain reacts to stimuli, deregulate neurophysiological interplay, and impair cognitive function. Children are particularly vulnerable to this devastation because their brains are still developing. These types of brain injuries can adversely alter everything about how children or adolescents approach and experience their life as they grow into adults. The normal development of their sense of trust, self-worth, ability to be assertive, and formation of their identity is thwarted. They are more likely to have pessimistic automatic thoughts, negative feelings, compulsive and self-destructive behaviors, and inability to maintain appropriate boundaries or form deep connections in relationships. Their brain injury might be expressed as one or more full blown psychiatric disorders.

Survivors may get lost in the cognitive and emotional manifestations of their impaired brain function. They may even accept that these symptoms are who they are instead of their brain’s unavoidable biologic response to the sexual violence.

Discussion of sexual violence is not typically encouraged and in fact society tends to at least partially blame the victim. In addition, because abusers put their own wants first and lack empathy (both of which can be hallmarks for serious psychiatric issues such as the Narcissistic Personality Disorder), their cavalier stance on the ramifications of their actions reinforces the view that the guilt rests with the victim.  So survivors of sexual violence may suffer in silence. Stifled, they can’t focus on how harmful the abuse was. Rather, they are stuck in “speaking” and “living” through their troubled cognitions and emotions and end up in a vicious cycle of helplessness and shame that can lead to a lifetime of dangerous choices and various addictions, including drugs, alcohol, and sex.

Of course there are multiple factors that can alter the biological brain effects of sexual violence—chronicity of the abuse, genetic susceptibility, family and peer support, etc. But there is no doubt that sexual violence can change a victim’s brain functioning. Still, healing is possible. It takes time because it requires a survivor to essentially “retrain” their brain to think, feel, act, and connect with people in a positive way. I often tell my patients that depending on how many years they’ve lived with their dysfunctional brain wiring, it might take them that many years to fully recover. This is not to make them lose hope but rather to foster empathy for themselves about the severity of the abuse they suffered. Empathy for themselves, as it turns out, is an important part of gaining insight into their ordeal. And insight is the first step on the path to healing. As survivors gain insight into the sexual violence they suffered, they escape the muteness of their trauma and learn to find words to separate themselves and verbalize their brain’s biologically conditioned cognitions, emotions, behaviors, and connections to people. This leads to empowerment because they begin to realize they are not what their thoughts and feelings tell them. They become aware that they are worthy of being more than sexual objects for others. They figure out that they can reinvent themselves independent of the sexual violence they suffered.

And I should know. Because besides my medical training in the effects of sexual violence on patients and the years I’ve spent treating them, I’ve spent years individuating myself from my role as my father’s intimate object. I’ve thought the worst of myself. I’ve felt the depths of depression. I’ve hated myself and wanted to die. I had years of nightmares about being kidnapped and gang raped by older men. I’ve indulged in quick fix self-destructive behaviors and made impulsive, bad decisions that hurt me and those I loved.

Eventually I gained insight into my brain’s negative hardwiring and it became clear to me that I’d have to work hard to overcome the existing circuits. Many tears and years later I succeeded in creating new ways of thinking, feeling, behaving, and relating to people. My self-worth is solid and my boundaries and decision making much improved. I am my own person.

Given the recent revelations of sexual violence by many high-profile men in a wide range of industries, I am hopeful that we as a society can use this political moment and the conversation it has provoked to reshape our understanding of sexual violence. We can do this by fully supporting victims and survivors of sexual violence on their journey to recovery. We can do this by not standing for any of the excuses for unacceptable behavior thrown around by abusers. And we can do this by eliminating once and for all the disgrace surrounding victim status.


ENABLING IS TOXIC.

People typically seek therapy for themselves or their children to find relief for emotional distress or improve behavior or habits. Therapy can be useful for personal and family insight, growth, and empowerment. However if therapy becomes a place for a person or family to simply confide and vent without any actual relief or improvement, then it may not be helpful.

In my work with patients, I advocate that one of the goals of therapy can and should be to not need it anymore. And this means that the therapeutic work by nature should involve understanding of thoughts and feelings as well as behavior change. One of my jobs is to listen to patients in a non-judgemental way, but if I do not use therapeutic techniques to point out how patients may be perpetuating patterns or not allowing themselves to make emotional gains, than I would be allowing them to stay in the sick role. This is called enabling. It is something I will not do. And by being aware of this potential therapeutic hazard and drawing firm boundaries against it, I can give patients and families opportunities to seek true improvement though it is difficult.


Enabling is toxic. The enabler (the person—a health professional, partner, family, or friend—trying to help) usually has good intentions but without expectations for the enabled (the person in need of help who is likely stuck in a cycle of poor decisions and distress) to make behavior change, he or she is only allowing or fostering the dysfunction to continue. The enabler thinks they are helping but the truth is they are scared and trying to control the situation that the enabled is not yet willing to fully address.

As long as the enabler keeps enabling, the enabled will never get a chance to make positive change. And this is what differentiates enabling from healthy, appropriate help. The healthy, appropriate helping approach allows for the control and decision making to be put in the correct, albeit unpracticed, hands.


Hawaii's Lack of Psychiatrists

Check out this informative article in Honolulu Civil Beat- Hawaii’s Mental Health Care Crisis: The lack of psychiatrists is a particular problem for people who rely on the state’s public health insurance for low-income residents.

https://www.civilbeat.org/2018/09/hawaiis-mental-health-care-crisis/

I am grateful to have my thoughts included.

BCDBC99E-E66A-4FCD-9186-8F974E2C9507.JPG