Asian American Psychology and Psychotherapy

Shin Shin Tang, PhD has provided psychotherapy to a wide range of Asian and Asian American communities for more than two decades, including to war refugees, adoptees, veterans, international students, immigrants, and subsequent generations. She has also conducted national and international research focusing on the intersection of trauma, gender, and culture. Dr. Tang maintains a private practice in Eugene, Oregon, the traditional homeland of the Kalapuya people. Her website shinshintang.com hosts resources for therapy with Asians and Asian Americans.

• AcknowledgmentsUser’s Guide: Please Read Before ContinuingPerceptions of Asian Americans Quiz Answers and More Questions Trigger Warning and Self-Care If You Identify as Asian or Asian American If You Identify as Other than Asian or Asian AmericanIntroduction: A Battle on Two FrontsThe First Front: Anti-Asian Racism The Second Front: Intergenerational Trauma Asian Americans Are Not Doing Okay Barriers to Mental Health Services (Breaking the) Code of Silence Why Air the Dirty Laundry? Toward a Liberation Psychology of Asian AmericansChapter 1: The Model Minority Myth and Anti-Asian Racism, Past and PresentThe Collective Lie Are Cultural Values Responsible for Asian American Success? Unseen Diversity: Chopsticks versus Spoons Ethnic Diversity among Asian Americans KJ’s Story George Floyd, Racism, and Asian American Identity Evolving Ethnic Identity and Relationships Native Hawaiians and Pacific Islanders Economic Disparity among Asian Americans Diversity in Generations Historical and Intergenerational Trauma: Knowing and Remembering, Wounded and Wounding Historical Trauma Intergenerational Trauma Figure 1.1 The Los Angeles Chinatown Massacre Forgotten American Colonialism: The Philippine-American War Figure 1.2 A Resurgence of Anti-Asian Hate Racial Microaggressions Summary: Moving Toward Liberation Additional ResourcesChapter 2: Rings of Betrayal: Contextualizing Asian American TraumaAttachment, Health, and Happiness Social Context, Trauma, and Asian Americans Betrayal Trauma: The Rupture of Attachment Misoo’s Story Recovering Traumatic Memories through Art Figure 2.1: Twinkle Twinkle Figure 2.2: I Am the Barrier Publicly Disclosing Sexual Abuse Experiencing Racism and Sexism How Common Is Betrayal Trauma among Asian Americans? Table 2.1: Rates of Betrayal Trauma among APIs Overlooking and Forgetting Betrayal Racism and Betrayal Trauma Theory Betrayal and Shame Sudha’s Story Cultural Betrayal Trauma Theory Figure 2.3: Traditional Models of Trauma versus Betrayal Trauma and Cultural Betrayal Trauma Institutional Betrayal Trauma Institutional Betrayal, Historical Trauma, and Ethnic Identity Japanese American Internment: “Betrayal by a Trusted Source” Ecological Models of Trauma An Asian American Model of Betrayal Trauma Chronosystem: History and Time Figure 2.4: The Rings of Betrayal Model for Asian Americans Macrosystem: Dominant White Culture Exosystem: Dominant Culture Institutions Microsystem: Asian Community, Immediate and Extended Family, the Individual Mesosystem: Community Interactions Decolonizing Asian American Psychology Additional ResourcesChapter 3: ACEs High or Low? Biases in Research on Child Maltreatment among Asian Americans and Asian CanadiansAdverse Childhood Experiences ACEs and Racism Textbox 3.1: ACE Questionnaire Conflicting Research on ACEs The Problems with Relying on Abuse Reports among Asian Americans Cultural Betrayal Trauma and the Motivation to Disbelieve Survivors Loss of Face Self-Report Questionnaires Child Sexual Abuse Child Physical Abuse, Emotional Abuse, and Neglect Epistemological Violence in Psychology Decolonizing Psychological Research Additional Resources Chapter 4: Beginning Therapy with Asian Americans: Therapist Self-Awareness and Client WorldviewBeginning with You Implicit Bias and Internalized Racism The Harm of Self-Ignorance Rings of Betrayal Inventory Instructions for Using the Rings of Betrayal Inventory Self-Reflection Questions Worksheet 4.1: Rings of Betrayal Inventory: Asian American Version Worksheet 4.2: Rings of Betrayal Inventory: General Version Worksheet 4.3: Rings of Betrayal Inventory: Shin Shin’s Example Shin Shin’s Responses to Self-Reflection Questions Understanding the Client’s Worldview Shreya’s Story On Being Indian American Intergenerational Trauma Racism On Being Asian and Disabled Indian Patriarchy Sexual Assault Mental Health and Therapy Cam’s Story Finding His Birth Mother On Being Christian On Parenting and Adoption Trauma Kira’s Story Ethnic Identity Advocating for Adoptees Adoption as Trauma Adoption and Institutional Betrayal TraumaMoving Toward Liberation Additional ResourcesChapter 5: Decolonizing Therapy with Asian Americans: A Relational Cultural ApproachA Relational-Cultural Approach Asian Americans, Psychotherapy, and Risk Aranya’s Story Shame, Betrayal, and Asian Americans The Cartesian Cart: Colonialism in Counseling Irfan’s Story: The Ethics of Compassion Relational-Cultural Therapy: Growing through and toward Connection Mutual Empathy and Mutual Empowerment Empirical Support for RCT Relational-Cultural Therapy with Asians and Asian Americans Intersecting Identities Jesse’s Story Intergenerational Trauma Listening, Shame, and the Need for a Witness Using the Rings of Betrayal Model to Lessen Shame Ethnic Identity, Intersectionality, and Shame Growing through and toward Relationship Combining RCT with CBT and Other Therapies Moving Psychotherapy Toward Liberation Additional ResourcesChapter 6: In Our Voices: Asian American Experiences in TherapyWorking with a BIPOC Therapist Working with a White Therapist Positive Experiences Understanding Asian Culture and Family Dynamics Addressing Discrimination Processing Intergenerational Trauma Asking Clarifying Questions Supporting Client Sharing Negative Experiences Racial Microaggressions Devaluing Culture Devaluing Family: Transposing White Culture onto Asian Culture Educating the Therapist Additional Forms of Racism How to Decolonize Therapy: Advice from Asian American Clients Center Family Address Client Experiences of Racism Directly Addressing Microaggressions: Apologize and Repair Moksh’s Story Consider the Legacy of Colonialism Appreciate the Diversity of Asian Americans Understand the Stigma of Mental Illness Develop a Unique Racial Justice Lens for Asian Americans Just Ask Be an AdvocateAdditional ResourcesChapter 7: Liberating Psychology Graduate Programs: A Call to Institutional CourageDecolonize Curriculum Content and Training Models Institutional Betrayal of Psychology Graduate Students Victoria’s Story Cultural Betrayal Sexual Harassment and Racism The Silencing Effects of Betrayal Institutional Cowardice The Need for Institutional Courage How to Practice Institutional Courage 1. Comply with the Ethical Principles of Psychologists and Code of Conduct (American Psychological Association, 2017c). 2. Respond sensitively to student disclosures. 3. Bear witness, be accountable, and apologize. 4. Cherish the whistleblower. 5. Conduct anonymous surveys and disseminate results. 6. Have clinicians teach clinical training courses. 7. Commit resources to steps 1–6. The Role of the American Psychological Association Additional Resources ReferencesIndexAbout the Author

Dr. Tang’s book is one of the first of its kind to center the voices of Asian diaspora in the context of trauma. She offers rich clinical vignettes and theoretical frameworks that help clinicians new and old develop skills to better serve their Asian American clients. I only wish a book like this had existed when I was in training.