Immediately after Mimi Khúc gave birth to her daughter eight years ago, she fell into severe postpartum depression. While many mothers spend the first several months after giving birth fighting to stay awake, Khúc spent that time trying to figure out how to survive.
“I couldn’t find resources. I couldn’t find things that explained why life felt so hard for me,” says Khúc, a writer, scholar and teacher in the Washington, D.C. area who specializes in Asian American mental health.
People suggested the cause might be a chemical imbalance that could be cured with medication. But it wasn’t enough. So Khúc turned to her expertise in Asian American studies to find answers on her own.
Along with the difficulty of being a new mother, she found many underlying narratives that contributed to her sense of suffering: the difficulty of belonging as an Asian American in North America, her family’s refugee background and the pressures of being an Asian American mother.
Understanding these narratives helped Khúc acknowledge her pain and find new tools for healing when the individualistic and medical approach she was prescribed didn’t — having failed to account for important external factors that contributed to her declining mental health.
Indeed, according to Khúc, that approach can sometimes be counterproductive for many other people, including people of colour, who are often mentally affected by acts of oppression.
This is why professionals across North America are working to decolonize mental health by working toward collective healing to salve the wounds of colonization and oppression-based trauma, guided by Indigenous decolonial work.
A system that doesn’t work for everyone
Elisa Lacerda-Vandenborn shared a similar experience to Khúc. When she moved from Brazil to Canada in 2002, she confided in a therapist about her extreme bouts of loneliness and depression. But Lacerda-Vandenborn left each appointment feeling like it was her fault she was struggling.
“It was very individualized. Like, you know, go into a corner and figure out who you are and work on your self-esteem,” says the University of Calgary professor and PhD candidate in educational psychology.
On her own, Lacerda-Vandenborn discovered her sadness was actually caused by missing her family and a sense of community, which was a core part of her life in Brazil. She then moved into a co-op, allowing her to be part of a community in Canada. Her mental health improved drastically.
She says the way the mental health system works now — with medical professionals who use individualized, day-to-day coping mechanisms and medication as their main solutions — can be isolating and more detrimental than helpful for people who need more than traditional psychiatric help.
Both Lacerda-Vandenborn and Khúc think about how especially detrimental it can be for people like them, who were raised in more communitarian societies due to their cultures. They also say the mental health system needs to do more to recognize the cultural dynamics and racism that affects their daily lives — and the lives of many other people of colour.
Khúc says this is where the current mental health system can be improved for people of colour.
“We say that somebody is struggling because they visually are depressed or they’re going through their individual grief or individual struggle and we don’t often think about pain in the context of historical forces or social structures or cultural dynamics,” says Khúc.
That context, she says, is crucial for people of colour whose cultural backgrounds shape so much of who they are.
“Therapy is wonderful and it’s one tool but it also does not capture the extent to which suffering is experienced,” she says. “Therapy cannot explain to me — or at least most therapists can’t explain to me — how racism shapes my daily suffering.”
Although Jennifer Mullan, an author, academic, clinical psychologist and founder of Decolonizing Therapy in New Jersey, says that some people need individual therapy and medication to thrive, she agrees with Khúc.
“We cannot separate the people and our lack of wellbeing or dis-ease — not disease — we cannot separate it from what is happening systemically.”
This is why all three women — Lacerda-Vandenborn, Khúc and Mullan — are working towards decolonizing mental health throughout Canada and the United States.
Decolonizing mental health
Mullan focuses on decolonizing therapy through a peer education group she runs as a therapist at New Jersey University and as the founder of Decolonizing Therapy, which aims to raise awareness online.
“We do a lot of ancestral work, a lot of intergenerational trauma work, dealing with rage as a function and a normal understanding system of living in a world that continues to oppress us and not provide many of us with what we need,” says Mullan.
According to Lacerda-Vandenborn, many oppressed individuals need connection, which the current mental health system doesn’t make space for.
“It is our time to participate in decolonization. This is a shared process,” says Lacerda-Vandenborn.
Mullan emphasizes that decolonizing mental health is more than just doing research on cultural competence — the ability to understand and interact with people of different cultures. Instead, it’s recognizing that for many Black, Indigenous and Brown individuals, the trauma from oppression and colonization plays a major role in their state of mental health.
“Decolonization is not a metaphor and trying to be better mental health advocates is not going to be enough. Being culturally competent, in my humble, loving opinion, is not enough,” says Mullan.
Khúc’s work, which is focused on decolonizing Asian American mental health, aligns with this statement.
“I mean, who’s best to say how something hurts and why something hurts than the people who are experiencing it — not random doctors who think they’re trained in cultural competence,” says Khúc.
Moving toward collective healing
For Khúc, a decolonized mental health system would be one that allows communities to decide what is considered suffering, rather than having the system decide for them.
“When I say decolonizing, I want to question and interrogate the ways that these larger forces and institutions have told us what counts as mental health and what counts as suffering,” says Khúc. “In order to interrogate that, I have to draw on community and think about the kinds of knowledge that come out of our own communities around what suffering is.”
“How do we disrupt those systems of power to have people be able to claim their own knowledge and experiences?”
But, according to Mullan, the idea of collective healing was systematically taken away from people of colour by giving them no time to come together in groups or think about their emotional needs.
“I think that what has happened in the last 20 or 30 years is that many people of colour have started to just try to survive, understandably,” says Mullan. “The system is really good at having us just focus on surviving so much that we don’t have the time to collectively come together and heal in community, which I think is pretty crucial,” says Mullan.
Acknowledging colonization and oppression-based trauma, she says, would help with that.
Colonization and oppression-based trauma
However, it may also be difficult for people to recognize trauma caused by colonization and oppression as mental health issues.
Khúc, for one, struggled to make this connection until she dug deep into her narratives of suffering when she was experiencing postpartum depression. Now, she encourages others to use their experience and knowledge with trauma to decolonize mental health.
“My hope for decolonizing mental health is to centre community and to use the arts to think of new forms that can address our suffering and to empower those who are suffering to be the producers of their own knowledge, in their own healing practices,” says Khúc.
This suffering, says Mullan, is often rooted in colonization and oppression.
“I feel like so much of the depression, of the anxiety, of the constant state of trauma that we are going through, this complex, developmental trauma, this concept of fight, flight, freeze’ response that we’re in are due to systems of oppression — are due to these overt and covert acts of racism and colonization and the effects of colonization on our minds, bodies and spirits.”
Mullan says microaggressions — comments or actions that subtly and often unintentionally express a prejudiced attitude towards someone — are also acts of oppression that can cause race-based traumatic stress in many people of colour.
“The constant level of heightened awareness and hyperarousal and cognizance that Black and Brown folks have to constantly be aware of truly is staggering and it is often why we are very burnt out and very traumatized and very sad,” says Mullan.
The suffering or trauma caused by oppression, according to Mullan, is often passed down through generations. She says many people of colour are now feeling that trauma. This is often referred to as intergenerational trauma and sometimes as historical trauma.
According to a 2018 study published in World Psychiatry, scientists suggest trauma can be passed down to subsequent generations through an enduring change in the function of DNA. This change is epigenetic, as opposed to genetic. That means the structure of the DNA itself isn’t changed, but the expression of the DNA is. This can have a lasting effect on the individual and their offspring.
This is especially true for people of colour who may not have had the time to think about their emotional needs. Mullan saw this play out with her own parents, who worked two to three jobs to keep food on the table and a roof over their heads, but were still constantly struggling.
“There was no way that my father was going to look at any of his histories of trauma. There was no way at that time that my mother was going to look at any toxic relationships in her family,” says Mullan. “That minimization of our emotions, I truly believe, has just been passed down generation to generation until many of us now are re-remembering and reconnecting with our ancestors.”
Mullan is now trying to teach that many people experience intergenerational trauma, despite the term often being associated with victims of residential schools, the Holocaust, Japanese internment camps and slavery.
However, she wouldn’t have learned this if it weren’t for Indigenous ways of knowing.
Guided by Indigenous decolonial work
When Mullan began her research on decolonizing mental health, she looked to many Indigenous authors to lead the way and educate her on postcolonial psychology, such as Maria Yellow Horse Brave Heart and Eduardo and Bonnie Duran.
This literature allowed her to see a connection between the decolonizing work Indigenous communities are doing and the decolonial work she currently is doing, which are both rooted in intergenerational trauma.
“Since I was already doing intergenerational trauma [research], I started looking at all of the ways we had — I had — forgotten myself,” says Mullan. “That I had forgotten my people. I had forgotten because I had the privilege to, even my blackness because my family was trying to push that down.”
Indigenous decolonial work is also extremely important to Lacerda-Vandenborn, whose work focuses on Indigenous science, knowledge and ways of being and how that perspective is applied to psychology in Canada.
This perspective allowed her to feel a sense of familiarity when she was first suffering from loneliness and isolation in Canada.
“When I started to look for things that aligned with a more communal perspective, it was in Indigenous ways of knowing that I found a place. It’s almost like I found the home,” says Lacerda-Vandenborn. “We are connected to similar things — to the importance of community, to the importance of relationships, to the importance of looking at the context.”
Khúc often thinks about this similarity when using the term “decolonization” to refer to Asian American unwellness.
“I want to be respectful to Indigenous folks who are doing decolonial work and not to use the term lightly, but for me, as somebody who is Vietnamese American and Asian American, we have our own histories of colonization —our own histories of relationships with colonial practices,” she says.
“As a refugee, I feel like a displaced colonial subject,” she adds, referring to the history of colonization in Vietnam and how that still affects her today, despite her now living in the U.S. “So to decolonize the system is to take a practice related to Indigenous decolonial projects but is also separate from it.”
Lacerda-Vandenborn refers to this as a “third space,” which sits in between Western perspectives and Indigenous perspectives. For her and Khúc, this space integrates pieces from all three perspectives so the mental health system can give people what they really need, which is crucial to the decolonization of mental health.
Mullan adds that, in order to work towards a decolonized mental health system, healing for all people should come in more forms than just individualized therapy and medication.
“I really believe that our understanding of therapy needs to shift out of it only being a problem, an issue, with the brain,” says Mullan. “I also believe that Indigenous work and spirit work needs to be more included as a form of therapy, that it shouldn’t be considered that only one-on-one therapy in an office with a licensed person is therapeutic work.”
This means when prescribing resources for healing, ideally mental health practitioners will recommend methods that are appropriate specifically for the patient they are treating. That can look like Indigenous spirit work, yoga, shamanism and more.
Mullan says that some people need individual therapy and medication in order to thrive. However, she would like to see more collective, holistic healing approaches to mental health as options — the way they were done, and successfully worked, before colonization.
“I do think that we continue to blame ourselves or our brain or our trauma histories — and not that they do not have a major impact — but we are not continuing to look at and hold these systems of oppression accountable.”
Khúc stresses this work is important for everyone — not just people of colour.
“I think that decolonization practice has to come out of communities of colour but the idea is that it benefits everybody because it takes mental health and puts it back in the hands of communities,” says Khúc. “All communities would benefit from it being in their hands and not in the hands of so-called experts.”
Editor: Georgia Longphee | firstname.lastname@example.org