One “Bad Indian” Therapist’s Nuanced Take…

I’m a Malayali-Indian American woman who was raised in a Catholic household in the Midwest. English is my first language and my parents spoke English with me at home. Due to my parents’ work, we almost always attended Sunday mass with white people, instead of the hours-long Sunday mass at the Syro-Malabar Catholic several miles away. Although my family certainly didn’t have it easy, we were socialized to whiteness. So it’s unsurprising that when I started therapy to address my traumas, therapy wasn’t ineffective for me. Overall, despite some cultural gaps in my parents’ understanding, I was raised with a Western mindset. So therapy in an American context helped me a lot. 

But that didn’t necessarily mean that my therapists understood me. 

I had therapists who were well-meaning and well-intentioned, but didn’t necessarily get the cultural gaps, especially when it came to boundaries. And while I also had well-meaning therapists of color, they didn’t necessarily understand how strong cultural guilt and shame are in Indian households. While I’ve gotten better with communicating with my parents, there’s still a lot of pain and hurt that exists like a giant elephant in the room. Sometimes this pain looks like  words that aren’t being said out loud, context cues that I’ve learned to pick up on when my parents quiety express disapproval.. And when I met with an Indian American therapist, I found that not only was she dismissive, but her immediate advice was to tell me to talk to my parents, or reduce me to superficial Indian stereotypes, because that was her idea of “culturally competent” therapy. 

If this is MY experience as an Indian American who is also a therapist, I can’t even imagine what it’s like for other Indian and South Asian people who grew up in even more culturally conservative and traditional homes than I did.

Currently, there’s a lot of discourse around the Westernization of therapy. Many therapists and therapy-seekers believe that therapy is too Western because it did not work for them. Does therapy, particularly in the Western sense, work for Indian and South Asian people? 

Therapy for Indians vs. Indian Americans

There are many people of Indian descent, especially those who are living in India, who actually enjoy traditional Western therapy. Many therapy modalities have its origins in the West. Even the founding fathers of Psychology are from the U.S. However, what’s lesser known about Western therapy is that many of its practices were co-opted by Eastern spirituality, including ancient Indian and Hindu spirituality. 

Everyday I see social media accounts from Indian therapists who promote CBT, DBT, and evidenced-based therapy that was developed in the West. Evidence-based means that the treatment underwent peer review and has shown to be effective on clinical (usually white) populations. There are Indian people who prefer Western therapy because they identify with its individualistic nature. What many Indian people may not know is that so much of Western ideas of individuality were co-opted by Indian spiritual practices over the last three centuries. However, in a modern Indian society post-British colonialism where personal autonomy isn’t always respected, Western therapy provides Indian people the freedom to exercise individual choices and assert boundaries. 

But for many Indian Americans, who are the descendants of immigrant parents, this may not hold as true. Our immigrant parents held tightly to the beliefs and values that they had when they left India. For most of us, this was back in the 1970s and 80s. Our parents held tightly to these values to conserve what they had left of the culture when they came to the U.S. They may hold on tightly to outdated values because they’re afraid of cultural erasure. Meanwhile, India was developing and changing without them. I find in my clinical practice that many Indian and other people from countries in the South Asian subcontinent tend to be more progressive and open to different ideas compared to our parents and even our generation. 

As a therapist, I often find that many Indian clients born and raised in India prefer more evidenced-based, structured, and Western forms of therapy, while my Indian American and South Asian American clients who were born and/or raised in the U.S. are more likely to prefer free-flowing, unstructured talk therapy. This is because, for many Indian and South Asian Americans, they’re coming to therapy for the first time. They grew up in more culturally conservative households where talking about problems wasn’t encouraged, mental health wasn’t seen as important, and airing your “dirty laundry” to strangers can bring shame to the family. So the idea of even talking to a stranger, let alone engaging in evidenced-based therapy, is a huge first step. If you’re an Indian American and it’s your first time going to therapy, you likely just want someone to talk to, someone who makes you feel like you’re not crazy for questioning the cultural norms, and you might not know what kind of therapy works for you yet, or even what goals you need to work on. You just want to feel less alone! 

At the same time, I’m concerned about the misconceptions Indian and South Asian Americans have about what therapy can do and what it is about. I find that many Indians and Indian Americans think therapists are supposed to give advice, or find quick-fix solutions to problems. I find that many also think that therapists are supposed to make their emotions or problems go away, or that therapists are supposed to fix world problems. Therapy has never been about these things. Many of these beliefs are rooted in urgency culture, a tenet of white supremacy culture. The urge to fix things quickly and instant gratification feed into myths about therapy that are rooted in white supremacy culture. These are very Western values that are a product of the fast-paced society that we live in. 

Therapy can also take on these Western values, and many therapists don’t realize that their approaches to mental health are rooted in Westernization. Many therapists believe that they have to give advice, be constantly available, and fix people’s problems in order to be “good” at their jobs, ignoring the training that we were given in grad school, because of the pressures of urgency culture. This is why I see many Indian and South Asians say they would never go to therapy, because therapy is Western and therefore “bad”. Or, they were disappointed that their problems weren’t “cured” in 2 or 3 sessions. 

If you’re one of these people, I’m going to gently call you in–you’re struggling with a Western perspective too. The idea of “good” vs. “bad” is a rigid hierarchy that is also rooted in white supremacy culture. This either-or thinking leads to othering, a concept many of us should be familiar with. We’ve been othered by many people who didn’t consider us the “norm”, facing racism and discrimination as a racial minority in America. Not to mention that medicine is also Western, nursing is also Western, dentistry is also Western–does that mean you shouldn’t go to the doctor? 

Yes, therapy is Western, and therapy that takes your culture and collective trauma into your consideration is really important to your well-being. There are many therapists out there, both South Asian and non-South Asian therapists of color, who understand the importance of criticizing the very white industry of therapy. A lot of things in our society are Western, but that does not mean it’s inherently bad for you. 

It’s important to find a therapist who holds a non-Western, critical lens of mental health, while also questioning the “norms” of South Asian culture, most of which come from European colonization and other forms of oppression. You deserve a therapist who does both. You deserve a therapist who doesn’t buy 100% into both Western and “it’s just cultural” approaches to mental health. You deserve a therapist who is nuanced and balanced. 

So what kind of therapy is effective for South Asians? 

As a therapist who specializes in EMDR, I have found that mind-body techniques and trauma-informed therapy are some of the most effective types of therapy for South Asians, but with a couple of caveats. Eye Movement Desensitization and Reprocessing (EMDR) is a type of trauma-informed therapy that engages both the left and the right sides of the brain in order to mimic the brain’s natural rapid eye movement (REM) cycle. Engaging the left and right sides of the brain helps process traumatic events, triggers, physical sensations, and deep emotions that make us feel stuck. Basically, EMDR helps you process better. 

But just like any type of Western therapy, it’s not perfect, and it needs to be adjusted for South Asian client populations. I know that EMDR purists will get mad about this, but I don’t do “pure EMDR” with Indian and South Asian clients. As someone who is trained in EMDR, I have found that EMDR as a manualized, scripted approach is not effective for therapy-seekers of the global majority. Pure EMDR is very intimidating for many clients, especially for South Asian clients who are brand new to therapy. In addition, many Indian and South Asian clients do not like to feel in our bodies. We’re very cerebral, and prefer to talk things out to process before feeling in our bodies. While I think that EMDR can help Indian and South Asian clients feel, they may not be ready to jump right into reprocessing negative events or traumatic memories early in treatment. That’s why I do a mix of talk therapy with EMDR to support Indian and South Asian clients with an easier transition into feeling in their bodies. 

You don’t need to have a trauma history to benefit from EMDR or any other types of trauma therapies and somatic therapies. I find that many Indian and South Asian clients have experienced what’s called small “t” traumas: emotional neglect, verbal abuse, or discrimination and harassment. You also don’t need to go too deep into your past with EMDR either. EMDR can be used for Generalized Anxiety, Social Anxiety, and OCD, in combination with other types of therapy like Cognitive Behavioral Therapy (CBT) and Exposure and Response Prevention (EXRP) . Because of the multiple methods required to treat these conditions, and because Indian and South Asian clients need a therapist who just GETS THEM, I practice from an eclectic approach! This is why many therapists are calling for the decolonization of therapy–the one-size fits all approach that the field of therapy preaches just does not work for all of us!

Regardless, not every South Asian therapist may agree with me, and that’s OK. We don’t all have to be the same or have the same approach, and we are allowed to be just as diverse and unique as our diaspora! I would say that the best type of therapy is the one that takes your unique and individual experience in mind, along with your relationship to your cultural identity. Therapy isn’t one size fits all! 

How do I find the best South Asian therapist for me? 

Just because a therapist is of South Asian descent doesn’t necessarily mean that they’re a good fit for you. Some South Asian therapists can be just as judgemental as the relatives in your community. Some South Asian therapists may also believe that they should be “unbiased” and “blank slates”, aka completely neutral, with no opinions about how your culture and politics impact you. Therapist is political. I don’t want to be a political therapist (in fact, I’m pretty adamant about not taking on titles outside of “The Bad Indian Therapist”), but I  accept uncomfortable truths: in a racist, sexist, heteronormative, capitalist, imperialist, and ableist society, therapy is political. And that also means that all therapists (including me), are fundamentally flawed. We are human too. We’re also subject to biases, and we’re also surviving these systems of oppression. We don’t fly off to Mars at the end of session–we live on this same planet as you do!

That doesn’t mean you can’t find the best fit therapist *for you*. Yes, it is kind of like dating: you’re not going to find the perfect match, but it’s important to identify your deal-breakers and let go of the rest. Here’s how to find the right South Asian therapist for you: 

1. Identify 2 or 3 qualities or characteristics you would like in a therapist: this can be anything from their personality, to their demeanor, their gender, their cultural background, and their cultural understanding. This can even be their beliefs and values, where they stand on social issues, and who they voted for.

2. Identify 1 or 2 logistical deal-breakers: this can be insurance, fee range if you choose to go out-of-network, in-person or virtual sessions, and approach (like CBT or EMDR). In the U.S., most therapists are licensed by state, so be sure to also check for location and the states that the therapist is licensed to practice in to make sure you can work with them (even for virtual sessions). 

3. Identify your current resources: Do you have the time, space, and the financial resources for therapy? Therapy is about the right time, right place, and right therapist. Sometimes you might find the right therapist, but it might not be the right time or place for you, and that’s OK. Check if your insurance covers therapy, and if you have out-of-network insurance benefits just in case. If you’re employed, your employer might help you save money on taxes by funding a Health Savings Account or Flexible Spending Account, which are debit cards that can help pay for out-of-pocket medical and mental health costs. This usually comes as an employee benefit, so talk to HR about your options. 

4. Visit The South Asian Therapists search directory, Inclusive Therapists, or insurance websites like Headway. South Asian Therapists is the largest directory for South Asian therapists in the U.S., Canada, and the UK. There’s also Inclusive Therapists, an online directory for therapists who practice with a liberation mindset. Inclusive Therapists even offers a BIPOC Therapy Fund for clients in financial need. If you live in the U.S. and you need someone who takes your insurance, visit Headway. You can filter by ethnicity and choose South Asian. Other insurance-friendly websites include Alma and Grow Therapy. 

5. Take some time to visit a therapist’s website! Many therapists have an online presence, whether it’s a mix of social media, an online website, or both. Some therapists work at group practices, so it might be worth taking the time to check out their website to see if there are other South Asian therapists who also work there, or what their practice policies are like (i.e. what their cancellation policy is, their intake process, etc). Many therapists will detail what conditions they specialize in on their website.

6. Schedule several consultations. Most therapists offer a free consultation call to see if they’re a good fit for you. Many therapists have online booking calendars like mine where you can book a free intro call, or may require you to reach out via email on their website. These calls are short, so take the time to prepare what you would like to say to the therapist when you get on the call. What would you like for them to know about you? What do you need help with? 

How do I know if a therapist practices with my cultural background in mind? 

There’s nothing I hate more than spilling your guts out to a new therapist only to find out that they’re not a good fit for you or that they truly don’t understand you. It’s such a raw process! That’s why it’s also important to interview your therapist during your consultation call. Here are some examples of questions to ask: 

1. What is your relationship to your cultural background? 

2. Are you familiar with working with people of my cultural background? 

3. I’m also queer and non-binary. How do you take intersectionality into consideration? 

4. What are your opinions of Western or mainstream therapy?

5. Do you incorporate politics into your work? 

6. Who did you vote for in this most recent election? 

7. What trainings do you take to stay culturally informed and competent? 

Any therapist who has ever had to deeply question their relationship to their profession and their relationship to the world will not be offended or taken aback by these questions. In fact, they might fully expect them. Considering that we just re-elected a felon for the second time in the U.S, you are also allowed to ask your therapist who they voted for. Unfortunately there are many Indian Americans who voted for Trump, so we should expect this with South Asian therapists as well (seriously, you have no idea how often I get socially conservative Indian Americans commenting on my Instagram, who I suspect might be in this career field too). 

You don’t belong in a box! 

You deserve a therapist who understands that your cultural identity is an important and fundamental part of who you are, AND that it doesn’t define every single part about you. You are so much more than just your culture. A culturally competent therapist who is critical of Western therapy will also recognize that you are a human being before labels, and that you are deserving of individual autonomy and choice. 

Personally, I’m a South Asian therapist who understands cultural norms in South Asian families AND I also deeply question where these cultural norms come from. Just because it’s “cultural”, doesn’t mean it’s OK. Some cultural norms deserve to be questioned and called out. 

Are you looking for an Indian American therapist who takes the time to GET YOU? I work with South Asian American clients in New York, New Jersey, California, and Florida. Click the link below to book your Free Intro Call on my calendar! 

Can’t work with me? No hard feelings. I have an online community with workbooks, mental health resources, community chaat sessions, and history articles to help you connect your relationship to your identity to your mental health. Subscribe to Misfit Chaat House today!