Supporting Asian American Clients in the Post-COVID Era

The COVID-19 pandemic created one of the most challenging seasons for mental health clinicians across the globe. Many of us faced similar challenges as our clients and experienced the same feelings of confusion and helplessness as our lives seemed suspended in uncertainty. As a psychologist of Asian American descent who works with predominantly Asian American clients, the pandemic also brought to light for me another struggle. 

While the pandemic raged on, reports of anti-Asian attacks and harassment began to surge across the globe. StopAAPI Hate, a nonprofit organization that formed during the pandemic to track anti-Asian hate incidents, reported more than 9,081 incidents of anti-Asian hate between March 2021 and August 2021. The researchers believe that this number reflects only a fraction of the total number of hate incidents that occurred due to underreporting. 

Harmful rhetoric about the supposed origins of the COVID-19 virus only fueled the vitriol and hate toward the Asian American community and left many of us worried about our children being bullied in school, or fearful for our elder parents during their routine walks in the neighborhood. Social media circulated alarming video footage of Asians being verbally or physically harassed in restaurants, parks, and malls across the United States. It was heartbreaking to witness and even harder to process these experiences for ourselves and our Asian American clients. 

Learning to Name Racialized Experiences

When the Atlanta spa shooting occurred, in which eight people were killed, six of whom were Asian women, many of my Asian American clients struggled to contain their emotions. Their suppressed fears and concerns about their conditional acceptance in the United States came to the surface. Workplaces no longer felt safe. Friends failed to understand how certain interactions could be harmful, or didn’t even bother to acknowledge how the shooting may have impacted the Asian community. We found ourselves having to explain, educate, and name that racism has always been a part of the Asian American experience, but never seemed to be recognized by anyone else—always glossed over even by our parents, friends, or loved ones.

In the months that followed the Atlanta shooting, my clients were flooded with memories and emotions about racialized encounters that they had suppressed for most of their lives. Stories of racially motivated bullying at school or graffiti drawn across their family storefronts poured out of my clients. Many of them admitted that they had never shared these incidents before. Some never told their parents about being called “a ch*nk” or “to go the f*ck back to where you came from.” They often believed that sharing these encounters only further burdened their parents. In other instances, their reports of racial bullying were met with encouragement to ignore the harassment and endure it. Without having the ability to name, label and speak these racialized experiences, many clients felt powerless against them and stuck reliving these experiences unable to move forward, much less heal from them. 

How to Support Asian American Clients in Therapy

Within Asian culture, there can be an emphasis on enduring or “swallowing” our struggles without protest or fighting back. Many Asian Americans witnessed their parents utilize this survival strategy to navigate their early immigration experiences, often filled with discrimination and harassment. The prolonged history of anti-Asian discrimination and xenophobia within the United States, largely left out of American history textbooks and courses, only further alienated Asian Americans from their own voices and invalidated their experiences of racial trauma. 

The question that emerged from colleagues of all backgrounds was “How do we support Asian American clients through this time?” I offer a few suggestions below to help non-Asian or Asian clinicians, as they engage in the difficult work of holding space for the Asian American community in the aftermath of COVID-19.  

1. Acknowledge race in the therapy room. 
For clinicians with different racial backgrounds from their clients, it can be incredibly powerful to acknowledge the impact of these differences within the therapy room. In Asian culture, there is a value system of honoring and deferring to those in authority or of higher status, which may make it difficult for Asian clients to bring up topics of race with their mental health providers. When a white or non-Asian clinician inquires and holds space for the complex emotions that might exist for an Asian American client to discuss power, privilege, and race in the therapy room, it may be one of the few times in an Asian client’s life in which their race or ethnicity is being openly acknowledged. 

It is important to mention that an Asian client’s hesitancy to speak about race may not reflect a lack of desire, but a fearfulness that the clinician may lack understanding or, sometimes even worse, respond with complete disregard or disbelief about their racialized experience. When mental health clinicians can name the power and privilege dynamics embedded within race hierarchies and how they show up in the therapy room, we begin the difficult work of carving space for our clients to work on their racialized experiences. We convey that we are open to exploring these themes within our therapeutic work, and give our clients the opportunity to explore their racial and ethnic identities as well as their racial trauma. 

2. Name racial trauma and racialized encounters. 
For some Asian immigrant parents, the encouragement to minimize or ignore racialized encounters may have been the adaptation strategy that they believed was most effective in the face of racism. I consider my own parents, who came to the United States as Taiwanese immigrants, at times too fearful to answer the phone in their broken English. How could they have been equipped to have discussions about race with us? How would they have known how to manage the emotional upheaval that these encounters could have caused? How could they have advocated for us in school when they hardly could do so for themselves in the workplace and our communities? For many immigrant parents, silence felt like the best or most effective strategy in the face of racism. 

But our parents’ struggle to acknowledge and process our racial encounters and to point out the structural racism inherent in many societies also meant that we had no language or awareness to understand the detrimental impact of the hierarchies of race. This may have allowed many Asian Americans to internalize systemic racism, which exerts negative effects on our identity and mental health. Helping our clients identify and name their racialized encounters can be a powerful first step to working through racial trauma. This vocalization and naming may be one of the first times in which many Asian American clients have identified and verbalized their racialized experiences in such a direct way. 

3. Orient to safety.
While understanding and healing from racial trauma is a journey much more than a destination, mental health clinicians can play a powerful role in helping our clients understand how to orient to safety during times of activation or arousal. Within Asian culture, negative emotions are often framed as disruptive or unhelpful, needing to be ignored or suppressed. When we help our clients understand the power and usefulness of their emotions, it can be an important step in inviting our clients to trust their emotions and intuition. 

I often share with my clients that trauma is a felt sense that “I am not safe” in certain contexts. However, safety is much more a bodily sensation than it is a cognitive one. It’s difficult to think your way to safety if your body doesn’t feel safe. It can be empowering and powerful to teach our clients self-regulation skills to manage the physiological arousal that racism can trigger. Encouraging our clients to develop a self-regulation toolkit might provide them with tangible ways to re-regulate after racialized (and other) overwhelming encounters. Some toolkit skills might include exercise, dance or movement, connection with trusted individuals, creative outlets such as art or writing, breathing exercises, singing, humming, or mindfulness techniques. One’s ability to self-regulate can help remind them that their strong emotionality is not destructive but exists to provide them with useful data about their world. 

These emotions focus our attention, direct our energy, and help us decide how to act in response to difficult situations. These regulation skills might also help them develop the emotional tolerance necessary to engage in deeper processing and healing from these painful racialized experiences. 

The Asian American community is still coming to terms with how to move forward after these past two years. And though the news cycles about anti-Asian harassment and violence have begun to fade, the hate incidents and discrimination continue still. As an Asian American clinician, creating spaces in which Asian Americans can feel seen and heard is crucial. This validation is the necessary ingredient for a community that has largely felt ignored and silenced within American society. For mental health clinicians looking to support Asian Americans clients, we must interrogate our own biases and assumptions and create spaces of safety for our Asian American clients, as they write new narratives about their own racial and ethnic identities.