[지니 장의 마음 상담소] “정신과 상담받고 싶은데 가족 반대가 두려워요”

애틀랜타 중앙일보가 독자 심리상담을 위한 오피니언 칼럼 ‘Dear, 누나’를 시작합니다. 정신적 치유가 필요한 한인들의 말 못할 고민에 답해드리는 비대면 마음상담소입니다. 마음속 이야기를 진솔히 나누고 싶은 사람은 누구나 칼럼니스트 이메일로 내용을 보내주시면 됩니다. 상담 사례는 익명으로 본지 오피니언 페이지에 장 치료사의 칼럼으로 게재될 수 있습니다. <편집자 주>

Q. 저는 예전부터 정신과 치료를 받고 싶었지만 가족의 반대가 심해 어떻게 이야기를 꺼내야 할지 모르겠어요. 정신 건강, 특히 상담 치료와 관련된 이야기를 하면 화를 내기만 합니다.(31세 애틀랜타 한국계 2세)

A. 제가 흔히 접하는 질문입니다. 정신 건강을 둘러싼 낙인이 깊은 한국 문화에서 특히 다루기 어려운 주제입니다.

가족 간 갈등, 스트레스, 불안, 고통, 분노, 좌절, 씁쓸함 등을 경험하는 것은 매우 정상적이지만 많은 사람들은 이 감정들을 피하고 있습니다. 특히 유교 윤리가 지배하는 한국 문화는 심리상담에 대한 교육이 많이 부족합니다. 저는 한국계로서 심리 치료의 편견을 깨기 위해 환자뿐 아니라 환자의 가족들에게도 상담의 필요성을 설득하고, 가르칩니다.

가족의 지원 여부와 관계없이 치료를 받기로 결정한 환자에게 자신감을 불어넣기 위해 가장 중요한 것은 정신 건강과 정신 질환이 다르다는 것을 알리는 것입니다. 두 용어는 서로 얽혀 오해를 부릅니다. 정신 질환은 당신의 행동, 사고, 기분에 상당한 영향을 미치는 정신 건강 장애입니다. 이것은 치료될 수 있으나 완치는 종종 어렵습니다.

정신 질환 진단을 받았다면 증상을 관리함으로써 멋진 삶을 살 수 있습니다. 가령 제 피상담자 중 한 명은 직장 스트레스와 가족 문제로 저를 찾아왔지만, 상담 과정에서 저는 그가 양극성 장애, 우울증, ADHD를 진단받은 적 있다는 것을 알게 됐습니다.

진단과 치료는 별개입니다. 정신 질환 진단 이후에도 삶을 잘 살 수 있습니다. 증상을 잘 관리하고, 약을 정기적으로 먹고, 모든 감정 변화를 인지하려고 노력하는 사람들이 그 증거입니다. 그들의 치료는 만성 질환과 비슷합니다. 당뇨병, 고콜레스테롤혈증, 심장병, 심지어 암에 걸린 환자처럼 최선을 다해 증상을 통제하기 위한 노력과 투자를 해야 합니다.

정신 건강은 본질적으로 매 순간, 매일 일어나는 일입니다. 세계보건기구(WHO)는 “정신 건강 없이는 건강도 없다”고 말합니다. 정신 건강은 정서적, 사회적, 심리적 웰빙을 말합니다.

정서적 웰빙은 우리의 감정을 가리키고, 사회적 웰빙은 가족, 친구, 동료 등 타인과의 관계를 말합니다. 심리적 웰빙은 우리의 뇌가 스트레스, 트라우마에 어떻게 영향을 받고 회복하는지에 관한 것입니다. 정신 건강은 삶의 스트레스 요인과 자신의 회복력을 얼마나 잘 조화시키는지에 따라 결정됩니다.

치료를 결심했다면, 가족의 기분과 관계없이 자신감을 갖고 결정을 확고히 하세요. 타인의 마음을 바꿀 수 없습니다. 사람들은 타인의 영향을 받더라도 스스로 마음을 결정합니다.

저는 한국계 미국인으로서 가족의 허락을 갈망하는 마음을 이해합니다. 한국인들은 대개 가족을 기쁘게 하고, 그들의 바람을 존중하고, 자신이 하는 모든 일이 가족을 존중하는 방식으로 이뤄지기를 원합니다. 이런 의무감은 종종 가족의 반대에 부딪혀 우리의 결정을 흔듭니다. 하지만 정신 건강에 대해 더 많이 알수록 우리는 치료의 필요성을 확신할 수 있습니다.

심리 상담 치료는 모든 사람을 위한 것입니다. 큰 위기에 빠지거나 절망한 이들만 위한 것이 아닙니다. 저는 상담 치료사로서 모든 사람이 정신건강을 돌보는 데 적극적인 자세를 갖길 바랍니다. 매일 이를 닦고 충치 예방을 위해 1년에 두 번 치과에 가듯 일상적인 방식으로요.

가족에게도 이성적인 설명을 해줄 수 있길 바랍니다. 정신과 치료는 정신 건강을 유지하기 위해 마음을 돌보고, 정신을 맑게 만드는 것입니다. 모든 사람에게 정신과 치료가 필요하진 않지만, 치료에 대한 오명과 편견은 없어야 합니다. 부모님은 당신이 치료를 받는다는 사실을 결코 받아들일 수 없을지 모릅니다. 하지만 치료를 통해 당신이 자신감을 되찾고 행복해하는 모습은 치료의 의미를 설명하는 데 충분할 겁니다. WHO가 강조했듯 정신 건강이 없다면 건강도 없습니다.

☞지니 장(장유진)은…

결혼·가족상담치료사(LMFT) 겸 공인임상트라우마전문가(CCTP). 한인 2세이자 4명의 자녀를 둔 엄마로 ‘K-드라마가 당신의 삶을 바꾸는 방법’을 집필했으며 한미 양국에서 강연자로 활발히 활동하고 있다.

▶상담 이메일: connect@noonasnoonchi.com

Q. I’ve been wanting to seek therapy for a long time now and believe it would be good for me, but I’m not sure how to speak to my family about it, especially because they don’t believe in it. They get upset each time I bring up anything related to mental health especially therapy. What can I do? (2nd generation 31-year-old Korean American therapy seeker in Atlanta)

A. Hi therapy seeker,

Thank you for your question which I think is a common one that I encounter. It can be especially difficult in our Korean culture because the stigma surrounding mental health runs deep. That’s because Korean society has roots in Confucian philosophy where its core tenants lie in promoting peace, harmony, filial piety, education; core values we still see today in our Korean culture. These are wonderful values for a society to abide by but perhaps they’re taken too literally because although we can strive for things like peace and harmony, it doesn’t mean this is a normal, everyday occurrence or even commonplace. It is very normal to experience stress, anxiety, have family conflict, feel pain, anger, sadness, frustration, bitterness, etc. Emotions in our culture that people are aware of and yet they avoid them thinking they shouldn’t be feeling them. Then again, I see them questioning the positive emotions like happiness and joy and even surprise. The peace and harmonious living stated in Confucian philosophy are again core tenants, values we can most certainly abide by as they’re admirable for any society to follow.

However, we are emotional beings, connective creatures and we are expected to feel what we are feeling from the good, bad, ugly and beautiful. In fact, not feeling stressed or anxious and feeling sad or mad at the times when you feel this way is what I would say is not normal. I word this diplomatically, of course. We will experience all these emotions because we are human, but we hope and long for peace and harmony in our lives which can be our daily goal.

What our Korean culture lacks has historically been psychoeducation. Considering that education is a core value of our society, once we also understand the significance of psychoeducation being incorporated in Korean society, including the Korean diaspora, there will be a breakthrough in stigma, and what I feel will be a burden lifted among all of us from Korean nationals to the Korea diaspora. I include all of us when it comes to Korean mental health because we are of Korean descent. Therapy seeker, to provide you the leverage you may need to convince your family that it’s okay to seek therapy, here’s what I want to tell you and what I tend to teach (and peach) to people to breakthrough the stigma surrounding mental health. Everyone, all of us, will struggle or be faced with a mental health challenge or condition in our lifetime. However, not all of us will experience a mental illness. This is psychoeducation 101. To help you feel confident in your decision to seek therapy regardless of your family’s support, first things first. It’s imperative to know that mental health and mental illness, though both terms are intertwined; they are not the same thing. It’s why they’re misunderstood and misconstrued.

Mental illness is a mental health disorder that significantly impacts your behavior, thinking, and mood. But though this may be the case, we need to understand that mental illness is treatable, though it is not curable. People diagnosed with mental illness who take care of managing their symptoms can live wonderful lives. For instance, I have had clients come in for things related to their work stress, family, children, marriage, but found out somewhere along the therapy process through their sharing or via their patient file that they are living with a mental health disorder diagnosis from Bipolar Disorder to Major Depression Disorder to ADHD, etc. But they hadn’t come see me because of their diagnosis. In fact, I most likely wouldn’t have known since it did not pertain or interfere with their therapy. I am sharing this because it goes to show you that people can live their lives well without letting a mental illness diagnosis get in the way.

Now, it’s also important for me to share that these were clients who stayed on top of their symptoms, regularly taking the medication needed to manage their illness, being aware of any flair ups, etc. This is of utmost importance in understanding how people can live well with mental illness. They must work daily on managing their symptoms. In our field, we compare this to those who are diagnosed with a chronic physical illness. For patients diagnosed with conditions like diabetes, high cholesterol, heart disease and even diagnosed with cancer, they must do the investment to ensure their symptoms stay under control to live to the best of their ability. This is the same for a mental illness diagnosis. I hope this makes sense.

Now, let me focus on the definition of mental health since this is what I believe we need to all be clear on. Mental health, the health of your mind, is in essence an every moment, everyday thing. Mental health is health. As the World Health Organization says, “There is no health without mental health.” Mental health refers to your emotional, social, and psychological wellbeing. Emotional wellbeing refers to our emotions and social wellbeing is about the health in our relationship with others from family, friends, colleagues, etc. Lastly, our psychological wellbeing is how our brain is impacted by life stressors, trauma and the resilience it shows. Believe you me, whether we know it or not, we are thinking about our mental health all the time. For instance, when we wake up first thing in the morning, we might feel stressed or happy depending on what is planned for the day (emotional wellbeing) and then throughout the day we are aware of how we are feeling in relation to others (social wellbeing) whether it’s within our family or at work with our colleagues. Our overall psychological wellbeing must be taken into a larger context since that is referring more to our overall resilience.

Mental health is no way linear. I describe it as a circle, ebbing and flowing all the time whether its clockwise or counterclockwise and so on. Mental health is about how well we are balancing life stressors with our own resilience and mental health is about how well we are not balancing life stressors with our own resilience. Mental health is important always, at every life stage, not just in a crisis or a natural disaster, but when things are going well and calm in your life; peaceful and harmonious like our Korean society wants us to lean into. And again, to reiterate my point, mental health is not mental illness. They are not the same thing.

Therapy seeker, I hope I am helping you get closer to the confidence you need to stand firm in your decision to seek therapy regardless of how your family feels. That’s my second to final point here. In the end, we cannot change anyone’s mind as much as we would like to or believe we can. It just doesn’t work that way. People change their minds on their own even if we believe we had a hand in it (wink, wink). That said, as much as you want your family’s support, as a Korean American, I know very much how we seek our family’s approval despite the many times we want to deny this to be the case. It is rooted in our very blood to lean into filial piety because it is what’s in our society, taught by our family members, and behavior we have learned and observed. Filial piety refers to the duty and obligation we feel to serve our parents, family; doing what we can to please them, respect their wishes, and honor them in all that we do. This obligation we feel can make us waver in our decisions when they disagree or are upset with us. Hence why I provided some psychoeducation to equip you as best as I can with the knowledge you need to stand your ground. The more knowledge you have and the more you know about mental health as it relates to therapy, then the more confident you will be in front of your family as to why you are seeking therapy.

Therapy seeker, I know I threw a lot of information your way so let me tie this all together. Therapy, also known as psychotherapy or talk therapy, is for anyone and everyone. One does not need to be in a crisis or at rock bottom or unstable to seek therapy. In fact, what we therapists prefer is that people be proactive, not reactive when it comes to taking care of our mental health. The same we would take care of our physical health. For example, we schedule our dental appointments to upkeep our teeth, making sure to take care of them, avoiding cavities, etc. We make sure to do our best to see the dentist twice a year for a cleaning, so we stay ahead of any problems or issues with our teeth. This is as routine as it gets. The same can be said for therapy and how you can reason with your family and others who question what therapy means. It means we are doing what we can to upkeep our mental health because without mental health, there is no health, and we of course want to take care of our mind. Through therapy, we can get our minds clearer (as dentist appointments make our teeth cleaner). To clarify, this doesn’t mean everyone should seek therapy or needs therapy, I’m just trying to destigmatize its meaning in one’s life.

Going to therapy is a personal (or family) decision and can help those who are in their darkest times and in greatest need, but it must be also understood that therapy can provide an outlet for someone to talk things through because they’re going through a time of adjustment, life transition, or trial and challenge.

In the end, therapy seeker, your parents or family may never accept you going to therapy or try to understand mental health. Although it would help ease the tension if they did, I hope you can understand that due to the lack of psychoeducation in our culture, along with Confucian thought our elders were raised with, it is difficult to grasp the idea of therapy, mental health and mental illness. It could take time, or God willing it can happen easily or, it may never happen. This is why I hope with the psychoeducation I provided here; you have the confidence in moving forward with your decision to seek therapy so it can help you. When your family members see your confidence, happiness, and success as you proceed, that may be reason enough for them to accept it. Until then, know that you are doing what you can do take care of your mental health, the health of your mind, because, in the words of the WHO, “There is no health without mental health.”