What children of immigrants can teach everyone about mental health

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Sahaj Kohli, whose family immigrated to the United Kingdom from India, struggled with an identity crisis familiar to many children of immigrants.

As the first in her family to marry a non-Indian, the first to go to therapy and the first to start talking openly about mental health, she found herself needing an outlet to share her challenges. In 2019, she founded Brown Girl Therapy, an online mental health community for children of immigrants in the West, to marry her two passions of mental health advocacy and narrative storytelling.

Wherever their parents were born, children of immigrants are often straddling two cultures. They are being raised with values inside the home that can be different from those they are experiencing outside of it.

Immigrant parents still teach their children in the ways of their home country, often rooted in deferring to elders. That’s why children of immigrants can struggle with chronic guilt, noted Kohli, who earned a master’s degree in clinical mental health counseling from The George Washington University in Washington, DC.

Children of immigrants don’t all share the same experiences, but Kohli learned behavior patterns and obstacles that many of them face. Setting boundaries and discussing mental health with parents will be the focus of her forthcoming book, “But What Will People Say?”

“If you aren’t doing what is told of you,” Kohli said, “you feel like you’re doing something wrong or betraying your family.”

In a conversation with CNN, Kohli shed light on the struggles that first- and second-generation Americans face while also offering guidance on how to navigate difficult conversations.

This conversation has been edited and condensed for clarity.

CNN: Why do children of immigrants experience unique mental health challenges?

Sahaj Kohli: Children of immigrants are often straddling two different cultures. They are raised in a culture where the norms and the values are different than the values and norms that they’re being socialized in outside of the house. You are taught the role you are supposed to play, and it’s rooted in deferring respect to elders. That’s why children of immigrants struggle with chronic guilt.

CNN: Where does that feeling of guilt stem from?

Kohli: Guilt tells us when we are doing something wrong, when we may have wronged someone else or when we may be acting outside of our values. But when your values are different than those around you, then that guilt is holding you back. It’s making you act out someone else’s values rather than listening to your own. Recognizing that guilt is a warning sign for you to slow down rather than a stop sign for you to turn around is something that I find is difficult for children of immigrants to embrace.

CNN: How do you see these challenges manifest in the workplace?

Kohli: I often see it with children of immigrants who identify as women and the gendered roles that have been placed on them. If they grew up in a culture where they were taught to submit to an elder and are working with a boss or a colleague who’s been at the company longer than (they have), they might struggle to say no to that person, to ask for help or struggle to say that they have too much on (their) plate right now.

A lot of children of immigrants grew up in (a) hierarchical family system, and that hierarchy transcends into the workplace. They feel because they’re lower on the rung in the hierarchy, they have to defer to people who are higher on the rung. They feel like they need to constantly prove themselves or make those who are superior to them happy. Boundary setting feels intangible because they’re constantly trying to make other people happy.

CNN: How does the definition of success vary between children of immigrants and their parents?

Kohli: Immigrants come to a new country oftentimes without people they can lean on for support and sometimes a language barrier. They’re coming because maybe they were forced to, they might have been refugees, or maybe they’re coming because they want to give better opportunities (to) their children. The historical legacy of immigrants is in having to prove themselves and having jobs that show value to the economy. Immigrant parents pursued stability and security, whereas children of immigrants have the privilege to pursue passion and happiness.

CNN: What tips do you have for children of immigrants who struggle to talk to their parents about these issues?

Kohli: When having a difficult conversation with parents, it’s about addressing their fear. Often, immigrant parents come from a fear-based mindset and scarcity mindset because they might have come to this country with very little. They may be scared that you’re going to revert to not having enough, and they don’t want that. That’s why they prioritize security and stability.

Be vulnerable and address their fear. Help them understand that they don’t have anything to worry about, because they’re just worrying about their child being OK. Educate them on what you want to do so they can understand that it doesn’t need to be scary.

CNN: Where might there be disconnect in languages between the child and parent?

Kohli: In many cultures, the words don’t exist at all. We have to stop thinking in English when we consider where our parents might be coming from. That can look like addressing feelings of anxiousness. How can you identify what it feels like physically?

In a lot of Asian cultures, mental health symptoms manifest as physical symptoms. Headaches can be depression, or stomachaches can be anxiety. Making that connection could be helpful. For example: “Mom, when you have a lot on your plate, I notice you get stomachaches. That’s how I feel when I get anxious.” You can also highlight the severity and talk about how it affects (you) day to day. For example, “I used to love playing soccer, but recently I haven’t been able to get up and go.”

CNN: These children often experience survivor’s guilt — the feeling they’ve done something wrong by surviving a tragic event when others could not. What guidance do you have for navigating that experience?

Kohli: Children of immigrants often think, “I should just be grateful, because my parents had it worse.” I call it gratitude shaming — where we shame ourselves into feeling grateful. The most important thing to remember is that just because someone had it worse, your feelings are not invalidated.

The desire to make immigrant parents proud can be isolating when you’re left alone to deal with your struggles and don’t know how to ask for support. Having systems of support in or outside of the family is important.

Pain and suffering are not a competition. It doesn’t mean you’re betraying your family or your culture. If you struggle, you are human.

CNN: What have you learned that can apply to anyone?

Kohli: Self-care is an important part of mental health care. … (It) strengthens the roles you are responsible for as a child, parent, partner or sibling. For example, reframing therapy as something that’s not selfish, but something that helps you in the values that you’re rooted in within your family.

Self-care looks different for different family systems. It’s important to seek out external support with people who share your values. You never want to do this alone and free-fall without any kind of support as you’re navigating mental health conversations.

Build those systems of support inside or outside of the family before you start tackling the subject because it can feel isolating. For all of us, self-care in mental health is finding the agency you have within the systems you live in.