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Thursday, June 25, 2015

10 Tips on Self-empowerment in the Nepalese Culture

"Give a man a fish, you feed him for a day.  Teach a man how to fish, you feed him for a lifetime."
~Proverb
    
     As a mental health professional practicing counseling for over 17 years and owning my own therapy practice, my career is all about empowering people so they can lead healthier, autonomous lives. In my work, the focus tends to be on effective communication skills, healthy emotional regulation, self-care practices, relationship building and maintenance skills, etc. My clientele is very diverse from the very poor to the very affluent, from children to grandparents, and from Americans of various national heritages to refugees who have experienced extreme trauma in multiple countries, both natural and human-made.  Additionally, I do consultancy work as a "cultural broker" in mental health, when empowering the Bhutanese refugee community in Baltimore, MD who are of Nepali origin. I take extreme pride and satisfaction in the work I do as I help people rebuild lives.

     In Nepal, at this time, there is a movement going on where there is a push for Nepal to be empowered rather than be helpless and mere recipients of donations from the international community. These advocates realize that Nepal cannot prosper in this way if this pattern continues in the rebuilding process. There is also a call for action to empower the Nepalese people by teaching them skills that can be sustainable long-term. Hence, I am responding to this call for action here by focusing on strategies to enhance self-empowerment given the Nepalese cultural context. Quite frankly, the skills I will focus on will help anybody really, both on a micro and macro level.  However, let us first understand some key terms: empowerment versus self-empowerment.

     Empowerment is when you derive strength from something or someone external like volunteers’ leaders who are empowering their volunteering team in the rescue, relief, and rebuilding efforts as it is happening right now in Nepal post-earthquakes.  Empowerment can also be derived from inanimate objects like achievement awards and job salary increase which validate to someone that they are competent and worthy of this award or monetary compensation. There is no shortage of the crave for this type of external validation in both collectivistic and individualistic cultures, but we will not get into the dynamics and implications here. 

     Self-empowerment is slightly different than empowerment. Self-empowerment is when you derive strength from within yourself. This difference is critical to understand as we explore the Nepalese culture, which is one of the most fascinating and ethnically diverse societies in the world.  Nepal is a collectivistic culture, which basically means that group values and beliefs take precedence over individual ones.  However, the implications for self-empowerment are great in this type of group-oriented culture whether it be Nepal or elsewhere.   

    As you read the tips on self-empowerment below please keep in mind that these assumptions hold true: (1) Not one culture is better or worse than another culture (2) Just because something has been done in a certain way for a long time, it does not mean it cannot be challenged and changed (3) When something in our lives is not working for us, then we do have a choice in the matter in terms of how we deal with our circumstances. The choices may not be good or fair ones, but we do have a choice nonetheless, and this is in and of itself empowering.  Here, I will just ask you to entertain the possibility of these cultural shifts, but not necessarily to agree with my assertions. 

The 10 Self-empowerment Tips:   
 
1.      Engage in healthy emotional regulation. All human beings have emotions, and regulating these emotions requires basic three steps: emotional awareness, expression, and management. The tricky part is when cultural values and beliefs impact this process.

     In the Nepalese culture, we are not encouraged to share our emotions but rather to suppress them. You will often hear loved ones say things like "Let's forget the past," or "You shouldn't feel that way." This happens mainly for these three reasons. First, we believe that we will hurt others’ feelings and disrupt social harmony in families and with friends if we were to share how we honestly feel about someone or something. It can upset our loved one, so therefore, we are not to share our emotions. Second, expressing our emotions is seen as a sign of weakness, which makes us vulnerable to others. There is a belief system that people may take advantage of us, dominate, or exploit us ("hep cha" or "faida utaucha"). Thirdly, when we express our true feelings to others, this will compromise “ijat,” which is essentially a combination of social status and saving face so we do not make ourselves or our loved ones look “bad” and lose our place in the very complex social hierarchy in the Nepalese culture, which itself is very diverse ethnically with its own subsystems within the caste system. Couple that with the class system, then this really complicates matter thousandfold.

     Here is the part we must understand. If we do NOT adequately regulate our emotions, then those emotions (now very intense emotions since regular expression has not occurred) come out in very unhealthy ways and in the most inconvenient of times and places like a large social gathering, a job interview, social media, etc. where there are many, many witnesses to our emotional outbursts or other vulnerabilities.  So, this cultural belief that it is not ok to express our emotions to others is what actually goes against our Nepalese cultural values because this practice compromises social harmony, makes us more vulnerable, and creates tension in the family and peer dynamics. Furthermore, this compromises not only ijat but also group solidarity, which ultimately ends up hurting others’ feelings and stunting our emotional growth both individually and collectively….the very things we are trying to avoid. In psychology, we call this the self-fulfilling prophecy.  
          
2. Know the difference between what is within your control and outside of your control. This is a simple principle but a difficult one to practice, especially if you do not have much practice with #1 (emotional regulation). If you identify a problem, then you have to ask yourself  first: “Are the solutions to this problem within or outside of my control?” If they are within your control, then you do whatever appropriate to solve it given your personal circumstances.  If they are not in your control then you just simply let natural consequences take its course and have faith in a higher power to make it all work out at the end. Wasting time and energy on something that is outside of our control is draining emotionally, physically, and mentally.  That time and energy can be better spent in productive ways elsewhere.

     When the earthquakes happened in Nepal, we understood that we cannot control Mother Nature, but we can certainly make sure that we have adequate buildings codes that can be implemented across the board so we are not so vulnerable in the future.  I have slept through earthquakes in Tokyo because they have good building codes and they are implemented well.  The Japanese system works, ours does not.  Any earthquake expert will tell you that we have to first change our mindset to "earthquakes don't kill people, buildings kill people" if we really want to see meaningful changes. We can collectively choose to move towards this mindset.

3. Hold yourself responsible for both positive and negative behaviors.  This is basically asking oneself: “What is my role in all of this?” If it’s something positive like getting a promotion then this will foster feelings of pride, joy, competency, confidence, etc. when you recognize your own efforts and when others recognize your efforts.  

      If it is negative like losing a job, then understanding our role in the problem will also help us to be self-empowered. We can successfully identify the problem and take measures to correct it so it does not happen again and again.  In other words, we cannot fix a problem if we do not know what the problem is. 

On a national level, an example of this that sticks out for me is the piles of garbage on the streets in Nepal which contribute to the pollution that harms everyone.  If we invest in better sanitation systems as well as hold ourselves and our children accountable by not littering, then this is a major progress in my humble opinion. If we just pick up the trash in our immediate surroundings as we go shopping or play outside, others will see it and with time, they will do the same. This is the beauty of our group-oriented culture: if there is a good leader, then people will follow.  We can channel our group values in positive and productive ways. The positive ripple effects of this cultural shift is truly mind-blowing and ever so empowering.   

     When we do not hold ourselves accountable, we are more likely to play the blame game, which really just ends up hurting ourselves and others. It is very counterproductive and disrupts social harmony. Admitting to making a mistake and apologizing for it is one simple way to hold ourselves accountable for negative behaviors.  We cannot be successful until we hold ourselves accountable first.  
 
4.  Hold others responsible for their positive and negative behaviors and consequences without playing the blame game. This can be applied in both individual and at the societal level. Post-earthquakes, it’s no news that many Nepalese people have been utterly dissatisfied and distrustful of the nation’s leaders for a very long time and the animosity towards the government is all over social media and other communication mediums.  We can hold others responsible without blaming them and we can use a respectful, productive approach when doing this. When we hold others responsible, then we are telling them that we are watching and they cannot exploit us. If we keep quiet, then we are giving them permission to treat us badly.  Assertiveness training can also be helpful if this is a personal challenge. Inaction is also a decision we choose to make.  At the end of the day, we teach others how to treat us.  If we want to be treated with respect, then we need to treat others with respect no matter what their status, education, class, caste, etc. It's just that simple.  

5. Engage in self-care. This is a MUST! In our Nepali culture, we are trained to take care of others more than we are trained to take care of ourselves. This is a good thing, but only if we are taking care of ourselves first. Otherwise, you risk experiencing compassion fatigue which is essentially known better as "burnout." If you have ever flown on an airplane, the flight attendant doing the safety demonstration or video always tells the parent to put on their oxygen mask first and then put it on their child.  This happens on every airline whether it be from Singapore, Thailand, America, etc. In other words, if we are not healthy first, then we are not in the best position to help others, especially our loved ones. 

     In the case of Nepal right now, I am very concerned about this for all of the courageous and compassionate volunteers involved in the rescue, relief, and rebuilding efforts. The support system with highly skilled mental health professionals needs to be put in place for the volunteers, especially those who are also the earthquake survivors and who are at very high risk such as if they have lost their own homes during the earthquake. Their efforts are to be commended, but they also need to understand that they have to take time to recharge their batteries and their support systems have to positively support them in this way by encouraging self-care practices rather than adding negativity. There is such a thing as a negative support system. Psychological First Aid curriculum states that negative support system should be avoided as much as possible or it can make matters worse.  

6. Pay attention and engage in the nation's politics no matter how frustrating.  You do not have to be a politician to be engaged in the politics. Nepal's has a very interesting and complex political system with many political parties for such a tiny nation to represent its diverse political and ethnic views.  You do not have to follow every issue in the political scene to be politically engaged. You can choose few issues that are close to your heart and pay attention to what the politicians are saying and doing about it. People take advantage of a situation when they think you are not paying attention. It is the bitter truth. So pay close attention to the issues and vote for the ones you agree with, regardless of how your family, friends, and neighbors vote. Pay special attention to people who use flattery and flowery words to hook you in because their intentions may not be pure and can swiftly steer others in the wrong direction. They may be sweet as honey, but you may get stuck in the molasses if you are not paying attention. 

7. Teach ETHICS in grade schools and onward.  Corruption is the opposite of ethical behavior. Ethics is a complex subject because what is right and what is wrong is not clear cut though in real life. What is legal and illegal is a black or white thing, but ethics is primarily grey matter. Ethics is a value judgment that cannot be just assumed or expected.  It needs to be taught and practiced. Understanding and practicing ethical behavior is a process that evolves over time. 

     For example, teaching a young child ethical behavior may look something like this. "If someone in front of you dropped their money, and didn't know about it. What would you do?" When I completed my Master's of Science in Clinical Psychology, one of the requirements was that we all had to take comprehensive exams to be deemed competent to practice Psychology. One of the exams was on Ethics. We had to take a semester long course on Professional Ethics in order to pass this exam but more importantly, to practice ethical behavior in the real world. It was the most feared course and exam by the graduate students in my circle of peers.  Ethics can get murky, but it can be taught. Without teaching Ethics, it will be quite hard to reduce corruption.

8. Listen, without judgment...especially to those who differ in opinions.  It is impossible to resolve any issue without listening first. Listening to opposing viewpoints is the key. This communicates a lot of things, but mainly it communicates respect and gives you more information in making your own arguments stronger. Listening does not mean we have to do whatever someone asks us to do. Without listening, there can be no understanding. Without understanding, there can be no empathy. Without empathy, there can be no compassion. Compassion for all is what will drive the nation forward.

9. Say "NO" guilt-free  The most powerful little word in developing self-empowerment. Saying NO does not have to be mean or disrespectful. Saying NO can be freeing. Saying NO is about understanding the boundaries we all have and need to be respected, which will cultivate empowerment. Saying NO is about setting limits without feeling guilty.  Feeling guilty and remorse when you do something wrong is a healthy thing, but when we feel guilty when we are not in the wrong, is unhealthy and can become quite self-destructive.  In the Nepalese culture, there is an implicit message that it is not okay to say NO to your elders and authority figures, as a way to communicate respect. This mindset does have benefits, but the risks are also there and they are significant if imbalance occurs.  In particular, we do not teach our children how to speak up or be assertive when it is necessary to do so and therefore put ourselves at risk of being vulnerable in the hands of people in power in childhood and beyond. This perpetuates a vicious cycle that undermines self-empowerment and fosters learned helplessness. It is possible to say NO in a positive way without compromising social harmony or "ijat."

10. Move from a victim to a survivor mindset.  At the beginning stage of post earthquakes, it is appropriate for the Nepalese people to view themselves as victims because of the shock, trauma, grief, loss, pain, etc.  However, the psychological impact of viewing oneself as a victim can be quite detrimental because when you think you are a victim, you will feel and behave like a victim. Furthermore, others will treat you like a victim who needs to be rescued. There is an invisible, fine line between helping and helping too much (aka rescuing).  Too much rescuing can lead to learned helplessness and hopelessness, which can lead to future risk of being victimized again and again because one has not learned the skills to be self-sufficient.  This is what the peaceful protestors are demonstrating about. 

     The survivor mindset cultivates resiliency and empowerment. Nobody can take that mindset away, no matter how rich and powerful they are. Self-empowerment can only come from the people themselves.  Let's be clear that this is not promoting anarchy and/or chaos at all, but promoting the need for self-sufficient individuals and systems via self-empowered people.  The Nepali people are resilient, talented, and forgiving people who can ask and accept help but at the same time, rebuild for a stronger, self-sufficient Nepal. Never underestimate the power of the Nepali people!


Tuesday, May 5, 2015

During Crisis, Understanding Yourself is Vital

     First and foremost, please accept my deep apologies for not blogging in over two years! What can I say?  Life has been hectic.  I miss writing as it is very therapeutic for me so I hope to continue it as best as I can.  As I reflect on it, I think I have been too consumed with my own life and so disconnected from what has been happening all around. I am back now and I would like to shed light on a very important topic dear to my heart. Do let me know what your thoughts are (favorable or unfavorable)! Here it goes...       
 
      During a crisis, we experience a stress response, which is also known as "fight or flight." In the past week, there have been two crises deeply affecting me. My home country of Nepal is experiencing devastation of incomprehensible proportion due to a massive earthquake, with a magnitude of 7.8, that hit my beautiful country of birth on April 25, 2015.  Over 7,000 lives perished and still counting. Entire villages completely wiped out, centuries old monuments and temples symbolizing our beautiful cultural heritage turned into rubble and debris everywhere. Ever since, there are have been so many aftershocks and the people are being re-traumatized. Two days after Nepal's earthquake, just 20 minutes away, in my home city of Baltimore, an important social justice movement was born.  I felt sandwiched between my two homes and it was quite unsettling to the say the least. Emotions were running high and still are. Erratic sleep and eating patterns emerged. Self-care was compromised. That is what happens during a stress response. Our primitive brain gets activated and our sophisticated brain shuts down.  Pure instincts, raw emotions surface. Survival is our main purpose. Logic and reason go out the window.

     When survival becomes our primary purpose, then it becomes essential "to know thyself" otherwise things may unfold quite differently than we intended it to. This starts with our emotional self-awareness. Emotions are essential to our survival. Without fear, we could not save ourselves from danger. However, with too much fear, we could become immobile and not save ourselves from danger or mobilize in ways that are harmful to us and become self-sabotaging. It is a balancing act, like many aspects of Life. 

      One day last week after the earthquake hit Nepal, I was conversing with a very senior (he knew B.F. Skinner) clinical psychologist colleague about religion, philosophy, and mental health. He shared that love and fear are the essential emotions we have to work through. I shared that I felt it was love and anger. Then, he responded that anger is just a mechanism to express fear. I have been thinking about my colleague's comment all this week as I read the news about Nepal, Baltimore, and other places where crisis is unfolding. People have been saying things and doing things that seem so out of character for them. The rhetoric sound so hurtful and angry, but I know these folks are kind, loving individuals.  I know this because I am a seasoned psychotherapist who have worked with a diverse group of people for many years and they are all loving, kind people.  I have family and friends who are experiencing what my patients experience and they are loving, kind people.  I experience what they experience. We all have one thing in common. We all struggle with our emotions, especially during times of crisis. We are all humans. 

      It is natural to feel a range of emotions. It is human to do so. All emotions are okay. Nobody has any right to tell another how to feel or how not to feel. If they do, understand that it is more about them than about you. However, it is what we do with our emotions that determines our survival when crisis hits.  Crises have this imminent power to open up old emotional wounds that may or may not have anything to do with the crisis itself, and leave us hanging to fend for ourselves. This makes us vulnerable because we are all humans.  We are not alone because we are all human.

      When an external crisis hits, an internal turmoil gets ignited. In order to prevent an internal, psychological crisis, it is imperative that we all work through our emotions otherwise we say or do things we may regret later.  This also helps us to channel them in healthy ways so we are in a better place to listen and understand others for a better tomorrow.  We know we are in a better place when we do not feel the need to judge, ridicule, hurt, or "unfriend" others who express different emotions or see the world differently because we understand that this is not a personal attack.  It is that they have some work to do when it comes to their emotions. The President, world and faith leaders, doctors, media people, poor people, rich people, people of all shades of color, children, seniors, etc. are all vulnerable because we are all human.

      It is imperative that we work through our own emotions so we can work towards forgiveness, peace, social justice, and happiness. Without it, humanity in and of itself is at risk. Wanting it is not enough. We have to work hard at it. Together. It is the human thing to do. 

"Be the change that you wish to see in the world."   ~Mahatma Gandhi