If you want to understand Asian addictions, you need to understand the principle of cultural shame and its underlying impact on those from Asian backgrounds. This concept of shame is what undergirds Asian societies, families, and thus individuals. When it comes to Asian people, our lives, families, and cultures revolve around some aspect of shame. Asian identities are forged by trying to avoid any shame-producing feelings.

Asian cultures, unlike American or Western society, are collectivist by nature. Unlike the US— which prides itself on the individual or “I” factor—Asian nations hold the “we” to an exalted status. As a result, Asian societies are often referred to as shame-based cultures where social order is maintained through the use of shame.

Asian cultures view “self” much differently than in the Western world. Consequently, even shame is viewed differently since individuals from Asian countries will see themselves and their actions as interdependent upon those close to them. In other words, a traditional Westerner may experience shame as a result of something they did, whereas Asians entrenched in a shame-bound system or culture will experience shame not only individually but also collectively. So much so, that Asians will also experience shame in response to something someone close to them has done.

For example, a married, 35 year old Korean-American confides to his parents that he is dealing with gambling and sexual addictions (i.e. pornography & prostitutes) after questions started swirling as to his wife’s absences to various family functions.* Tired of making up excuses, he courageously shares his struggles in an attempt to garner support from them. But instead of getting support, he gets shamed. Mom yells at him, “How could you?! We didn’t raise you to be like this!” The shame being communicated here is beyond the Western view of a mother’s disappointment or hurt. It’s the mother’s internalization that her son’s shame has tainted her honor and the family name. Upholding this concept of cultural honor is what drives Asian relationships, thus shame and honor are inextricably tied together. They are the yin and the yang of the Asian life. They coexist together to bring harmony, cohesion, and order to Asian countries.

Honor and upholding honor among our culture is paramount. As Asians, we learn early-on from our parents that everything we do is predicated on bringing honor to our families: our grades, our achievements, our careers, and our relationships.

Because of the Asian fixation on honor, we learn early on to achieve as a means to “save face.” “Face” is the equivalent of how one is seen or judged by another in the Asian culture. So when people talk about how Asian cultures are shame-based, they’re referring to the concern one has for what others think about them and their “face.”

Since saving face is seen as bringing honor to oneself and one’s culture, then hiding one’s true feelings also carries a degree of honor. Hence, the outward display of emotions is shunned since that would be seen as losing face by showing your true self. Many Asians will do everything in their power not to show any negative emotions or feelings for fear of losing face. Anger, disappointment, sadness, and issues related to shame such as bankruptcy, divorce, out-of-wedlock children, sexual issues, and addictions remain shame-bound. Seeking help for addictions, while praised and encouraged in mainstream White American society is seen as a major umbrage to the Asian individual, family, and extended Asian community.

It’s no wonder that when it comes to addictions, there is scant attention given to Asians. Part of the limited attention lies in the age-old Asian custom of secrecy, silence, and shame. From an Asian addict’s perspective, it’s the ultimate blow of humiliation to be seen as weak. It’s the most difficult thing to admit to themselves, their families, and other loved ones that they have a problem and need help.

For Asians growing up in traditional Asian households, physical abuse, emotional deprivation or neglect (i.e. lack of nurturing, validation, or praise), combined with shame-bound messages of conditional love create the fertile ground where the seeds of addiction are planted. Later in life, without an understanding of healthy emotional expression and how to get their emotional needs met, Asian addicts will turn to compulsive and/or addictive substances (i.e. food, alcohol, drugs) or process addictions (i.e. behaviors such as gambling, spending, work, or sex) to meet that need.

 That’s the essence of addiction. The emotional “high” is reliable and dependable. The craving for competency, validation, empowerment, affirmation or amelioration of painful emotions can be met through addictions. Addictions help anesthetize (i.e. self-medicate) and ward off negative feelings and consequently serve as a way to cope with life. But in reality, not dealing with the underlying feelings driving the addictions robs Asians of the ability to truly connect with themselves and with others.

 Some areas to consider when trying to help clients of Asian descent break the stranglehold of shame:

 • Exploring their Asian support system (i.e. “do they have anyone of Asian descent whom they can confide in with their shame?”)

• Since a large percentage of Asian-Americans adhere or are affiliated with some form of religion or spiritual practice (i.e Christianity, Buddhism, Confucianism, etc.) it is important to see if the church or someone from their religious background (i.e. a church elder, a shaman, a monk, etc.) can be a source of healing.

• Do they belong to any Asian group where they get a sense of “community” (i.e. sports league, Asian-American professional group, etc.) and understanding?

From a clinical perspective, I’d highly recommend the following:

Psychodynamic group therapy or issue-specific group therapy in addition to individual counseling if possible (one Asian client grew and healed significantly when I transitioned her from individual therapy to my co-ed group therapy)

• Therapeutic self-disclosure (when appropriate) to increase the alliance with your client.

• Active vs. passive engagement in therapy. Asian cultures adhere to hierarchically and see you as an authority figure. You may need to guide the sessions and be more active (verbally) than a traditional client-centered approach.

• Psycho-education/coaching should be woven into your practice with Asian clients. It may not feel “therapeutic” but I learned a lot more about my family and culture when my past therapist also taught me about boundary setting and guided me through that process.

• Reflecting of feelings: This may seem obvious but having an empathetic therapist who can not only validate your feelings but articulate them is invaluable. Some of my clients who can’t verbalize their feelings feel I get them when I give voice to what I think is occurring in their lives. (e.g. “So I’m not sure if this fits but if I was in your situation I think I would feel ___________________, does that seem right to you?”) 

** to preserve the confidentiality of the people described, clinical examples are composites. In each case, all names and identifying characteristics are fictitious.

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