by/作者: Genevieve Roberts

Talking to someone from the same background is an enormous plus, ...I was always the unwanted extra bowl, told to sit at the end of the table, despite the table being round

Caroline Li Howard, a Chinese psychotherapist, helped establish the Chinese Mental Health Association in the early nineties, the first mental health association geared towards Chinese people living in England. She gained her counselling qualifications in England, and began working with around 50 clients, counseling them in individual and group sessions. She also trained less experienced counselors. She says: 'Migration and mental health has always been linked, these are psychological barriers which have to be overcome in order to cope with the dual face of being Chinese, living within a British culture."

It is an essential service, as many cases of depression and mental illness with the Chinese community are at least partially caused by problems associated with migration, adaptation to an alien culture where different, and in some cases, contradictory values prevail. The counseling and support services offered by CMHA are able to take into account these culturally influential problems, in a way that mainstream mental health charities never could.

Mental health issues have been suppressed within the Chinese community until very recently, and the stigma which surrounds the subject seems positively Victorian. Chinese health trends have been orientated around medicine, with doctors dispensing medicine so patients can 'regain' their health. Counseling is a fundamentally new idea to the majority of the Chinese community, and talking about problems as opposed to keeping them 'within the family' cuts through traditional Chinese culture. Ah Wei has had counseling from Caroline for the last three months and finds the avoidance of personal subjects amongst her friends and family difficult to cope with. "If your mother cleans her floor 200 times a day that means she is a clean woman, and you should be more like her" shouts Ah Wei, in utter frustration.

The Chinese community still avoids discussing mental health problems. Ah Wei says: 'I couldn't tell a Chinese person I was having therapy unless I was an alcoholic, or wanted to give up smoking, or was obese. If your problem is physical, then it can be understood. I couldn't tell anyone openly about my problems without feeling a sense of rejection. This is a taboo subject; the Chinese never air their laundry."

In China, mental health issues have been deeply neglected; services for individuals suffering from mental health problems are barely established. There are approximately 14,000 qualified psychiatrists within the population of 1.3 billion. France has a similar figure within a population of 60 million. 16 million people in China suffer from mental disorders and the country has the world's largest number of reported suicides by virtue of its large population, with 600 to 800 individuals taking their own lives each day.

Ah Wei, now 37, came to England when she was eight, from the New Territories in Hong Kong. She had never traveled on a bus before, nor seen snow and the creaminess of milk made her retch. Yet, she was resilient to the changes, and adapted fast. However, she found this new world hard to cope with. She says England is: "the most austere and unfriendly place to come to." She constantly felt like a cultural outcast, and could not understand why people picked on her and her family, in one incident a classmate ripped a necklace from her sister's neck. She always wondered whether she was accepted or just tolerated.

When she was 20, Ah Wei started questioning who she really was, whether she was British or Chinese. Then in 1994, she returned to live in Hong Kong. She says: "I did not feel like I belonged but I wanted to conquer it. I felt inhibited and compromised myself, but never felt quite Chinese. Some days I felt like I wanted to leave. The first few years, I was just coping, the last few years I grew to enjoy it."

She returned to England a year ago, and the questions of self in-identification and belonging contributed to her spiral of depression. She felt that the mainstream support systems rejected her; they were really impersonal and required her to fill in extensive forms at a time when she was so desperate that the very act of filling in forms seemed an almost impossible feat.

She found CMHA by word of mouth, and received her first informal counseling session over the telephone. "Talking to someone from the same background is an enormous plus," she says. "I saved so much time and stress. When I described to Caroline that I was the youngest of four daughters to a landless father, she immediately understood the lowly position I played within the family. I was always the unwanted extra bowl, told to sit at the end of the table, despite the table being round."

For Chinese people, talking about your problems is shameful, there is a stigma attached to trying to find answers. Ah Wei added "My parents did not divorce because it was considered shameful. In China, men don't cry." It is this stigma that the Chinese Mental Health Association hopes to tackle, by offering support without shame.

 

 華心會的概況

作者: Genevieve Roberts

李佩儀是一位華人心理治療師。 她在九十年代早期參與創辦為英國華人服務的精神保健服務工作。 她在英國取得專業資格,並開始致力在心理治療的工作, 包括個人輔導和小組輔導。 初時她大概有五十位服務使用者。 她亦訓練一些經驗尚淺的輔導員。 她說:“移民與心理健康總是色色相關的, 因為作為居住在英國的華人需要面對及應付多種心理壓力和文化差異等障礙。

因為華人社區的抑鬱症和精神病問題, 或多或少是源於移民, 文化觀念的差異等問題, 心理保健是非常重要的。華心會的輔導服務, 能顧及到這些被文化影響而產生的問題, 在某程度上, 其他主流心理健康服務是未能顧及到的。

心理健康的問題, 在華人社區內, 一直是被壓抑著的。直至近期,人們對精神病的 "偏見",“羞恥”等觀念才慢慢改變。 華人一般很依賴藥物, 由醫生發配藥物, 然後病人就能“恢復”健康。 輔導服務對於很多的華人社區來說, 基本上是一個新概念, 對別人說出自己的問題, 無疑是違反 '家醜不出外傳' 這傳統觀念。 亞慧接受了華心會李姑娘的輔導服務有三個月的時間,她發現, 她的朋友和家人一直避開不談的個人問題都很難得到解決。“如果你的母親每天都清潔200次地板, 這表示她是一個清潔的女人,你應該更加喜歡她。”亞慧非常灰心地大聲呼喊。

華人社區依然避免談論心理健康的問題。 亞慧說:“我不能告訴一個中國人我正在接受治療,除非我只是一個酗酒人士,或者想戒煙,或者是過肥。如果你有生理上的問題,他們都會很明白。我不能開放地告訴任何人我的問題, 我怕感到被抗拒。這是一個禁止的話題,華人從來不會對人講他們的問題。”

在中國,心理健康問題更是被忽略的; 心理健康服務是很缺乏的。 在十三億人口中大概只有14,000個有資格的心理學家, 而在法國, 六千萬人口當中, 已經有差不多14,000個心理學家了。在中國, 有一千六百萬人遭受著心理問題,而且據報導,中國是全世界最多人自殺的國家,每一天有600到800人選擇結束他們的生命。

現年37歲的亞慧,在她8歲的時候就從香港新界來到了英國。在此之前,她從來沒有乘坐過公共汽車,亦都沒有見過雪,奶油還令到她感到噁心。然而,她開朗地面對改變,然後很快地適應了。不過,她發現這個新的世界很難應付。她說英國是:“最嚴厲和最不友善的地方。”她經常覺得自己像一個文化流氓,不能明白為什麼人們常針對她和她的家人,有一次她的同學從她姐姐的頸上扯下了她的項鏈。 她總是想知道人們是接納她們,還是只是忍受她們的存在。

當她二十歲,亞慧開始質疑她的真正身份是什麼,到底她是英國人還是中國人。於是在1994年,她回到香港居住。她說:“我並不感到有歸屬感,但我想嘗試去克服這種感覺。我覺得自己很內向和常常向自己妥協,但從來不覺得自己像中國人。有些時間我覺得我想離開。開始的幾年,我只是應付著,直到最後幾年我才開始享受生活。”

她在一年之前返回到英國,關於自己的身份和歸屬問題使她陷入了沮喪的旋渦裏。她覺得那些主流的機構都拒絕她,他們非常沒有人情味,在她感到絕望的時候, 還要求她填寫大量的表格,填寫那些表格, 簡直是一個超乎尋常的技能。

她在朋友口中聽到了華心會的名字,通過電話接受了第一次非正式的輔導。“與同自己有相同背景的人交談有很大的幫助。”她說。“我省下了很多時間,也減輕了壓力。當我向李姑娘描述我是一個一無所有的父親的第四個女兒時,她馬上就明白了我在家裏處於一個如何低下的位置。我總是那個沒有人想要、多餘的飯碗,被叫到去坐在桌子的尾端,但其實桌子是圓形的。”

對於中國人來說,談及自己的問題是一件羞恥的事,而嘗試去尋找一個答案亦是羞恥的。亞慧說:“我的父母沒有離婚因為他們認為那樣很不體面。在中國,男人從來不哭泣。”華心會就是希望能夠透過提供支援來解決這個所謂的“羞恥”的困惑。