chinese culture and psychopathology 中華文化与心理病態學 melvin w. wong, ph.d....

Chinese Culture and Chinese Culture and PsychopathologyPsychopathology

中華文化与心理病態學中華文化与心理病態學Melvin W. Wong, Melvin W. Wong, Ph.D.Ph.D.

黃偉康博士黃偉康博士Licensed Clinical Psychologist Licensed Clinical Psychologist

ChristianMentalHealthChristianMentalHealth.com.comACTS: Associated Canadian Theological ACTS: Associated Canadian Theological

Schools, Trinity Western University, Schools, Trinity Western University, Langley, British Columbia, CanadaLangley, British Columbia, Canada

April 30 - May 4, 2001April 30 - May 4, 2001

David Chow Mark Vegh Melvin Wong

Pablee Wong Gayle MacNab Rosamond Chan Loretta Luk Teresa Leung Vera Ma Alice Yu

Chinese Canadian Culture and Psychopathology (Class of 2001)

Course DescriptionCourse Description

This is a two unit graduate introductory course in This is a two unit graduate introductory course in the relationship between Chinese culture and the relationship between Chinese culture and

psychopathologypsychopathology

It is designed to help mental health professionals It is designed to help mental health professionals and ministry leaders in discerning the and ministry leaders in discerning the counseling needs of a client, patient or a counseling needs of a client, patient or a congregation membercongregation member

Students will be expected to know the strengths and Students will be expected to know the strengths and pitfalls of the Chinese culture in helping someone with a pitfalls of the Chinese culture in helping someone with a family problems or a disorder. The pastor will know family problems or a disorder. The pastor will know when to make a referralwhen to make a referral

Course RequirementsCourse Requirements

Each student is expected to complete Each student is expected to complete either either one one of the following two paper of the following two paper

assignmentsassignments

Paper 1: Paper 1: A Case StudyA Case Study

oror

Paper 2: Paper 2: A Theoretical Study-presentationA Theoretical Study-presentation


Paper 1: Paper 1: A case study of the impact of culture on one A case study of the impact of culture on one aspect of a psychological symptom (of a person; a aspect of a psychological symptom (of a person; a client, a congregation member or family member)client, a congregation member or family member). .

Students are required to present a study of an Students are required to present a study of an individual (someone that you have counseled, individual (someone that you have counseled, someone that you know as a friend or relative) will someone that you know as a friend or relative) will suffice. suffice.

Give an Give an introductionintroduction, a , a family history family history with a with a genogramgenogram, , a description of the a description of the one-symptom one-symptom that marks the that marks the pathologypathology, a , a formulationformulation of the cultural correlation and of the cultural correlation and some suggestion for a brief some suggestion for a brief treatment treatment recommendationrecommendation. .


(No differential diagnosis is required.) (No differential diagnosis is required.)

A BRIEF written (not more than 10 pages) A BRIEF written (not more than 10 pages) summary is to summary is to be presented to the office by be presented to the office by June 18, 2001 (deliver to Mary West). Do not June 18, 2001 (deliver to Mary West). Do not give paper to the instructor.give paper to the instructor.

While paper presentation in class on Friday is not While paper presentation in class on Friday is not required, extra credit could be earned and required, extra credit could be earned and students are encouraged to sign-up (by students are encouraged to sign-up (by indicating to the instructor) to make their indicating to the instructor) to make their presentationspresentations

Paper 2: Paper 2: A theoretical study-A theoretical study-presentationpresentation

Paper 2: Paper 2: A theoretical study-presentation of the A theoretical study-presentation of the impact of Chinese culture on psychopathology as impact of Chinese culture on psychopathology as manifested in the clinical population (or church-manifested in the clinical population (or church-based communities): The Intervention based communities): The Intervention recommendationsrecommendations: :

Students are required to present a more detailed Students are required to present a more detailed theoretical study of the effects of the influence theoretical study of the effects of the influence (subtle or obvious) on the development of (subtle or obvious) on the development of psychological disorders, depending on the work psychological disorders, depending on the work environments of a student, such as a clinician or environments of a student, such as a clinician or a minister. a minister.

Paper 2: Paper 2: A theoretical study-A theoretical study-presentationpresentation

This paper is intended to facilitate the understanding This paper is intended to facilitate the understanding of the student in formulating a prevention response of the student in formulating a prevention response towards a wellness approach in their line of work. towards a wellness approach in their line of work.

A BRIEF written (not more than 10 pages) summary A BRIEF written (not more than 10 pages) summary is to be presented to the office by June 18, 2001 is to be presented to the office by June 18, 2001 (deliver to Mary West). Do not give paper to the (deliver to Mary West). Do not give paper to the instructor.instructor.

While paper presentation in class on Friday is not While paper presentation in class on Friday is not required, extra credit could be earned and students required, extra credit could be earned and students are encouraged to sign-up (by indicating to the are encouraged to sign-up (by indicating to the instructor) to make their presentationsinstructor) to make their presentations

Class TimeClass Time

08:30 to 10:00 AM08:30 to 10:00 AM Instruction session 1Instruction session 1

10:00 to 10:10 AM10:00 to 10:10 AM BreakBreak

10:10 to 11:15 AM10:10 to 11:15 AM Instruction session 2Instruction session 2

11:15 to 11:25 AM11:15 to 11:25 AM BreakBreak

11:25 to 12:30 PM11:25 to 12:30 PM Instruction session 3Instruction session 3

Chinese is a “River Culture”Chinese is a “River Culture”

Fate of survival depends “nature’s ways”Fate of survival depends “nature’s ways”– Need for rain, sunshine, no flood, no pestsNeed for rain, sunshine, no flood, no pests

Communities are important for survivalCommunities are important for survival– During harvest time, floods and faminesDuring harvest time, floods and famines

Harmony is important for survivalHarmony is important for survival– Smooth interpersonal relationships facilitates workSmooth interpersonal relationships facilitates work

Non-aggressiveNon-aggressive (contrast with “Island Cultures”) (contrast with “Island Cultures”) Dependence on nature and conditions for cropsDependence on nature and conditions for crops Position of village-house critical to survivalPosition of village-house critical to survival

Chinese Cosmology: Triadic ForcesChinese Cosmology: Triadic ForcesBalance: Relationship-EmotionsBalance: Relationship-Emotions

Goal in life is to master the eternal balance of the Goal in life is to master the eternal balance of the three relationships between heaven, earth & men.three relationships between heaven, earth & men.

Heaven-Earth-Person: Relationship & Love BasedHeaven-Earth-Person: Relationship & Love Based ThereThere is a is a God in HeavenGod in Heaven: Sense: Sense of of JusticeJustice & & FairnessFairness

Parent-Child: Love analogous to heavenly loveParent-Child: Love analogous to heavenly love Ethnocentrism (Sinocentrism):Ethnocentrism (Sinocentrism):

Chinese PictographChinese Pictograph

狂狂The “animal inside” becomes “king” The “animal inside” becomes “king” (taking over our self-control and made us (taking over our self-control and made us do “crazy” “wild” and irrational things)do “crazy” “wild” and irrational things)

China: The Central KingdomChina: The Central Kingdom

中中國國




Parent-Child: Love analogous to heavenly loveParent-Child: Love analogous to heavenly love Ethnocentrism (Sinocentrism): Ethnocentrism (Sinocentrism): “foreign “foreign

devils.” Frame of reference: Idiosyncraticdevils.” Frame of reference: Idiosyncratic




Parent-Child: Love analogous to heavenly loveParent-Child: Love analogous to heavenly love Ethnocentrism (Sinocentrism): “foreign Ethnocentrism (Sinocentrism): “foreign

devils.” Frame of reference: Idiosyncraticdevils.” Frame of reference: Idiosyncratic– Familial-centrism: Family isolation & self-sufficiencyFamilial-centrism: Family isolation & self-sufficiency





devils.” Frame of reference: Idiosyncraticdevils.” Frame of reference: Idiosyncratic– Familial-centrism: Family isolation & self-sufficiencyFamilial-centrism: Family isolation & self-sufficiency– At the expense of women: Martyrdom, sacrifice.At the expense of women: Martyrdom, sacrifice.





devils.” Frame of reference: Idiosyncraticdevils.” Frame of reference: Idiosyncratic– Familial-centrism: Family isolation & self-sufficiencyFamilial-centrism: Family isolation & self-sufficiency– At the expense of women: Martyrdom, sacrifice.At the expense of women: Martyrdom, sacrifice.– “ “Us-against-them” mentality: a win-lose paradigm. Us-against-them” mentality: a win-lose paradigm.

The Triadic Balance The Triadic Balance (( 三三和和 )) of of Relationships and EmotionRelationships and Emotion

Heaven-Earth-Person: Relationship & Love BasedHeaven-Earth-Person: Relationship & Love Based– 天地有情天地有情

There is a God in Heaven: Sense of Justice & FairnessThere is a God in Heaven: Sense of Justice & Fairness

– 舉頭三尺有神靈舉頭三尺有神靈 Parent-Child: Love analogous to heavenly loveParent-Child: Love analogous to heavenly love

– 孝感動天孝感動天 Openness & Acceptance of ErrorsOpenness & Acceptance of Errors

– 人誰無過人誰無過

Fundamental Cultural ConceptsFundamental Cultural Concepts

Relationships of 3-Dynamic-Forces (Relationships of 3-Dynamic-Forces ( 三勢三勢 ))– Heaven, Earth & Person: Heaven, Earth & Person: 天地人天地人

Life goal: Master the balance of the three Powers Life goal: Master the balance of the three Powers – 天地人天地人 :: 天時天時 ,, 地利地利 ,, 人和人和 (( 三和三和 ))

Do not upset the spiritual balance in the Do not upset the spiritual balance in the relationships of these Triadic Forces (relationships of these Triadic Forces ( 三和三和 ) )

Physical (Geomantrics) Physical (Geomantrics) Feng-ShuiFeng-Shui ( ( 風水風水 ) ) – Integrate People with nature & ergonomics Integrate People with nature & ergonomics

(Yin-Yan) Spiritual Balance ((Yin-Yan) Spiritual Balance ( 陰陽變數陰陽變數 ))

What is Asian-Canadian culture?What is Asian-Canadian culture?

Asian-Canadian (Asian: Ethnic Chinese) is Asian-Canadian (Asian: Ethnic Chinese) is an extremely diversed group of Asians an extremely diversed group of Asians ethnically from all over Asian with different ethnically from all over Asian with different cultural, religious, economic and political cultural, religious, economic and political backgrounds. Koreans, Japanese, Chinese, backgrounds. Koreans, Japanese, Chinese, Taiwanese, South-East AsiansTaiwanese, South-East Asians (Vietnam, Laos, (Vietnam, Laos, Cambodia, Burma, Thai, Singapore, Malaysia, Indonesia)Cambodia, Burma, Thai, Singapore, Malaysia, Indonesia)

As diversed as we areAs diversed as we are: There are common : There are common threads: Rice, Chop-sticks, Family Values, threads: Rice, Chop-sticks, Family Values, Education, Arts, with diversed ethnic subculturesEducation, Arts, with diversed ethnic subcultures

Asian-Canadian Cultural UnderstandingAsian-Canadian Cultural Understanding

Life is a stage: Role-playLife is a stage: Role-play 人生如舞台人生如舞台 Being a Person:Being a Person: 做人做人 == 做戲做戲 Life is about On-stage, Off-stage:Life is about On-stage, Off-stage: 上台上台 ,, 下台下台

– In an interpersonal shameful situation, it is In an interpersonal shameful situation, it is known as “hard to get off stage” known as “hard to get off stage” 難下台難下台

– To help, provide a graceful exit: To help, provide a graceful exit: 下台階下台階 Detested CharactersDetested Characters (animal-temperament) (animal-temperament)

– Human-faced, Animal hearted Human-faced, Animal hearted 人面獸心人面獸心– Wild-animalWild-animal put in a m put in a man’s dress an’s dress 衣冠禽獸衣冠禽獸

Asian-American Cultural UnderstandingAsian-American Cultural Understanding

Filial Piety (most favored virtue): EducationFilial Piety (most favored virtue): Education 老子老子 ,, 孝順孝順 ,, 老子文老子文 == 教教

Favors sons over daughters:Favors sons over daughters: 重男輕女重男輕女–子承父業子承父業–女子無才便是德女子無才便是德

Conformity & Self-Denial:Conformity & Self-Denial: 克己服禮為仁克己服禮為仁 Gentlemen vs. the ConceitedGentlemen vs. the Conceited:: 小人君子小人君子

Day TwoDay Two

Patterns of ImmigrationPatterns of Immigration

Bachelor laborerBachelor laborer Laborer and his village (mail order) brideLaborer and his village (mail order) bride Children of laborer and village brideChildren of laborer and village bride Bright scholar from big cities at ivy leagueBright scholar from big cities at ivy league Foreign students who stayedForeign students who stayed Pre-post 1997 political refugeesPre-post 1997 political refugees

– Bosses and professionalBosses and professional Children of Shanghainese elites: ivy leagueChildren of Shanghainese elites: ivy league

Asian-American Culture & PhilosophiesAsian-American Culture & Philosophies(* Local-Domestic Origins)(* Local-Domestic Origins)

*Confucianism *Confucianism 儒儒Buddhism Buddhism 釋釋*Taoism *Taoism 道道

Western-Christianity Western-Christianity 耶耶*Self-Material-Pragmatism*Self-Material-Pragmatism 錢錢

BuddhismBuddhism

An Indian prince’s response to human painAn Indian prince’s response to human pain– Prince lived a life of pleasure within palace gatePrince lived a life of pleasure within palace gate– Noticed pain of peasants when outside gateNoticed pain of peasants when outside gate

Pondered about the sad human conditionPondered about the sad human condition– Personal guilt of pleasure that was for grantedPersonal guilt of pleasure that was for granted– Social sufferings: Birth, aging, illness, deathSocial sufferings: Birth, aging, illness, death

Bad things happen to you because you have Bad things happen to you because you have done something wrong: “Karma”done something wrong: “Karma”

Death: Reincarnation: Good deedsDeath: Reincarnation: Good deeds

Chinese Sexual BeliefsChinese Sexual Beliefs (Role of Women) (Role of Women)(Adapted from (Adapted from Christian Ethics: Principles and Applications, Christian Ethics: Principles and Applications,

Dr. Ping-Cheung Lo, Hong Kong Baptist University ‘92)Dr. Ping-Cheung Lo, Hong Kong Baptist University ‘92)

Taoism Taoism Tenets: Longevity, Transcend to Become a god Tenets: Longevity, Transcend to Become a god

Methods: Diet, Qigong, MeditationMethods: Diet, Qigong, Meditation By Practicing Special Sexual TechniquesBy Practicing Special Sexual Techniques

– ““Take from Yin to Compensate Yan”Take from Yin to Compensate Yan”» Virgins & Women used as means to an end Virgins & Women used as means to an end

to benefit the Men’s desire to have longevityto benefit the Men’s desire to have longevity

– ““Return Sperm to Compensate Brain”Return Sperm to Compensate Brain”» Sex to benefit Men’s desire for longevity & staminaSex to benefit Men’s desire for longevity & stamina

Day ThreeDay Three

The Five-Hierarchical Harmonious Relationships The Five-Hierarchical Harmonious Relationships (The Five-Orders “Wu Lun”) (The Five-Orders “Wu Lun”) 五倫五倫

Copyright (C) Melvin W. Wong, Ph.D. 1996-2001Copyright (C) Melvin W. Wong, Ph.D. 1996-2001

Orders Relationships Virtues Manifestations Emotions Pathologies

1. The King & his subjects

Loyalty 忠

Obedience “Kowtow” Corruption

Domination- Fear

Antisocial

2. Father and son Filial Piety 孝

Deference Respect of

Elders

Respect-Shame

Rage

3. Older-brother & younger brother

Brotherly Love 愛

Dependency Respect-Conspiring

Divisiveness

4. Husband & Wife Love-Chastity

貞

Acceptance Power-Bitterness

Neurasthenia

5. Between Friends Trust 信任

Harmony Tactfulness Face-work

Order 1: The King and his SubjectsOrder 1: The King and his Subjects

君要臣死君要臣死 ,, 臣不死臣不死 ,, 不忠也不忠也If the king decrees death to his subject, if he If the king decrees death to his subject, if he

doesn’t kill himself; it is not loyaltydoesn’t kill himself; it is not loyalty Authoritarianism: Do as the king says, obeyAuthoritarianism: Do as the king says, obey

– Reinforces dependencyReinforces dependency: “Emperor's new clothes”: “Emperor's new clothes”

– Hypocrisy: “Public self vs. Private self” “Self-identity”Hypocrisy: “Public self vs. Private self” “Self-identity”– Externalized locus of control: Reduced personal responsibilityExternalized locus of control: Reduced personal responsibility

The all-powerful king: analogous with godThe all-powerful king: analogous with god Deified king: Idolized-worshipped the kingDeified king: Idolized-worshipped the king

Day FourDay Four

Order 2: Father and SonOrder 2: Father and Son

父要子亡父要子亡 , , 子不亡子不亡 , , 不孝也不孝也If father wants his son to die, if he doesn’t kill If father wants his son to die, if he doesn’t kill

himself; it is not filial pietyhimself; it is not filial piety Fatherhood equals Kingdom governmentFatherhood equals Kingdom government Generalized authority to the elderlyGeneralized authority to the elderly : Wisdom: Wisdom AuthoritarianismAuthoritarianism: Do as the father says, obey: Do as the father says, obey

– Reinforces dependency: “Must please father”Reinforces dependency: “Must please father”– Externalized locus of control: Reduced personal responsibilityExternalized locus of control: Reduced personal responsibility

Filial PietyFilial Piety

Resulting virtue of a harmonious relationship Resulting virtue of a harmonious relationship between father and child is Filial Pietybetween father and child is Filial Piety

First-born son is most valued: first-born son is the First-born son is most valued: first-born son is the first child that can carry on the family lineagefirst child that can carry on the family lineage

Fathers have unquestioned authority over their childrenFathers have unquestioned authority over their children

– have the right to the lives of their children have the right to the lives of their children – The reasoning is that, “They are my own.”The reasoning is that, “They are my own.”

This virtue gave rise to patriarchy and nepotismThis virtue gave rise to patriarchy and nepotism Ancestor-worship (Idolization of ancestors)Ancestor-worship (Idolization of ancestors)

– Complex of respect and fear for the deceasedComplex of respect and fear for the deceased

Reciprocity-Entitlement-EmpathyReciprocity-Entitlement-Empathy

ReciprocityReciprocity (Family Culture Demands It) (Family Culture Demands It)– Duty > Personal Desire = Sacrifice; PaybackDuty > Personal Desire = Sacrifice; Payback– Trauma Re-Enactment of Mother-In-LawsTrauma Re-Enactment of Mother-In-Laws

EntitlementEntitlement (Takes It For Granted) (Takes It For Granted)– Do It, Give It, Or Else! (Shame-Guilt-Injury)Do It, Give It, Or Else! (Shame-Guilt-Injury)

Empathy (Lack of) “Form > Will”Empathy (Lack of) “Form > Will”– Do It-Perform It-You Don’t Have to Like ItDo It-Perform It-You Don’t Have to Like It– My Way > Your Needs (Self > Others)My Way > Your Needs (Self > Others)

Order 3: Older brother and younger brotherOrder 3: Older brother and younger brother

兄弟如手足兄弟如手足Brothers (older and younger) are like hands Brothers (older and younger) are like hands

and feet and feet (they are irreplaceable, blood is thicker than water)(they are irreplaceable, blood is thicker than water)

Older-brother in command during father’s absenceOlder-brother in command during father’s absence Facilitates family operations: Internally-externallyFacilitates family operations: Internally-externally AuthoritarianismAuthoritarianism:: Do as the brother says, obey Do as the brother says, obey

– Reinforces dependency: “Must please brother”Reinforces dependency: “Must please brother”– Externalized locus of control: Reduced personal responsibilityExternalized locus of control: Reduced personal responsibility

Order 4: Husband and Wife Order 4: Husband and Wife

夫妻如衣服夫妻如衣服Relationships between husband and wife is Relationships between husband and wife is

similar to clothing (change them at will)similar to clothing (change them at will) Women’s identity begins after marriageWomen’s identity begins after marriage

三從三從 : : 在家從父出嫁從夫老來從子在家從父出嫁從夫老來從子 Authoritarianism: Do as the husband says, obeyAuthoritarianism: Do as the husband says, obey Reinforces dependencyReinforces dependency: “Husband-pleasing”: “Husband-pleasing” Externalized locus of control:Externalized locus of control: Reduced personal responsibility Reduced personal responsibility

Faithfulness in marriage: Wife must be chasteFaithfulness in marriage: Wife must be chaste

Seven Facets of Chinese Face WorkSeven Facets of Chinese Face WorkAfter Bond and Hwang “Six types of face work“After Bond and Hwang “Six types of face work“

© Melvin W.Wong, Ph.D.2001© Melvin W.Wong, Ph.D.2001

LevelLevel DescriptionDescription ManifestationManifestation Chinese pinyinChinese pinyin

11 Enhancing your own faceEnhancing your own face Etiquette consciousnessEtiquette consciousness yao mianziyao mianzi

22 Enhancing other’s faceEnhancing other’s face ReciprocityReciprocity gei mianzigei mianzi

33 Losing your own faceLosing your own face Shame, humiliationShame, humiliation diao mianzidiao mianzi

44 Hurting other’s faceHurting other’s face Retaliation for shame feltRetaliation for shame felt shang mianzishang mianzi

55 Saving your own faceSaving your own face Avoid shame, be properAvoid shame, be proper baocun mianzibaocun mianzi

66 Saving other’s faceSaving other’s face No criticism, give apologyNo criticism, give apology mian mian qu yuanmian mian qu yuan

77 Tearing your own faceTearing your own face Relationship destroyed Relationship destroyed mou mianmou mian

Biblical Order of RelationshipsBiblical Order of Relationships“The New Five-Orders” “The New Five-Orders” 新五倫新五倫

Copyright © Melvin W.Wong, Ph.D. 1999-2001Copyright © Melvin W.Wong, Ph.D. 1999-2001

1.1. Christ the King and His ChildrenChrist the King and His Children ((Isaiah 9:6-7)Isaiah 9:6-7)

Love and SacrificeLove and Sacrifice

2.2. Father and Mother (Exodus 20:12)Father and Mother (Exodus 20:12)Love and Honor (Leave, Cleave becoming one flesh)Love and Honor (Leave, Cleave becoming one flesh)

3.3. Husband and Wife Husband and Wife ((Ephesians 5:21-25Ephesians 5:21-25 ) )Love and CommitmentLove and Commitment

4.4. Parents and Children Parents and Children ((Ephesians 6:1-2Ephesians 6:1-2 ) )Love and AcceptanceLove and Acceptance

5.5. Fellowship of Believers, Friend-Foe Fellowship of Believers, Friend-Foe ((1 John 4:11-121 John 4:11-12 ) )

One another love, Hospitality & Forgiveness One another love, Hospitality & Forgiveness (Mat 22:39)(Mat 22:39)

Day FiveDay Five

GuiltGuilt

True guilt: Biblical guidelines & mandatesTrue guilt: Biblical guidelines & mandates– Absolute: Objective (conscience)Absolute: Objective (conscience)

False guilt: Imposed family-social valuesFalse guilt: Imposed family-social values– Subject to change: Subjective (conscience)Subject to change: Subjective (conscience)– Overly-harsh conscience vs. “relaxed” conscienceOverly-harsh conscience vs. “relaxed” conscience

Over-control vs. Under controlOver-control vs. Under control

Compulsives vs. PsychopathsCompulsives vs. Psychopaths

Perfectionists vs. Anti-social narcissistsPerfectionists vs. Anti-social narcissists

Effects of Migration on Effects of Migration on PsychopathologyPsychopathology

Social up-rooting, destruction of networkSocial up-rooting, destruction of network– Increases isolation and lonelinessIncreases isolation and loneliness– Timing is when support is needed the mostTiming is when support is needed the most– Pre-mid-life crisis: May hasten crisis: DivorcePre-mid-life crisis: May hasten crisis: Divorce

Migration requires personal adjustmentMigration requires personal adjustment– Polarize the gap between the well and the sickPolarize the gap between the well and the sick

Increases coping demands: Breaking point?Increases coping demands: Breaking point?– Exacerbates pre-existing marital problems Exacerbates pre-existing marital problems – Exacerbates pre-existing parent-child issuesExacerbates pre-existing parent-child issues

Effects of Migration on Effects of Migration on PsychopathologyPsychopathology

Men’s adjustment problem of ego & identityMen’s adjustment problem of ego & identity– Underemployment causing self-doubt, prestigeUnderemployment causing self-doubt, prestige

Women’s new found freedom & powerWomen’s new found freedom & power– Threatens “unhealthy balance” of marriageThreatens “unhealthy balance” of marriage

Intergenerational conflicts of valuesIntergenerational conflicts of values Role-reversal: English proficiency = PowerRole-reversal: English proficiency = Power

– First-born daughter controls the familyFirst-born daughter controls the family– First-born daugther made to doubt self-worthFirst-born daugther made to doubt self-worth

» Ensure the authority of parents (mother)Ensure the authority of parents (mother)

Diagnostic criteria for Narcissistic Diagnostic criteria for Narcissistic Personality DisorderPersonality Disorder

A pervasive pattern of grandiosity (in fantasy or behavior), A pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy, beginning by need for admiration, and lack of empathy, beginning by

early adulthood early adulthood

(1) has a grandiose sense of self-importance (e.g., exaggerates (1) has a grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as achievements and talents, expects to be recognized as superior without commensurate achievements)superior without commensurate achievements)

(2) is preoccupied with fantasies of unlimited success, power, (2) is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal lovebrilliance, beauty, or ideal love

(3) believes that he or she is "special" and unique and can only (3) believes that he or she is "special" and unique and can only be understood by, or should associate with, other special or be understood by, or should associate with, other special or high-status people (or institutions)high-status people (or institutions)

Diagnostic criteria for Narcissistic Diagnostic criteria for Narcissistic Personality DisorderPersonality Disorder

(4)requires excessive admiration(4)requires excessive admiration(5)has a sense of entitlement, i.e., unreasonable (5)has a sense of entitlement, i.e., unreasonable

expectations of especially favorable treatment or expectations of especially favorable treatment or automatic compliance with his or her expectationsautomatic compliance with his or her expectations

(6)is interpersonally exploitative, i.e., takes advantage of (6)is interpersonally exploitative, i.e., takes advantage of others to achieve his or her own endsothers to achieve his or her own ends

(7)lacks empathy: is unwilling to recognize or identify (7)lacks empathy: is unwilling to recognize or identify with the feelings and needs of otherswith the feelings and needs of others

(8)is often envious of others or believes that others are (8)is often envious of others or believes that others are envious of him or herenvious of him or her

(9)shows arrogant, haughty behaviors or attitudes(9)shows arrogant, haughty behaviors or attitudes

Common Female DisordersCommon Female Disorders

Somatization Disorder (Neurasthenia)Somatization Disorder (Neurasthenia)– Anxiety-Repression: Anxiety-Repression: – Socially acceptable disorder: Concrete Vs. AbstractSocially acceptable disorder: Concrete Vs. Abstract

Hysteric-Borderline Personality DisorderHysteric-Borderline Personality Disorder– Features Vs. Full-Blown DisorderFeatures Vs. Full-Blown Disorder– Object Relation Type of Disorders: Trust IssuesObject Relation Type of Disorders: Trust Issues– Attachment Deficits: Trust IssuesAttachment Deficits: Trust Issues– Attention Deficits: Narcissistic, ExpansivenessAttention Deficits: Narcissistic, Expansiveness

Common Male DisordersCommon Male Disorders

Anxiety Related DisordersAnxiety Related Disorders Conforming (Over-Control) DisordersConforming (Over-Control) Disorders Obsessive-Compulsive DisorderObsessive-Compulsive Disorder

– Control-Mastery Issues (Compensational)Control-Mastery Issues (Compensational)– The Perfectionistic-Intellectualization DisorderThe Perfectionistic-Intellectualization Disorder– Trauma Response SyndromeTrauma Response Syndrome– Shame-based cycle adjustment constellationShame-based cycle adjustment constellation– Workaholism vs. Pathological GamblingWorkaholism vs. Pathological Gambling

Common Male DisordersCommon Male Disorders

Impulse (Under-Control) Antisocial DisordersImpulse (Under-Control) Antisocial Disorders– Intermittent Explosive Disorders: ProfanitiesIntermittent Explosive Disorders: Profanities– Family violence: Physical and VerbalFamily violence: Physical and Verbal

Subtle Impulse Dyscontrol Symptoms: Lying, PornSubtle Impulse Dyscontrol Symptoms: Lying, Porn

Attachment Deficits Disorders: Trust IssuesAttachment Deficits Disorders: Trust Issues– Poor relationship with males (Father-Son) Poor relationship with males (Father-Son) – Lacks meaningful & intimate male friendshipsLacks meaningful & intimate male friendships– Friendship themes are rivalry-based (Win-Lose)Friendship themes are rivalry-based (Win-Lose)

Common Marital DisordersCommon Marital Disorders

Angry Husband - Depressed-Hurt WifeAngry Husband - Depressed-Hurt Wife Angry Wife - Withdrawn HusbandAngry Wife - Withdrawn Husband Avoidance of Emotional InvolvementsAvoidance of Emotional Involvements

– Focus on the Concrete, Practical issuesFocus on the Concrete, Practical issues– Over-Rationalization, Over-IntellectualizationOver-Rationalization, Over-Intellectualization– Judgment Passing: Reason, Right or WrongJudgment Passing: Reason, Right or Wrong

Rigid Structure, Non-Cohesive:Rigid Structure, Non-Cohesive: Stress prone Stress prone

Common Parent-Child DisordersCommon Parent-Child Disorders

(Father)-Man Haters (Misogynist)(Father)-Man Haters (Misogynist)– First-born son’s grudge against fatherFirst-born son’s grudge against father– Daughter mistrusts, despises fatherDaughter mistrusts, despises father– No relational conversationsNo relational conversations– No-win situationsNo-win situations

(Mother)-Woman Haters (Misandry)(Mother)-Woman Haters (Misandry)– First-born son’s grudge against mother for First-born son’s grudge against mother for

being too involved with his lifebeing too involved with his life

Specific DisordersSpecific Disorders

Impulse Related disordersImpulse Related disorders– Rage and Destructive potential of Asian malesRage and Destructive potential of Asian males– Workaholism-Gambling (Winners ethics)Workaholism-Gambling (Winners ethics)

Codependency Related DisordersCodependency Related Disorders– Emotional dependency of the Asian femalesEmotional dependency of the Asian females– Physical PunishmentPhysical Punishment– Family Secrets. Involuted No-Win Family LoyaltiesFamily Secrets. Involuted No-Win Family Loyalties

– Roles of martyr, rescuer, mascot, clownRoles of martyr, rescuer, mascot, clown

Treatment ConsiderationsTreatment Considerations

Match Client - Therapist ExpectationsMatch Client - Therapist Expectations Must be Concrete-Practical to the ClientsMust be Concrete-Practical to the Clients

– Just attentive listening is not enoughJust attentive listening is not enough– Advise-giving is often expected(Concreteness!)Advise-giving is often expected(Concreteness!)

Focus on Short-Term, Achievable GoalsFocus on Short-Term, Achievable Goals Clarify expectations at mid-point to avoid Clarify expectations at mid-point to avoid

disappointments later & unrealistic goalsdisappointments later & unrealistic goals Therapist Self-Disclosure expectedTherapist Self-Disclosure expected

Culture & Treatment RevisitedCulture & Treatment Revisited

Bridge Culture & Psychology by dialoguesBridge Culture & Psychology by dialogues Involvement of cultural factor into Involvement of cultural factor into

parenting practices to prevent parenting practices to prevent rebelliousness of teensrebelliousness of teens

““Experts” Provide training of a variety of Experts” Provide training of a variety of parenting skills based on the psychological parenting skills based on the psychological principles that are compatible with cultureprinciples that are compatible with culture

Short-term Pastoral InterventionShort-term Pastoral Intervention

Establish Realities of Pain & SufferingEstablish Realities of Pain & Suffering– Believe the Person with Pain: Victim?Believe the Person with Pain: Victim?

» Develop Empathy: “Beyond my own Pain”Develop Empathy: “Beyond my own Pain”

– Pain-Pleasure Polarity: “Recalibration”Pain-Pleasure Polarity: “Recalibration”– Acknowledge Hopelessness & HelplessnessAcknowledge Hopelessness & Helplessness

Prayers and Visitation: AccountabilityPrayers and Visitation: Accountability Encourage Networking with Cell GroupsEncourage Networking with Cell Groups Prevent Drop-out: Reduce ShamePrevent Drop-out: Reduce Shame

Long-term Professional CounselingLong-term Professional Counseling

After the Crisis has Resolved but Conflicts After the Crisis has Resolved but Conflicts continue: Frequency & Intensitycontinue: Frequency & Intensity– Physical-Sexual Intimacy is reduced/absentPhysical-Sexual Intimacy is reduced/absent

When “The Affair” stays (mental-physical)When “The Affair” stays (mental-physical) Personality Disorders are CharacteristicsPersonality Disorders are Characteristics Depression & Anxiety are SeriousDepression & Anxiety are Serious

– Suicide Prevention, Medication ManagementSuicide Prevention, Medication Management ““Problem Child” Issue that persistsProblem Child” Issue that persists

How to Make a Referral? How to Make a Referral? ChristianMentalHealth.comChristianMentalHealth.comReferrals@[email protected]

Thoughtfulness makes Referral SucceedThoughtfulness makes Referral Succeed– ““You are too messed up so I can’t help you”You are too messed up so I can’t help you”– Problem is Chronic & You Ran out of Problem is Chronic & You Ran out of

SolutionsSolutions After the Referral: Your Care ContinuesAfter the Referral: Your Care Continues

– How did the week go? How did the week go? – Counseling Helpful? Learned Anything? Counseling Helpful? Learned Anything?

Establish Link with ProfessionalEstablish Link with Professional

chinese culture and psychopathology 中華文化与心理病態學 melvin w. wong, ph.d....

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