Tuesday, July 2, 2013

Immigration and Family Dysfunction

In psychotherapy with American patients who are repetitively self-destructive and self defeating, we attempt to create an emotional/historical family tree (genogram) that looks at the events and personalities in earlier generations that seemed to combine to create the ongoing dysfunctional family roles and interactions that we see in the present. These stereotypical interactions, the subjects of many of the posts in this blog, both trigger and continue to reinforce my patient’s problematic behavior. The behavior is a family role that helps to stabilize the way the family functions to a degree, at least over the short term. 

A good example was presented in my discussion of the resentful female caretaker role in some Mexican-American families, described as part of my post about borderline family dynamics.

A frequently ocurring historical factor seen in many of my patients’ genograms is the immigration of parents, grandparents, or even great-grandparents to the United States, particularly from countries that have more traditional, collectivist social structures. The process of immigration to American, depending to some extent on the reason for the move, often led to situations in which children seem to have one foot in their traditional culture and the other in American culture.

Such kids go to school along with typical, individualistic American children and will try to fit in, but in doing so their behavior may upset their parents, who see their children becoming, in their view, licentious and/or disrespectful. These parents tend to socialize mainly with other adults from their own ethnic group, who all maintain some of their “traditional family values.” 

Nonetheless, the adults are also exposed to the American siren song of “living with all the gusto you can,” to quote an old beer commercial. Yet they feel far less free than their children to succumb to its charms. 

Meanwhile, they are often dependent on their children to help them interface with the larger American culture when they have a need to do so. Their kids speak the language, so to speak, and are more familiar with it and therefore can negotiate it more easily than their parents.

This can set up a situation in which the parents seem to push their progeny to become acculturated, while at the same time objecting vociferously if they dare to do so. The potential for double messages and the creation of ongoing dysfunctional behavior patterns is very high in many of these cases.

One of the worst examples of same that I heard tell about was the case of a female physician from India who did her post-medical school training (her residency) here in the States after her family emigrated here. As with most of her ethnic group, her parents had made specific arrangements for her marriage with a suitable suitor from her caste and ethnicity back home.

The only problem was, the woman had fallen in love with another American doctor who was not of her ethnic background, and was planning to marry him. 

I only heard about this second hand, so I cannot vouch for any of the details of this story, but what I heard was that she ended up committing suicide.

Due to my interest in the genesis of dysfunctional family dyanamics, I was pleased to see a seminar at this year’s annual meeting of the American Psychiatric Association (APA) about this very type of phenomenon, entitled Accultural Family Distancing:  Developmental and Clinical phenomena for Children of Immigrants. It was put on by Drs. Dawn Sung, Andres J. Pumariega, and Shashank V. Joshi.

Since I use the term distancing in a different, although somewhat related sense, I prefer the more general term “acculturation gap” in discussing this. 

Research in this field is obviously a highly complex endeavor and therefore quite difficult to do, and that research which has been done is, I sense, not informed by family systems theory, let alone by my unified therapy perspective. The studies that have been done show somewhat mixed results.

After attending the APA session, which did seem to have a point of view that was similar to mine, I located two studies, [Hwang et. al., Child Psychology and Human Development 40(1), Mar. 2009; Farver et. al., Journal of Family Psychology 16(3), Sept. 2002] - one with Asian-Americans and Latinos, and the other with Asian Indian families - which support the idea that this acculturation gap does seem to create family conflict and psychological stress.

I found a third study using Mexican-American families (Lau et. al., Journal of Family Psychology 19(3), Sept. 2005) that did not show that. Interestingly, the latter study had the rather surprising finding that more problems occurred when the member of the younger generation was more aligned with the traditional culture than the parent!  Sometimes the patterns that I see on patients’ genograms do seem to show that a role reversal pattern does occur in a lot of families. The underlying game being played, to use an analogy, is often quite similar, but the players change sides. The pattern is much like that of a modern family characterized by an aggressive, careerist wife and a submissive and subservient househusband.

My own presentation at the APA meeting centered on how social psychological factors such as the ones discussed in this post are often completely ignored in research about the nature and treatment of dysfunctional personality traits within individuals. Many of the sessions at the meeting were attuned to the current prototypical “nothing but biology” mentality. Now that is crazy.


  1. Quite a remarkable observation. Great read. Was checking online for Canadian Immigration Services when i found this blog.

  2. As a child of (adult) immigrants I can attest to the fact that this issue is both huge (for me) and systematically ignored (by the research and/or profession).

    I did find another study by Hwang:

    Acculturative family distancing: Theory, research, and clinical practice.
    Hwang, Wei-Chin
    Psychotherapy: Theory, Research, Practice, Training, Vol 43(4), 2006, 397-409.