From a schema perspective, many clients from Asian cultures may appear to score high on the Enmeshment Schema. This schema suggests that an individual has not fully completed their process of individuation, making it difficult for them to see themselves as independent from their family or caregivers. This is directly tied to the question of how we establish boundaries within our culture. Since setting boundaries is often a crucial aspect of therapy, understanding the cultural differences that influence boundary-setting becomes particularly important in its application.
As I discussed in my previous article, in collectivistic cultures, individuals tend to define themselves as part of a larger group. Consequently, self-evaluation is often made in relation to others to a greater extent. Concepts such as good and bad, reasonable and considerate, polite and socially appropriate—all of these are shaped by a collectivistic foundation.
As a Chinese individual, I look to Confucianism, which has had a significant influence on our culture. Confucianism provides concrete examples and guidelines for interpersonal relationships. A fundamental aspect of Confucian thought is the hierarchical nature of society, with clearly defined interactions between different levels of hierarchy. For example, the relationship between a father and son is hierarchical, with the expectation that a son should obey his father, as this is considered an expression of respect and love. There is even a saying: "If your father steals and you hide it to protect him, there is honesty within." (父為子隱、子為父隱、直在其中矣。—《論語》) This reflects how family harmony is traditionally maintained and how hierarchy is preserved in Chinese culture.
Given that the ways we interact with one another are so well-defined, many judgments arise based on these expectations. For instance, if a son points out his father’s faults—no matter how tactfully—it is likely to be poorly received in a Chinese cultural context. This is because a son is not supposed to cause his father to lose face or feel ashamed. If done publicly, this can be linked to the concept of face (面子) in Chinese society; even in private, it challenges the notion that a son should make his father proud.
Thus, this cultural framework often promotes the schema of Subjugation. In Schema Therapy, the Subjugation Schema refers to a tendency to suppress one’s own opinions or disagreements to avoid rejection or criticism. Additionally, Chinese culture also reinforces Self-Sacrifice. Many Chinese individuals can easily recall proverbs that glorify self-sacrifice for the greater good of the community or country, such as "Sacrifice the small self to achieve the greater self" (犠牲小我、完成大我). The Self-Sacrifice Schema in Schema Therapy describes individuals who prioritize others' needs over their own, sometimes to the extent that their sense of meaning and happiness depends on fulfilling others' needs.
With this understanding, we can better adapt the application of Schema Therapy to Chinese clients.
A client might have very complicated feelings towards their parents, which makes the therapist’s work more difficult. The therapist needs to pay close attention a client’s nonverbal cues and check in with the client often to ensure they know what the client is feeling, moment by moment.
Growing up and becoming independent in a collectivist culture often involve a lot of grief and require a great deal of self-compassion and acceptance. There is a deeply intense thought process required to make peace within oneself in order to set healthy boundaries.
Technically, many times, a therapist might find themselves doing reparenting with a client’s parents in imagery as a way to reparent the client’s Vulnerable Child Mode. This is definitely a difficult balance and requires tactful skills to apply. There are demonstrations in the upcoming one-day workshop below.
In the next article, I shall elaborate on the role of authority and how its affecting psychotherapy.
Beatrice Ng-Kessler
Registered Clinical Psychologist (HK and UK)
Advance Certified Schema Therapist and Supervisor (ISST)
Certified Mindfulness Trainer from Canada
Reference:
(1) Li, J. (2010). Mencius’ refutation of Yang Zhu and Mozi and the theoretical implication of Confucian benevolence and love. Frontiers of Philosophy in China : Selected Publications from Chinese Universities, 5(2), 155–178.
(2) Lu, Y. (2021). Confucianism and phenomenology: An exploration of feeling, value and virtue. Brill.
(3) Li, J. (2021). Confucian Self-Cultivation: A Developmental Perspective. In Hershock, P. D., & Ames, R. T. (Eds.), Human beings or human becoming?: A conversation with Confucianism on the concept of person (pp.91-120). State University of New York Press
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