[00:00:00] Christine Ko: Welcome back to SEE HEAR FEEL. Today i'm excited to continue my conversation with Dr. Eunice Yuen. In case you didn't hear the last episode here is her biography. Dr. Eunice Yuen is an Assistant Professor of Psychiatry from the Yale School of Medicine and Child Study Center. She integrates clinical and research work in a bio-psycho-social cultural framework. She's interested in mental health from genetic and neurobiological underpinnings to practical interventions and education within communities. She looks at acculturative stress, a stress that is common to many immigrants, affecting children and families in a cross generational manner. Dr. Yuen is the founder and director of Yale Compassionate Home Action Together, abbreviated CHATogether, and it's a program that uses interactive theater as an educational tool to increase wellness in Asian American families across generations.
[00:00:51] In our last conversation, we left off with permission to feel, that concept, and we will take it from there.
[00:00:58] Eunice Yuen: Permission to feel is really important.
[00:01:00] Christine Ko: I've read a little bit about that concept. Permission to feel. Can you talk about that concept of permission to feel, It has to do with emotional intelligence, right?
[00:01:08] Eunice Yuen: At the beginning of the introduction I mentioned about Yale CHATogether, Compassionate Home Action Together. We are using interactive theater as the tools to help teens, parents to come together to talk about something really stigmatized. It can apply to so many different places. And so we create this video skit. Based on many people's storytelling, based on people who identify themselves as AAPI: teens, young, adult or parents, and come up with a conversation. Something really taboo, really stigmatized, mental health or a racial identity.
[00:01:46] And some of the conversation did not go well. For example, the parents as first generation did not believe much in mental health. It's hard to understand what is it about to validate feeling, to express feeling in the Western way, like saying, I love you. I care about you. It may not be that direct and explicit, for example, but the second generation kids will feel like, Oh, my parents don't care about me. This cross-cultural conflict there. So we create a lot of theater skits, and we have our volunteer, who wrote a skit, create a video to showcase many of these conversations around mental health. And we share many of this video on social media, and we demonstrate not just showing the videos of how conversation did not go well. We also have a moderation with the teenager and the parents about what go wrong in the conversation. And then would bring up a lot of this concept, including the permission to feel, to help the parents understand about actually talking about your vulnerability or talking about your trauma. Many of the parents say, Oh, I don't care about talking about trauma. Talking about the past, and make me feel more depressed and upset. Helping the parents to understand sharing emotion is a powerful way to allow your kids to share theirs, too. Bring up the past. You need to demonstrate and model. You're the best teacher for your teenager. The concept of permission to feel is almost like an invitation. To let the other side be okay to be vulnerable because I validate that feeling, right? So that's permission to feel.
[00:03:21] Another concept is called mentalization. Mentalization is really to think about each other's shoes. Helping the parents think in the shoes from the teens. Parents experience that without judging and be able to keep curious at what is it like to feel like another? And then go both way. Having the teens imagine, What do you feel like your parents, who grew up in another country, to know about what does it feel like to be a teenager? This concept would create imagination, non-judgmental conversation, and being able to validate each other, and trying to meet each other in the middle. So that's the process of mentalization. Permission to feel and mentalization.
[00:04:03] We also do a alternative scenario. We do the same skit again after we can apply this concept. So that's a before and after to show the parents, Oh, what could be done in a better way to talk to my kids? Oh, what can be a hopeful conversation with my mom about my career in something, not in medicine or in law? Like something like that.
[00:04:26] We create a lot of the skit video and share on social media. And we also do live skit performances in many webinar events as well. That's something we do. So that's some of the CHATogether activity that we do.
[00:04:38] Christine Ko: That's awesome. I love that because what you described with the skits and a moderator kind of saying, Oh, let's go over this, and say this is how it could have gone, optimally or better; then, to do it again, after the feedback. That really goes along with the growth mindset and deliberate practice, with the growth mindset being we can always improve at stuff. Being willing to see a challenge, you know, Okay, I didn't do it so well, I can do it better. And then deliberate practice where you get immediate feedback and actionable steps on what you know you can really do differently. So do you do you use those techniques with your kids?
[00:05:18] Eunice Yuen: I do, I try, which is hard. Easy to teach other people. But like when you practice it, it could be hard. I'm human, too, as a mom. Sometimes it works, sometime it does not. But it's like going to the gym. You need to keep it daily, and yeah, keep up the muscle. It's practice. That's what I tell other parents as well. You keep trying, practicing the mentalization skill. We need to regulate our own emotion before we even can mentalize someone else. So that's self-compassion. We need to take care of our own self before we can take care of other people.
[00:05:49] Christine Ko: Yeah. Naming and regulating my own emotions. It's not easy.
[00:05:54] Eunice Yuen: That's true. That's true. So to think about it, if we also struggle, like sometime at times, we also feel challenged to regulate our own emotion, then we can also empathize that for our kids, or for our patient, they will also struggle too.
[00:06:08] Christine Ko: I'm a fan of Brene Brown, and her most recent book is called Atlas of the Heart. Interestingly, she starts off with saying that many people can only really name three emotions. I only laugh because I was like, Oh, it makes me feel better. Because I would definitely say that was me before I started thinking about emotional intelligence.
[00:06:29] Eunice Yuen: Yeah. I related to that too. We don't have the mindset to really pause, to calm down, to really reflect on this emotion and what does that mean? And sometimes like when we are stressed, like the raw emotion can come out, but underneath there's so much to explain what emotion, what is on our mind. Sometimes we just did not have the time to allow ourselves to sit down and reflect like what that emotion means, what the thinking means behind the emotion, and what do we do afterwards to cope or not cope. And so I think that's really interesting conversation, compassion to ourselves and to help our kids to learn the same.
[00:07:06] Christine Ko: It's hard to have self-compassion. In theory I think it's easy, but in reality I think it's very difficult.
[00:07:14] Eunice Yuen: I hear you. I hear you. We'll try. We are human. We support each other. I think a circle like this is just amazing so we don't feel alone that we need to manage this by ourselves.
[00:07:25] Christine Ko: Do you have advice, especially since you specialize in the Asian American Pacific Islander community but also the medical culture, do you have tips, after having seen a lot of adolescents and their families, on how to start? Some really practical tips on how to start regulating your own emotions and learning how to enact permission to feel and mentalization in practice, practically speaking?
[00:07:52] Eunice Yuen: Yeah. We need to be in the state to practice that as well. So before mentalization, like both parents and teens, as a physician, we really need to regulate our emotion before we can care about other people. And imagining, or not judging. Many Asian parents just want to fix the problem for my kids, which is like automatic. It's like a reflex. But what is missing? What could be missing in the process would be really validating our child's emotion and validating our own. That will be the step before mentalization, because otherwise become like a shouting match and fixing solution. Permission to feel for ourself and self-compassion. Sometimes it's just really hard and we need to think of when we are at that moment. We need to know we are at that moment. We need our own mood thermometer like, Where are we at right now at this, at the end of the working day? I'm so exhausted. Like, this is not the right moment to talk to my kid because I need a space to regulate my own. It could be a quick five, 10 minutes. Do you have an immediate coping right away? I think the step would be really helpful in terms of practicing self-compassion and mentalization for someone you care and love.
[00:09:07] Say, Christine, you like to read, do you want to read something? Or, I wanna have a shower, just to calm myself. Cool off my mind a little bit. So I have my moment. I think that moment is very important and that's self-compassion. Doing like quick five minute, 10 minutes thing. I need that so I can feel before the conversation. Tune in to someone I care so I can really listen to understand, but not listen to tell them what to do.
[00:09:33] Christine Ko: That resonates with me. In terms of like permission to feel, it helped me crystallize it in my head of what that means. Before I respond, like you were saying, really try to understand and how do I make sure I'm understanding? I'm thinking, okay, mentally I'm like, I'm sitting here on some bench with you, whether it's my child or a patient or like talking with you right now and just sitting there first before I say something. It sounds so simple. And yet I would say I was not doing that before.
[00:10:02] Eunice Yuen: I'm not doing all the time. We don't wanna react to the patient, especially like difficult patient we're talking about. They could be angry, they're complaining to you.... you really need to sit with them like what you said, like trying to listen to understand and you don't react to what happened to the patient or what happened to our kid. That's what they need: to connect with them emotionally.
[00:10:25] Christine Ko: Yeah.
[00:10:26] Eunice Yuen: So they feel they're heard, they're understood.
[00:10:28] Christine Ko: Yeah.
[00:10:29] Eunice Yuen: And then you talk according to what they need. I think that's how they meet in the middle. It's like in a conflicting, emotionally conflicting zone, and somehow you meet with them in the middle.
[00:10:38] Christine Ko: That is one thing the pandemic brought home to me is we just want to be seen and we want to be heard.
[00:10:45] Eunice Yuen: Yeah.
[00:10:46] Christine Ko: And I think I definitely do want permission to feel my emotions.
[00:10:51] Eunice Yuen: Yes, let's do it. That's right.
[00:10:52] Christine Ko: Do you have any final thoughts?
[00:10:54] Eunice Yuen: Final thought? Yeah, I really appreciate this space, and I think that we are doing such an important work together. For the listener, no matter you identify yourself as AAPI or not, no matter you may be children, teens, or parent. You are important. Your feelings deserve to be listened to, heard, and shared, and we want to embrace that.
[00:11:17] Christine Ko: Thank you, Eunice, for spending time with me and talking about your work and all the great things that you're doing.
[00:11:24] Eunice Yuen: Oh, thank you, Christine, for inviting me. This is great. I appreciate your listening.