Invisible and Scrutinized, An Interview with Dr. Sheila Modir

An interview with Dr. Sheila Modir on racial trauma and identity within the Middle Eastern North African (MENA) population. Curt and Katie talk with Sheila about how MENA individuals are impacted by racial profiling, prejudice, and the lack of data on the MENA community. We also explore typical coping strategies as well as how therapists can support MENA clients.

It’s time to reimagine therapy and what it means to be a therapist. To support you as a whole person and a therapist, your hosts, Curt Widhalm and Katie Vernoy talk about how to approach the role of therapist in the modern age.

Transcript

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Interview with Dr. Sheila Modir

Dr. Sheila Modir is a pediatric psychologist at Children’s Hospital of Orange County (CHOC). She obtained a combined doctoral degree in Clinical, Counseling, and School Psychology at the University of California, Santa Barbara and her master’s degree in social welfare at UCLA. Prior to coming to CHOC, Dr. Modir completed her doctoral internship at the UCLA Semel Institute for Neuroscience and Human Behavior where she worked at the UCLA Stress, Trauma, and Resilience Clinic. Her research interests include racial trauma and understanding risk and resilience factors in the context of trauma, and she has presented at conferences and published articles on this topic. Most recently, she has written a children’s book (coming fall 2021) called The Proudest Color, which is a timely and sensitive introduction to race, racism, and racial pride for children.

In this episode we talk about MENA clients:

• MENA (Middle Eastern and North African) clients
• The common mistake of assuming that all MENA clients are Muslim
• A lack of data on immigration and the demographics of these clients
• The lack of clinical research and education on MENA clients
• An invisible community that is greatly scrutinized due to profiling
• The layers of racial trauma
• Bronson Brenner’s ecological model: Sociopolitical discrimination, Institutional discrimination, Relational discrimination due to “cultural ignorance”
• The consistent portrayal of MENA individuals as terrorists, the Middle East as war-torn

“The final thing that really came out that I think was the most devastating finding was that all of our participants at some point have been called terrorists.” — Dr. Sheila Modir⠀

• MENA individuals called terrorists versus white individuals called “lone wolves” who are “mentally ill”
• The impact of how the insurrection in January is viewed as “white terrorism”
• What influences racism and bias against MENA clients
• The typical coping strategies for MENA clients related to racial trauma
• Resignation, cowering, “getting used to it” leading to depression and anxiety
• Coping strategies, including education and being a cultural representative
• The contrast between the Asian American community pushing back against the “model minority” while MENA clients are aspiring to be a model minority
• The importance of identification of MENA individuals on the census
• How the Muslim Ban has impacted MENA individuals’ relationship with the government

“Discrimination [is a MENA individual’s] whole interaction with the world…on multiple levels. I think we want to remember, as therapists, that this is a community that will minimize, will deny and tends to be very private and not disclose these things, because they don’t maybe want to be a nuisance in any sort of way, or want to see that as problematic. And we still need to assess for it, we need to ask about it, we cannot shy away from the uncomfortable dialogue related to race and racism, because…this is a community that will be quiet about it, but will carry it, and it will influence them.” — Dr. Sheila Modir

• Clients minimizing, denying, not disclosing racial trauma
• The thirst for appropriate and accurate information on culture
• The benefit of affinity groups
• How non-MENA therapists can best support MENA clients
• The nuance of asking a MENA client to educate you as a therapist
• Collectivist culture and how it shows up in the room, how it can be complicated
• The challenge of cultural sensitivity when there is little research
• A call to action regarding research and education

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For more information on Dr. Sheila Modir’s research:

Modir, S. & Kia-Keating, M. (2018). Exploring the Middle Eastern American college student experience: Discrimination, adjustment, and coping. Journal of College Student Development 59, 563-578.doi:10.1353/csd.2018.0053

Learn more about her at:

Twitter: @drsheilamodir

Instagram: @thelittlewellnessbookshelf

AMENA Psy

Relevant Episodes of MTSG Podcast:

Iran, The News, and Your Clients

White Terrorism and Therapy

Let’s Talk About Race Again

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Curt Widhalm, LMFT

Curt Widhalm is in private practice in the Los Angeles area. He is the cofounder of the Therapy Reimagined conference, an Adjunct Professor at Pepperdine University and CSUN, a former Subject Matter Expert for the California Board of Behavioral Sciences, former CFO of the California Association of Marriage and Family Therapists, and a loving husband and father. He is 1/2 great person, 1/2 provocateur, and 1/2 geek, in that order. He dabbles in the dark art of making “dad jokes” and usually has a half-empty cup of coffee somewhere nearby. Learn more at: http://www.curtwidhalm.com

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Katie Vernoy is a Licensed Marriage and Family Therapist, coach, and consultant supporting leaders, visionaries, executives, and helping professionals to create sustainable careers. Katie, with Curt, has developed workshops and a conference, Therapy Reimagined, to support therapists navigating through the modern challenges of this profession. In her spare time, Katie is secretly siphoning off Curt’s youthful energy, so that she can take over the world. Learn more at: http://www.katievernoy.com

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Transcript for this episode of the Modern Therapist’s Survival Guide podcast (Autogenerated):

Transcripts do not include advertisements just a reference to the advertising break (as such timing does not account for advertisements).

… 0:00
(Opening Advertisement)

Announcer 0:00
You’re listening to the Modern Therapist’s Survival Guide, where therapists live, breathe and practice as human beings. To support you as a whole person and a therapist, here are your hosts, Curt Widhalm, and Katie Vernoy.

Curt Widhalm 0:15
Welcome back modern therapists, this is the ModernTherapist’s Survival Guide. I’m Curt Widhalm, with Katie Vernoy. And this is the podcast that deals with all sorts of things related to therapists in our lives, in our practices and the world around us. And it’s been a little bit more than a year since we’ve talked about some of the Middle East culture stuff. And we had a wonderful podcast last year around this time. And surprise, surprise, prejudice and racism against clients and people from that kind of the world hasn’t gone away in the last 12 months. And so talking about some of the background, we’re joined today by Dr. Sheila Modir, and she is here to share with us about the experiences of prejudice and discrimination against Middle Eastern North African American community members. Thank you so much for joining us.

Dr. Sheila Modir 1:10
Thank you for having me. I love your podcast. I love listening to it. I’m really excited to be here today and talk about this topic.

Katie Vernoy 1:16
We are excited to have you here too. You’re a friend of the show. And so it’s so wonderful that you’re willing to share your knowledge with us. So other people can know you just like we do. Who are you? And what are you putting out into the world?

Dr. Sheila Modir 1:28
I am a pediatric psychologist at CHOC Children’s, which is a children’s hospital in Southern California. I’m also an Iranian American. Just to tell you a little bit about my background, I have my master’s in social work from UCLA. And then I went on and I got my PhD at UC Santa Barbara, in a combined degree, which is like clinical counseling and school psychology. But I got an emphasis in clinical psychology. And that’s when I really started getting into the research on discrimination, racial socialization, and which I would love to also talk about too, and specifically started really looking at the Middle Eastern and North African community, which I’ll call MENA for sure. And just really the different layers of racial trauma that they’ve experienced.

Curt Widhalm 2:09
So we’ve moved this question up to the front of the show. And I think that we’re probably far enough having moved this question up in the show to stop giving that disclaimer to help therapists not make the same mistakes that other people have already made. So as a as learning point, what do you think therapists get wrong when working with MENA clients?

Dr. Sheila Modir 2:31
Yeah, it’s a great question. I think the challenge is that therapist really don’t know much about MENA clients, or they confuse the Muslim culture with the MENA culture and the MENA culture is actually it’s very diverse. You have the Jewish community, you have Catholic, you have Christian, you have Islam, but then you also have people in Israel and people in North Africa. And then you have the Arabic countries. And then you have Iran and Turkey and Afghanistan. So you just have all these different pieces of the Middle East. And unfortunately, we really don’t have a lot of data on the MENA community. Middle Easterners have emigrated to the US since the 1890s. And we don’t really have an exact population count. And the reason for that is because the US Census actually taxonomically categorizes them as white, Caucasian. So we don’t really know exactly what their experience is, and we can’t capture it. So how that’s really problematic is we don’t have clinical research. We can’t really make therapeutic considerations based off of this population. We also can’t track health trends. So with COVID-19, we don’t know exactly what’s happening with the MENA community. So basically, they’re really lost in the shuffle of things. So if you’re really thinking about, okay, how does this impact therapy? Well, again, if we can’t do the research, then we really don’t know what’s going on with them and everything that people are doing right now, it’s very foundational. And we’re just starting to this new generation of MENA psychologists are just starting to really look into this population. I think one of the few people that have accurately captured a MENA community is in Dr. Sue’s book on multicultural counseling. There’s a few chapters in there, and I remember, even being in graduate school, the only time I really learned about the MENA community was from those few chapters that were assigned to be able to look through. So, I think if we all reflect back on our graduate training, how much did we really get to know about the MENA community I think probably very little and I do attribute that to the fact that they’re ultimately a very invisible community which is very ironic because they’re very much under scrutiny and surveillance but then they also are very much overlooked on a lot of different levels.

Katie Vernoy 4:41
It’s interesting to be invisible yet scrutinized.

Dr. Sheila Modir 4:46
Yeah, yeah, you’re definitely under the eye in terms of the negative things, right. So, when you go to the airport or anytime you are a some sort of terrorist attack happens, you know, all eyes are on the Middle East and talked about and it’s paid attention to. But then when we want to know exactly like, how is the mental health of this community, or how many Middle Easterners are residing in the US, we really don’t have that information.

Katie Vernoy 5:13
I mean, it seems to me and one of the areas of expertise that you have is around racial trauma. I think it seems to me there would be so many different layers of racial trauma that the MENA community is experiencing. And I, I feel like we’re starting to know, but maybe we don’t even have the basic information. But but what do we know about the racial trauma experienced in the MENA community?

Dr. Sheila Modir 5:38
Okay, this is definitely a great question. Because I have a ton of research on this piece, because this was actually my own research was on the multiple layers of racial trauma. So please, interject and stop me because I’m very passionate about this topic. I can go on. So, there’s multiple layers. So what I want us to imagine is really Bronfman Brenners, ecological model, and really, the concentric circles that he has, and really looking at the different layers that people experience. So, I use that model for racial trauma. And what we first found in the literature and it within our analysis of the data was that there’s a socio political level of discrimination that occurs. And then it goes into community, relational and individual, which I’m happy to get into. But socio political is really interesting, because it really started after 911, where a lot of the MENA community was forced to make this choice of whether you’re Western or you’re Eastern. And for some people, it really wasn’t much of a choice, because the Western community was very much saying, Well, you physically look MENA, so we’re going to discriminate against you. And you’re part of this other group as a part of as opposed to being part of us. Even though this population, a subset was born within the US and felt like they were patriotic. But if we remember after 911, it was patriotic to be against the MENA community. You make sure that you are outwardly expressing that.

Curt Widhalm 7:03
Even on that point, I remember it. This is, you know, the the highest levels of cinema. But I remember seeing an interview with some actors who had been on an Adam Sandler movie who were like, Oh, you want us to play cab drivers after 911? Like they were so excited to not play terrorists in movies that it had permeated just so many different areas of the culture.

Dr. Sheila Modir 7:25
Yes, that’s exactly. So that’s perfect entrance into the next piece of that. The next layer of socio political climate is the media influence. You’re exactly right. So, they were very much vilified. So all the if we recall, all the bad guys in the movie spoke Arabic.

Katie Vernoy 7:40
Yeah.

Dr. Sheila Modir 7:40
You know, there were very far from our days of Aladdin. We were now moving towards things like there’s shows about terrorism, there were shows about Arabic graffiti in the background. The Middle East was portrayed as war torn, and everybody there was burning American flags. I mean, any sort of villain, essentially, after 911 was seen as Middle Eastern. And that’s really hard for a group of people that are growing up in this generation of A: for that to be all that they’ve known and B: for example, to sit in a cinema and watch the bad guy and be like, Oh, I understand his language. I know everything he’s saying, you know, I understand it perfectly. And, and so I think that’s very, very impactful on how this community is really grown up to see the world. And ultimately on the socio political level, the final thing that really came out that I think was the most devastating finding was that all participants at some point had been called terrorists. And to have your culture so tied to such a horrific thing, and to find it very normal to be like, Oh, yes, I’ve been called terrorist. Yeah, but they were joking, or even if they weren’t joking, you know, I understand why they would say that because of the political climate. Or, at the time that I was gathering my data, a lot of the ISIS murders were happening and ISIS terrorist attacks. I think it’s just very unfortunate, because if we simultaneously compare this to actual terrorists, like Dylann Roof, or who actually did terrorize, you know, the black community and as a mass murderer, and a white supremacist, but instead of him being labeled as a terrorist, he was labeled as a lone wolf, someone that had a mental illness. As opposed to when a terrorist attack has occurred, the entire MENA community is now responsible for this attack. And I think that that’s something that the media does is it takes one person’s action and especially for ethnic minority communities, and makes it a representation for the entire cultural group.

Curt Widhalm 9:33
With the insurrection that happens at the US Capitol at the beginning of January, and even the language that that’s initially been used around this the insurrection, the coup. Starting to hear more regularly about this being called white terrorism. We had our episode last month that was about white terrorism. How are people from the MENA community responding to this. Now that the limelight is on white people doing this, but the there has to be some kind of observation that seems to be maybe a little bit different here.

Dr. Sheila Modir 10:06
Definitely, I think right now a lot of what is coming out is very anecdotal. I think it’s very different for every person as they’re taking in the information that’s coming in. But overall, I believe this is one of the first few times that we were seeing the label of white terrorism being thrown around to describe the awful events that had occurred that day. And I think that it’s a very fitting label, because in your episode on white terrorism, you know, you had the FBI definition of what terrorism is. And I think that for so long, when people imagine what a terrorist is, unfortunately, they are picturing a Middle Eastern or someone from the MENA community. And I believe that the events that had occurred at the capitol for the first time shed light that other groups, including the majority group in the US, the Caucasian white group can be labeled as white terrorism, but I think that we won’t, we’re all still holding our breath to see what the consequences of that event will be. And if this community will also continue with this label, because I do think that we are hearing different labels. So ultimately, I don’t, I can’t really say what the Middle Eastern community is feeling about this. But I do believe that we are at a place right now that we are labeling accurately events as terrorism in the US.

… 11:21
(Advertisement Break)

Curt Widhalm 11:21
Are there particular backgrounds, or particular people within the MENA community who are more at risk of this kind of discrimination, or these kinds of microaggressions?

Katie Vernoy 11:32
Or full on aggression. “Terrorist” isn’t a micro aggression.

Dr. Sheila Modir 11:36
Yeah, from what we found in our data, it was physical appearance, you know, has a really big component to it. So whether you are dressed in like an Islamic hijab, or even if the darker skin tones that you have. Our participants that are what we call racially pass. So you pass for the Caucasian white group, they were the ones that experience much less of it. But you know, there are identifying factors like in your name, or how, like how you say your name, or different things like that, that they were much more discriminating. And having an accent, all these things were things that came out in the literature,

Katie Vernoy 12:09
You were talking about, like, Oh, I understand why they called me a terrorist. And it was kind of just taken in stride. I mean, does it feel like it is socially acceptable, broadly, socially acceptable for this type of racism to occur?

Dr. Sheila Modir 12:25
I think though that’s actually interesting. Because there another concept that came out of the data was this thing called cultural ignorance. So so we have so we’re looking at the concentric, concentric circles, we have socio political discrimination, we have institutional discrimination. And then we have something called relational discrimination. And within relational discrimination, there was a concept of cultural ignorance that was coded in the data because these participants would say, yes, I experienced discrimination, but it’s ignorant. And they didn’t mean it. It’s because there was this lack of knowledge on the MENA community. If these participants are college students, they are like 18. And they would say things like, you know, if you go back to our history classes, we never learned about the MENA community. So how could I expect my peers to learn about it, and now that I’m in college, my own college does not recognize me as a minority community or doesn’t have events that highlight my cultural group. So how are they supposed to get this knowledge, they’re coming from their homes into college, and they are, you know, doing or saying maybe what their parents have told them or what they’ve seen in the media. So, what we realized is that the coping skill for discrimination for the MENA community, one of their major things was to A: avoid any sort of backlash, and B: to get used to it. So we kept coding the word getting used to it, I’m just used to, it happens. I’m just used to it. It’s not that big of a deal. The minimization. And previous literature actually has found that the MENA community does tend to Marva See, which is one of the researchers said, they tend to cower or resign in the face of discrimination, which definitely was something that came out a lot. And it’s very, very sad, because if you do not address something as discriminatory, then others won’t recognize it as discriminatory, and will continue to do it. And then this will soon become this ignored problem that’s never addressed and will just accumulate. And what we ultimately realized is that, yes, you can avoid and yes, you can get used to it, but you’re still carrying the psychological distress of the discrimination. That doesn’t go away. So the participants still felt depression, anxiety and all of these mental health concerns. Despite using these methods of coping skills that they thought were effective for them.

Curt Widhalm 14:44
So how do they cope? Other than internalizing everybody else’s ignorance and intolerance, how are people from the MENA community coping with this other than just kind of in this nebulous, like, deal with it?

Dr. Sheila Modir 15:03
Yeah. And I think this is a great question for therapists to know. Because when we were talking about like, what do they know, what do we know about it, and I think coping skills were always, you know, referring to that as therapists. So, there’s different ways that they cope. And one is by being educators, and by being representatives of their cultural group. Since the media isn’t doing it, we have, the community has taken it upon themselves. So, one of the quotes that I have from participants say, like, if they think that I’m an uneducated Arab, I want to show them that I’m an educated Arab, I want to teach them about the beauty of my culture. So many of them don’t see it as like, oh, I have to, because I’m minority, I have to educate others. It’s felt like this group was taking power and taking pride in being a cultural representative, and really wanting to break those stereotypes. The next piece was avoidance. So, due to that fear of backlash, so I better not say anything. And one of the things that really influenced that was messages from their families. So, a lot of these participants were talking about how, when they went off to college, their parents were saying things like, you know, don’t be too Arab, don’t speak Arabic, or, you know, Farsi, try to blend in, you know, and also, every time a terrorist attack occurred, everybody was holding their breath. You know, I remember when the a lot of the basis of my research was actually based off of how I emotionally experienced the Boston bombing, and how there’s that period where we just didn’t know who it was, and the whole country was waiting. And it was awful. And I just remember, every MENA person that I ran into that day was just like, please pray that it’s not a Middle Easterner. Like, please, if there’s anything we can do. And I was like, Oh, my goodness, like this level of stress is like, A: my country is under attack. And now I have to be stressed because I don’t want it to be someone from my culture, I that’s just the psychological toll that that takes on a person is just so extreme. And that’s really what I was like, I need to understand this, I need to know like, why do we think this way? And how are we coping with this? And then the final thing is to that this is a community that actually enjoys working towards being a model minority. The literature has found that with Asian American communities, that’s actually something that they don’t like being identified as. And so it’s interesting to see that the MENA community found it as something that they did strive for. And I think that they’re just constantly pushing back against this negative depiction. And I do think that 911 was that date that forever really made them, made that community change.

Katie Vernoy 17:39
So, this is kind of pulling it into I’m channeling Curt, and I’m pulling it into the therapist education realm, but I for MENA therapists and and kind of this desire to make sure that education is occurring, and combating the cultural ignorance. How is it for you? How has it been for your MENA colleagues to start trying to address this in a more comprehensive way?

Dr. Sheila Modir 18:06
I think that it’s been actually a very supportive experience right now. I think that there’s this new generation of psychologists that are in graduate school from the MENA community. We actually have a listserv, our division within the American Psychological Association called AMENA Psych, which I really recommend people joining, because this is the first ever organization for MENA that are in the mental health field. And I think that there’s been a lot of collaboration and I think most recently, people, you know, emailing about, you know, this is my research, can you promote it. And so I do think that we’re at this excellent time where foundational research is being done, that I feel like in the next decade or so, we will have more information about this community. I think, ultimately, what we do need to change is getting ourselves on the census, and being our own category.

Curt Widhalm 18:56
So I’ve seen here in the last week that the Biden-Harris administration is looking to specifically identify MENA on the Census, at least is one of the steps. And on one end of the spectrum, I hear people like you who are like, this is fantastic at research, and it’s going to open up all sorts of avenues to understand us as a distinct community. And on the other end of the spectrum, I’m hearing, there is no way in hell that I want the government to have any other reason, and so this fear is even beyond the interpersonal interactions that people are having, but also to that political interaction that I guess it just speaks to, there really is a broad experience, even within this community of the level of trust and mistrust to to American culture.

Dr. Sheila Modir 19:45
I mean, can we blame them? We have, every everything that’s ever happened in the Middle East is somehow got America’s hands tied into it somehow. So, I think there’s that component of it. And then also, what was one of Trump’s first initiatives, the Muslim ban? You know, and so from there, it’s, it’s terrifying. I think that I think that there’s going to have to be a lot of trust rebuild in a lot of minority communities right now, especially after the current administration, I think that a lot of Latino communities are also worried about putting down their ethnicity. And I think that this is just something that’s going to be rebuilt over time. For the MENA community, a lot of celebrities have come together that have been trying to say, you know, don’t be scared, put it down. But I will say personally, you know, I had to spend some time convincing my own parents to, to do it, because, you know, they don’t they’re worried about what could happen, even though they’re US citizens. I think that I don’t think it’s really the current administration was even talking about, you know, people that are born here, but still have parents from another country might get deported. I mean, there’s just so much talk that had happened these past four years that it’s really scared people.

Katie Vernoy 20:50
So when we’re supporting MENA clients in our or therapy spaces, what is it most important for us to know? And for us to keep in mind as we’re walking through therapy with them?

Dr. Sheila Modir 21:07
Yeah, that’s a really great question, because I think I can speak from the at least the discrimination piece. And if we’re looking at discrimination, it’s their whole interaction with the world, right, and on multiple levels. I think we want to remember, as therapists that this is a community that will minimize will deny and tends to be very private, and not disclose these things, because they don’t maybe want to be a nuisance in any sort of way, or want to see that as problematic. And we still need to assess for it, we need to ask about it, we cannot shy away from the uncomfortable dialogue related to race and racism, because what we’re finding in the literature is that this is a community that will be quiet about it, but will carry it, and it will influence them. And I think the most powerful thing that I found in my research was that when we looked at the multiple levels of discrimination, ultimately how it impacted the individual was so powerful on a social level. This group at least 80% gravitated toward joining cultural and religious organizations within their first year of college. That’s huge for students to do, you know, they said, that means that they wanted to go back to their cultural roots. So they just left home, maybe getting away from parents, and now they were feeling lost and needed a sense of belonging within their community. So sense of belonging is huge in this community. On an academic level, a majority of them were choosing careers that we would consider prestigious, like being a professor or physician or an engineer. In addition to that a majority of them were minoring, or double majoring in Middle Eastern Studies. There is this thirst for appropriate and accurate knowledge on their culture that the media has not provided for them, and that they have not been able to find out there. You know, even I was in graduate program, and I was taking Middle Eastern Studies. And that’s how I was like, Wait, where, what, what’s going on? Like, how do we all find each other here and form this community. And I think, again, that for universities is huge to know that, that academically, the this, this group of people really is seeking this out. And then on an emotional level, this was a group that would say things like, I’m angry that I’m being discriminated against. But I do not want to confirm the stereotype of an angry Arab. You know, I don’t want people to think like, oh, you’re mad, are you going to go bomb a place right now? You know. And so and that’s what people would say if there was some sort of emotional expression. So there is this emotional repression that’s occurring around discrimination, around these experiences that they’re having out in the world. And as therapists it’s our job to start unraveling and supporting and processing things that they might not even be recognizing that they’re carrying.

… 23:54
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Katie Vernoy 23:55
With a MENA client working with a non MENA therapist is there is there advice there because I can hear the the affinity groups and being able to really to gain more education and knowledge around culture and kind of finding your way home, so to speak. I think when you’re talking about this need to stay quiet, or this need to get used to it or get along, I could imagine looking at a white person, because you know, I’m a white person, and having someone be like, I don’t know that she’s gonna get it or this could hurt my relationship or those types of things. Like is there? Obviously, maybe this is a big, big ask, but is there a way for non MENA therapists to be able to show some solidarity, some comfort, some ability to say, Hey, I’m here and you can open up to me?

Dr. Sheila Modir 24:44
Yeah, I do. I think that I think that definitely, and there is literature that says that, that the MENA community is comfortable seeking out non MENA therapists. At the same time, there is some that say that they’re not comfortable. And so things I think to keep in mind is just finding whatever cultural information that you can and and really being able to understand the cultural. Like if we want to be culturally competent therapists then we need to enrich ourselves or into this information like we do with all other ethnic minority cultures, right. And so there is some literature out there. But there’s also some things to kind of realize with with working with a MENA population, and that is really being able to just say exactly what you’ve said. I’ve like, you know, I might not recognize your experiences or not understand them. But I would I would like to know, you know, I know that something has happened, you know, in the US or overseas, I heard this thing on the news, is this impacting your family in any way? I think what we did deem from the data was that they’re not offended. And so some cultures might, or communities might be offended, they’re not offended by asking or probing about these things. And, and putting them in a position of educating, we want to be careful, because we don’t want for example, the black community to have to educate us on black culture, we should know these things. Or the Latin X community. But I think with the MENA community, because there isn’t a lot of literature out there, I think it’s okay for us to ask and inquire and further explore and, and let them maybe teach us a little bit about what they’re going through. And really, we can attribute it to the fact that there isn’t much out there. But just general things for therapists to be aware of, too, is that this is a collectivistic culture. So, when you have an individual patient in the room, you can actually feel like the whole family is in the room with you, because they’re very much like present even though they’re not physically there. The oldest son, the fathers, you know, those, they definitely could be the ultimate decision maker similar with Latinx family. So there is some overlap there. I actually did a lot of research on Latinx families, because I was interested in collectivistic cultures, and I found that there was a lot of cultural overlap. So, I do think that therapists are looking for understanding the MENA community can look at just collectivism in general to help support them with that. The MENA community tends to go to their physicians for mental health problems. So there might be a lot of physician referrals. And so and they can add a lot of somatic complaints when it’s really maybe anxiety. So just different things like that to be aware of. I do think that the Middle East has grown in their acceptance of therapy. So much more, I know that in Iran, right now, there is acceptance, commitment, therapy conferences that a lot of young people attend, and they’re just different, like CBT, and ACT genres that have like really grown. I know that in Egypt, like PCIT, is starting to maybe be implemented. So, I do think that as the Middle East kind of becomes more accepting of Western models of therapy, I think that we can definitely see them opening up more in within the US with non MENA therapists.

Curt Widhalm 27:49
One of the associates that has been working in my practice is Iranian. She’s been on one of one of our previous podcast episodes, as well. And some of the things that she talks about is just to the levels of understanding the collective cultural aspects, is the Western approaches of therapy having so much with the individual efforts towards interventions that, you know, why don’t you stand up to your family? Well, that just doesn’t work in a MENA household. That, that it does, in my point in this is that it does take a understanding of how how this applies. It’s not just applying West to collectivist cultures, it’s really getting into the understanding of how that relationship plays out. Because otherwise, we can be well intentioned, but still completely off the mark.

Dr. Sheila Modir 28:43
Yeah, yeah, I think it’s being sensitive to that every decision is run by the family and run past the family. I think that where we can definitely support the, in what we’re giving in terms of the individualistic components of our therapy, because we want to help them with the distress that they’re experiencing. But I do think that things like setting boundaries, right, it’s such a Western component to what we’re doing. But I feel like if boundary setting is needed, in terms of the fact that there really their functioning is impaired due to poor boundaries, I think there are ways to make it culturally sensitive and be able to apply. But yeah, I think it’s definitely aligned that we walk. But fortunately for us, there’s a similar communities that have the same cultural backgrounds, right, Asian Americans, Latin X, MENA communities, they are very collectivistic the decisions have to be run past families, they work together towards common goals, you know, the elderly often live within the family unit. So these are things that we can definitely consider when we are looking at Western approaches like CBT and ACT. I think we’re trying to change the individual but we’re not trying to change the context that they’re, they’re residing in so they so it’s almost like working into impact the outside, if that makes sense.

Katie Vernoy 30:03
It does. And it makes me think about some of the clients that I have that are from more of a kind of a collectivist culture, but are also pushing back on it and, and kind of kind of the Eastern versus Western situation. And so I think it, it’s something where, you know, I hear this oftentimes, and it’s been a lot of the conversations that we have is that it’s not a monolithic group, but it’s under, it’s important to understand kind of the larger picture so that you can see where someone fits within that culture. Because someone could be more individualist within a collectivist culture, and that could be part of the conflict. And if you’re going to like go individualism, and not understanding that this is a huge piece, a huge, you know, rift in the family, and that kind of, even for them understanding how it works, I think it just is, it’s really rich, to be able to have that information so that you understand the full context, not just how it fits into your own lived experience and Western culture. I guess the question that falls here is kind of the what are the resources and support and the different things that therapists can use when working with MENA clients?

Dr. Sheila Modir 31:18
Yeah, that’s a really great question. Unfortunately, I don’t have an answer for that, because there really is not that much out there. And I think, again, we’re speaking to the fact that we are still in the foundational part of gathering data, providing for this community. And this again, even in our therapeutic world, this is a group that’s being overlooked. And we don’t have the resources that we that we should have to be able to support this community.

Curt Widhalm 31:43
And if there is a call to action on that piece, well, people like Sheila are developing that research and doing it in the more scientific way. There is a huge space for anecdotal and case studies to be developed in the meantime. And if you are a MENA therapist, if you are working with MENA clients, write that stuff down and share that with the rest of us of what’s working and what particularly works. Maybe what some people what doesn’t work. Because in the absence of have a deep history of research and background information, anything helps, even if it’s kind of only right, that is something that does help our whole community end up being able to build from there and have a better collective knowledge of being able to serve all of our clients and our therapists coming from this background.

Dr. Sheila Modir 32:38
Definitely, I agree. The more case studies, the better.

Curt Widhalm 32:41
Where can people find out more about you?

Dr. Sheila Modir 32:44
You can follow me on Twitter at Dr. Sheila Modir. I also have an Instagram handle called @thelittlewellnessbookshelf where I list children’s books that promote themes of diversity and mental health in order to build resilience in children as I am a pediatric psychologist. And also my husband and I have actually written a children’s book called “The Proudest Color” which is coming out in September. And we’re really excited about it. It’s about a young girl of color who experiences discrimination. And we used racial socialization theory and evidence based practices to help her navigate this experience. It’s a timely sensitive introduction to race, racism and racial pride. And all the author proceeds will be donated to causes and organizations that promote equity and social justice. So I will definitely provide you with all that information.

Katie Vernoy 33:34
That’s amazing.

Dr. Sheila Modir 33:35
Thank you.

Curt Widhalm 33:36
It will include links to those on our show notes. You can find those at mtsgpodcast.com. And while you’re over there, check out all of the wonderful things that Katie and I are doing with all of our other various projects. And until next time, I’m Curt Widhalm with Katie Vernoy and Dr. Sheila Modir.

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