What It Means to Work With a South Asian Therapist

By Tushi S. Patel

I was trained in a Western model of therapy. I learned the theories, the frameworks, the evidence-based approaches. I learned how to actively listen, how to reflect, how to sit with silence, how to ask the questions. And those tools matter. They’re valuable, grounding, and necessary.

But they are only a part of the approach.

What I’ve learned, both as a therapist and as someone who has been in therapy herself, is that culture lives in the spaces between the words. In what we hesitate to say. In what feels “too complicated” or “too much” to explain. In the parts of our lives that don’t translate neatly into diagnostic language.

I work with clients navigating relational struggles, whether that is intimate partnerships, family dynamics, friendships, or the quiet loneliness that can come with life transitions. I see people who are divorced or questioning what the next chapter of their relationship looks like. People dating again after years of not knowing where to begin. People noticing patterns in their lives and asking, Why does this keep happening? I see folks entering new eras of life, i.e. career shifts, caretaking roles, grief, independence, embracing their identity, etc. I see Desi women later in life, finally giving themselves permission to ask, Is this the life I want?

And woven through all of it is culture.

As an Indian-American, first-gen therapist from an immigrant background, someone who grew up in the U.S. and spent all her life in predominantly white spaces, I know what it’s like to belong neither here nor there. I also know what it’s like to experience therapy through a Western lens that doesn’t always know what to do with nuance.

I remember starting my own therapy journey and feeling terrified. Not of the therapist, but of the fallout.  “No one is going to find out I’m in therapy, right?”,  “What if my parents find out?”,  “What does it say about me that I’m here?”.

There’s a specific kind of fear many people from collectivist cultures carry when entering therapy: the fear of exposure. Of being seen as ungrateful, dramatic, disloyal. The fear of the inevitable questions: What’s wrong with you? Why do you need therapy? What are you telling them?

And then there’s the deeper fear: If I tell the truth about my childhood, will my parents be labeled monsters?

So many clients hesitate when they talk about how they were raised. About discipline. About expectations. About being hit when they were young. And in many Western therapeutic spaces, these disclosures can quickly be framed as abuse. And while harm is real and deserves to be named, what often gets lost is context. The parenting models our parents inherited. The survival strategies shaped by colonization, migration, poverty, war, and displacement. The difference between understanding harm and erasing complexity.

Too often, clients are told, explicitly or implicitly, that healing requires cutting people off. Going no contact. Burning bridges. And for some, that is the right choice. Safety matters. Boundaries matter. Space can be lifesaving.

But for many of us raised in cultures where family is central, family is not something you can simply opt out of: not emotionally, culturally, or practically. And the pressure to do so can create even more shame, guilt, and confusion.

In therapy with me, your people are not automatically villainized. Instead, we make room for several things to be true. We can hold love and anger. Gratitude and resentment. Loyalty and grief. We can acknowledge harm without flattening the story into “good” and “bad.” We can explore your parents and people as full humans shaped by their own histories without using that understanding to minimize your pain.

Because many of us are already very good at understanding others. We’ve spent our lives justifying, contextualizing, explaining. What we haven’t had is space to feel.

Therapy doesn’t have to be about fixing or cutting off. Sometimes it’s about sitting with emotions you were never allowed to have. Grieving the childhood you didn’t get. Saying the raw, unfiltered truths you’ve never spoken out loud. Naming the exhaustion of always being the responsible one, the bridge, the translator, the peacemaker.

Working with a South Asian therapist doesn’t mean rejecting Western models. It means expanding them. It means therapy that understands why starting this process can feel so daunting. Why guilt and shame show up before clarity. Why healing isn’t linear or tidy. Why love and pain are often deeply entangled.

This work isn’t about telling you what you should do with your family, your relationships, or your life. It’s about creating a space where all of it belongs: without judgment, without rushing, without erasure.

You don’t have to explain the unexplainable here. You can just be.

If you found yourself nodding along, pausing, or feeling seen while reading this, therapy with Tushi may feel like a meaningful next step. She works with clients who want space for nuance, complexity, and culture- without being rushed toward answers or decisions.

You can schedule a consultation with her if and when you’re ready.