Preserving old among young

Mayranacri Moeung, 14, has her makeup done by Sothary Sou, 15, as they prepare to perform a traditional dance at a Cambodian New Year celebration at the Park Village Apartments community center Monday. (Photo: Victor J. Blue/The Record)
Sophanary Sok, 21, performs a traditional dance during a Cambodian New Year celebration at Park Village apartments in Stockton. (Photo: Victor J. Blue/The Record)
Min Ua, left, and Olthat That lead a group of musicians in a Cambodian New Year celebration at the Park Village complex Tuesday in Stockton. (Photo: Victor J. Blue/The Record)

Cambodian New Year celebrates tradition with food, music, prayer

April 16, 2008
By Jennifer Torres
Record Staff Writer (Stockton, California, USA)

STOCKTON - In the last frantic minutes before the Cambodian New Year dance program was set to begin at Park Village Apartments this week, women passed handfuls of gold-colored belts and bracelets across a table and coaxed stiff, straight ponytails into curls.

Kunthea Tuy tucked flowers behind Mayuranacri Moeung's ear. Later, Mayuranacri would perform a classical blessing dance in bare feet on stage in the Park Village community center. And even later, she would take down her hair, trade her traditional dress for jeans and dance to hip-hop and Cambodian pop under lanterns and balloons on the complex's basketball court.

"I like both kind of dancing, both the same," the 14-year-old said. "It's just, like, culture. It's important."

Local Cambodian residents have celebrated their new year over the past three days with traditional food, music, games, dance and prayer.

After decades in California, many within the refugee community say the ties of language and culture are strained as children pursue lives that are more decidedly American.

They don't speak Khmer and they don't wear Cambodian dresses to the temple, 19-year-old Sophany Yinn said. "You can see the way they dance at nighttime. It's different."

Events such as this week's new year celebration become, at least in part, a means of preserving what's old in the lives of the young.

According to Yale University's Cambodian Genocide Program, about 1.7 million people - 21 percent of Cambodia's population - were killed in the country from 1975 to 1979 when Pol Pot-led Khmer Rouge forces took over the country.

Yinn's parents were among the thousands who fled.

Now a student at California State University, Stanislaus, she has been studying Cambodian dance for about 10 years.

She was recruited to dance through her Girl Scout troop.

"I liked it because I was learning new things, especially about my culture," she said. "We're trying to live in a new society here. I wanted to keep at least something alive."

Before the dance on Monday, she lit incense outside the Park Village community center, pressed her palms together and bowed. "I just prayed to the ancestors to give me strength to do the dances correctly."

More than 10,000 Cambodian people live in San Joaquin County. According to U.S. Census Bureau figures, about 9,000 of them speak Khmer, or Cambodian. Nearly 60 percent also speak English.

Increasingly, though, language and culture gaps between parents and their children are becoming more pronounced, said Sophaline Buth, a liaison for the Stockton Unified School District.

"It's very difficult. Kids nowadays are so Americanized," Buth said. "In order to maintain that traditional culture, the only way the parents can is through the temple."

At the Wat Dhammararam Buddhist Temple on Carpenter Road on Tuesday - the last day of new year festivities - hundreds of families prayed, danced and left offerings at the temple's giant Buddha statues.

Children could play traditional games and practice speaking Cambodian - links to their parents' culture, Buth said.

According to research published Tuesday in the Journal of Epidemiology and Community Health, minority adolescents who maintain cultural identify, especially through their clothing, have fewer mental health problems than children who adopted the style of the dominant culture.

"If you don't know who you are and where you came from, it's hard for you to be able to stand for something," said Sovang Lam, program manager for Stockton's United Cambodian Families.

Earlier this month, the nonprofit organization led a focus group of about 30 Cambodian families to discuss concerns and priorities.

Parents were concerned about their children's education and ability to find jobs, Lam said.

Many, she said, have trouble communicating with teens who learned English in school and don't speak Cambodian well.

"I see that all the time here," Lam said. "Most of it is, 'I don't know what they're saying, and they don't know how to tell me.' "

Yinn said her parents insisted she study Cambodian. "I read, write, speak, understand," she said. "Kids are losing that too. They're losing a lot of that right now."

Keeping it is a challenge, she said, waiting to make a new year offering to monks at a temple in Lodi.

"It's hard. You have to balance it out," she said. "For one thing, you don't want to change so much that you lose your Cambodian culture. You don't want to keep so much because you want to be updated on American society. ... You keep some things and change some things."

Contact reporter Jennifer Torres at (209) 546-8252 or jtorres@recordnet.com.

Culture gap

In other countries, symptoms of mental illness vary, with treatments that American doctors are just beginning to appreciate

March 24, 2008
By Patricia Wen
Boston Globe Staff (Massachusetts, USA)

LOWELL - Heap You's doctors thought she was crazy. The Cambodian immigrant kept saying her neck was going to explode, though an examination showed nothing physically wrong. One hospital put her on antipsychotic medication.But eventually, the mother of five was referred to Dr. Devon Hinton, a psychiatrist with a clinic in this city's struggling downtown. She arrived in his office one spring day 10 years ago with her neck upright and rigid, even as she sobbed about her troubled family life. She told Hinton that she didn't want to move her neck because excessive "wind," bottled up in her body, might surge through her neck, break blood vessels, and kill her.

Hinton realized the patient was not out of her mind. The Harvard assistant professor, who specializes in treating Southeast Asian patients, knew that some Cambodians believe that the circulation of wind throughout their bodies maintains their health, and poor circulation from an ill body can cause a dangerous strokelike explosion of wind.

Hinton, speaking in You's native Khmer language, told her to taper off her antipsychotic medications, according to his records, and handed her prescriptions for two other drugs - one to help her sleep, another to control her anxiety attacks. He urged her to continue her traditional Cambodian practices to help "wind" flow.

After regular therapy sessions with Hinton, You's emotions stabilized. And she trusted these words from him: You're not going to die from your neck vessels bursting.

Hinton was one of the first foot soldiers in a national push to offer more culturally sensitive mental health care to immigrant groups, often in small clinics in urban areas. These clinicians are part cultural anthropologists, part psychiatric professionals, part medical detectives. A key part of their work is properly diagnosing mental illness that patients often first articulate as body pain, headaches, or stomach ailments.

"You often see emotions expressed as a bodily symptom," said Dr. Glenn Saxe, a psychiatrist at Children's Hospital Boston who has helped develop a new mental health clinic for Somalian refugees.

Among newcomers to this nation - one in eight Americans is now foreign-born - mental illness can be an alien, stigmatizing term, and many immigrants from Latin America, Africa, and Asia are far more likely to talk initially about physical ailments than seek psychiatric services.

Over the past several years, top mental health specialists have begun a number of new initiatives to improve psychiatric care for immigrants. The Massachusetts Department of Mental Health, along with a team of researchers, are educating primary care doctors around the state about what physical symptoms might be signs of mental disorders.

Primary care clinics in Somerville and Cambridge, run by the Cambridge Health Alliance, are going a step further, installing computerized educational programs in Portuguese, Spanish, and Creole, aimed at teaching immigrants how fatigue, intestinal complaints, and other physical ailments, as well as intense homesickness or loneliness, can be signs of depression.

Researchers say cross-cultural psychology was once relegated to the margins of mental health practice, viewed as a kind of exotic sideshow to mainstream medicine. But ever since a 1999 surgeon general's report on mental health found the impact of culture has been "historically underestimated," a growing number of clinics focused on immigrants' needs have opened. Many have blended traditional practices from patients' homelands with conventional Western treatments, and have hired translators and staff who share the patients' immigrant roots.

Like many other clinicians, Hinton, who practices at Arbour Counseling Services, in Lowell, is careful not to overgeneralize about any ethnic group. Not every Cambodian with anxiety disorders, for instance, will focus on neck pain. And some neck pain is just that - and needs an X-ray follow-up. But after working with Southeast Asian refugees for more than two decades, Hinton has identified more than 400 Cambodian patients who complained about neck ailments while being diagnosed with panic and anxiety disorders. In research papers he has published, he calls the phenomenon "sore-neck syndrome."

Hinton said each immigrant group has a particular "ethnophysiology," or the way in which they perceive their body's inner workings. He said English and German culture often raise "heart-focused" complaints when conveying anxiety, while Latin American cultures refer to attacks of "nerves."

Hinton said many Cambodians believe in the importance of wind, and that this wind must exit regularly through their feet and hands. But when their extremities become cold, perhaps because of an involuntary physical response to stress, they worry that the wind is becoming trapped in their torso.

As a result, Hinton said, they develop culturally rooted fears about the trapped wind suddenly bursting through the neck. He sees it as his job to reverse this type of snowballing, disastrous thinking - which can lead some doctors, unfamiliar with Cambodian culture, to mistakenly think the patient is psychotic.

During Hinton's sessions with You, he asked her to rotate her neck repeatedly while he was present, a way of convincing her that she would not die from such movement. He encouraged her to use native treatments to help alleviate her stress, such as "cupping," in which a person places a suction cup on the forehead for several minutes to help the wind flow. When the cup is removed, it leaves a red circular mark that looks like a raised welt, which can remain for days.

"It helps me suck my headache out," the 50-year-old You said in an interview in her Lawrence home. Her therapy with Hinton has convinced her she will not die of "wind overload," she said, and she no longer has the overwhelming worries that she once did.

But, at home now and then, she still uses the "cupping" technique, which she learned from her grandparents in Cambodia, and has since encouraged her children to use it as well. She also continues to take what she calls "Dr. Hinton's medicine," including a sleep medication and an antidepressant.

Hinton believes that his encouragement of "cupping" practice helped build You's trust in him, and explains in part why she continues to confide in him about her family and financial struggles.

Ultimately, Hinton diagnosed Heap with depression and a panic disorder common among Cambodian refugees, particularly those who lived through the brutal Khmer Rouge regime, responsible for killing more than 1 million Cambodians in the late 1970s.

Dr. Francis Lu, a specialist in cultural diversity with the American Psychiatric Association, who is familiar with Hinton's work, said the typical American clinician may find it a daunting task to understand the nuances of all the culturally diverse groups in this country.

"We don't know all the intricacies of hundreds of cultures, but that doesn't mean we throw up our hands," Lu said. "There's a certain body of knowledge that we're collecting. And at least we should know what we don't know."

Patricia Wen can be reached at wen@globe.com.