Elizabeth Nguyen, psychiatrist and author of "Aloha, Vietnam" discusses mental health

Elizabeth Nguyen is from Honolulu, Hawaii, and is the daughter of Vietnamese refugees who arrived in 1975. 

She has a background in Human Biology and Psychiatry, which gives her a unique perspective on the cross-cultural aspects of mental health.

Her career in community mental health and her interests in spirituality and psychiatry led her to write her first book, Aloha Vietnam.

Elizabeth reached out to me a while ago and shared her book with me. I am a notoriously slow reader so this interview has been a long time in the making but I’m so excited to talk to share her story with you today. 

In this episode we discuss the gap between mental health needs in Vietnam versus the reality, and compare the perspective of mental health in Vietnam to Western outlooks in countries like the USA and UK.

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Transcript

Niall Mackay: 2:29

Welcome back to a Vietnam podcast. I'm your host, Niall Mackay. If you're a regular listener, you'll know that this is the first new episode since September, 2022. I've come out of retirement. I've been on a break. The podcast is on hiatus as I've started other projects in the podcasting world, and you can go check them out. One of them is the Vietnam is Awesome podcast, where we talk about. Experiences in Vietnam for tourists. But today I have an exciting guest for a Vietnam podcast. My guest today is originally from Honolulu in Hawaii, and she's the daughter of Vietnamese refugees who arrived there in 1975. She has a background in human biology and psychiatry, which gives her a unique perspective on the cross-cultural aspects of mental health. Her career in community mental health and her interest in spirituality and psychiatry led her to write her first book, Aloha Vietnam, which was sent to me recently. And I read from cover to cover. I say cover to cover. I read it on a Kindle, so I don't really know if that counts anymore. But anyway, my guest today is Elizabeth n.

Elizabeth Nguyen: 3:38

Thank you so much Niall. Welcome back from retirement. I'm glad you came out to to have this conversation with me.

Niall Mackay: 3:45

Well, thank you so much for sending me your book. It was quite a while ago, and uh, I'm sorry about that. I'm a notoriously slow reader, so this interview has actually been a long time in the making, but I'm really excited to talk to you today. So welcome to a Vietnam podcast.

Elizabeth Nguyen: 4:00

Excited to be here. It's great to reach an audience in Vietnam because this book is really meant to be a cross-cultural, cross-national. book to reach readers. I, I dedicated the book to Vietnamese people and to the people of Hawaii everywhere. So, but it's really for all readers.

Niall Mackay: 4:19

Well. If anyone, if you are a regular listener of this podcast, you'll know that I have interviewed a lot of people who have been Vietnamese boat people, or children of Vietnamese boat people. And so it's a story that's comes up again and again on this podcast, and it's heartbreaking and fascinating and tragic all at the same time. And so, To read a fictionalized version of that story from a very specific perspective to me was really interesting. There was so many themes that came up that I identified with not as a person, not personally. As I mentioned to Elizabeth before we started, I'm just another white guy, but being in doing this podcast and talking to people, so many things came up in that book that I could connect with. So give us the overview of the book.

Elizabeth Nguyen: 5:05

So Aloha Vietnam. Is a novel, and it's a novel about a Vietnamese American refugee family who leaves Vietnam after the American War, ended in 1975 and finds themselves on the shores of Honolulu, Hawaii, where they start a new life, uh, for their family. But alongside that story of sharing their experience of adjusting to a new life, a new land, a new culture, their adolescent daughter, Develops, uh, a manic episode and is diagnosed with bipolar disorder in her teenage years. And the story also follows the family's journey through mental health treatment to that world from told mostly from this perspective of both the mother and the daughter. and as a, as a cross-cultural child, adolescent, adult psychiatrist. There were so many. Themes and missions that I wanted to transmit in this story, and I, I welcomed the opportunity to really unpack that with you. so even though my family and I did not leave Vietnam by boat, there's so many similar themes and stories around loss and grief of, of having to leave your motherland and leave your country abruptly, and it's this unprocessed. Loss and grief that I really wanted to bring some healing to in this story.

Niall Mackay: 6:27

I think for me that was something that I thought was different to my experiences of people I've spoken to was that your family didn didn't leave by boat.

Elizabeth Nguyen: 6:35

So, my father was working for the South Vietnamese, government, uh, in in economics. And so he was already in the US at that time on a. Economic policy mission to study the economics in America. So he was in Washington, DC in the spring of 1975 doing research on economics to bring back that knowledge to Vietnam, to modernize the the Vietnamese economy. And then, While he was there, he heard, you know, that Americans are pulling out of the country and, and if you go back, you'll likely be put in a reeducation camp. So my father's sister who had also studied, in America, In the sixties had married an American and he had military contacts. and so they were stationed in Hawaii at the time, my aunt and her husband. And so my, my uncle, the American, uh, military officer was able to go back to Vietnam and, and arrange for my mother and my grandmothers and my uncle and my oldest sister to, to leave. By plane, that sort of same, same sort of week. I forget what actual day. I think it was like April 27th or something that they left. so very, very abrupt leaving as well, but probably not as traumatic. And, uh, as, as the boat experience.

Niall Mackay: 8:10

Mm. But what I, what I thought was fascinating was, That those mental, the mental health aspect of it, I guess, or the psychology of what your mother went through. Cuz some of it was written from her perspective and I have some more questions about that, but about leaving her parents behind. I remember there's one I think it was, and yeah, I'm interested to find out, one of the things I am interested to find out about is what is real and what's not real, because I love that aspect of, of creativity because, so I have a, another po, I'm a standup comedian as well and I have another podcast called Did that really Happen? And, uh, Talk to a comedian, play one of the jokes, and then ask them, did that really happen? And as I've become more creative throughout my life, I've realized that most outputs come from reality. There's there, there's very few that are completely made up from nothing. Some of the most craziest jokes you hear are stories you hear, or things that have happened to me and you're like, I cannot believe that actually really happened. So I do wanna get into that in a second. But one of the, the. Comments from your mom's dad who your grandfather was? I think it was along the lines of, I was born in Vietnam and I will die in Vietnam. And, and he didn't wanna leave. And throughout the book, the theme of your mom's guilt of, of leaving behind her family and her motherland and, That was an aspect of the Vietnamese refugees that I'd never really come across before. Cuz it's normally portrayed in, not portrayed not reality is, it's a positive story. We were able to leave, we were able to create a new life and, but I've never read before the, the real deep psychology of the feeling of having had to leave your homeland.

Elizabeth Nguyen: 9:43

Yeah, and I would say there's both. I think, on the surface, my, my family was very grateful to be able to find safe refuge in America and to be able to start over and have a new life. But there are deeper layers of loss and grief that aren't always acknowledged, which I feel adds to the mental health challenges that intergenerationally we pass along. And the more I worked with clients in, you know, Vietnamese American and other, other immigration families, there is always an under stream of loss and sadness and feeling very torn apart at the very fabric of your own identity. Having to leave your motherland that I wanted to bring to the surface and, and help heal because ultimately we can't change the past. But if we can acknowledge that this was an experience of really feeling torn from your motherland, we can come to a new peace with it.

Niall Mackay: 10:45

Mm. So following on from my comment there, without giving spoilers away for anyone who's gonna go read the book, how much of it was true?

Elizabeth Nguyen: 10:55

I would say 50 50. So Aloha Vietnam is a fictional novel. The characters in the story are completely made up in the sense that ING and her mom are amalgamations of different people, places, experiences. But about 50% of it is based on autobiographical fact that my family did leave Vietnam, ended up in Hawaii. I grew up there in a Vietnamese-American refugee household. My parents had. You know, they, they had tourist shops in Waikiki. I worked at them. I love renting boogie boards across the street. And, and there was mental illness in my family. And, and then I became a psychiatrist, partially to, to help understand what was going on. And then a lot of my experiences working in the mental health field as a psychiatrist with the Vietnamese-American community informed. My representations and stories told in there, but, but I really did not wanna write a memoir or an autobiography. I wanted the element of creativity to take the story and the characters where that wanted to go. So what happens in the story is not what happened in my family's life at all. It's,

Niall Mackay: 12:14

Oh really? That's what, that's the whole time reading it. Cuz I knew I was reading it and we were gonna, I was gonna get to meet you and I don't think I've ever really met an author of a book I've read. And the whole time I was thinking, so I was like, is Elizabeth Ang

Elizabeth Nguyen: 12:27

I'm not. I'm not, I did not, so I did not go through a bipolar journey myself. Yeah.

Niall Mackay: 12:33

I mean, I'm not saying ah, like I wish you'd gone through a bipolar journey. I don't mean it like that. I just mean I, the whole time I was reading it, I was like, this must be her. Because I, I think, like I mentioned, so much creativity comes from personal experience. So even if it is fictionalized and it's, told through a story, I was just imagining in my head that this had gone, this had happened to you and there is a part of the book where, I don't know if I've ever read a book and had a visceral reaction like this, and I'm gonna tell you what it is, but I'm gonna cut it out so I don't spoil it for the readers cuz it's a quite a big major plot point. But I was actually, reading it here in Vietnam and as I read it, I literally went. And grasp my face, and I think I cried a little bit as well, I literally was don't think I've ever had a visceral reaction like that to a book before. How did your family's experience and their journey to Hawaii, how did that shape your upbringing and your identity?

Elizabeth Nguyen: 13:34

Well, in so many ways, I, I tell people that. My family won the refugee lottery by ending up in Hawaii because there's no more beautiful place, especially if you're coming from Vietnam to land than on the shores of Hawaii. And actually, when I was in Hawaii recently and we went to UNB Beach. It literally felt the same as Hawaii. So there is a very similar feel to a Hawaiian beach and a Vietnamese beach. So there is that, that that similarity to that feeling. There is some cross-cultural similarity there, but at the same time, Hawaii is completely culturally different than Vietnam and it was an interesting experience growing up. A Vietnamese American refugee family in Hawaii because for all looks and purposes, we looked like a local Asian family, but culturally we were not. We had no idea what living in Hawaii was like. You know, my, my dad knew English well, but most of my family didn't. They were so used to living life. In Vietnam with its markets and culture and motorbikes and Hawaii is very different. So this is the piece of cross-cultural identity that I wanted to explore in the book because I, as a child and an an as an adolescent and even as a young adult and and growing adult, continued to. Explore my what, what is my cultural identity? And it's not so simple when you immigrate and are forced to live in a different country, in a different culture. And you probably have similar experiences as well, exploring cultural identity, and, and my family wanting to assimilate. So wanting us to become, Fit in and, and having to leave behind some of their Vietnamese culture and traditions and customs, but inevitably being unable to completely assimilate. They brought all that with them, so it was just a rich melting pot of old and new. And I, I think at the end of the day, it really gives an opportunity to really ask ourselves like, what are the common. Themes that, that all humans, across cultures, what is the one, what are the, what are we trying to all, what are we all trying to do? Which is we're all trying to live our lives, take care of those that we love, find a way to, to make some meaning and, and pass on something better to the next generation. So,

Niall Mackay: 16:27

when did you first come back to Vietnam?

Elizabeth Nguyen: 16:30

So this is a good story. I was, I, I felt like from a young age, whether it was because I could sense my mother and my grandmother's longing for Vietnam in some way, but conf conflict around that longing, I had this strong pool to really go. Back to Vietnam and see my mother land and know where I came from as very young. I think I felt it as a child. and so in college when I finally felt like I was an adult and wanted to go back to Vietnam, which is when I went back and college, I asked my parents like, I wanna go back to Vietnam and see where you came from. But they were very against it. They were like, it's not safe, I don't think. I don't think it's safe for you to go. So they were very against me coming back and I haven't fully explored with them why, but I think it was around safety. You know, if you leave a country because of safety, you're not going to be, you know, super excited about sending your children back.

Niall Mackay: 17:36

Now this has come up time and time again, but because it is a, a growing trend, I don't, not trends maybe not the right word, but a growing thing that is happening that a lot of vq first gener, I always get it wrong. Is it f first gener? Are you first generation, second generation Vietnamese?

Elizabeth Nguyen: 17:51

goes both ways. I'm first generation born in America, but I'm second generation in terms of leaving. So.

Niall Mackay: 17:59

I always get the terms confused, but a lot of people now children of Vietnamese parents who left Vietnam and not just because of the war, maybe for economic or educational reasons, but they, they left Vietnam, are coming back to Vietnam for the same reasons. They want to explore their, their country. They wanna see where they came from. Their roots reconnect and often, and many of them have been on this podcast. And then they often come to V Vietnam and just fall in love with the police cuz it is such a wonderful country. And, but the same, they've told me the exact same thing that you just said. There was one, I think it was, and we have done a lot of episodes and my memory's not great, but I'm pretty sure it was Nema who was Swiss? Uh, Swiss Vietnamese, her parents. Ended up in Switzerland. And if I do remember rightly, I think that was not as refugees. I think that was economic reasons or educational reasons. Cause I know there's, there's three kinda big waves of immigration from Vietnam's education, economic, and, and both people, but for whatever reason they. She came back and again, they just couldn't understand why she wanted to come back. And as I'm, as I'm speaking, I'm remembering there was somebody, same, same thing. Their parents were like, it's not safe. You can't go back there because, and it's, it is traumatic to think that they left for very unsafe reasons and they don't know much better that it ha it is a changed country now. They, uh, there was one guest who talked about her parents assumed that they would be arrested on site as soon as they came back to Vietnam. Things like that.

Elizabeth Nguyen: 19:21

Mm-hmm. So the first time I went back was in college and I was teaching English in HU for the summer. And so I got to spend time with other college students who were studying English at the university, and it was so. It was so wonderful to come to a place that I had never stepped foot in and been before, but to feel, oh, this is, this is who I am. Like I am Vietnamese.

Niall Mackay: 19:50

You had that feeling.

Elizabeth Nguyen: 19:51

I had that feeling of, even though I've never been here before, this is part of who I am. and so, but at the same time, spending a whole summer there, it was very clear like, oh, I'm Vietnamese American because that's just as much as my identity, the American part as my Vietnamese part maybe even more. Or it's hard to really know what percentage, but it was a real moment of like, oh yes, I am Vietnamese American. And So that was my first time. And then this second time, which was this earlier this year, was only my second time going back. I went with my mom and my children. It was my first time going together with three generations, and it was a really powerful homecoming trip to again, have that feeling of. This is my motherland. I, I know I'm Vietnamese. There's so much here. That's part of who I am. And yet I, I'm also very American. And to honor my mom and grandmother's legacy and my grand, my paternal line as well. But there was, you know, I went with my mom and then to bring my children back was very, there was like an ancestral healing. That was completed with that?

Niall Mackay: 21:12

So what kind of cultures, traditions, values did you learn growing up that were from your, that came from that Vietnamese background that you still practice today, that still carry with you today, that gave you that feeling of Vietnamese identity?

Elizabeth Nguyen: 21:28

Well, I grew up with, Three grandmothers in the home because I had my mom's mom and then my father had two moms and they were very devout Buddhist in this sort of like lived Buddhist family culture of a family ancestral altar and just sort of chanting Buddhist mantras all day. and so I grew up with an ancestral altar being a very important. It was just always there. My grandmother's always changed the water and the incense and the fruit on the altar every day. It was just like part of something you do. And that's something I still practice today without even thinking about it, that just honoring the ancestors. And I think this line of, listen to your elders. Know your ancestors, know your roots, even though I rebelled and questioned it as a teenager. I feel like it's actually a very important part of the Vietnamese culture that I now really, really value and honor and want to pass on to my kids.

Niall Mackay: 22:33

And was there a big Vietnamese population in Honolulu? Yes.

Elizabeth Nguyen: 22:37

there wasn't, yeah, there wasn't very much at all. Very small. but enough, enough, you know, my, my family had maybe 10 families. That, you know, they, they knew and, and we kind of got together and eat the food. but Hawaii itself is a very special cultural place, and I think this book was meant to honor both Vietnam and Hawaii because Hawaii is such a interesting place where different cultures mix. So very quickly, the Vietnamese and Hawaiian. Living in a Hawaii culture just kind of came in to my family's culture.

Niall Mackay: 23:22

Mm. Well the book obviously touches a lot about mental health and, and you're a psychiatrist yourself, and the there came up a time and time again in the book. I thought that was a really great perspective using your mom's perspective as well, because. In the book anyway. She didn't fully really understand mental health. So when they, now I can talk about it a little bit differently because now I know it's not you cuz I was a little bit like this is gonna be

Elizabeth Nguyen: 23:46

Yeah, it's not me and it's not really my mom

Niall Mackay: 23:48

Yeah.

Elizabeth Nguyen: 23:49

It's not really

Niall Mackay: 23:50

makes it a bit more freeing to talk about, cuz it is quite traumatic, the book. And I was like, if you're gonna talk about this, but it, but it was actually you and your mom that makes it, adds another dimension to it. So it's actually a bit more freeing. So in the book though, so your mom has, like you mentioned in the beginning, cuz we don't wanna give away too much, but the main character Ang, who is the female character, uh, has a manic episode and. Has diagnosed with bipolar and her mom and dad, Vietnamese mom and dad who've come from Vietnam. Um, the mom and dad have no concept really of mental health, of what this means. The, the mom continually blames herself. Has she done something wrong? and. That. And so living here in Vietnam, uh, one of the podcasts I just produced for another show called, you Don't Know, Vietnam has just interviewed somebody called Han from a company called Soften Mind, and I dunno if you've come across them, they're quite new, but they provide mental health services for Vietnamese people. It's one of the first of its kind in Vietnam. And the reason she created that was because, When she was looking for therapy or a therapist, she could not find anything in Vietnam. In Vietnamese, you could find some in English. But when she was searching in Vietnamese and she realized that if she was searching in Vietnamese and couldn't find anything, other people were doing the same thing. So she created her own. but the same things come up again as. Mental health is, is a, I mean, even in the Western world, it's only now being recognized as something that is really, needs to be taken care of. Vietnam in a lot of ways is still 20 years behind the rest of the world, and I feel like mental health is, is one of those areas. So how did that. Intersection of your Vietnamese background. Then combine with you becoming a psychiatrist, then dealing with mental health.

Elizabeth Nguyen: 25:36

This is such a rich topic, and I would love to kind of just dive more deeply into it. So I think first of all, I'll start with, you know, there was mental illness in my family. So I witnessed, you know, family members having mental illness and going through the journey of. Of not really understanding the, the American Western explanation of these disorders. and then as a psychiatrist, I saw that over and over again as well, where the Western psychiatry model of describing and treating these. Disorders is a, such a foreign concept to the average Vietnamese-American family or average Vietnamese family. And I, I, I totally agree with you that it's still a, probably a relatively new concept in, in Vietnam, like mental health awareness. And, and part of me as a cultural anthropologist was really curious if. The prevalence of these disorders are the same in America as they are in Vietnam. And I think for the severe mental illnesses where it's completely just, you know, biological, they probably are the same. But as far as sort of like some of the other mental health symptoms and awareness where there's like, you know, depression and anxiety, not to the severe extent, I, I do agree that, We probably wouldn't diagnose that in in Vietnam or it was interesting when I was in Vietnam this past time as I was looking in through the lens of a psychiatrist and a cultural anthropologist, and I was really noticing how communal life in Vietnam, even though it's tiring and maybe stressful and maybe there's not as much resources as there are. In America, there really was a connecting feeling like you don't feel alone and isolated in Vietnam, which is probably because there's so many people around. But when I work with Vietnamese-American refugee or immigrant families in America, one of the biggest causes of depression and anxiety is this. Social isolation and disconnection from the larger culture and their community. So I know that a lot of the mental health disorders I see in America and these Vietnamese American families is partly due to the trauma of leaving and cutting yourself off from a community and a lifestyle. You're so used to. But it's also because of the isolation we have in, in America. Living in the modern world is very different than the life you live in a, in Vietnam. So I think there is an element of, we see things here that we don't necessarily see in Vietnam. There's a way that I felt the Vietnamese people actually have found a, a very effective way to flow through life stressors in Vietnam. There's a, there's a flow to life in in Le in Vietnam. There's still mental health, there's still mental illness, but I don't think there's the same.

Niall Mackay: 28:56

Well, so you made an interesting point there, right? So I'm talking, I'm what am I'm always worried on this podcast that I just sound like an idiot because I'm not an expert on anything really. and so this question might make me sound stupid, but you, you said something interesting there about. So are the rates of mental health illness. So it's the same in America and in Vietnam, but they're just undiagnosed here. Which then is a scary thought that the, it's not that the mental health doesn't exist here, or the mental health challenges don't exist, they're just not diagnose. Or obviously those two cultures, like you've just described, are so different. So are they, are there less of them here? It's hard to, I don't know how to quantify that, but do you know what I'm saying?

Elizabeth Nguyen: 29:39

I know exactly what you're saying and I think it's, it's yes to both. I think there is undiagnosed mental illness in Vietnam just because there's less awareness and treatment and resources available. And then I think there also probably is conversely, less maybe depression and anxiety and social isolation that Americans face because of the differences in our lifestyles.

Niall Mackay: 30:09

Mm. But I live in Saigon, and Saigon is just a big bustling metropolis. Many people like me now live in big apartment buildings. I barely know my neighbors. Uh, I don't connect with the community. I don't see other people in my building or buildings like this connecting with the community. At the same time, I know there are also buildings with four generations in the one building. And, and when you, who do you live with? I live with my aunt, my uncle, my cousins. And so that still exists, but I think as Vietnam does modernize, it's gonna lose that.

Elizabeth Nguyen: 30:45

Yeah, I think it probably will, you know, That is one of the, the, the questions I felt that when I was talking to people in Vietnam, there was this sort of, as Vietnam changes and modernizes away from everyone, multiple generations living on that family plot of land, what are we going to lose in terms of Vietnamese culture and and lifestyle? And there's gonna be pluses and minuses. I do think the modernization of people living alone, In their own spaces, even though they're, that's a positive in some ways does lead to some increased, uh, isolation. That also is a, a risk factor for mental health challenges.

Niall Mackay: 31:33

And it's one of these things where we look at the Western cultures or when I say we, or American culture is held in such high regard in the Western culture and, and that, let's be honest, most people are kind of aspiring towards that. I mean, even Japanese culture, south Korean culture, you know, consumerism, capitalism, apartments, all of this stuff, and Vietnam is. Changing dramatically towards, I guess, yeah, it's probably like my western centric viewpoint to say like trying to be American because lots of Vietnamese people want to be like Singapore and they wanna be like South Korea and Japan. So all of those to me, I'm seeing are very similar cultures where, like we said, not living together with four or five generations. So I do, I would assume then that as that happens, there will be an increase in depression and isolation and mental health issues. Which is just one of these symptoms of the modern world, which is so sad. We're like, yeah, we wanna be more modern. I want to be more modern. I wanna live in a nice apartment building. I don't want to talk to all my neighbors. I like my own little isolation. But then at the same time, it's gonna come with all these new modern problems that Vietnam, to be honest, from what we're just discussing and what I know already is not equipped to do with that at all.

Elizabeth Nguyen: 32:47

Yeah, I think, I think we're talking about a really big social, cultural health issue that that is, Probably something important to be mindful of. Yeah.

Niall Mackay: 33:00

And from your knowledge of the Vietnamese culture, and we touched, touched on it already, and you touched on on your book. How do you think that gap can be resolved? Because like we mentioned, it was in, in your book, which is obviously comes from reality. Your parents for one, again in the book, I keep trying to separate between the book in real life, but I think this topic is probably blended between the both. They didn't know what, bipolar was. They couldn't accept it. They blamed themselves. I remember in the book as well, there's a lot of guilt about leaving Vietnam as well and blaming that on the, the mental illness. Vietnam culture, Vietnamese culture does have a lot of superstitions that are maybe not backed up by science. you know, so I wonder how much of that plays into not being able to treat mental health properly because they equate these challenges of these issues with something that it's not related to.

Elizabeth Nguyen: 33:53

Yeah, so I think there's multiple challenges to treating mental health issues in both the Vietnamese-American population and then in Vietnam too, about what can we do to just start addressing this, And, and your question was, what, what are some solutions? What are some thoughts around this? And I think one thing that comes to mind is this intergenerational communication and understanding. I see that in, in my, in Vietnam, in in America, as one of the biggest challenges that Vietnamese American families face is, is this. Big gap between the younger generation and the older generation. Not understanding each other, not kind of understanding, especially when you move across cultures. you know, kids in my generation, like not really, not really understanding our, our parents and where they come from. And then likewise, my parents having grown up in Vietnam, really feeling. Very confused at understanding their American born, children's, uh, psychology and understanding of the world, and that that gap between the generations can cause a rupture in the, the family line that that can be very, uh, damaging to mental health. So the world is modernizing. We can't stop that. But what we can do is increase understanding between each generation so that there doesn't have to be a rupture or a disconnect between the generations. Because sort of like how I talk about water water's, one of the main things I, I really just, you know, like Vanny Vietnamese water is like a teacher and like there's a spiritual element to the healing qualities of water that. That just seems to flow through my family, and, and not just not interrupting that flow between the generations is gonna be really healing for all of us as we move through these transitions together. So whether the transition is migration out of the country to a new land, or whether it's changing the whole culture and economy of a growing, changing dynamic country. You're not changing land. Well, maybe you're, some people are being displaced. You're not changing countries, but you're changing a huge social, cultural, uh, culture in one or two generations and not disrupting that flow of connection, love, and understanding and support between the generations. As we navigate these transitions, I think it's gonna be a huge. Support, uh, and resource to help. Cuz family is one of the biggest resources that the Vietnamese culture and all, you know, communal cultures have. Family is the biggest sort of yeah. Resource we have. And let's not throw that out as we modernize.

Niall Mackay: 37:14

Do you think it's too late? I think that may already

Elizabeth Nguyen: 37:17

I

Niall Mackay: 37:18

be past that. Yeah. We'll see. It is still beautiful. Like even living in this big, I'm in this big modern building. You do see, you know, older people. That are clearly living with the, the children still in this building. But my question was gonna be how do you balance then as a psychiatrist, your blend of the two cultures into your practice? Because you've grown up hearing one thing that we talked about that guilt or not knowing about mental health or, or a signing blame to something else for the, for the mental health issues. But then your studies as a doctor and then. Putting that into practice with your patients.

Elizabeth Nguyen: 37:58

Yeah, so I think as a psychiatrist, one of the best lessons I've learned about what helps people get better is, is really them feeling listened to and understood. When people feel listened to and understood, they're more likely to, not all of them, but the reasonable ones, they're more likely to listen to you and try to understand you. So I really try to understand the cultural background and beliefs that my patients have and, and so if someone comes from a background where they have their own beliefs about. What mental illness is, you know, whether it's like, uh, you know, like it's, it's karma or it's demons or it's some other non-western explanation of the illness. I wanna really listen to that and try to understand it because this is this person's worldview and it's valid because it's their worldview. We were just talking about that earlier, about every experience being valid and. If they, if they're not gonna take it, if I'm not gonna really listen to that and expect them to take in my western worldview of, no, this is not spirits causing your daughter to hallucinate or not sleep or act erratically. It's something. Called bipolar disorder, which we don't even have a Vietnamese word for it. You're just gonna have to say bipolar, you know, this English word for it. Then they're, they're not gonna take that in either. But if you can really try to understand them, but then also say, you know, that, that, you know, is valid, but also, you know, we're learning and just try to explain using simple words, simple language. A different way of understanding what could be happening, and it's really, it takes, it takes time to buy trust and to develop that trust that you're here to help.

Niall Mackay: 40:11

That what you've mentioned there is also another huge, gap I guess you could call it, is there's not a word for it, and that linguistically and mentally, if, if you don't have the concept of what this is, It's just you just tell somebody, oh yeah, it's bipolar. It means nothing. So for example, I know I've done some work here with Saigon Children's Charity in the past, and I've interviewed their executive director and they do a lot of work around autism. And Damian went into detail about it on this and on this podcast about how there they're just, up until very recently there was not a world for autism in Vietnam and a lot of children, it's really sad. He said they would essentially just be warehoused because they didn't know how to. Handle them. So they would just be kept separately, never treated, never diagnosed. And now Saigon Children's Charity has been doing a lot of really amazing work over the past few years to, to make awareness that autism is a real thing. It is a thing. Uh, and that can be treated as well. And a lot of, Uh, ch children, a lot of children can then go on to live fulfilling lives or, or not be warehoused and just left to, to be by themselves. And the challenge he was seeing as well with that family unit would be when the children got older and the family passed away, the mother or father passed away. Then they were just left. By themselves and they'd never been looked after. So my point being that it is part of that education as well of just like making sure people understand what it is. And that's a, a big gap that we have here in Vietnam. We're talking about mental health is not a big thing here or it's undiagnosed. And part of it is because people are just not aware that it even exists and they will assign it to something like, something unrelated.

Elizabeth Nguyen: 41:58

Yeah. I mean, I don't even know if there is, I, I, I should know, but I don't If there is a Vietnamese word for bipolar, and if there isn't, then you know, that, that just speaks to the chasm of the translation, not just of the word, but of these concepts. Into the Vietnamese culture and psyche, that will, you know what I wrote in the book that the word like you're just, which means crazy, like mental illness was just like, that person's crazy. They don't know what their. They're, they're, they're not thinking, right? That's just like a blanket term for anyone who's mentally ill. And it's a very, uh, you know, hopeless, derogatory, sort of, there's nothing more to do with those people. term, which, and, and even in the western world, I think, where there's more awareness of mental illness and there's like differentiation between schizophrenia and bipolar and depression. There still is a stigma. If you see a person, the homeless population, if you see a homeless person who's mentally ill on the street, you're not necessarily, you know, there's still a lot of stigma around.

Niall Mackay: 43:12

No, I was gonna say it's something, I guess it's changed in the last few years for me, that that kung if you see somebody acting, acting crazy, you would just be like, oh, they're a crazy person. And I now have changed now, even just this week, I saw somebody here in, in Vietnam, even back home as well, though I don't, I no longer say that in my mind. I, no not, I no longer go, oh, that's a crazy person. I normally now go. Oh man, they have mental health challenges. I hope they get help and it's a totally different mindset from being like, oh, they're just a crazy person to being like, oh, that that person needs help.

Elizabeth Nguyen: 43:46

I think that switch alone is gonna do so much for mental health awareness and reducing stigma. When I was in Vietnam recently, I, I, I also walked by this woman who was clearly in distress and it was, it was, you know, very clear that she had mental health issues going on and, it, mental health does cut across. All cultures, even though we're talking about the increased risk of modernization and social isolation, even without that mental illness does cross cut across all cultures. Uh, there's mentally ill people in every place and every social economic class in the world.

Niall Mackay: 44:33

well, the book, like I said, is incredible. And how long did it take you to write it?

Elizabeth Nguyen: 44:39

It took me about a year and a half to actually write it, but I wrote it about six years ago and then I just stuffed it into my writing drawer cuz I just didn't feel finished with it. And then it was recently when my father passed away. That I felt there was some, just some energy around my father passing away that felt like the book is ready to be birthed into the world. And so, uh, I finished kind of just putting the finishing touches on it and, and published it, uh, six months ago. But it was, you know, years after I had originally written the manuscript.

Niall Mackay: 45:15

Uh, one, one of the things I guess I thought why I find it hard to separate you and the main character Ang, because it seems so realistic, because obviously, so you are a psychiatrist, you know what bipolar is and you deal with it. But her description of it and what she went through, I just 100% assumed that you had been through this.

Elizabeth Nguyen: 45:34

Mm, I hadn't, but I will tell you that. I became a psychiatrist because I love listening to people's stories and really getting to as best as any other person can know, another person's experience of really trying to understand what it's like for my patients to be going through their life experiences. So I've sat with so many people going through mental health. Challenges and even just other challenges really intimately and ING's descriptions of her experiences come from a whole collection of different people sharing with me what it's like for them to experience and anxiety, depression, obsessive thoughts, you know, a manic episode. but it, it, it, yeah, it's something I personally have not gone through.

Niall Mackay: 46:32

And has anybody, reached out to you and told you you got that 100% right, or anybody who's been through it and been like that, that was not accurate at all. Like, that's not what it feels like.

Elizabeth Nguyen: 46:43

Oh, I've gotten so much of the former of people saying, wow, you really captured what it feels like. but you know, bipolar itself is so varied, so I definitely have had people say like, it felt really real, but my experience of it is a little different, which is completely what bipolar is. If you, bipolar is a huge umbrella of experience and no two people with bipolar have the exact same experience. but telling one story. As accurately as I could hope, hopefully opened up the doors for other people to just decrease stigma around talking about mental illness in themselves and their family. And then just increasing awareness, right? So just by you and me having this conversation that hopefully people in both Vietnam and around the world will listen to. I think we're gonna raise awareness of mental health in in Vietnam, and. And that's, that's part of what this is all about.

Niall Mackay: 47:47

Yeah. Well, what was the reaction from your mom and your family and and other people to the book, especially your mom? I guess reading this fictionalized version of herself that people like myself believe to be her, but I guess it was based on her a lot.

Elizabeth Nguyen: 48:02

so like any good Vietnamese daughter, I didn't tell my mom or my family that I was writing this. Actually until I was about to publish it, it didn't even cross my mind really. There's so many things I keep from my family, you know? It's just like I, as a Vietnamese-American woman, I think a lot of us learned what to tell our family and what not to tell our families. I just, I didn't even, it didn't even cross my mind to tell my family I was writing this. So I was pretty much about to publish it and I was like, oh, I should run this by my family, and I ran it by my family and. You know, it went, it went fine. And I'd surpri surprisingly, my mom was one of my biggest, supporters. I, there was no resistance or shame or stigma around me writing this and sharing this. She's, she really was verys supportive of it.

Niall Mackay: 48:53

That's good. That could have gone the other way. Your

Elizabeth Nguyen: 48:55

It really could.

Niall Mackay: 48:56

me. You're not putting this out there. People are gonna think that this and that. But one of the, I mean your mom's character is, is amazing in the book. And again, it just sums up that Vietnamese, I hate doing this whole tarring, everyone from one culture with the same brush, cuz it's not true. But it is summed up that Vietnamese optimism and hardworking. nature that when your family landed in Hawaii, and you mentioned at the beginning that this part was true, right? They opened a store and, you know, they don't rest on the laurels. They're like, we're okay, well this is the situation. We're gonna get this done.

Elizabeth Nguyen: 49:28

Yeah, Vietnamese people are very hard working. They're very like, let's just deal with what the situation is and let's just do what needs to be done and, and move forward.

Niall Mackay: 49:40

Tell people where can they get the book, where can they read it, where can they follow you? All that good stuff.

Elizabeth Nguyen: 49:45

So the book is available wherever books are sold at your local independent bookstore on Amazon, wherever. If you want to download the first four chapters for free and just kind of get a taste of it, you can go to my website, the book's website@alohavietnam.com, and there'll be all the information about the book there. And if you wanna follow me on Instagram, I'm at multidimensional Psychiatry.

Niall Mackay: 50:10

Well Make sure you check that out. Uh, I read it, which as I said in the beginning, I'm not a massive reader and I absolutely loved it. So check it out. I completely recommend it. And my last question before you go is, if Vietnam was a person, how would you describe Vietnam?

Elizabeth Nguyen: 50:27

I think the shape of the country of Vietnam on the map is always so beautiful. It's, I've always been captured by the shape of the country on a map. It really looks like. A woman, like a woman wearing a conical hat. And I think, you know, I'm a woman so I'm, I have a female bias, but I think the heart and soul of Vietnam is really the feminine, it's really both the young and the old feminine. And there really is, I don't know if you've seen those sort of like you see a picture and they're like, do you see the old woman? Or do you see the young woman's face? And I really feel like Vietnam is that there's the old and the new, and it's the woman that's really driving the culture. Even though it's a very Confucius and patriarchal culture, the woman is the backbone of the Vietnamese culture. Whether she's young or old, she has been carrying. The blood, the history, the water, the children, and the future of Vietnam from the past. And, and that's, that's how I would describe Vietnam as an old and young woman looking to the past, but also to the future.

Niall Mackay: 51:44

That is perfect, and it, it's been surprising when I first came up with that question, I didn't really think much about the answer, but nearly every answer has been about it being a female, being feminine and, and having lived here now for seven years, you do not mess with a Vietnamese woman. And the Vietnamese women are the backbone of this country. Like I've worked in companies where every senior manager was female. Then you go by a building site and everyone on the building site is female lugging up sand and bricks. And you're like, where are the men? What are the men doing? And I'll be honest, you go by a coffee shop at nine o'clock in the morning. There's no females in the coffee shop. It's all men hanging out, drinking coffee, uh, smoking cigarettes. Talking away. So this, Vietnam is built and run by women, in my opinion. Even if it, even if you might not think you can see it, it's, it's definitely female led.

Elizabeth Nguyen: 52:35

Thank you Niall for, for making time for us to talk about this. I really appreciate your work.

Niall Mackay: 52:40

No problem. Thank you so much for being the first guest in nine months on a Vietnam podcast. So for regular listeners, we'll be doing sporadic episodes, but there's no new seasons coming up. But, after Elizabeth sent me her book, uh, I couldn't wait to talk to her and, and discuss more about that and share it with you. So make sure you go check her out. And thank you very much for joining me today, Elizabeth.

Elizabeth Nguyen: 53:00

Thank you. Come on.

Niall Mackay: 53:03

Thank you again for listening to a Vietnam podcast and a massive thank you to my guest today, Elizabeth Nguyen. If you do like this podcast, just remember rate, review, follow, subscribe, all that good stuff. Turn on notifications. You will get an update the next time there is a new episode. As I mentioned at the beginning, there's no plans right now for a new season, but I will be publishing sporadic episodes and pod swaps from some of my other podcasts that are Vietnam related, like the Vietnam is awesome podcast. So check that one out As well, as you may know, I'm taking a break from a Vietnam podcast to focus on other projects, so go check out my website, Seven Million Bikes stock. Com, you can go to the head of the top, go to clients, and you can see all the other podcasts that I'm working on around the world. So thank you very much for listening and enjoy this episode and future episodes of a Vietnam podcast. Cheers.