June 8, 2007

Speaking for her sister
A CSUF researcher is writing a book about Asian-American women and suicide.
By BLYTHE BERNHARD
The Orange County Register

Eliza Noh thought her family was unique. She thought the intense pressures, the binding obligations and the high expectations were different somehow, stronger.

Now, through her research, she realizes the tragedy that rocked her family touches too many others. Among women who are 15 to 24 years old, Asian-Americans are the most likely to commit suicide.

Noh's sister died by her own hand when she was 21. Noh was 20. Both were college students. It was 17 years ago.

But Noh's story is not just about her sister's suicide or her family's still-constant pain. In fact, Noh doesn't want to share her sister's name or those of other family members. She wants the focus to stay on her work. Yet, she knows it's impossible to ignore her family's experience. Their tragedy was the inspiration for her career.

As an assistant professor of Asian-American studies at Cal State Fullerton, Noh researches questions that she knows, too well, don't have easy answers. What makes young Asian-American women more susceptible to suicide? What's different about their pain? Why do some react by hurting themselves? And what can be done?

Suicide as a research subject typically is studied by psychologists. Their expertise lends itself to the family dynamics or hereditary factors behind depression and suicide. Noh wanted to focus on social factors – race, gender, community – and the roles they can play in suicides.

She's working on a book that she hopes will raise awareness about the problem. So far, Noh has interviewed 41 "suicide survivors" – Asian-American women who have contemplated or attempted suicide. Most of the women are college-aged. Most are the children of immigrants.

"The parents want the children to have a better life than they do," says Noh, who has two young sons. "Daughters have an obligation to make sure the parents aren't additionally stressed."

The depression among these second-generation Asian-American daughters frequently stems from family conflicts, parental pressure and high expectations for success.

But the expectations on Asian-American women extend beyond their families. Noh says a lot of people have their own ideas for how Asian-Americans should act and feel. They can be held to the stereotype of a "model minority," the idea that Asians are smart and quiet and lead trouble-free lives. Noh found that the pressure to conform to that standard comes not only from family, but from teachers, co-workers and bosses.

So why is it that Asian-American girls are more likely than boys to suffer from depression?

"Gender differences are large in the Asian community," Noh says. "She might not have much of a voice, not be allowed to make her own decisions. She might be considered secondary to males in the family. She doesn't have the freedoms that a boy has."

In one interview Noh conducted, a woman who had been suicidal said she became depressed because her mother was so hard on her. She was a stellar student, yet she couldn't shake the pressure. At the same time, her brother was a gang member who had dropped out of school and become abusive to the family. But the mother wasn't worried about the son, because eventually he would get married and another woman would be responsible for taking care of him.

"That kind of obligation and stress are often put upon the daughters because the daughters don't want to be burdens on their parents," Noh says. "The daughters really want to help the parents."

Noh's father emigrated from Korea, her mother from Vietnam. They worked as a doctor and a nurse, struggling to get their medical practice off the ground and gain respect in their Houston community in the 1970s.

"They would come home; they would be angry," Noh says. "As soon as they came home, they would look for ways to criticize us."

As the eldest daughter in the family, Noh's sister took it especially hard. She felt a tremendous amount of pressure.

"If my parents had a rough day at work, they would talk to her. If my father had expectations, they would be on her."
She was supposed to grow up to be a doctor, just like her dad. To this day, Noh doesn't know if her sister was truly passionate about medicine, or if she was just obedient.

"It was so much of an expectation, her own personal wishes were never entertained."

Starting in high school, Noh's sister rebelled. She wanted to date and stay out late at night, both forbidden by their parents. So she ran away from home at least once. Feeling insecure about her appearance, she decided to have plastic surgery on her nose and eyes to try to look more like a white woman. She continued to defy her parents by staying out late and breaking curfew. She dropped out of one college and moved back home.

After two suicide attempts, the family rallied around their eldest daughter. They tried desperately to keep her happy and helped her with treatments. Still, there were conflicts, different points of view between parent and child that were never reconciled. A third try ended her life.

Noh says that being a middle child and having a stubborn personality helped her escape much of the pressure. The women she has interviewed, like her sister, may have lacked their own coping mechanisms.

After their attempts or thoughts of suicide, some of the women felt comforted by a clinical diagnosis of depression. It justified their feelings and gave them hope for treatment. Some turned to herbal medicines, acupuncture or other alternative therapies. Others kept journals or expressed themselves through art and music.

Some told Noh that they'd told no one else that they'd attempted suicide, not their family, not a friend. They may have been hampered by the notion, held by some Asian-Americans, that to admit to mental illness is a sign of weakness.

Suicide, for many, is a taboo subject.

To break that cycle, Noh says family and community must be willing to listen and help someone who is depressed.

"The number one thing they needed was not to feel alone. There has to be constant communication and willingness to listen and support."

Noh works on her research, and writes her book, as a tribute to her sister. She wants the work to be the one productive thing that comes out of her sister's suicide.

"My sister told me she really wanted to write a book about her life," Noh says. "I am taking the liberty of speaking for her because she's not here."