The Worst of Both Worlds: Nurturing the Mental Well-being of Eldest Daughters in Immigrant Families

Eldest daughters often play a crucial role as cultural bridges and caretakers within their families, which can lead to unique challenges and pressures that impact their mental well-being.

The specific mental health concerns experienced by eldest daughters in immigrant families is often treated as the punchline of a familiar joke. And yes, it can be funny. (If we didn’t laugh, we might cry.)

But I also want to discuss how tailored therapy can provide my fellow eldest daughters with essential support and tools to navigate these challenges. After ten years of providing therapy, as well as being in my own therapy as an eldest daughter, these are some of the common experiences I’ve witnessed.

The Unique Challenges Faced by Eldest Daughters in Immigrant Families

Eldest daughters in immigrant families often find themselves straddling two worlds—their family's cultural heritage and the new society they are growing up in. They may be responsible for interpreting, translating, and navigating complex systems, such as education and healthcare, for their parents. This added responsibility, coupled with cultural expectations of obedience and sacrifice, can create immense pressure on these young women.

Eldest daughters often take on the role of additional parent in the household, sometimes even being responsible for looking after the demands of older male siblings, extended family, or family “back home.” Despite the additional responsibility, they are not given any additional authority.

They may also experience conflicts between their desire for independence and their family's traditional values, leading to feelings of guilt, confusion, and stress. Depending on your culture and your specific family, the concept of independence vs. obligation isn’t so cut and dry. Many parents do want their children to advance beyond what they were able to do, including their own independence. But the pressure may still show up indirectly, as we face our parents’ sacrifices every time we come home. Or, our parents may not want us to take care of them, but they may need us to.

In so many ways, they are kept busy finding their place “between two worlds”: In the home and outside the home; in this country and also back in their ancestral homeland; responsible for siblings and also in the same boat as them.

These unique challenges necessitate specialized therapeutic approaches to address their mental health concerns effectively. it’s not enough to simply draw boundaries in the same way another family - perhaps, without a very recent history of displacement - might.

Culturally Responsive Therapy for Eldest Immigrant Daughters

When it comes to therapy for eldest daughters in immigrant families, a culturally sensitive approach is vital. Therapists who understand the nuances of the immigrant experience can create a safe and empathetic space for these young women to explore their emotions and unique challenges. By incorporating cultural perspectives, therapists can help validate the experiences of eldest daughters and address the interplay between cultural identity and mental health.

These therapists may understand the difference between external and internalized pressures, and the validity of both. They may ask about the role of extended family members in a way that other therapists may not. They may understand how gender, ethnicity, class, birth order, or even which decade the family was displaced, may have an impact on the family unit.

Even without knowledge of their specific culture, a therapist who is cognizant of and de-centers mainstream family dynamics will do a lot more for a client who doesn’t come from that typical background.

Family Systems Therapy for cultural trauma

Family Systems Therapy is a valuable therapeutic approach for eldest daughters in immigrant families. This type of therapy focuses on understanding and addressing the dynamics within the family unit. Therapists can help eldest daughters navigate the complexities of their roles and responsibilities, fostering healthier communication patterns and setting boundaries that work for them.

By involving the entire family in therapy sessions, Family Systems Therapy can facilitate open dialogue, cultural understanding, and mutual support, ultimately alleviating the burden on the eldest daughter and improving family dynamics.

Narrative Therapy in Immigrant Families

Narrative Therapy allows eldest daughters to explore and reshape the narratives they have internalized about themselves and their roles within the family. This approach focuses on empowering individuals to rewrite their stories, challenging dominant narratives that may contribute to their mental distress. Therapists can help eldest daughters explore their strengths, identity, and aspirations, enabling them to cultivate a more positive and empowered sense of self. By reframing their experiences, eldest daughters can gain a fresh perspective on their roles and responsibilities, fostering resilience and mental well-being.

Feminist Therapy for eldest daughters

I will keep saying this forever: Feminist therapy isn’t just “therapy for women.” Feminist therapy is an approach to therapy recognizing that the external power structures of our society also have an impact on our internal mental health. This is even more important when we live in two different societies - one inside the home and one outside.

The tenets of feminist therapy, which involve the role of interpersonal power dynamics in our own mental health, can be tricky when there is a values discrepancy between daughters and their families. The daughter may experience a power discrepancy, but the parents may not see it that way. In other words, the daughter may be more privileged because she can navigate life outside the home with more ease, while the parents may be more privileged because they can dictate the daughter’s options for her future.

Community Support and Peer Groups for eldest daughters

This one might be my new favorite.

Eldest daughters in immigrant families can benefit greatly from community support and participation in peer groups. Engaging with individuals who share similar experiences provides a sense of validation and camaraderie. Peer groups can serve as a platform for sharing stories, seeking advice, and building a support network. These spaces allow eldest daughters to find solace, gain insights, and realize they are not alone in their struggles. Additionally, community support can connect them with resources such as mentorship programs, counseling services, or cultural organizations that address their unique needs.

What’s an immigrant daughter to do?

Eldest daughters in immigrant families face distinct mental health concerns due to their roles and responsibilities within their families. However, with culturally sensitive therapy approaches, such as Family Systems Therapy, Feminist Therapy, and Narrative Therapy, these young women can find support, cultivate resilience, and navigate the complexities of their dual or multiple identities. Engaging in community support and peer groups further strengthens their mental well-being by supplementing a sense of belonging that may not exist anywhere else. By recognizing and addressing the specific challenges faced by eldest daughters in immigrant families, we can empower them to prioritize their mental health and thrive within their families and communities.

A Note About Immigrant Sons

Yes, sons often experience very high expectations as well. There is still pressure to be “successful” according to the parents’ definition. This may extend to their career/ability to provide, religious beliefs and behavior, and their choices about marriage and children. Anecdotally, many of these sons also live double lives. Ones in which they appear to carry out their responsibilities, but secretly do not follow any of the rules laid out for them. The main difference seems to be that parents are more likely to look the other way when sons don’t follow the rules, but daughters are not given the same leeway. Of course, this is a generalization, based on my anecdotal observations so please take this with a grain of salt.

Regardless, people who come from immigrant or refugee backgrounds would benefit from culturally competent therapists. It’s not enough to understand the context of their culture, but to understand the effects of displacement specifically.

Read more about Culturally Affirming Therapy here.