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Sixerfan

I am rather worried right now about one of my students. She seems to be suffering from depression. She has low self esteem, is slow to move, and will often "cling" to people. She really likes me (as a friend) but seems to say things like "I need you" or "I hope you never forget me" or "I am very poor at English" (when she scores a 96 on a test). I used to think it was simply low self esteem, but the more I get to know her, the more I wonder.

Her friends at school are good to her, yet also keep her at arms length. It's almost like she's too crazy to completely trust.

Anyway, today she said that she hates to laugh. I asked her why, and she told me she liked crying better because she hated life. I couldn't get anything more out of her, but saying things like that concern me.

I am not sure if she's depressed, or if she's a teenage girl that wants attention. I'd rather be safe than sorry, and I'm taking the statements rather seriously. I simply don't know what to do. How do you help a student with depression in a "face sensitive" nation like China? Does anyone have experience with this? I don't know what to do, but I care for the girl and don't want to see any harm come to her.

Also, Talkdoc, since this is your field, if you have any ideas or advice, I'd appreciate it.

beck's · Joined: 06 Apr 2003 Posts: 426

You are a very senstive teacher to pick up on your student's troubles. I would take the case seriously, although I don't know what you should do. Last term two students at our school committed suicide. I found out about these deaths at Englsh corner, not through any official channels. I aksed the students at English corner whether or not any memorial service would be held. They said no. I would suspect that there was some face saving involved.

kev7161 · Joined: 06 Feb 2004 Posts: 5880 Location: Suzhou, China

I have a student whose father just died of cancer - - and she's back in class! I figured she might bow out for the rest of this school year. She did go back home for a couple of weeks to be with him and her family for the end days.

Last year a student was wearing a black patch due to the death of a family member. He seemed very sad, but I didn't know how to talk to him. Luckily, most of my students have a circle of friends here that are akin to family.

I would probably encourage the girl as much as possible. When she says she is poor in English, then tell her she is quite good. Try to be complimentary when you can without giving the wrong impression. My students (boys and girls alike) seem to enjoy it when I notice they have a new haircut or hair coloring. One boy has taken to wearing blue contact lenses and he just smiled ear to ear when I complimented him on his beautiful BLUE eyes! Of course, letting them know when they've done an extra good job with an English assignment doesn't hurt either. I joke with my students and make sure we have plenty of photo ops (and they always get a copy, naturally) - - I don't know what advice to pinpoint this particular girl, but as long as they know you care for them and you are kind to them may be all that you can do.

You may try to have a conversation about an "imaginary" friend who seems to be sad lately and what are some things your students do to make themselves or their friends happy. What would they do for your friend? That sort of thing.

struelle · Joined: 16 May 2003 Posts: 2372 Location: Shanghai

I take it she's a high school student. Unfortunately, there are too many people like her in that environment, especially when faced with the pressures of Senior 3. It's really dehumanizing, actually.

The fact that you care for her must speak volumes, and that's better than any sort of strategy you can do to help her feel better. On that note, I'd suggest listening to her story more, encourage her on the positive results, i.e. the test scores. If there's anything you can do to help, by all means do so. Are there people in school she can be referred to, counselors, etc? Some of the more progressive schools may have these resources.

Steve

Roger · Joined: 19 Jan 2003 Posts: 9138

I guess depression is most rampant among Chinese, less so among westerners. Suicide rates are considerably higher here than you would think because they are taboo. How can it be different when everyone has to bottle up their most normal feelings and sentiments?

Maybe you need a word of caution: do not pay too much attention on a single student! She might attach herself too strongly to you; One day, you will have to tear yourself away from her... it would be more helpful to improve class dynamics so that she finds a social network among her peers. That's where she belongs.

drumbeat · Joined: 13 Jul 2004 Posts: 46 Location: Nanjing

Hi. It seems you are a very kind teacher.
My suggestion is to mention to your principal that you would like to hold a parent/teacher interview with the parents. We do this each term at our school. I find it a great time to express my concerns. YOu do not need the student there. YOu can suggest some counselling for the student.
By the way, I have experience with that since I needed counselling myself here. I have found it here in China and there are psychologists and counsellors and psychiatrists.
We have one student who is on some medication. I think all this should be documented for teachers to read about on each student- eg. what medications /or what medical issues or issues the students have. These areas are well needed and are far behind in china. There are no counsellors. Things pop up all the time and our librarian used to be someone they could talk to. It is necessary with the stress of the students - to have a kind of hang out lounge. We do not really have one any more. They are getting very tired with this break approaching. So are us teachers!
all the best,

Talkdoc · Joined: 03 Mar 2004 Posts: 696

Hi Sixerfan,

It�s difficult to know from your description exactly what is going on with this girl. She does sound to be manifesting some signs of depression but I have a hunch that what you are observing may be far more indicative of underlying character pathology than clinical depression itself.

The constellation of low self-esteem, clinging behavior and fear of abandonment (i.e., �I need you,� �I hope you never forget me�) suggest to me a borderline characterological organization. The following are the DSM-IV (Diagnostic and Statistical Manual of the American Psychiatric Association, 4th Edition) criteria for borderline personality disorder:

Diagnostic criteria for 301.83 Borderline Personality Disorder

Currently, she sees you as an �idealized object,� meaning, in her eyes right now, you are �all good.� The problem is, at some point in time, if you attempted to help her, she would necessarily perceive some sort of abandonment on your part (perhaps you didn�t respond quickly enough, or you looked the other way momentarily) and you would then become a highly devalued and aggressive object, i.e., �all bad.� Patients with this type of personality organization are extremely difficult to treat, even for highly- and well-trained clinicians.

Assuming she is not clinically depressed (which is unlikely if she had enough psychic energy with which to score a 96 on an exam), her depressive symptomatology is the result of an underlying abandonment depression and, as a rule, receives little or no relief from anti-depressant medication. Borderline individuals are more susceptible to major depressions than others and, when clinically depressed, do benefit from medication. Some analysts do prescribe anti-depressant medication prophylactically when beginning an intensive treatment with these patients in anticipation of an exacerbation of the abandonment depression that the process necessarily elicits.

Unfortunately, there isn�t very much you can do for her unless you are currently working in a city large enough to possibly have someone sufficiently competent to treat her; in which case, the most helpful thing you could do for her would be to give her the name of a decent clinician and encourage her to get help. Chinese psychiatrists who do practice psychotherapy appear to charge about 100 RMB per hour, so money might be a problem. If you e-mail me (use my personal e-mail as I am having trouble sending mail from my member account here: [email protected]), I will try to find you a good referral.

In the interim, I would be appropriately responsive to her but would not engage in any behavior that could be construed by her as solicitous or overly concerned. She�s implicitly asking you to rescue her and to assume the role of the �all good� object in an attempt to fill her void. That�s simply not a function you can provide nor should you try to as it won�t work.

I hope this has been of some help to you.

Doc

woza17 · Joined: 25 May 2003 Posts: 602 Location: china

A couple of years ago in Wuhan I was made aware of the alarming suicide rates in China and chose the topic for English corner. This was an English corner that I went to voluntarily because there was a great mix of people there. I spoke about suicide a few stats my own personal experiences and then gave out copies of the lyrics to REM Everbody Hurts. Played the song a few times got everyone to sing along. A few people were in tears and afterwards came up to me and told me some very personal accounts.
I have taught the song in middle school not focusing on suicide but using the song to point out that everbody hurts and you are not alone.
I agree with Roger don't focus too much on this one student also she may see that your concern about her depression may actually feed her need for attention.
Respect for your concern

Sixerfan · Posted: Tue Apr 26, 2005 5:08 am Post subject:

I just wanted to thank everyone that has already given suggestions. Many of these are helpful, and I will take them to heart. I am slowly beginning to think that she is getting a bit TOO attached, and like Talkdoc said earlier, than can be a big problem.

I'm glad so many of you were able to give advice. Thanks so much!

Kurochan · Joined: 01 Mar 2003 Posts: 944 Location: China

It's tough to deal with this sort of thing both because of the cultural differences involved, and because you haven't really known the student for that long. If I were you, I'd mention the student's problems to one of her Chinese teachers, if you can, in the general way that someone else suggested ("What if I had a student with this problem, acting like this," etc.) to sound out the teacher's attitude about this kind of thing. If she/he seems to have a good attitude about helping students, you can talk directly, mentioning who the student is. The teacher may have some more insight into the student -- for example, if the kid is always like this, if the kid is known to be manipulative, if the kid's behavior has recently changed in a troubling way. Maybe the teacher, knowing the student better, could be more helpful. If it relates to a parental problem, the teacher would also have more chance to make a positive impact on the situation than you would. B/c of the cultural respect for teachers, she/he might be able to speak to the parents about whatever's going on, and they would be more likely to listen to her than to you. In my school, there was a student who was acting strangely in school, and her teacher found out her parents beat her when she didn't do well enough in school, the teacher called them in for a conference, and they actually listened to what she said about changing their discipline methods.

william wallace · Joined: 14 May 2003 Posts: 2869 Location: in between

Nothing to say.

travelingirl68 · Posted: Fri Apr 29, 2005 7:05 pm Post subject:

Interesting thread... How are things going Sixerfan?

Just curious, but when dealing in a different cultural context (different mentality, values, etc.) are the symptoms or cues for mental illnesses or personality disorders the same? How do Chinese psychiatrists/psychologists define mental illness and treat patients? Do they even have psychiatrists in the "Western" sense?

Talkdoc · Joined: 03 Mar 2004 Posts: 696

travelingirl68 · Posted: Sat Apr 30, 2005 11:45 am Post subject:

Thanks for the information Doc, I would love to hear about your research as you gain new insights! Are there many hospitals for those with psyhciatric problems in China, or as this is such a "face saving" culture, are things just handled quietly within the family? (Maybe 'handled' is not the right word, perhaps 'kept' is better.)

The Barbarian · Joined: 03 May 2005 Posts: 21

Hi good job there, great to hear you care.

there's lots of advice on complimenting her on her scores and results. This is usually negative when compared with encouraging her by pushing her vigorously through the process and making her feel like a full participant in the class. So process is more important than outcome when motivating a student and making them happy in class. Im sure you can google some ideas on how fire up the process and play down performance. Perhaps ask her for her ideas about learning, what to do in class and so on - like a co-researcher into the process of learning english. This should work for all of them as long as they arent a bunch of complete turnip headed kids.

The problem here may be issues outside of class - why not just ask her what they are? If she likes you and tell you things about her inner state it shouldnt take too much cajoling. Remember the Chinese are good followers so provide strong academic and pastoral leadership!