When Family Honour Keeps Iranian Families from Getting Help
For many Iranian-Canadian families, the decision to see a counsellor is not a private one. It passes through a silent committee of grandparents, aunts, uncles, and neighbours — people who may never know the details, but whose imagined judgment weighs on every conversation about seeking help. The word for this weight is aaberoo (آبرو), and for many families it is the single biggest barrier standing between a struggle that is becoming unbearable and the professional support that could change everything.
Aaberoo is not simply “reputation.” Poregbal (2017), presenting at the Centre for Addiction and Mental Health, described it as a concept that “goes beyond stigma; broader and more complex … that includes the notion of self.” It is the understanding that your actions reflect not only on you but on your parents, your siblings, your children, and your family name across generations. When a family member sees a therapist, aaberoo reframes the act: it is not a sign of strength or self-awareness — it becomes evidence that the family has failed, that something is broken enough to need an outsider.
This article explores how aaberoo operates in Iranian-Canadian families, why it is especially powerful in the context of immigration, and how families can begin to move past it — not by abandoning their values, but by expanding what those values allow.
How Aaberoo Becomes a Barrier to Mental Health
In a 2025 study of Iranian Americans seeking mental health services, Koohestani and colleagues found that cultural stigma was among the most frequently cited barriers to help-seeking, alongside language access and unfamiliarity with Western therapeutic models (Koohestani et al., 2025, Archives of Psychiatric Nursing). Participants described feeling that admitting to emotional difficulty was equivalent to admitting moral or personal weakness — a perception reinforced by family and community expectations.
This pattern is not limited to individuals. Taghva and colleagues (2022), studying Iranian families’ attitudes toward psychiatric diagnoses, found that roughly one-third of families actively concealed a member’s mental health condition from extended family and community. The researchers linked this concealment to cultural perfectionism — the belief that families should appear flawless, and that any visible imperfection threatens the family’s social standing (Frontiers in Public Health).
For Iranian-Canadians, immigration adds another layer. Parents who left Iran — often sacrificing careers, homes, and social status — carry an implicit expectation that the family will succeed in Canada. A child who is struggling, a marriage that is fracturing, a parent who cannot stop crying: these realities feel like betrayals of the sacrifice. Seeking professional help can feel like confirming the failure publicly.
The Family System as Gatekeeper
What makes aaberoo particularly powerful is that it does not operate through individual shame alone. It works through the family system. In many Iranian-Canadian households, the decision to see a counsellor involves — or at least is influenced by — the extended family.
A wife who wants couples counselling may hesitate because her mother-in-law would interpret it as proof that she is not a good wife. A young man dealing with anxiety may avoid therapy because his father sees it as weakness and his grandmother says he just needs to pray more. A teenager whose parents are separating may never be offered the chance to talk to someone because both sides of the family are focused on managing the story — who knows what, who should not find out.
This is what Samuel sees regularly in his Vancouver practice. The person sitting across from him is rarely struggling with a problem that no one else knows about. More often, the family knows — and the family has decided, implicitly or explicitly, that the correct response is to manage it internally. “We don’t take our problems outside the family” is not just a preference; it is experienced as a moral duty.
What Research Tells Us About Breaking Through
The research on Iranian and Middle Eastern communities consistently points to the same set of facilitators. Koohestani et al. (2025) found that the most effective predictors of help-seeking were having a therapist who understood the cultural context, being able to access therapy in one’s own language, and — critically — learning that therapy is confidential and that the family will not be informed without consent.
Jafari, Baharlou, and Mathias (2010), studying mental health determinants among Iranian immigrants in British Columbia, found that social connectedness and a sense of belonging were protective factors, while isolation and language barriers increased vulnerability. Their findings suggest that the pathway to help is not through rejecting the family system but through finding a professional who can work within it — someone who understands that the client’s relationship with their family is not a complication to be managed but a central part of the therapeutic work (Journal of Immigrant and Minority Health).
This is the approach Samuel takes. He does not ask families to abandon aaberoo or dismiss its importance. Instead, he helps them see that getting professional help is not the opposite of protecting the family — it is an expression of it. A mother who gets help for her depression is protecting her children. A couple who works through their conflict with a counsellor is protecting their marriage. A father who learns to talk about his anxiety is teaching his son that strength includes honesty.
Confidentiality as the Foundation
For families where aaberoo is the primary barrier, confidentiality is not a legal formality — it is the foundation that makes everything else possible. Under British Columbia law, Samuel cannot share any information about a client with anyone — not family, not employers, not community members — without explicit written consent. He cannot even confirm whether someone is his client.
This means that therapy can happen entirely within the family’s privacy. A husband and wife can work on their relationship without anyone knowing. A young woman can process a trauma that her parents do not know about. A teenager can talk about feeling trapped between two cultures without it becoming the subject of a family meeting.
Many of Samuel’s clients begin not with a phone call but with a text message or a WhatsApp message — because even the act of calling a therapist’s office feels exposed. This is understood and welcomed. The first step does not need to be dramatic. It just needs to happen.
When the Family Discovers Therapy Is Happening
Sometimes aaberoo becomes an issue not because a family is considering therapy but because they have already started — and someone found out. A mother-in-law discovers that her son and daughter-in-law are seeing a counsellor. An uncle hears that his nephew is “going to a psychologist.” A grandmother is told and reacts with alarm.
In these situations, the couple or individual often faces pressure to stop. The message is clear: you are making us look bad. You are airing our dirty laundry. If you need help, come to us, not to a stranger.
Samuel helps families navigate these moments without escalating the conflict. The goal is not to confront the extended family or to demand that they change their views. It is to help the client or couple establish a boundary that is respectful but firm: “We are taking care of our family. This is how we are doing it. We are not discussing the details.”
Often, the very act of being calm and non-defensive in the face of family pressure is enough to de-escalate the situation. Grandparents and in-laws who see that the couple is stronger and happier tend to stop objecting — even if they never fully accept the idea of therapy.
Aaberoo Hits Different Family Members Differently
It is worth understanding that aaberoo does not land equally on every member of the family. For women — wives, daughters, daughters-in-law — the pressure is often the most intense. A woman who seeks counselling risks being seen as someone who cannot manage her household or her emotions, and in some families this carries implications for her standing with her in-laws and her husband’s extended family. The question “What will people say?” falls disproportionately on her.
For men, the barrier often takes a different shape. Iranian men are frequently raised with the expectation that they are the emotional anchor of the family — that their job is to solve problems, not to have them. Admitting to depression, anxiety, or feeling overwhelmed can feel like a fundamental failure of masculinity. Many of the men who come to see Samuel have waited years — sometimes decades — before reaching out, and nearly all of them describe the same experience: they could not bring themselves to tell anyone in their family that they were struggling.
For the older generation — the parents and grandparents who made the decision to leave Iran — the stakes feel existential. They gave up everything for the family’s future. If that future includes a child who needs therapy, a marriage that is falling apart, or a grandchild who is depressed, it can feel like the entire project of immigration has failed. This is why grandparents are often the most vocal opponents of therapy: not because they do not care, but because they care so much that the idea of an outsider entering the family system feels threatening.
For the younger generation — the children and teenagers who are growing up between two cultures — aaberoo often manifests as a double bind. They are expected to succeed in the Canadian system while also maintaining the family’s Iranian identity. When they struggle, they learn quickly that certain kinds of struggle are acceptable to talk about (academic pressure, homesickness) and others are not (anxiety, depression, identity confusion, relationship problems). The message is not that they should not feel these things — it is that they should not let anyone outside the family know.
Moving Forward Without Leaving Your Values Behind
The families who come to Samuel are not trying to become “Western.” They are not rejecting their culture. They are trying to hold onto the parts of their heritage that matter — family closeness, respect for elders, collective responsibility — while also acknowledging that sometimes the family needs help that it cannot provide from within.
This is not a contradiction. Every culture has mechanisms for seeking guidance from trusted outsiders: elders, religious leaders, community mediators. Professional counselling is simply another form of that tradition — one that happens to be confidential, evidence-based, and available in Farsi.
If aaberoo has been keeping your family from getting help, know this: the hardest part is the first step. Everything after that is a conversation — in your language, at your pace, with someone who already understands the weight you are carrying.
Dr. Samuel Ezati-Lord (PhD, RCC, CCC, LMCC) is a Farsi-speaking counsellor and psychotherapist in Vancouver, BC. He works with Iranian-Canadian individuals, couples, and families on trauma, anxiety, depression, relationship conflict, and intergenerational tension. Sessions are available in Farsi, English, or both — in person at 1500 West Georgia Street or online across British Columbia. The first 20-minute consultation is free.
Fees and expenses are covered by ICBC, CVAP, FNHA, IFHP, RCMP, VAC, and most other insurers, and direct billing is available.
📞 604-721-0604 — Call or text. If calling feels difficult, send a WhatsApp message.
References
Jafari, S., Baharlou, S., & Mathias, R. (2010). Knowledge of determinants of mental health among Iranian immigrants of BC, Canada: “A qualitative study.” Journal of Immigrant and Minority Health, 12, 100–106.
Koohestani, F., et al. (2025). Barriers and facilitators of mental health help-seeking among Iranian Americans. Archives of Psychiatric Nursing. PMID 40467280.
Poregbal, N. (2017). Shame and Aberoo: Understanding mental health stigma in the Middle Eastern community. Webinar, CAMH Immigrant and Refugee Mental Health Project (IRMHP).
Taghva, A., et al. (2022). The stigma of mental illness in an Iranian family: A qualitative study. Frontiers in Public Health, 10, 1027002.