Notice: For general interest only; may contain inaccuracies. Not a diagnosis, treatment, prognosis, or professional, clinical, or legal advice. Reading this creates no counsellor-client relationship. By reading this page, you agree to these terms. Full disclaimer. In an emergency, call 911.
Most Iranian-Canadians who eventually find their way to therapy say the same thing in the first session: I should have come sooner. And then, often: I didn’t think it was for people like me.
This article is about that gap — the space between needing support and actually seeking it — and why it is particularly wide for many in the Iranian-Canadian community.
I am Samuel Ezzatilord, PhD, RCC, CCC, LMCC, a Registered Clinical Counsellor with 25 years of clinical experience — from International Red Crescent trauma work in refugee camps to veterans’ mental health programs and BC health authority hospital care. I work in English and Farsi at Dr Samuel Counselling & Neurofeedback (drsamuel.ca) in downtown Vancouver, BC, and a large part of my practice serves Iranian-Canadian clients navigating the very barriers this article describes.
What stigma actually looks like in practice
Mental health stigma is not usually a single, explicit belief. It is a cluster of smaller, often unspoken assumptions that shape behaviour without being openly examined. Research on Iranian immigrants in Canada has documented how cultural norms create significant barriers to accessing health services, including counselling (Dastjerdi, 2012). In many Iranian families, these assumptions include:
Therapy is for people who are broken. The logic goes: if you are struggling, it means you are weak, or damaged, or failing at something other people manage just fine. Seeking help confirms the deficiency.
It is family business. What happens inside the family stays inside the family. The Farsi concept of âbroo (آبرو) — honour, face, reputation — is partly built on this. Dastjerdi (2012) found that Iranian immigrants in Canada described concerns about family reputation and community judgment as barriers that prevented them from seeking the health services they needed. Telling an outsider about your struggles, your marriage, your children’s problems, or your own mental state is understood as a form of betrayal, or at minimum, as a loss of dignity.
Talking about it makes it worse. There is a widespread belief that examining painful emotions intensifies them. That the healthier response to hardship is to push through, stay busy, and not give problems more attention than they deserve.
What would people think? For first-generation immigrants, community reputation is both a social resource and a form of insurance. In a small, interconnected community, being known as someone who “went to therapy” can feel risky — even if the risk is mostly imagined.
Not ready to talk to anyone yet? Text or WhatsApp me one line — “thinking about counselling” is enough. I reply personally within a day: 604-721-0604.
The immigration layer
Migration itself is a form of grief that most people never name as such.
Leaving Iran — whether in the 1980s after the revolution, in the 1990s and 2000s as the economy worsened, or in more recent years as political conditions deteriorated — meant leaving behind a whole life: language as a natural environment, family networks, professional status, a sense of being known. Many Iranians who came to Canada as engineers, doctors, or academics spent years rebuilding from scratch.
That kind of loss tends to go unnamed, because the official story of immigration is opportunity, not grief. There is often no cultural space to say: I lost something enormous when I left, and I have not finished grieving it.
Unprocessed migration grief is one of the most common underlying currents I see in therapy with first-generation Iranian immigrants. It shows up as depression that does not fit neatly into any clinical box, as anger that seems disproportionate to the current situation, as a pervasive sense of not quite belonging anywhere.
The parent-child gap
For second-generation Iranian-Canadians — born or raised in Canada — the dynamics shift. Hwang (2006) describes this as “acculturative family distancing” — the problematic distancing that occurs between immigrant parents and children as a result of differences in the rate and direction of cultural change.
Growing up bicultural means absorbing two sets of expectations that do not always agree. Canadian culture generally supports self-expression, individual autonomy, emotional honesty, and the idea that your feelings are valid by definition. Iranian family culture, in many households, prizes collective harmony, respect for elders, restraint in emotional expression, and sacrifice of individual needs for family stability.
Navigating these two worlds is its own form of psychological stress, and it is one that many therapists trained exclusively in Western models are not equipped to handle well. Hwang (2006) identifies two dimensions of the problem: communication breakdown as children lose heritage-language fluency, and incongruent cultural values as children absorb the values of the new country faster than their parents do.
The first 20 minutes are free, by phone, with me — no receptionist, no intake forms, no obligation. You describe what is happening; I tell you honestly whether I can help and what a first block of sessions would look like. If I am not the right fit, I will say so and point you somewhere better. Call 604-721-0604 or book at drsamuel.ca/book-a-call/.
What is changing
The stigma is real. It is also shifting, particularly among younger generations and in communities with high education levels. Several things are driving this:
Social media and Persian-language mental health content. There is now a significant body of mental health content created in Farsi, for Iranian audiences, by Iranian therapists and psychologists. On Instagram, YouTube, and podcasts, younger Iranians are encountering normalised conversations about anxiety, depression, trauma, and therapy.
The political situation in Iran. The events of 2022–2023 — the protests, the violence, the grief that moved through diaspora communities around the world — pushed mental health into conversations that had previously stayed private. Many Iranian-Canadians who had never sought help before found themselves dealing with trauma responses that exceeded what they could manage alone.
The normalisation of therapy among educated professionals. In Iranian-Canadian communities concentrated in cities like Vancouver, Toronto, and Calgary, therapy is increasingly common among people in their 30s and 40s. When people you respect are open about going to therapy, the stigma decreases.
Access to Farsi-speaking therapists. The availability of bilingual therapists — still limited, but growing — removes one of the practical barriers. When therapy can happen in your first language, with someone who understands your cultural context, the threshold to try it drops significantly.
What good therapy looks like for Iranian families
A few things distinguish therapy that actually fits the Iranian-Canadian context from therapy that applies a generic Western model:
The therapist understands what âbroo is, without needing it explained. They understand why a client might be reluctant to say certain things out loud, and they create space that makes it safer to do so.
Family is treated as context, not as pathology. Western therapy has a tendency to frame family loyalty as the problem to be overcome. Good therapy for Iranian clients does not ask them to choose between their family and their wellbeing. It works with the family as a real and important part of the person’s life.
Language is available. For clients who think primarily in Farsi — especially for emotional and relational material — being able to express themselves in Farsi is not a luxury. It is a clinical necessity for the work to reach its real depth.
Stigma is acknowledged, not dismissed. A therapist who says “the stigma in your community is not rational” is not a therapist who will be effective with Iranian clients. The stigma is real, it has real costs, and a good therapist works with the reality of it rather than against it.
Does Insurance Cover Counselling in BC?
More often than people expect. Most extended health plans in BC cover services from a Registered Clinical Counsellor (RCC), and I direct-bill most plans. If stress or trauma follows a car crash, ICBC may fund approved counselling sessions for active claims. Veterans, serving RCMP members, and their families are covered through VAC and RCMP programs, which I also bill directly, along with CVAP, FNHA, and IFHP. On the free call I will tell you plainly which funding route applies to you before you spend a dollar.
مشاوره روانشناسی به فارسی در ونکوور
اگر تا حالا فکر کردید که «مشاوره مال ما ایرانیها نیست» یا نگران حرف مردم بودید، شما تنها نیستید. بسیاری از مراجعان من همین احساس را داشتند — تا وقتی که اولین جلسه را تجربه کردند. من، دکتر ساموئل عزتیلرد، با بیش از ۲۵ سال تجربهی بالینی، جلسات را به فارسی و انگلیسی برگزار میکنم — حضوری در مرکز ونکوور یا آنلاین در سراسر بریتیش کلمبیا. بیست دقیقهی اول مشاوره تلفنی رایگان است. برای اطلاعات بیشتر صفحهی مشاور فارسیزبان در ونکوور را ببینید.
Book a free 20-minute call
Call or text 604-721-0604 (WhatsApp works too), or request a callback at drsamuel.ca/book-a-call/. Evening and weekend appointments available, in person in downtown Vancouver or by secure video anywhere in BC. The first 20 minutes are free, by phone, with me personally. More detail: Individual Therapy. جلسات به فارسی برگزار میشود.
Written with expert editorial assistance.
References
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Dastjerdi, M. (2012). The case of Iranian immigrants in the land of the north: Newcomers’ health information needs and seeking strategies. International Journal for Equity in Health, 11, Article 55. https://doi.org/10.1186/1475-9276-11-55
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Hwang, W.-C. (2006). Acculturative family distancing: Theory, research, and clinical practice. Psychotherapy: Theory, Research, Practice, Training, 43(4), 397–409. https://doi.org/10.1037/0033-3204.43.4.397
