An In-Depth Interview With Dr. Zou

As the screen comes to life in a telepsychiatry session, Dr. Chenhang Zou greets her patient with a warm, understanding smile. Reflecting her unique journey and approach in psychiatry, Dr. Zou's presence instantly conveys a sense of empathy and depth.

Traversing continents from China to the United States, Dr. Zou's life story is testament to a profound understanding of diverse cultural experiences and their impact on mental health. Her own personal experiences, complemented by extensive training, have converged to shape her conviction in a balanced, holistic approach, seamlessly integrating varied perspectives.

Dr. Zou’s practice is therefore not confined to a singular path; instead, it weaves together the scientific rigor of psychiatry with the introspective depth of psychotherapy, a synthesis that stems from her belief in the complementary nature of these two disciplines.

"I do both medication management and psychotherapy," Dr. Zou explains. “I think it helps me better understand if someone comes to me and says, ‘I've been through therapy for many years and things are still not changing,’ or ‘I've been on medications and this is not working.’ It helps me better identify: Is there something else that perhaps therapy or medication is not addressing in isolation? Because I understand both sides of the treatment."

In her experience, medication often plays a crucial role in managing the severity of symptoms, creating a foundation upon which deeper psychotherapeutic work can be built. "We can't really learn well when we're constantly overwhelmed or in such a deep depression," Dr. Zou states. “We can't really see how we handle stressors and learn from the stressors themselves."

But there are also things that medication cannot target. “This is where psychotherapy comes in," she says. “Even when I do medication management only, I still like to share some psychotherapy skills."

Tailoring Therapy

Thanks to advanced training at Emory University School of Medicine’s Psychoanalytic Institute, when it comes to engaging in psychotherapy treatments, Dr. Zou is adept in a range of modalities, always tailoring her approach to best suit the unique needs of each patient. This flexibility is central to her therapeutic practice, facilitating personalized care that resonates with each person’s individual experiences.

Dr. Zou does however find that certain types of therapy come up more often than others. “I gravitate towards CBT — Cognitive Behavioural Therapy — as well as psychodynamic therapy,” she shares, emphasizing the distinct roles each plays in her practice.

“CBT is a little bit more behaviorally oriented, meaning we are working on certain types of behaviors that we want to either improve upon or reduce,” she says. “It's really good at identifying cognitive distortions or thinking traps.”

She finds that this approach is particularly effective in giving patients tangible skills and clear steps to work through their problems, making it a fitting starting point for many.

But Dr. Zou also deeply values the less structured, more reflective nature of psychodynamic therapy. "It's usually less about particular skills and more focused on your understanding of the situation," she says. "We look into past experiences, relationships, and how these can affect your current symptoms."

This method offers patients a chance to explore the deeper undercurrents of their mental state, providing insight into how their history shapes their present.

Dr. Zou explains how the choice between therapy options often depends on her patients’ own inclinations and needs. "Sometimes one person tends to gravitate towards one form versus another," she notes, highlighting the importance of patient-centered care. In her practice, the decision on which therapeutic path to embark upon is a collaborative process, guided by the patient's comfort level and specific mental health goals.

By offering a spectrum of psychotherapeutic techniques, Dr. Zou ensures that her treatment is not only comprehensive but also deeply attuned to the individual stories of her patients.

Embracing the Cultural Context

A significant element of each individual's personal story is the cultural context in which they grew up and live. This understanding is central to Dr. Zou's approach to psychiatry, where she emphasizes the importance of seeing each person as a whole, considering not just their symptoms but their cultural background and how it shapes their experiences and perceptions.

Dr. Zou's own journey, transitioning from China to the United States at a young age, has itself been pivotal in shaping her perspective on the impact of culture on mental health. “I was actually born in China and lived there until I was 10,” she shares, highlighting her firsthand experience with the shift from a collectivist culture to a more individualistic one. “It helps me understand how important a person's background and their cultural norms are — how much that contributes to somebody's mental health. Something can perhaps be considered pathological in one culture versus another culture where it is actually celebrated.”

Her cultural transition also taught her valuable lessons in non-verbal communication. “There was a time in early childhood when I didn't know much English, so I had to rely on understanding the tone and body language,” Dr. Zou recalls. This ability to read beyond words is a skill she still finds invaluable in her practice, especially when working with patients from diverse backgrounds.

Additionally, Dr. Zou's native multilingual ability plays a crucial role in her culturally sensitive approach. “I do speak Mandarin, though I'm less familiar with its medical aspects,” she acknowledges. This linguistic skill is not just about conversing; it's about truly understanding her patients. “A lot of people, what they want is just to be understood,” she says.

She notes the importance of language in psychiatry, where so much can be lost in translation. Emotions and nuances often embedded in one's native language are vital for accurate understanding and empathy in treatment. “Even with medical translators, sometimes you just don't quite get the feelings across — and feelings are so important in psychiatry,” she adds, highlighting the intricate link between language, culture, and mental health.

Dr. Zou also explains how mental health issues can manifest differently across cultures. "In many Eastern Asian cultures, mental health often manifests as somatic symptoms [of the body]," she explains. "Unfortunately, physical complaints are sometimes considered more socially acceptable than admitting to depression or anxiety." Recognizing these cultural differences allows Dr. Zou to approach her patients with a deeper understanding and to interpret their symptoms within the appropriate cultural context.

Ultimately, Dr. Zou emphasizes the importance of being culturally mindful, but not necessarily culturally aligned, in therapy. “I'm not saying every Chinese person should definitely see a Chinese psychiatrist or therapist — it may be helpful to look at things from a different perspective,” she says. “Therapy is a process where you're trying on different ways of thinking about the problem. It's like in those American teen movies where people go to the mall and try on different outfits, and some of them may fit and then for other outfits people are like: ‘Eugh, that looks awful, let's take it off and try something new.’”

Navigating New Frontiers

Dr. Zou’s adaptation to telepsychiatry in recent years marks a significant shift in her practice, reflecting her ability to embrace change and innovation in the field of mental health. "I know a lot of telepsychiatry started because of the recent pandemic," she acknowledges, "but I decided to stick with telepsychiatry because of its many benefits."

Significantly, this shift to a digital platform has allowed her to extend her reach to patients who might otherwise have not been able to access her services. And she further highlights the privacy and adaptability that telepsychiatry offers. “You don't have to sit in a waiting room and worry about potentially running into someone you know, and there's more flexibility in terms of when and where to do it,” she says.

However, Dr. Zou is open about the fact that there can also be challenges with this relatively new mode of therapy. “As with everything I think there is a double-edged sword,” she says. “We have to understand: what are its benefits and what are some limitations?”

One such limitation of video calls she points to is the inability to see patients' full body language, a key aspect of traditional therapy. "I can only see people from the shoulders up — I’m missing part of your body language and how you’re positioning yourself," she notes.

Dr. Zou emphasizes that while the visual information may be limited through telepsychiatry, it is still important, and she will gently explain this to patients if they ask to talk without their video switched on. "I remind people that there's a lot more information I can gather by seeing you eye to eye, so I really need that information to make a good diagnostic evaluation,” she explains. "All in all, I still think telepsychiatry is a good area of our field of psychiatry."

Prioritizing Patient Education

Dr. Zou’s approach ensures that the essence of personal connection is not lost in the virtual format. At the heart of this, she emphasizes, is clear communication, which is also key to another key pillar of her practice: education.

"Patient education is one of the most important, if not the most important, aspects," she stresses, explaining that a well-informed patient is central to effective treatment. “It's hard to judge whether something is helpful or not without really understanding more about your own condition, the things we’re trying to target and the things that we’re trying to use the medication or psychotherapy for.”

She says that in some respects, social media and popular culture have done a lot to open up discussions about mental health and bring more information into the public domain. But with so much information out there, she believes it can be a challenge for patients to sort through it all. "It's essential to get information from reliable sources," she advises, highlighting the challenge of navigating through the vast array of information available today. “When I'm talking to my patients, I always encourage them to use me as one of the resources they have available.”

This educational approach is intertwined with Dr. Zou's belief in collaboration. "If I'm unsure about something, I ask the patient," she says, fostering a two-way street of knowledge and understanding. “Because oftentimes the patient has been living with symptoms a lot longer than I have known them. In many ways, patients know more about their symptoms than I do.”

Dr. Zou extends this collaborative approach to addressing potential conflicts in information. She encourages her patients to discuss any discrepancies between external sources and their therapy discussions. "Bring it up, let's talk about why that's different," she suggests, advocating for a partnership approach. "It's not about, ‘My team wins and your team loses.’ We're on the same team, trying to understand.”

Celebrating the Small Steps

Contemplating her role as a psychiatrist overall, Dr. Zou finds profound joy and fulfillment in interacting with — and learning from — her patients. "It’s a beautiful thing to exchange ideas and reflect on experiences," she shares, expressing how this interaction not only benefits her patients but also enriches her own professional and personal growth.

Dr. Zou's enthusiasm for psychiatry stems not just from clinical successes but from the broader impact she observes in her patients' lives. "There's a lot of things that make me really glad that I chose this profession," she reflects, “because I think I’ve learned, and I'm trying to teach other people, about how to improve their quality of life and to have better, healthier relationships — how we take care of ourselves and have a healthier mind.”

This holistic focus on well-being is something she actively tries to implement in her own life, applying the same principles of effective communication and clear boundaries that she discusses with her patients.

As she looks back on the changes she has witnessed in many of her patients, Dr. Zou emphasizes the significance of the seemingly small steps in the journey towards mental wellness. "I've seen big changes, but it's the little changes that really stick with me," she remarks, adding that these incremental changes can ultimately have profound effects and positive transformations in various aspects of a patient’s life.

"These initial small changes can have a rippling effect, leading to better exercise, better sleep, and overall improved well-being," she concludes. “And I think that's a really beautiful thing that I get to do that with my patients.”

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This blog post is brought to you by Apraku Psychiatry.

Apraku Psychiatry is a private practice offering video appointments with Board-certified psychiatrists licensed in multiple states. To schedule a psychiatric evaluation with Dr. Zou, patients can complete the online booking form below.