Trigger warning: This post discusses emotional and physical abuse, generational trauma, and the impact of cultural expectations on mental health. Please read with caution.
They Called Us Exceptional: A Book Review and A Reflection On Generational Trauma and Mental Health in Immigrant Communities
I remember the marks on my body and how my voice grew hoarse from screaming. Every day in my house felt like a battle, with arguments erupting over even the smallest things. I thought this situation was normal at the time — maybe all families lived like this. Despite the emotional and physical abuse, my parents still showed kindness and told me they cared about me. I forgave them because I felt I had to. They provided three meals a day, a roof over my head, and access to education. How could I complain when so many children lacked even these necessities?
My parents had high expectations. They wanted me to be an ideal, obedient daughter who was always ready to support them emotionally and tend to their needs. From a young age, I felt parentified, vigilant, and responsible for the care of my younger sister — often more than my parents did. This description might sound dramatic on paper, but it was a childhood reality for me. Through the lived experiences others have shared with me, I’ve come to see that many children from immigrant and South Asian families have faced similar realities. Considering I was only one of many facing these situations, I assumed it was simply a fate I should endure, leading me to mistakenly rationalize in my young mind that my healthy and normal emotional responses were somehow unjustified.
As a result of comparing my experience to peers and not having an understanding of healthy relationships, I repressed my feelings for years. Unsurprisingly, repressing my normal emotional expression led to chronic anxiety and depression. When I read They Called Us Exceptional by Prachi Gupta, my perspective on my childhood shifted: I finally understood that those emotions I had once silenced were justified.
Particularly in South Asian immigrant families, some cultural dynamics and expectations passed down cyclically through parent-child units perpetuate generational trauma. In They Called Us Exceptional, Prachi Gupta masterfully articulates this concept, recounting how her father, a successful physician, harshly imposed strict and unrealistic expectations on those around him while projecting a façade of kindness to the outside world. Like many children of immigrant parents, Gupta internalized the abuse and unreasonable standards as normal, believing that her emotional responses were unjustified because her parents met her basic needs. This dynamic mirrors my own experiences—growing up in a home where emotional and physical abuse coexisted with acts of kindness, leading to confusion and guilt. In South Asian culture, cutting off family members, no matter how toxic, is rarely an option due to a strong belief in familial loyalty. Instead, social norms dictate that children should carry the weight of their parents’ needs, as I did by informally taking on the role of the ‘third parent’ for my sister.
Reading Gupta’s story was transformative. Her narrative gave me permission to recognize that the feelings I denied as a child were valid. I now understand that repressing emotions in an environment that normalized emotional neglect was a primary contributor to the chronic anxiety and depression I developed. Gupta’s vulnerability in sharing these experiences resonated with me deeply, facilitating a critical step on my own path to healing and growth by empowering me with the language, perspective, and reference points to articulate my needs and experiences to my mental health professional. Gupta’s work is an essential read for anyone unpacking generational trauma, especially those in South Asian or immigrant families where cultural expectations often obscure the emotional toll on children.
Whether or not you share my motivations for reading this work, I encourage you to give it a chance. For disabled medical students navigating the journey to becoming physicians, Gupta’s narrative can help unpack the weight of generational trauma and provide the tools to move forward with confidence. More broadly, medicine needs empathetic, culturally sensitive, and trauma-informed physicians—ones who recognize that a patient’s mental and physical health cannot be understood in isolation from their lived experiences. Too often, I’ve seen clinicians dismiss anxiety, pain, or chronic conditions without considering the deep-rooted trauma that may underlie them. Invisible disabilities—particularly those shaped by abuse and neglect—can profoundly shape a person’s well-being, yet they frequently go unrecognized in clinical settings. As future physicians, we must do better. We may never fully grasp an experience outside our own, but we can cultivate the knowledge and sensitivity needed to approach our patients with greater understanding, validation, and care.
