Adult Psychiatric & Counselling Services Archives - Promises Healthcare
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Counsellor, Psychotherapist, Psychologist, Psychiatrist. Which is right for you?

Counsellor, Psychotherapist, Psychologist, Psychiatrist. Which is right for you?

If you’ve been pottering around the Promises Healthcare’s ‘Our Team’ page, and are new to the world of mental health in that you’re considering making the leap to seeking help from a mental health professional, it’s our hope that this casual guide to demystifying the titles, designations and dizzying abbreviations that adorn each profile will point you in the right direction.

 

For starters, there’s one thing that each of our mental health professionals have in common. They all possess at minimum a Master’s level certification in their discipline, so you can be assured of all their competencies.

 

Psychiatrists

As we’ve shared in a previous article, a psychiatrist is at their core a medical doctor, which certifies them to prescribe neuropharmacological support – i.e., medication.

But of course, psychiatrists more often than not do indeed possess relevant counselling and psychotherapy certifications, because being well-versed in the craft of patient care in the mental health sector does help them delve deeper into the minds and psyches of their clients, and assist them in skilfully and empathetically overcoming boundaries that some clients may consciously or unconsciously put up that stymie the therapeutic process. 

Prescribing the most effective neuropharmacological support is buttressed by the psychiatrist’s skill in interpersonal communication, both verbal and non-verbal. Psychiatrists often describe themselves as observers, but it goes without saying that navigating these one-on-one interactions requires input from their side of the desk. While you might think that psychiatrists have reached the peak of the career trajectory of a mental health professional, keep in mind that by no means should you think of a psychiatrist as the fount of all mental health knowledge. Think of the ‘helping’ professions encompassed in the form of a large tree, rooted in a common desire to help people in need and supported by a trunk of science and evidence based knowledge , from which grows different branches representing the many ways in which mental health professionals can help someone in need – certain disciplines are applied more rigorously in helping certain conditions or situations. This is why Promises is described on our page as a multidisciplinary team of mental health professionals. Your treatment plan is provided by our team, and under the shade of our tree, you will be prompted to reach for certain branches – but at the end of the day, it is your choice to pick the leaves which seem most lush to you.

Psychologists 

Psychologists differ from psychiatrists in one key authority. They are not medical doctors, and therefore cannot prescribe you medication. You’ll notice that our stable comprises a good number of clinical psychologists – so, what exactly are they, and how can they help you? Clinical psychologists possess doctorate degrees in psychology, and are imbued with the ability to cater to clients who suffer from any number of the discombobulating disarray of mental health conditions which sadly, are still negatively stigmatised in society. Think schizophrenia, bipolar disorder, depression, and their ilk. A clinical psychologist can make a diagnosis for you, if you think you are suffering from a mental health condition. Using the tools in their arsenals which they are trained in, such as psychometric testing, intelligence testing, personality testing, and much more, their diagnoses are firmly rooted in evidence based science. You could then make the logical conclusion that if they deem your condition treatable with medication, they would refer you to a psychiatrist. There’s a lot of symbiosis going on in our clinic!

 

The difference between Counsellors & Psychotherapists 

We’ll deal with counsellors and psychotherapists next, because the two fields are very much intertwined, aligned in some facets, while possessing in granular detail key differences. Counselling and psychotherapy are both broadly concerned with betterment of clients in need, and there is significant overlap in the goals of either mode of therapy. Now, on to the differences, which will help you better distinguish which leaf you’d like to choose. First, there is a temporal difference between the two in both the length of treatment and how far back into your life each mode of therapy delves into in order to solve your current issue.

Counselling, on one hand, tends to favour clients who are more self aware and sensitive to their emotions and thought processes, and need a helping hand in unpacking a recent difficulty or life altering experience that they wish to resolve. This is rather unlike psychotherapy, rooted in a humanistic tradition – some may refer to it as height psychology, a term which gained currency during the time of Abraham Maslow and his espousement of self-actualisation. Psychotherapy, in this sense, takes a long, lingering look at a person’s past, life changing experiences, deep seated traumas and neuroses, or any relevant factors – all to help a client gain mastery of self (self awareness) and challenge them to enact the necessary life changes that lead to self improvement. You might well think of counsellors more as “advisors”, and psychotherapists as the “life guides”. Of course, detract nothing from both disciplines – their practitioners chose their specialities precisely because they fit into their world-views and probably, because they thought that they were good at it!

 

How do you choose?

Of course, given the array of therapeutic modalities and mental health professionals, we understand that choosing the right leaves can be a bewildering experience. That’s why we feel it’s best that you browse the profiles of our therapists, read their biographies and see which of them you feel most comfortable seeing. In the near future, Promises Healthcare intends to refine and streamline your selection process by having a list of issues or conditions that you are having problem(s) with – your input will then guide you to the mental health professional in our team that is best equipped to deal with your issues. For now, take  a deep breath, sit back, read, absorb, think with clarity about what you want to deal with, and pick one to make an appointment with. Choosing the right therapist isn’t a one hit wonder – it takes time and patience, but rest assured that we’ll do our best to help you in that regard. 

 


Featured Photo by Evan Dennis on Unsplash

Coping With Difficult Family Members (Including Parents, Spouses & Siblings)

Coping With Difficult Family Members (Including Parents, Spouses & Siblings)

Written by: Dr Mark Toh, Consultant Clinical Psychologist

 

It is a reality that we can choose our friends. If at times we find them annoying, we can always choose to make adjustments or even terminate the friendship if needed. But unfortunately, we cannot choose our family members. As such, it can be a challenging and sometimes very difficult situation when family members are emotionally unhealthy and they have not sought help to address their own difficulties. 

 

Instead, by having to live with them as members of the same family, they become a regular source of mental distress. This can pose a particular burden for minors, or those still dependent on the difficult member as the financial source of living, or during the current coronavirus lock-down imposed by the government when family members are confined together. In some cases, especially when violence and harm is a possibility, these unhealthy members can become damaging or dangerous and more drastic action may need to be taken to promote safety.

 

For the child, this may be confusing if the source of difficulty from parents are due to attempts to parent or from inappropriate control. Or they may have siblings who like being bossy to their siblings. Here are some signs to consider in trying to differentiate healthy from unhealthy behaviours from difficult family members. 

 

They are always blaming you while not accepting their own responsibilities.

Individuals who engage in unhealthy relational behaviours often have difficulty taking ownership for contributing to the problems that emerge between each other during disagreements or conflict. Their need to blame others is usually a defensive response against accepting their own guilt or responsibility for their fault or wrong in the situation. 

 

They are always critical towards you. 

Unhealthy family members also often present themselves as critical. This goes beyond a simple discussion to point out about errors if or when you or someone else has made them. But it appears more as a pattern or their habit in regarding you as a target of contempt. Words that undermine your character are often expressed. It is also often expressed regardless of the many accomplishments you may have achieved. It is often an expression of projection that reflects deep resentment or the unfulfilled wishes of the parent on a family member. Sometimes it is a resentment shared between both parents and projected on a child who they have identified as the “scapegoat”. The scapegoat in unhealthy families are usually children who are targeted for blame because the parents need to fault the child to avoid taking ownership of a problem.  

 

They are dismissive of your feelings. 

A healthier family is more prone to being encouraging or supportive especially in difficult times. But the unhealthy family member is often unconcerned of your feelings or even your opinion. The extent of their dismissal of you may show up as disagreement with you even if you are right. In severe cases, if you attempted to approach them to resolve a disagreement, they may even resort to convincing you as the problem. In this focus, they could convince you to see that you are the problem rather than to problem-solve in search of a solution that has mutual benefits.

 

They often make threats.

Physical altercations are not the only signs when the relationship or behaviour is unhealthy. Making threats especially when repeated is often employed as a means of control. This is going beyond anger which is a common feeling within long-term relationships. Anger is a sign when someone feels offended, frustrated or hurt. But the use of threats goes beyond anger to become an instrument of intimidation or domination, and a misuse of power. It is a common  behaviour of abusive individuals.

 

They are controlling.

There is a difference between control from healthy parenting and unhealthy parenting. Healthy parenting is focused on what is in the child’s best interests. When discipline is exercised, it is done to facilitate learning for the child. In unhealthy parenting, control is displayed more because it is primarily attentive to the parents’ wishes and not in the best interests of the child. This is often expressed when the parent becomes forceful and induces fear on the child so that the parent can feel powerful or have his or her way. This control can also be applied between couples or siblings. The family member is expected to take the role of submission in their engagement for the controlling person to be pacified. 

 

Additional signs for concern in this area is suggested by (a) prohibition of personal decision-making that is good for the family member, (b) issues of appropriate concern are denied from being raised for discussion, (c) material resources such as money or food are used to manipulate the family member towards submission, (d) there is direct restrictions into personal choices pertaining to clothes, appearances, spending, friendships, or even use of time, and (e) there is an opposition towards the family member becoming independent, to be separated from the unhealthy individual, or for the family member to be individuated (mature to become their own person) over time. Between couples, a controlling spouse is often violating the boundaries of his or her spouse. It is as if the controlled spouse is not allowed to be free to exercise his or her own choices.

 

They confuse punishment with discipline.

Discipline is the means to teach someone to abide by a code of conduct, or correction for a child to learn right from wrong. But for the unhealthy individual, punishment or discipline occurs when there is no lesson to be learned. It shows up usually because the person is unhappy for some reason. Their need to lash out is their attempt to vent out their anger or rage even if it becomes hurtful to others, and they feel justified conducting themselves this way. At other times, this punishment is expressed through passive aggressive behaviours when “silent treatment” is employed instead of yelling or shouting. Or the punishing behaviour is excessive and disproportionate to the action or event.

 

Unhealthy parents take sibling rivalries or ‘misbehaviour’ to the extreme.

This usually occurs when the unhealthy parent is resentful of all his or her children. They may feel that having children (or marriage) have become a personal cost to them because of the responsibilities required for the care of the children. They feel prevented or deprived of their freedom and so the children or family member are to blame. Or this could show up with a parent showing favourites to one child over the others. In the course of sibling rivalry, the unhealthy parents is revealed by (a) blaming one child more severely over the other and consistently, (b) humiliating the scapegoated child, or (c) the unhealthy parent experience the sibling rivalry or conflict as a personal or vindictive act against the parent.

 

Strategies for Coping with Unhealthy Parents or domineering spouses and/or siblings

It may be a sad reality that parents can consider themselves parents simply because the infant is born following his or her physical birth. But beyond the biology, the emotional maturity, readiness or mental health can often be found lacking in parents to create the healthy conditions for the infant to develop or thrive. Controlling family members who are narcissistic in nature are also more interested in their control than the well-being of others. When family members regularly display the above behaviours, there is a need for concern. Given the potential for mental distress, developmental disruption and suffering, the following strategies may be essential to assist in coping.

 

Know that you are your own person.

Although you may share some traits or the same family name with your parents, remember that you are not 100% of the same people who raised you. If you recognise that your parents are emotionally unhealthy, understand that you do not need to follow their same values or behavioural patterns. When you realise that you have been hurt by them repeatedly and their use of authority serves their own interests over your needs to develop in a healthy way, be ready to break away from their self-serving values to work towards a healthy development for yourself. Explore to find healthy models of functioning among others to seek their influence over your lives rather than what is practiced at home.

 

Create space for your own emotions to nurture your own sense of self.

The unhealthy parent, spouse or sibling often do not respect your personal boundaries. They may deny your personal space or your feelings because they are preoccupied with their own. They may not discuss matters out or they may attempt to deny an essential part of who you are. While they deny how you may feel in their relationship with you, this does not mean you cannot acknowledge or express your own feelings by blogging or journalling.

 

Find supportive relationships elsewhere.

When your family members have made themselves unapproachable, you can turn to others for support instead. Friends, teachers, counsellors, or colleagues are often available to relate to who engage with a healthier appreciation for you. You do not need to go through difficulties alone. So find a support system from those who appreciate you for who you are and who value you in the person you can become.

 

Understand that your parent, spouse or siblings may have narcissistic tendencies or a self-serving biases so set your expectations low in conversations with them.

Unhealthy parents, spouses or siblings highlight the need to understand mental illness. Having to engage family members who have already discounted you, or hold you in contempt is often more reflective of them than of you. For this reason, understanding if they have a narcissistic or anti-social personality or tendencies is useful to recognise their biases. You may wish to have deep, meaningful or respectful conversations with them. But since this is not possible for those who are narcissistic or anti-social in nature, keeping exchanges brief and light is best to minimise stress or conflict.  

 

Be prepared to employ diversion tactics in conversation.

Being diversionary may not be appreciated in social circles. But if your family member is controlling or looking for conflict, having a mutually respectful conversation may not be possible. As such, their attempts to dominate or argue can be diverted. For example, if they choose to criticise your choice about what you bought, you can note their comment while affirming your choice. Then this can be followed up by you changing the topic. This may allow you to have some control while you may be under attacked.  

 

Recognise the traits that make you an easy prey.

For some, the need to dominate can be influenced by their perception that you have difficulty standing up for yourself. Their view that you are unable to be firm in protecting yourself may appear as an invitation to them to bully or dominate. Learning to stand your ground will help to establish yourself as deserving of respect.  

 

Expect their angry response but do not surrender to it.

Your attempts to hold your ground or establish personal boundaries may be seen as a threat to the controlling parent or spouse. They see it as a challenge to their need to dominate or control. As such, anger can be employed as their weapon. It is important to not be paralysed by the person and to remember that you still have power. This power may not be accepted by them but you have power nevertheless. You can continue to pursue what is clearly in your best interests despite the threats and anger they express. Choosing the right timing to pursue your interests with them may be required. Or being able to refer to the credibility of someone else with authority on the subject may be helpful to borrow these views to help you to hold your position. 

 

Aim to be self-sufficient and independent.

The need to establish your healthy sense of self and personal integrity is important. Your own mental health depends on it. In the face of parents or family members who are clearly focused against your best interests in pursuit of their own interests, you can set goals to be financially independent in order to become autonomous with what is needed to establish your own integrity and identity. Unhealthy parents often employ money as a means of keeping the child dependent. As such, learning to budget and be self-financing will help to establish your independence from them.

 

Do not accept abusive behaviour and the effects of it.

Recognising the signs of mistreatment from abusive parents, spouses or siblings should allow you to feel the anger you have reason to feel. Often these people may also engage in seduction or manipulation to downplay their dysfunction and hide their mistreatment of you. Being able to recognise their self-serving bias and the potential damage that this can create is important to not allow them to justify it. If their mistreatment is justified, it is more likely that you could minimise the damage and practice it yourself.  

 

If the abuse is persistent or violent, be prepared to get help and seek shelter and protection outside the family. 

This is hard to do for children but the sad reality is that some parents are poorly prepared to parent or they are mentally ill when they decided to have children. It is a sad and tragic reality that children have died from neglect, abuse or mistreatment while in the hands of their parents or caregivers. Children have been starved, exploited, tortured in the hands of violent, mentally ill parents. This has also occurred between couples as indicated by one spouse being regularly abused by another. Abuse can be physical, emotional and/or sexual, and they can happen between couples and on children within a marital or family system. If only one parent is aggressive or violent, the other parent has to be prepared to seek shelter to protect themselves or their children. If in the case of one parent being violent and the other parent ignores the child being abused, the children need to be protected from both parents.

 

This article is a call to alert those who may be suffering within families. Tragically, there are hidden dangers that vulnerable family members may be exposed to. They may already be suffering in subtle or obvious ways at the hands of unhealthy, abusive or emotionally damaging family members. Our collective concern for the weak calls out for us to be sensitive to when this danger is present within our community to protect the vulnerable among us.

 

 

 

References:

Faubion, D. (2020, Apr). Toxic family dynamics: the signs and how to cope with them.

Chen, C. (2015, Feb 25). What to do when the toxic people in your life are (unfortunately) your parents. The Huffington Post.

Streep, P. (2016, Dec 14). 8 strategies for dealing with the toxic people in your life. Psychology Today.

Thorpe, J. (2015, Sep 18). 7 tips for dealing with toxic parents. Bustle.

 

Dear Caregiver, You are not alone in this Circuit Breaker: Anger Management Tips

Dear Caregiver, You are not alone in this Circuit Breaker: Anger Management Tips

by Sharmini Winslow, Psychodramatist / Therapist

 

Anger is a response most of us have when we feel our territory is being threatened. This is a primitive reaction from our days as cavemen (and cavewomen) when a wild animal was nearby! This reaction has not quite been removed by modern civilisation.  When something threatens our security, the brain responds to it with a fight or flight reaction.  The body releases adrenaline which causes changes in the body.  The heart pumps faster, breathing gets faster, blood gets diverted to the legs and arms so we can run or fight back. The blood flow to the reasoning part of the brain is lessened so that thinking becomes difficult. Nowadays there are no saber tooth tigers coming out to attack us which require us to fight or flee.  However the body’s response to a threat remains the same and, unless we find ways to discharge the energy or change our perceptions, the fight response will persist. 

 

Powerless!! That’s the situation most people find themselves in at the moment during this Covid-19 Pandemic Circuit Breaker.  From the home maker, who has to see her family all day long to the child who wants to have his friends over; teenagers who are restricted in their activities with peers to husbands who have to adjust to being at home with no break! Cabin fever is setting in and many are not coping well.  Add to that mix an addiction that is running rampant in the household and you have a powder keg ready to blow!!! 

 

What can family members do at this time to stay sane and not get embroiled in another power struggle or argument with the addict in the house.  Anger that luxury during normal times is just magnified as all of us are forced to Stay Home. A simple request turns into a huge event; an innocent comment gets misinterpreted; and even demonstrations of concern become fuel for accusations of being manipulative or controlling. What to do??

 

Most family members of addicts or dysfunctional families (most of us can attest to being in this category),  have resorted for a while now to manage, manoeuvre, save or guilt trip.  This comes from a place of love and fear. However having time apart has always been a great diffuser of tension.  Now faced with a Stay Home situation things can get stressful. Once free to go out, meet friends, go to the gym and pursue our life goals, we find ourselves having to don a mask and stay six feet away from each other, with frequent temperature checks thrown in!  Yes we know it’s for our own good but just how do we go about removing that sense of irritation or frustration?? What’s wrong with me?  I never used to get SO upset?? Being stuck at home we ‘step on the toes’ of others or they inadvertently step on ours. 

 

So here are some possible ways to cope…..

 

1. Walk away and discharge the energy

Going for a walk, or a run and getting away from the source or trigger for our anger is one option.  Moving away and giving vent to the energy is what we need to do.  Digging in the garden, washing dishes, scrubbing the bathroom tiles or polishing the furniture is a great outlet for this energy. Shredding newspaper is another excellent technique.  After which you could turn the strips into Papier Mache pulp and create an art project.  One woman wrote that she would pull out weeds and imagine she was pulling out her husband’s hair! This is called Detaching.

 

2. Practice Deep Breathing and Self soothing

This taking in of deep breaths, helps bring more oxygen into the body and to the brain.  Especially important is the frontal cortex where our reasoning happens. Improved brain function helps restore some calmer thinking. Follow this up with doing something good for yourself such as listening to some music you like, dancing, playing a game on your phone, doing a craft or even having a nap. Seld care is important when you have to deal with a loved one suffering from an addiction.  We often say, “Put on your own oxygen mask before you attend to others.”

 

3. How Important Is It? 

Ask yourself this question.  After walking away and breathing for a bit, consider how the event figures in the larger scheme of things. Does this event require action right now or can it wait? Do I need to say what’s on my mind right now or can I pause and say it later.  Often I ask myself these questions- Does it need to be said? Does it need to be said by me? Does it need to be said by me now?? By the time ive asked myself these questions, my good sense would have returned and I can leave it for another time.

 

4. Respond not react

After calming down, consider a way to communicate which is kind and thoughtful. Say what you mean, mean what you say, but don’t say it mean. I’ve heard this said by someone- “Try to say it in ten words or less!”  Haha! Most of us have communication patterns that escalate tension! So, try this for a change.

 

Another great tool is the acronym – T.H.I.N.K.  Before I speak I need to THINK. 

Is what I’m saying Thoughtful, Honest, Intelligent, Necessary or Kind. If not take a piece of Masking tape and place it nearby.  This helps as a reminder to keep my mouth shut.  

 

When all else fails, go talk to someone you trust and let it out. A friend in need is a friend indeed.  Or seek one of many support groups or counsellors to help you cope. Whatever the case, we are all in this together! So don’t suffer alone. There are many helplines and people available to support you such as the ones listed below. 

 

    

What to expect during your visit to a Psychiatrist?

What to expect during your visit to a Psychiatrist?

If you’re considering seeking help from a mental health professional / psychiatrist, there’s a pretty good chance that you’ve realised there’s help out there that can assist you with whatever concern you have on your mind. Your mind may be in disarray, but remind yourself that whatever stigma against seeking mental help may exist in your mind, it’s there because of your lived experiences – created by the culture you live within. There’s absolutely nothing wrong with wanting to get better, or better yourself, and to feel constrained by some vague idea of what it means to be “a man” or “a strong woman” is unwarranted.

If you’re fearful of revealing your innermost thoughts and feelings to a stranger (by virtue of it being your first visit), keep in mind that your psychiatrist is first and foremost a doctor, bound by the Hippocratic oath, and second, believes in the value of offering a non-judgmental listening ear through their training and moral code. If that doesn’t comfort you, you should be aware of legal constraints that exist in your favour to protect the information that you share with them. Notwithstanding of course, if there is reason to believe you intend to injuriously harm yourself or another.

Because of the anxiety that may roil your thoughts, it may do you well the night before to sit in silent contemplation and pen down the reasons or thoughts you intend to divulge. Having a concrete list to bring into your psychiatrist’s office will help you ground yourself and serve as a reminder that you’re there for good reason – to get help. Nothing to be ashamed of, nothing to hide, nothing to unconsciously lose behind a preponderance of mistrust or other self-serving attitudes. Your psychiatrist’s office is a safe space.

If you feel that all this is a hard ask, consider bringing along someone whom you trust and knows you well, with your best interests in mind. They can serve as a calming influence that soothes your inner turmoil. Furthermore, they might be able to helpfully point out if there are discrepancies between what you tell your psychiatrist and the truth of the matter.

When you step into your psychiatrist’s office for the first time, you will most likely be greeted with an open-ended question such as “How may I help you today?”, or “What’s been bothering you?”. It’s normal to feel overwhelmed by the variegated ways you can choose to answer their greeting, especially if you have issues with how you are perceived by others. But remember, this is their way of getting to know you, especially since they have nary a clue of why you may have decided to make good on your appointment.

Because of the time constraints on your visit (your psychiatrist’s office is a place of business after all), you can expect them to try their best to elicit responses through a line of inquiry that their best judgment will allow them to evaluate and cohere into an accurate as possible diagnosis of your mental condition, if you are indeed suffering from one. No psychiatrist is a soothsayer or mind-reader, and you should be aware that the help you receive will very much be preponderant both the truthfulness of your responses and the skill of your psychiatrist, who is also trained in reading cues and tells that they feel will help them make a diagnosis.

As your visit comes to a close, based on the personal proclivities of your psychiatrist, you can expect a number of permutations to happen. They may prescribe you medication, if they feel confident in their diagnosis. They may point you towards psychotherapy or counselling (the difference between the two we will delve into in another post), they may prescribe both the former and the latter, or they may hold off on either if they feel that they cannot in good conscience do so.

Of course, it is very much your right to evaluate for yourself if the synergy between your initial choice for a psychiatrist is optimal for you. If you feel comfortable with them, do feel encouraged to continue on course, or if not, seek out another psychiatrist per a trusted friend’s recommendation, or look online for one that seems more promising in terms of a potential therapeutic alliance.

Ultimately, don’t forget that your psychiatrist has your best interests in mind. They are committed to formulate a treatment plan for you that runs parallel to your values and is in line with your goals.

Promises Healthcare is committed to providing mental health services to those in need, and has realigned how we provide these services in light of the current COVID-19 pandemic. Not only do we practice strict social distancing in the clinic, we have a new teleconsultation service up and running. This may be a blessing for those who are not yet comfortable with in person visits. Simply visit our main website and visit our teleconsultations page.

Alternate services of help are also provided by the Ministry of Health & National Council of Social Services in the public health and non-profit sector respectively. The Minister for Health has also written in response to a question regarding the use of Medisave for mental health therapy and counselling treatment: “No Singaporean will be denied access to necessary and appropriate healthcare because of an inability to pay.” 

Helping The Elderly During This COVID-19 Circuit Breaker Season

Helping The Elderly During This COVID-19 Circuit Breaker Season

Dr Rajesh Jacob (Senior Consultant Psychiatrist @ Promises Healthcare) was interviewed by Tamil Murasu on 19th April about his views on ways we can help the elderly during this COVID 19 Circuit Breaker season.

Here’s an English translation of that interview:

1.What kind of mental issues that the elderly can experience during a pandemic like COVID 2019

Physical distancing during this public health crisis is essential in preventing the spread of the virus, but it can come at a high cost to seniors’ mental health and well-being, resulting in loneliness, anxiety, depression, and cognitive problems. Self-isolation will disproportionately affect elderly individuals whose only social contact is out of the home, such as at daycare venues, community centres, and places of worship. Those who do not have close family or friends, and rely on the support of voluntary services or social care, could be placed at additional risk, along with those who are already lonely, isolated, or secluded. It’s hard to escape news updates about coronavirus disease (COVID-19). The constant headlines and media reporting may make some people anxious. In particular, older adults, people with chronic health conditions, and caregivers are likely to be at higher risk for increased stress and anxiety, since they face a higher risk of illness if they contract the virus. Fear and worry about your own health and the health of your loved ones can result in changes in sleeping or eating habits, difficulty sleeping or concentrating, worsening of chronic health problems and increased use of alcohol or tobacco.

2) What are the potential do’s and don’ts that the elderly have to observe during this period of time? (e.g. spreading unverified COVID-19 news via whatsapp)

Maintaining seniors’ connection to their healthcare providers using the telephone or video telehealth platforms is critical and “may be the most important thing we do as mental health professionals.These include greater use of computers or tablets to stay connected to family, loved ones, and friends through video chats and playing online games.Seeing each other’s faces, hearing their voices, and sharing the experience that we’re going through can be therapeutic for everybody.Mindfulness-based interventions and relaxation techniques could also be helpful.There are many computer-based applications for these mindfulness exercises that the elderly folks can try out.

For seniors who are not tech savvy , and have difficulty using smart phones and the internet, just calling their relatives or friends through the phone would be immensely helpful for their mental health and reducing anxiety and fears.

Seniors who are comfortable and confident in using the internet can also sign up to govt websites such as www.gov.sg to obtain correct factual information. Due to widespread internet access, numerous fake messages and videos can be potentially circulated through whatsapp causing increased unnecessary fear and anxiety. This can be avoided by restricting too much exposure to online news and messages and probably watching the news on TV once a day for those who are more prone to anxiety.

GO ON A NEWS DIET

Stay informed, know what’s going on but don’t get locked into endlessly watching “breaking news” on the 24-hour news channels.

3) How can family members in the household assist to ease their worries, concerns and fears?

Children and grandchildren of the elderly who are living alone can also help by being in regular online contact and also calling them on their phones and giving them verified factual information of the COVID outbreak . For family members living in the same household, it is good to regularly update the elderly people about correct factual information about the epidemic. It is also important for the family members to keep the elderly engaged in other activities such as reading, playing indoor board games, chess, and other activities. It is also important for the elderly to avoid going out  as they are more vulnerable and family members can help by providing groceries and other household essentials to them.

4) What kind of meaningful activities can the elderly engage at home during this period?

In addition to picking up the telephone, other  options that may help seniors stay mentally engaged include practicing hobbies or activities such as knitting, crossword puzzles, “or whatever else works for them. Whatever helps them cope and keeps them occupied during self-quarantine should be encouraged. If there is a positive aspect to the COVID-19 pandemic, it’s that it has forced people to slow down and connect with each other.You may not be able to control the virus, but you can help control your emotional reaction to it.Take breaks from watching, reading, or listening to news stories, including on social media. Hearing about the pandemic over and over can be upsetting.Take care of your body. Take deep breaths, stretch, or meditate. Here’s a free guide on how to meditate from Mindful magazine.

Eat healthy, well-balanced meals.

Relax by doing activities you enjoy. Try crossword or jigsaw puzzles, , cook healthy meals and freeze some for later, and seek out TV shows to watch that give you pleasure. Explore your library’s online offerings.

For those who are not tech-savvy , it would be useful to learn the basics of using the internet and also learning to use online tools such as Facebook or zoom, so that they can get in touch virtually with friends and relatives if they are living alone.

5) How can the community play its part to care for the elderly who have little family/external support and live alone?

It is important for neighbours living in the same floor to look out for the vulnerable elderly living next to them. It is at times of crisis like this, do people need to get more empathetic and concerned about their fellow human beings. Neighbours can check on their well being on atleast twice a day basis, help them to get their groceries and also check on their physical health and get medical help if required.

There are also community agencies run by the government  as well as NGO’s  who have volunteers who can provide additional support to the elderly living along or with poor family support.

There are organisations which can provide meals delivered to their houses which will avoid the elderly leaving their houses unnecessarily .

6) Taking care of elderly patients especially those with conditions like dementia can be challenging for care givers. How can care givers ease their tensions, worries and stress while taking care of the elderly at home ?

For patients with Alzheimer disease or other cognitive problems, maintaining routine is important. Any change in routine can lead to agitation and behavioural issues in these patients. Share simple facts about what is going on and give clear information about how to reduce risk of infection in  older people with cognitive impairment. Repeat the information whenever necessary. Instructions need to be communicated in a clear, concise, respectful and patient way. It may also be helpful for information to be displayed in writing or pictures. It will be also useful for caregivers of patients with dementia to take turns in looking after them to reduce the risk of caregiver stress and caregiver burnout. It will also be useful for caregivers to join online groups where they can share their concerns and other relevant information with similar caregivers looking after people with dementia.

Good Relationships Keep Us Happier and Healthier

Good Relationships Keep Us Happier and Healthier

“Good relationships keep us happier and healthier, period”. That’s what Robert J. Waldinger unequivocally says is the clearest message of the Harvard Study of Adult Development. It’s what may be the longest study of adult life that’s ever been done, having been started in 1938. The lives of 724 men were followed since they were then teenagers, a group which included men like former President of the United States John F. Kennedy.

Waldinger says they learned three big lessons about relationships. Social connections are apparently really good for us. People who are more socially connected to family, friends or the community are happier, physically healthier and live longer than those who were less connected. The experience of loneliness, he says, turns out to be “toxic”. People who are more isolated than they would actually like to be turn out to be less happy, with their health declining earlier in mid-life. Even their brain functioning declined earlier.

The number of friends and social connections you have also doesn’t mean much if the quality of those connections aren’t good. Living in a high conflict marriage is probably worse for you than getting a divorce. Waldinger found that good, warm relationships are “protective”. Searching for a predictor of health and happiness in old age, he found that it was the people who were most satisfied in their relationships at age 50 were the healthiest at 80. Even physical pain is magnified by the emotional pain of poor relationships, says Waldinger.

Good relationships don’t just mean that we will stay physically healthier. Good relationships also translate into sharpness of mind at old age. It turns out that being in a securely attached relationship in your 80s means that your memory will stay sharper, for longer, compared to those in relationships where they felt they could not count on the other person. Your marriage also doesn’t have to be completely smooth sailing. Even if you bicker constantly, what really matters is that you feel you can count on your partner.

It’s human nature to seek a quick fix to happiness, but the possibilities on how to foster good relationships are practically endless. And in doing so, you’ll probably have a lot of fun along the way. 

Come speak with one of our Relationship Coaches / Therapists and/or Family Therapists to help you facilitate the achieving of these goals.