As we celebrate World Mental Health Day (10/10), I pause to remember the patients/clients whom I have worked with in the past 17 years. I want to recognize and honour their courage, resilience and grit in continue living even though it is so hard.
I am heartened that there are more open conversations on mental health compared to a decade ago. Earlier this year there was even the inaugural Singapore Mental Health Film Festival. More sufferers are willing to step forward courageously to share their stories to encourage and inspire fellow sufferers. All of these efforts are pointing in the right direction and we should persist.
What makes mental illness so painful is the shame that individuals feel; the fact that they are less than, inadequate, weak and worthless. Society has not arrived at a place where we can talk about it as openly as our physical health. At least, no one is hesitant to get a medical certificate from a general practitioner but one from Institute of Mental Health, no way!
How can we reduce the stigma of mental illness?
I have one suggestion that I like to propose and it is as follows:
we need to start sharing our “failure” or “screwed up” stories.
Every person undergoes challenges in life and experiences deep pain for various reasons. For someone who suffers from mental illness, the natural thought is that “I am alone in this. Everyone but I can deal with life.” He/she looks around and sees “successful” people who seem to have it all and feel demoralised.
We, the supposed “successful” people have in some way perpetuate the stigma of mental illness by keeping silent and not share our pain openly.
Recently, I shared with a client of my struggle with anxiety and she was surprised because outwardly I appear mostly calm and confident. I believe my story gave her hope that if my therapist can overcome and learn to manage her anxiety, so can I.
The challenge that I want to extend to everyone is this: share your struggles, not just your victory.
When something painful is a common experience, there isn’t a need to hide the secret any longer and we can better support one another. Truthfully, all of us has some form of dysfunction; it is only a matter of degree and how well we manage it.
I shall walk the talk and share the times when I felt like a failure.
· After getting a scholarship to come to study at a top Junior College, I did so poorly for my promo exam that I was put on probation. That was my first taste of failure as I had been an excellent student up until that point. My self-esteem took a hit and I seriously considered quitting school and return to my hometown. I persisted.
· The first year of my marriage was really tough. It caught me by surprise as we had a wonderful courtship and seemed to get along really well. We went through several challenges, including my brain surgeries and stroke. I was left confused and disillusioned. The upside of it is that I started to learn more about what makes relationship work and I ended up discovering my call and passion.
· Infertility. As we looked forward to expanding our family, we received bad news after bad news with each visit to different specialists. I seriously felt that perhaps something was wrong with me that I was not good enough to be a mother. After 4 years, we had wanted to give up when our miracle baby came along.
· The years that I was a trailing wife, I lost my sense of identity and I watched my peers moving ahead in their career and life while I was trying to figure out what I wanted to do with my life at age 32. I couldn’t let go of the narrow definition of success. I was a nobody. It took me 3 years to re-calibrate and find my voice and I started my blog- Winifred & You, Flourishing Together.
The above wasn’t easy to write; it’s not what we usually do and it feels risky and uncomfortable.
That’s the challenge; are we ready to share and reveal the pain that we too keep in our hearts?
To de-stigmatize mental illness, we need to acknowledge and embrace authenticity and vulnerability. As long as we breathe, we hurt. We fall and we rise.
Let’s share our resilient stories so that everyone else will be inspired to do the same. In so doing, we kill shame because it no longer has a hold on us.
A question that I was asked recently is “how do I know when my relationship is ailing, and that intervention is needed”? In other words, what are the warning signs that you should watch out for in order to take actions? Let’s examine the following:
1. Lack of awareness, interest and knowledge
A strong and healthy relationship is one where both partners care and pay attention to what’s going on in each other’s life. Failing that, you lose the moments when you can connect and the sense that you are cherished is absent. When you are clueless and do not care about the external and internal world of your partner, it is a clear sign that your relationship is ailing.
2. Feeling lonely in the relationship
There is an increase in feeling unappreciated, invisible and a lack of connection with your partner. You behave more like a housemate (and co-parent), and the conversations that you have are mostly functional. You can’t remember the last time you have a meaningful dialogue, much less feeling cared for. You start thinking the worst of the other and there is a negative sentiment override that signals trust is broken.
3. Living a parallel life
Parallel lives happen when you no longer do things as a couple. Work may take you on many business trips and even when you’re back home, you and your partner have your own activities. Even though you live in the same house and sleep on the same bed, there is minimal communication and intimacy. This emotional distance and disengagement is a very hard place to be, a clear warning sign.
4. No physical intimacy and sex
While there are periods of time when healthy couples do not actively engage in sex, it is a problem when one partner feels that the need is not being met. He or she feels frustrated and rejected to the point of resentment. Open communication is missing to express what lies behind the hurt and when this is not forthcoming, the relationship is in trouble.
5. The waiting games
Unlike earlier days of the relationship where one partner (or both) was proactive in showing affection, expressing gratitude or initiating a date, the attitude now has changed to “why should I do it when he/she doesn’t bother?” The benefit of a doubt that you used to give to your partner is now replaced by suspicion and negative sentiment. The attitude is that of “I don’t want to risk getting hurt or rejected by taking the first move.”
6. Comparison and keeping scores
As a social being, there is a great tendency to observe what other couples do for each other, compare them to what you and your partner are doing and feeling resentful about it. This behavior is detrimental because you stop seeing the good in your partner and start focusing on what is lacking. Expecting your partner to behave like your friend’s partner isn’t going to compel him/her to behave the same way. In fact, it conveys the message that “you are not good enough” and that’s hurtful.
7. Stop being kind and respectful, and contempt is present
You might have heard that familiarity breeds contempt. Many at times, the people closest to us get the worst treatment. Instead of making requests, demands and complaints are being made. You stop minding the “please and thank you” and start taking your partner for granted. When your spouse feels that you’re kinder to everyone else but you, something is wrong with the picture. Treat your partner as you would your best friend. Relationship experts have found that the biggest predictor of divorce is contempt.
8. Forgetting your love story and dreams.
Couples who are deeply in love remember details of their relationship. This is important as it strengthens the commitment they give to each other. These details become fuzzy when you stop giving attention to them. As the memory of your relationship starts to wane, you forget what brought you together and the dreams that you’ve shared. When that memory is gone, it is easier to give up on the relationship because it is no longer meaningful.
Please seek help by (reading up, speaking to trusted friends, seeing a relationship coach or couples therapist) should you have more than half of the warning signs. A relationship is like a plant that needs to be nurtured and it suffers when no attention is given. You reap what you sow.
If there are topics that you’d like me to address, please email me your suggestion at [email protected] See you there.
My partner says his sexual behavior is normal – but he is hiding it and I know something is wrong. Am I crazy? What are the signs of compulsive sexual behavior disorder?
Partners of people with sexual compulsivity often come to the clinic in great distress.
They have just learned about the latest infidelity, daily Internet porn use, visits to Orchard Towers, massage parlors or KTV lounges. The images accidently left on the family computer may be shocking or alarming.
Perhaps they have discovered condoms in the person’s luggage after a business trip, unexplained expenses on their credit cards, and unexplained absences from their hotel rooms late at night when they tried to call the person. Childrens’ birthdays, graduations and family celebrations may be mysteriously abandoned for “essential” business trips.
Partners may notice strange messages or nude photos on the mobiles; or perhaps odd phone calls at night, that seem to make the person excited or embarrassed. They may come home intoxicated at 3:00 am, after a night out with colleagues, with unexplained credit cards slips in their pockets for hundreds or thousands of dollars. They may find an STI clinic report.
The person acting out will likely try to vigorously “manage” all this fallout with their partners.
They may rationalize, minimize, intellectualize, normalize – or simply lie, to explain away all this overwhelming cumulative evidence. They may “gaslight” their partner, making them think they are crazy.
And it may work…for a time.
Meanwhile partners may feel: shocked; rejected; confused; angry, even rageful; anxious; and depressed. They may even blame themselves and feel inadequate as a partner and ashamed.
They may: become irritable, angry or overly anxious with their children; stop doing things they enjoyed, stop seeing people; forego self-care and grooming; or try to become overly sexual and breach their own boundaries to save the relationship.
They may become sleepless, without appetite and lose weight – or over eat and gain weight; and they may use medication and alcohol to numb their emotional pain. They may keep getting flus and colds that refuse to go away; or chronic backaches and neck aches that make sleep or activities painful.
The shame may be crushing.
Some partners may have experienced earlier traumas in their own childhood or adulthood, in which emotional and sexual or other physical abuse, neglect and rejection were prevalent. The acting out person’s behavior may therefore trigger strong trauma reactions, and lead to bonded relationship traumas, resulting in self-harm or even attempted suicide.
How can a partner respond when they get a feeling something is not quite right?
If they can persuade the person acting out to undertake a clinical assessment, the person will be able to understand that their behavior has become a serious self-destructive compulsion, and that they need treatment.
Even if the person won’t attend therapy, the partner can take an assessment of the extent of their trauma, and the role of the person acting out. The partner can then receive sex addiction treatment, and explore the options for the family. Do they stay or go?
Promises Healthcare Pte Ltd. provides therapy for both those with compulsive sexual behavior and their partners, so that together they can find a way out of their suffering and plan a better future for their families.
“My partner’s sexual behaviour has left me devastated – should I stay or should I go?”
Many clients come to therapy wondering whether they should leave or stay, after they have discovered their partner’s infidelity, or other compulsive sexual behavior. This may include a combination of: serial affairs at work; Internet pornography; sexual massages; use of sex workers; and use of anonymous dating Apps. Excessive alcohol, drugs and workaholism may also be involved.
Even though the behavior is intolerable or very risky, and causing great suffering – there may often seem compelling reasons to stay.
Young children may be involved. If the acting out partner has been a “good enough” parent, the children will suffer greatly if they leave. Further, the burden of parenting the children alone may seem too much.
The client may worry about the family finances – that they may not be able to support themselves and their children if the partner withholds money or does not agree to split the money appropriately.
The client may have to return to their country of origin and may not be able to bring the children with them, if their partner contests this.
Leaving may cause the client great shame, particularly with their family, friends and work colleagues.
The client may fear loneliness; or may ardently fantasize that things will get back to the way they were – eventually. After all, the couple may have a long, shared history, and may have weathered many other difficulties together.
Starting with a new relationship in future may be as daunting as living alone forever.
Some clients may be so angry and resentful, that leaving may seem like the partner getting away it. Leaving may appear like giving the partner a license to continue their intolerable behavior – unchecked and unavenged. It may result in the partners frittering the family money away.
Friends and family may be unhelpful – full of directive and conflicting advice. Clients may be ashamed, or too anxious of the reaction they will receive to even share about their suffering.
If the partner is assessed for a compulsive sexual behavior disorder and subsequently undertakes recovery; and the client works in therapy on taking care of themselves; learning and growing from the experience; and improving their relationship – there may still be hope in keeping the family together.
Ultimately, both need to work on themselves and the relationship, if it is to be saved.
There has been a growing awareness of the need for mental health wellness in corporate work settings. For one, employers are recognizing how work stress negatively impacts an individual’s job performance and productivity. According to a survey reported by Forbes, 31% of responding employees experience extremely high levels of stress at work, thereby affecting productivity and innovation. Thus, as reported by the Straits Times on 25 March 2019, companies have started to view wellness programmes not only as an employee benefit or responsibility, but also as performance strategy for the company.
today’s world, such work stress seems inevitable due to competition,
cost-cutting measures, and the intrusion of work into our personal lives
through technology. Few cope well with sustaining these increasing demands and
pressures in their work place. Thus, companies that are committed to
safeguarding their employees’ mental wellbeing are empowering them with tools
to manage their stress at work.
tools are available at Promises Healthcare through our Employee Assistance
Programme (“EAP”). The EAP is premised on the belief that mental health has a
direct correlation to the performance and productivity of the employee.
Appropriate outlets for employees to address their psychological concerns can
help alleviate stress, leading to a positive and more balanced mental
disposition. This in turn will contribute more effectively towards the goals of
has developed and provided EAP services for a number of major corporations over
the years. EAP services include Employee Training Packages, Critical Incident
Intervention, Critical Incident Consultancy for Senior Management, Media
Information Management, Individual and Group Counselling, Confidential Helpline
services, and Family Support programmes.
customer references include present and past clients, such as the Ministry of
Health, SCORE, IMH, MSF, Singapore Prison Services, SAMH, Singapore Red Cross,
NTU, NUS, Ngee Ann, Temasek Polytechnic, Singapore Polytechnic, La Selle School
of Arts, Singapore Police Force etc.
has also been actively providing EAP services to the Singapore Press Holdings,
Exyte Singapore Pte. Ltd., Monetar Authority of Singapore, Connexion Asia,
Carrot Consulting, Allianz Prudential, MSIG, ANZ bank, IMDA, AVA Singapore,
Defence Science and Technology etc.
Do you have a persistent pattern, over 6 months or more, of being powerless over controlling intense, repetitive sexual impulses and urges, which result in repetitive sexual behaviour? Has this behaviour made your life, and the lives of loved ones, unmanageable?
As with other addictions, the disorder results in neglecting health and personal care, family, work and other responsibilities.
Typically, those with this compulsive behaviour have made numerous unsuccessful efforts to significantly reduce it – but it continues, despite severely adverse consequences.
Clinicians qualified in sex addiction treatment use validated and reliable questionnaires and detailed clinical histories to assess clients, in order to determine whether they have a sexual behaviour disorder. These clinical tools have high sensitivity in detecting the disorder.
There are also clear therapeutic protocols to assist a client into and through recovery, substantially reducing the risk of reoffending behaviour.