As a couple therapist, the question I sometimes get is, ”Is my problem serious enough to warrant a therapist?”
I like to address this question in this article.
There are 3 key reasons why you’d want to see a couples therapist/relationship coach
When you have issues in the relationship that you’ve tried to solve but you’re unable to.
When you want to do a health check for your relationship
When you’d like to enhance your relationship
Prevention is better than cure and this applies to relationship as well. If you’re in a committed relationship and not married yet, nothing should stop you from finding ways to strengthen your romantic competence.
The majority of couples that I see now in my clinic are those with troubled marriage or also known as ‘relationship recovery’. Increasingly, I have more couples who decided to seek help and they are in under category 2 and 3. It’s highly encouraging for me to see this trend as younger couples are less affected by the stigma of seeking help.
In enhancing your relationship, what you can expect is the identification of possible conflict areas, assessment of your communication and conflict management skills, emotional regulation skills as well as the strength of your relationship. The former framework of therapy is based on looking at the problems and trying to fix them. What was missing is how to focus on what is good in the relationship and magnify and fortify those strength? This is equally important and it’s also more positive.
For ‘relationship recovery process’, the types of cases that I see include infidelity, being stuck in conflicts, poor emotional regulation which leads to avoidance of conflict and rebuilding trust and commitment.
There is a certain transition in life where relationship coaching or therapy is highly recommended. This is as follows:
Pre-marital: Before you make the lifelong commitment, you want to be ensured that your chances at staying married is as high as possible. You want to know what the non-negotiables are and learn skills that make the process of integrating your life smoother.
Transitioning to parenthood: While bringing a baby into a family is a happy occasion, it brings about a lot of stresses to the marriage. 2/3 or 67% of couples who transition to parenthood suffer a decline in their satisfaction of marriage. Help and support is available foryou to learn how you can mediate this and continue to keep the spark in the marriage alive.
Couples who have suffered child lost or have unsuccessful attempts at assisted reproduction.
Couples who are planning to adopt: You will want to know what are the expectations that you have of each other and what sort of rituals of connection you can establish so that you don’t lose sight of your own relationship.
When you have a child with special needs either physical, intellectual or mental: This additional stress could make or break the marriage and often times, couples place so much focus on the child that he/she ends up neglecting the partner. What you want to cultivate is the mindset “we against the world” rather than “I am alone in this marriage”.
Empty nest: There is an increase in marital break-ups at this stage because they have waited for their young children to grow up. The many years of emotional disconnection and busyness of life in caring for the children may have caused neglect to the marriage but it is possible to breathe a new lease of life to the marriage so that you can enjoy your golden years meaningfully.
Ultimately, relationship is hard work. You will need to consistently invest in it just like how you would a plant. You will need to Create an environment that’s conducive for the relationship to thrive; learn the skills that can help you connect better with your significant other and be intentional in what you want in the relationship.
So you are going to see a psychologist for the first time – now what should we expect? The thought of having to step into a psychologist’s room for the first time can be nerve-racking, and understandably so. Oftentimes, individuals may be apprehensive and would wonder if talking to a complete stranger is really going to help, or if opening up your innermost thoughts to a stranger was too much of a risk to take. However, rest be assured that these mental health professionals are well-versed in psychotherapy methods to help you manage your issues as best as possible, and will work closely with you at a comfortable pace. Just like in the treatment of physical illnesses by physicians, patient privacy and confidentiality are also primary obligations for psychologists. In this article, we hope to give you a clearer idea of what you can expect from your visit to a psychologist, especially if it is your first session.
First things first, it is important to understand that psychotherapy isn’t merely a one-off session. While the duration of treatment may vary from one person to another, the American Psychological Association (APA) reports that “recent research indicates that on average 15 to 20 sessions are required for 50 percent of patients to recover as indicated by self-reported symptom measures.” The type and duration of treatment also heavily depend on the nature and severity of each client’s conditions, and it would simply be unfair to make an overgeneralised statement. Regardless, it would be beneficial to go in with an open mind, and to have an honest conversation with your psychologist. It really helps to trust that the process works, while acknowledging that it takes time.
Meeting the psychologist
At the beginning, the first few sessions would aim to help one identify the most pertinent issue that needs to be dealt with. The psychologist will talk through with you gathering some information on your life history, your family’s mental health history, the problems you are dealing with, and analyse those details – no matter how insignificant they may seem at first – that could have possibly led to emotional distress or coping difficulties. For the psychologist, being able to get a good grasp of the situation and seeing the big picture is vital for formulating the treatment plan and treatment process, as it will help to determine the type of psychotherapy that is best suited for you. The psychologist is trained to listen and analyse your conditions in order to help you with your recovery. As such, it is equally important that you don’t hold yourself back from being fully honest with your psychologist. To a large extent, the patient’s participation in the therapy is an important determinant of the success of the outcome.
While we fully understand that it can be unnerving, these mental health professionals are trained to help you work through the challenges you face, and the therapy room is very much a safe, non-judgemental space. Goal-setting is one of the key aspects of psychotherapy, and it is exceptionally important to set goals from the start that you can use to track your progress. You may start by identifying personally meaningful broad motives, hopes and dreams – having a clear direction in mind will better steer future sessions towards alleviating symptoms of distress and tackling the root cause of one’s concerns. Don’t worry if you feel the need to change your goals or take a different approach halfway through the treatment process. Psychotherapy is a dynamic process after all, and increased self-discovery along the way can certainly give you a better sense of what needs to be changed.
Different approaches to psychotherapy
There are several approaches to psychotherapy that can be implemented in the following sessions. Not strictly limited to one or the other, psychologists may make use of psychoanalysis and psychodynamic therapies, cognitive-behavioural, interpersonal, and other types of talk therapy. They can help you focus on changing problematic behaviours, feelings, and thoughts to build on healthy habits, or teach you emotion-coping strategies to cope with your symptoms. Forms of treatment like cognitive-behavioural therapy also aim to help individuals recognise negative thought and behaviour patterns, thereby working towards a positive change. Each session is essentially a problem-solving session. By allowing yourself to talk to your psychologist about your most difficult moments, your feelings and the change you want to observe, the psychologist is then able to make use of his/her expertise to assist you. Many mental health professionals don’t limit their treatment to any one approach. Instead, they blend elements from different approaches and tailor their treatment according to each patient’s needs.
To make the most of the treatment process, “homework” may sometimes be assigned as between-session tasks to clients as part of your treatment. A variety of homework assignments exist – sometimes in the form of practising new skills, habits, and other coping mechanisms, or someone who is dealing with complicated emotions could be asked to record your negative thoughts in nightly journal entries. When you return for your next session, the psychologist would then check in on your progress, and address any issues that may have arisen while you were completing your tasks. For some clients the benefits of therapy can be achieved in a few sessions, while for other clients they might need more to improve. Empirical evidence supports the benefits of homework in promoting positive symptom change and increasing patient functioning, that is, the quality of a client’s participation in therapy through active application of what they learn will lead to improvements in their conditions.
Was the psychologist right for you?
Often during the conversation with the psychotherapist, or after the session, you may feel a sense of relief, elation, or anxiety and exhaustion. However you feel, it is important to take note of those feelings. Did the psychologist put you at ease? Did he/she listen to you carefully and demonstrate compassion? Did he/she develop a plan to guide you with your goals and show expertise and confidence in working with issues that you have? For the treatment to be effective, you need to be able to ‘click’ with the psychologist, that is you are able to build trust and a strong connection with your psychologist.
To end off, the first session with a psychologist is understandably a bit intimidating and overwhelming, but the first step in the journey to recovery is a critical step to regain your mental wellbeing.
Depression! It’s a common term for many things. “I feel depressed!”, “This is so depressing.” The medical definition of depression, however, takes a more definitive approach than just the typical expression of exasperation. If you display five or more of the above symptoms over a period of two weeks or if the symptoms cause clinically significant distress or impairment to normal functioning, there is a chance that you may be diagnosed with depression.
Is it that serious?
A study was done by IMH in partnership with MOH and NTU to find out about Singapore’s mental health. In Singapore, one in 16 people may have depression at some point in their lives. That is just one of the most common mental disorders in Singapore! The percentage of lifetime prevalence of depression has seen a steady increase from 12% in 2010 to 13.9% in 2016. What’s scary is that 3 out of 4 (78.4%) people with mental disorders are not seeking help!
To find out more about depression you can read our recent article: What Is Depression & How to seek help? So, what is CBT, and how does that help with depression? Glad you asked! Cognitive Behavioral Therapy, otherwise known as CBT, is considered the “gold standard” treatment for depression. It is a combination of cognitive and behavioral therapy that targets our limiting or unhelpful thoughts and behaviors which most of the time can be untrue to reality.
Normally the therapy takes 8-12 sessions where the patient and therapist work together to identify problem thoughts and behaviors. With that as a reference, the therapist will equip the patient with tools and techniques to change the way they think, feel or behave in the situation. The basis of this model is the assumption that a person’s thoughts, feelings, and behaviors are deeply connected. Thus, by actively taking part in changing the way we think or behave (which is honestly easier than changing our emotions), we can affect how we perceive certain situations that might have given us a hard time. Also, “homework” between these therapy sessions is useful to help practice the skills acquired during therapy.
That sounds complex and great but the big question is, does this work well for depression?
Well, over the last few decades there have been a plethora of studies to assess just how efficient CBT is. These studies have shown that CBT is not only effective but also produces solid results as a treatment not only for depression but also other mental illnesses! One study that has shown just how effective CBT would be is a study done by Hollon et al (2005). The study found that patients who underwent and withdrew from CBT were less likely to relapse than those who underwent and withdrew from medications. In another six studies, CBT combined with medications added a 61 lower relapse/ recurrence rate (Vittengl et al, 2009, in Otto, 2013).
To conclude, CBT is efficient and definitely better than not doing anything about our mental health. If you do want to seek help or learn more about CBT therapy, feel free to contact us.
Social media trends are constantly evolving in today’s information age.
Generation Z (individuals who are born between 1997 and 2012) are considered to be digital natives where they are surrounded by vast technological advances since birth (Seymour, 2019). In contrast to other generations like the Millennials (those born between 1981 to 1996) and Generation X (those born between 1965 to 1980), Generation Z grew up with social media, smartphones and rapid information sharing (Seymour, 2019).
There are many different types of social media and some examples include social networking sites, dating apps, gaming apps, blogging or vlogging platforms. Globally, the top ten most used social media platforms are Facebook, YouTube, Facebook Messenger, Instagram, WhatsApp, Twitter, LinkedIn, Pinterest, Snapchat and Skype (Global Web Index, 2020). One of the latest additions includes TikTok, an app that comprises short entertaining videos created and enjoyed by younger users.
Impacts on youths
Given the increasing popularity of social media in recent years, it is undeniable that social media plays an important role in our society today. Social media provides a new lens for people to exchange information and interact with others. As youths enjoy their social connections with peers on social media platforms, the increased use of social media will likely pose a risk to their mental health and well being where they will feel anxious, depressed, lonely and the fear of missing out (FOMO) (Robinson & Smith, 2020). Youths also tend to compare their realities with other people’s best moments in which depicts an inaccurate representation of a person’s overall life (Robinson & Smith, 2020). Besides, youth may experience cyberbullying from others on social media platforms. As a result, youths will likely experience low self-esteem and psychological distress, anxiety or depressive symptoms.
Parents and teachers can assist youths by emphasising their youths’ values and strengths in relation to the different aspects of their lives in order to help them navigate the labyrinth of social media platforms. In addition, parents and teachers can focus on recognising signs which youths may exhibit when they are victims of cyberbullying such as social withdrawal, changes in mood and avoidance towards discussing their online interactions with others. Youths can also be encouraged by parents and teachers to seek counselling support if they find it difficult to manage unpleasant feelings related to their social media use. Please make an appointment to speak with one of our health professionals (a psychologist or counsellor) should youths require counselling support.
There is often much confusion between the terms psychiatrist and psychologist. People may use these terms interchangeably, but this is not to be the case. While both psychiatrists and psychologists treat people suffering from mental health issues and behaviour disorders, they are not the same. When should I see a psychiatrist? Is psychiatry and psychology even the same thing? Who should I see first? Such thoughts may run through your mind when mental health treatment is brought up. In this article, we hope to clear the doubts and achieve greater clarity on who they really are and how they differ.
Before we begin, if you’re reading this article to find important insights on seeking help from a mental health professional, we would like to commend you for taking the necessary steps to help yourself or your loved one. Making such a decision can be very daunting, and your mind might be in a disarray with constant worries of familial, societal and cultural stigma. However, it is ever so important to remember that there is no shame or embarrassment in wanting to help yourself or your loved one get better. Mental health is equally as important as physical health and seeking help is a sign of strength rather than weakness.
What’s the Difference Between a Psychiatrist and a Psychologist?
Fundamentally, the biggest difference between the two is in the approach they take towards treating mental disorders, and the capacity to prescribe medications. Unlike psychologists, psychiatrists are trained medical doctors at their core. Amongst the network of mental healthcare professionals, psychiatrists are certified to provide neuropharmacological support that is deemed essential in stabilising certain mental conditions, such as where chemical imbalances in the brain are involved.
As medical doctors, psychiatrists play a crucial role in the diagnostic process, as well as the prevention and treatment of emotional, mental, behavioral, and developmental issues. While conducting assessments, they may also involve relevant physical examinations, blood tests, or pharmacogenomic testing to narrow down the scope of diagnosis. While psychiatrists specialise in the mental phenomena, such physical examinations cannot be omitted entirely especially if they provide important clues to help them rule out other possible physical conditions.
Psychiatrists also have the capacity to assess your medical history. Physical and mental wellness go hand-in-hand – psychiatrists will need to grasp the full picture before finalising on a diagnosis. On the Huffington Post, Carol W. Berman, M.D., a clinical assistant professor of psychiatry at NYU Medical Center in New York City, writes, “Because we learned how the body interacts with the mind, we can rule out physical disorders as a cause of mental illness. This is important, since a person may have a hyperactive thyroid, for example, which can trigger panic attacks, anxiety, insomnia, or anorexia. We can look at thyroid blood tests or have a patient consult an endocrinologist if we suspect the problem stems from thyroid disease.”
In contrast, psychologists are not trained medical doctors, and thus cannot conduct any physical examinations nor prescribe medications. Clinical psychologists however, possess an accredited Master’s in Applied Psychology at the very minimum, and can make a diagnosis for the patient if he thinks he has a mental health condition.
Psychologists typically make use of various methods of psychometric testing, personality tests, observations and interviews to come to a conclusion. But that’s not all – psychologists also engage in psychotherapy treatment, with common forms including cognitive behavioural therapy (CBT). Psychotherapy aims to help clients identify their key issues and concerns, before moving on to create a treatment plan to achieve the desired outcomes. Often conducted over several sessions, psychotherapy equips the individual with problem-solving and emotion-coping strategies to overcome the problem. For example, if a client comes in hopes of seeking help for social anxiety, psychotherapy (such as CBT) would be greatly beneficial in tackling maladaptive, limiting thoughts and behaviours that fuel negative emotions.
While there are differences in qualifications and the methods of treatments applied by psychiatrists and psychologists, it is key to note that they still work closely together. For the optimal treatment of certain mental health conditions, psychiatrists may refer you to psychologists for concurrent psychotherapy. Likewise, if a clinical psychologist determines your condition to be better managed with medications, a referral to a psychiatrist can be expected. Often once a proper diagnosis is done, the psychiatrist and psychologist may work together to build a treatment plan for the patient, focusing on managing symptoms through the use of medications and psychotherapy.
Who Should I See First?
Where physical symptoms may be severe, or where it may be hard to take basic care of yourself, turning to a psychiatrist would be a good option. After all, psychiatrists are trained medical doctors who can also work with your primary care doctor (if any) to provide optimal treatment. It is also suitable for individuals who are unsure as to whether their physical symptoms are linked to other underlying medical conditions. In such cases, psychiatrists will be able to detect a medical mimic. To put it simply, take for example a presenting complaint linked to the shortness of breath. While it may seem like a panic attack, it is crucial to eliminate any other clinical suspicions of lung diseases such as pulmonary embolism.
On the other hand, you may choose to make a trip to see a psychologist if you think you have a less severe mental condition. For individuals seeking to overcome phobias or resolve difficult issues in life, it may be more effective to undertake psychotherapy. A Psychologist can help you work through your problems, deal with emotional challenges or cope with particularly traumatic life events so as to make positive changes in your life.
We can all play a part in alleviating our own or our loved one’s suffering by increasing our understanding of mental health disorders. If you’re still struggling with making a decision after much thought, making the first step to contact a professional would help. You can be assured that the team at Promises will serve with your best interests at heart, and will work closely with you to provide optimal treatment.
Spare the rod and spoil the child – is this a sensible justification for the use of physical punishment in disciplining a child? What is discipline really all about? To some parents, discipline is associated with corporal punishment, such as by caning, slapping or spanking. In extreme cases, it may include forcing hot sauce into a child’s mouth as punishment for swearing. Sometimes, it becomes difficult to draw the line between reasonable corporal punishment and physical abuse.
Not many parents will admit that they cane or spank their kids. But a survey conducted by an international research agency YouGov found that close to 80 percent of parents in Singapore adopted such physical means of punishment. Does caning still have a place in modern-day parenting? In some way or another, we are all shaped by different life experiences, cultures and familial backgrounds. It shouldn’t be a surprise that we each possess differing opinions and perceptions. Some of these parents themselves may have been parented under strict and harsh supervision, where they had grown accustomed to physical forms of discipline and do not view them to be problematic. However, there is an increasing need to recognise that the act of disciplining children can take on many other forms. While we do not have the right to correct your teaching methods, we hope to convince you, as well as other parents out there, that corporal punishment is not the only mean to teach a child good behaviour.
Why Corporal Punishment Isn’t The Best
We acknowledge that parenting isn’t easy. When your toddler “accidentally” smashes that one precious family heirloom, or when your underaged teenager gets caught for drinking, you might fly into a rage and rush to pick up the cane. However, corporal punishment has been proven to be ineffective and potentially harmful. It may serve its purpose of an immediate response to an undesirable behaviour and to curb it temporarily, but it will leave a long-lasting psychological mark on your child. As published in numerous research journals, physical punishment may bring about more harm than good. Let’s break it down:
Deteriorating Relationships Consider the message that you’re sending your child as you’re hitting him. While you may think nothing of it in a fit of anger, your child may – whether subconsciously or not – internalise that he is unworthy of love, or that he is worthless. Over time, this will also strain your relationship with your child.
Increasing Your Child’s Susceptibility to Mental Disorders Physical aggression often ties in with psychological aggression. At the end of it all, your child may develop a flawed belief that using violence to achieve desired results is completely acceptable. Not only does corporal punishment increase a child’s aggression, it may also lead to antisocial behaviour, as well as other mental health disorders. Long-term use of violence against a growing child can lead to the development of depression, anxiety, personality disorders, as well as intellectual disabilities. In particular, it may also cause a downward spiral of your child’s self-esteem.
Failing to Induce the Desired Behavioural Change
Corporal punishment does not develop compliant behaviour, it simply stops undesirable behaviour temporarily. This may give parents a false sense of security, and trap them into thinking that they’ve successfully steered their children away from unwanted behaviours. However, the reality is that children may only stop immediately for the fear of being punished further. There is always a chance for such behaviours to return. Assuming your teenager picks up a bad habit but is afraid of being punished, she may instead resort to various means of hiding it from you. As you can see, the unwanted behaviour isn’t eradicated at all.
By now, you’re probably curious about how you can encourage behavioural change more effectively without physical punishment. Here, we’ll share some useful tips in regards to educating your child the right behaviour.
When your child misbehaves, you can consider withholding or removing certain privileges from him. This is certainly less harmful psychologically and physically as opposed to spanking him. For example, if your child leaves his toys lying all over the bedroom floor, you can opt to confiscate them for a day or two. Do note that this will be particularly effective if the consequence is directly linked to the unwanted behaviour. In this case, it wouldn’t be ideal to punish the child by banning TV time for a day.
Needless to say, positive reinforcement plays a huge role in disciplining your child too. If your parenting style solely includes punishments and no rewards, your child may grow up feeling resentful, unhappy and lack a sense of self-worth. Be equally generous with praises and rewards when deemed fit – balance is key! If possible, you may also tie in a reward system with a certain behaviour that you want to encourage. Let’s say you want your child to develop a habit of returning home no later than 10pm. The consequence for not sticking to the curfew may be grounding her for the next two days. However, if your child adheres to the rules and returns home by the stated curfew for the entire week, perhaps you can reward her for being responsible and consistent. This could mean giving her an additional hour out during the weekends, or bringing her out for her favourite meal.
One major issue with corporal punishment is that apart from inflicting physical and psychological harm, it does not direct your child towards the desired behaviour. Discipline should be aimed at teaching. Ensuring your child learns from the event and to correct themselves in the future is what really matters. With that said, sometimes teaching them new skills can go a long way. If your child throws temper tantrums, teach him how to calm himself down and to deal with his frustration instead of spanking him. Such problem-solving and emotion-coping strategies will certainly help your child to build emotional resilience as well.
The environment around us can influence the way we grow and behave too. If you have children or teenagers at home, lock the cabinets to the heavy liquor. If you want to foster a non-gambling home environment, keeping items such as poker cards away from sight can also be beneficial. Small changes to the surroundings can have more influence than you may think, and will also prevent the need for any serious punishment.
Above all, it is necessary to be consistent with what you say and encourage your children to do. Be consistent with the rules you put forth and stand your ground, it is important for a child to know that the consequences and rewards aren’t selectively enforced. Guiding children away from misbehaviour can be a tough feat at times, but just as you’re about to reach for the cane, we hope you’ll think twice.