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How Do You Find The Right Therapist For You

How Do You Find The Right Therapist For You

For many individuals, therapy is a rather intense and personal topic, and it could have taken them a lot of courage to finally seek the help that they need. Keeping this in mind, it is exceptionally crucial that one finds the right therapist, for there’s a pre-existing implicit clinical belief that the level of treatment effectiveness is greatly dependent on the therapist-client fit. Of course, every client would love to be able to – ideally – find that one therapist whom they can fully open up to from the very beginning, but in reality, that may not be the case. At times, it is necessary to assess your relationship with your therapist and evaluate if there’s the good rapport you need for your sessions to be a success. Ultimately, it boils down to whether you feel a steady, reliable and safe connection with the therapist, and whether you are making the progress you hope for. 

To give you some background, studies over the years have shown that the more similar the therapist and the client, the higher the rate of recovery. As an example, an assessment instrument entitled the “Structural Profile Inventory(SPI)”, which measures seven “independent yet interactive” variables (behaviours, affects, sensory imagery, cognition, interpersonal, drugs/biological factors or BASIC-ID), showed that client-therapist similarity on the SPI predicted a better psychotherapy outcome for the client as measured by differences pre- and post-treatment on the Brief Symptom Inventory. Moreover, the demographic similarity between therapist and client facilitates positive perceptions of the relationship in the beginning stages of treatment, enhances commitment to remaining in treatment, and at times can accelerate the amount of improvement experienced by clients. More precisely, it can be said that age, ethnicity, and gender similarity have been associated with positive client perceptions of the treatment relationship. With gender and cultural similarities appearing the most strongly preferred among clients, these domains generally enhance clients’ perceptions of their therapists’ level of understanding and empathy, and as a result, sessions are judged to be more advantageous and worthwhile. However, besides these, there are also other means to assess your “fit” with your therapist, and we’re here to discuss just that.

First and foremost, consider if you are seeking help in the right place. Does the therapist you are looking at specialise in the area you are seeking help for? Before we can even touch on the topic of interpersonal therapist-client fit, it is important for you to take the time to do some research on various therapists’ profiles – in other words, to sift through and read up on their respective areas of expertise. Typically, therapists would have their area(s) of specialisation up on their online profile directories. It would be clearly indicated if they specialise in areas such as substance abuse, family therapy, or even anger management. It goes without saying that, for example, it would be inappropriate to consult a psychologist who specialises in child psychology when you’re clearly looking for someone who can help you with your substance-use addiction. With that said, it is to no one’s benefit for you to rush into therapy blindly. 

Once you have chosen the potential therapist that you are most likely to want to have see you through your road to recovery, another essential question you should ask yourself is whether you are comfortable with their suggested mode of therapy. During consultations, you will have the opportunity to enquire about their recommended techniques or treatment methods that will be explored during your subsequent sessions. If you are uncomfortable with any particular process, giving honest feedback and exploring other methods is always an option. However, at any point, you also have the right to seek other therapists who may be able to help you in other ways that don’t put you in a tight spot. After all, therapy is all about having a safe and comfortable space for you to sort out your difficulties. 

When assessing your interpersonal connection with your therapist, make sure to trust your gut. This way, you’ll also be able to track your progress better and to seek alternative help if required. Some questions you can ask yourself are:

  1. Am I satisfied with the current balance of talking and listening with my therapist?
  2. Is my overall therapy experience safe, warm, and validating? 
  3. Am I fully assured that I’m in a non-judgemental space where I can be fully honest?
  4. How much has the therapist helped me to gain greater insight into my own behaviour and thoughts so far? 
  5. Am I becoming more capable of coping (independently) with stressful or triggering situations over time?
  6. Am I noticing more positive changes in myself, as compared to when I first started therapy?

As mentioned, a major deciding factor should also be on whether you find yourself noticing positive changes in your thought cycles and behaviour after a couple of sessions. At the end of the day, therapy should be about working towards achieving your desired outcome, and should definitely not be limited to weekly venting sessions. Although venting and letting out hard feelings can provide temporary relief, it fosters a client’s dependence on the therapist over time and further reinforces the client’s problems. Therapy should instead help you to feel more confident that you’ve developed the relevant skill sets in order to cope with whatever emotional challenges that brought you to seek therapy in the first place.

Naturally, there’s no guarantee that we will find chemistry with the first therapist we meet. The chemistry between people varies, and sometimes it’s just not possible for us to force it. Thus, it is important to remember that a lack of fit between therapist and client is no one’s fault. However, remember that the ball is in our court, and it is within our control to start looking in the right place for the sake of our own well-being.


 1 Herman, S.M. (1998). The relationship between therapist-client modality similarity and psychotherapy outcome. Journal of Psychotherapy Practice and Research, 1998 Winter; 7(1): 56-64.

2 Luborksky, L., Crits-Christoph, P., Alexander, L., Margolis, M., & Cohen, M. (1983). Two Helping alliance methods for predicting outcomes of psychotherapy: A counting signs vs. a global rating method. Journal of Nervous and Mental Disease, 171, 480-491.

3 Jones, E. E., (1978). Effects of race on psychotherapy process and outcome: An exploratory investigation. Psychotherapy: Theory, Research and Practice, 15, 226-236.

4 Blase, J. J. (1979). A study of the effects of sec of the client and sex of the therapist on clients’ satisfaction with psychotherapy. Dissertation Abstracts International, 39, 6107B-6108B.

Beutler, L.E., Clarkin, J., Crago, M. and Bergan, J., 1991. Client-therapist matching. Pergamon general psychology series, 162, pp.699-716. (Accessed 30/08/2020)

https://www.counsellingconnection.com/index.php/2019/12/03/assessing-therapist-client-fit/ (Accessed 30/08/2020)

https://www.nytimes.com/roomfordebate/2013/02/14/think-like-a-pope-knowing-when-to-quit/when-to-quit-therapy (Accessed 30/08/2020)

Photo by Cytonn Photography on Unsplash

Emotional Self-Regulation: The difference between having a controlling behaviour and having self-mastery

Emotional Self-Regulation: The difference between having a controlling behaviour and having self-mastery

For someone who struggles with emotional self-regulation, what does having a “breakthrough” mean? A “breakthrough” could mean coming to a point of realisation and acceptance of one’s mental state, and taking a step forward to change his/her seemingly challenging behaviour. To achieve this, we’ll need to learn the art of self-mastery in order to transform our emotions, attitude and most importantly, our behaviour. 

Let’s not beat about the bush – the most pivotal factor to attaining self-mastery is for the person in question to understand that he/she needs to take charge of his/her own thoughts, emotions and actions. The model of self-mastery dictates that we should acknowledge and accept that we are the ones who are responsible for changing our own life experiences. It is often said that we are each the author of our own lives, in which we live in whatever we create. At any point in time, we should always be open to learning life skills to deal with whatever life presents us, instead of resisting or reacting against it. We should learn to control what happens to us by exercising creative control over the circumstances that we throw ourselves into. Without the will to take charge and make the relevant changes, this “breakthrough” would, unfortunately, be a tough feat.

There is a difference between control and self-mastery, and it is crucial that we internalise this. Oftentimes, people with mental health conditions tend to display controlling behaviours of themselves or others. To put it succinctly, controlling behaviour arises when we compel others to change their behaviour to cater to our own experiences of life. On the contrary, self-mastery means transforming our own behaviour in order to change our own experiences of life. Practising self-mastery implies that we adapt to what life presents us, instead of quitting or getting emotionally erratic when things become challenging. This involves learning new life skills that we have yet to master in order to carry us through frustrating tough times and eliminate controlling behaviour. Controlling or manipulative behaviour often emerges from within ourselves whenever things don’t go as we expect. We victimise ourselves and push the blame towards others or life in general for what was presented so as to “correct” the situation.  The truth is, when you feel that people aren’t showing you the gratitude or appreciation that you deserve, the fault is not with them. In actual fact, you are exhibiting a need to control – to bring your current life experiences to fit your idealised version of it. For individuals with disruptive emotions and impulses, self-mastery may not come easily to them, as a result of the dysfunction of their self-regulation skills. Yet, this doesn’t mean that it is entirely impossible. 

Self-mastery means not allowing our past negative experiences to affect our present and future. It is not easy to undo those past experiences, as they are like deep-seated stains on our clothes that cannot be removed. However, we can choose not to wear those clothes again. It is hard to pick up anything new if our hands are full of burdens. Making peace with our past by letting go, forgiving or even forgetting, will give us space for an untarnished and more objective approach to our present and future. Practising self-mastery also includes being mindful of how you interpret an event in a way that reduces the negative thought or completely replacing it with a positive one. This psychological strategy can be understood by looking at a glass and asking yourself whether it is half full or half empty. Instead of focusing on the dark clouds, we should change our interpretative lens to uncover the silver lining. For example, instead of envying your friend’s success, you should see your own failure as a temporary detour and not a dead end. 

Being mindful of our actions and reactions helps us see them for what they are so as to reign in any impulsive controlling, or difficult behaviour. Truth be told, we have all displayed difficult behaviour at times, which as a result, might have caused us to burn a bridge or two. However, the display of fluctuating emotions may be a regular occurrence for some individuals who may not know how to work towards a “breakthrough”. In this case, only if we are mindful of our behaviours can we be less reactive and better able to reframe our perception of our current experience in a less emotional and upsetting manner. With practice, we will slowly become better at creating that space which will then allow us to choose our reactions rather than just reacting out of habit or impulse. Of course, this, in turn, leads to happier and healthier relationships, ultimately improving our mental state of health as well. 

Last, but not least, a crucial step in developing self-mastery is to start with self-honesty and truthfulness. Do some self-reflection. That is, have an honest assessment of your own strengths and weaknesses, as well as owning up to your problems. When you are able to identify your weaknesses, you will be able to direct yourself better to what needs to be worked on and the relevant life skills you’ll need to master in order to find a breakthrough. In contrast, focusing on your strengths will also help boost your self-confidence, and act as a motivation for you to work towards making the change you need (i.e., self-improvement). If it helps, attend a peer support group. Peer support groups are built on shared personal experiences and empathy – it focuses on one’s strengths and helps you work towards your mental health and happiness goals. At the same time, it comforts you that you aren’t on the road to mental resilience and self-mastery alone and that there are many out there like you. Don’t be afraid to reach out for professional help too, for it could very well be the push you need to help you achieve the breakthrough you desire.

 


Photo by Annie Spratt on Unsplash

Tanya Curtis, Control vs Self-Mastery: A Key to Lasting Change for a Person with a Mental Illness, video recording, Mental Health Academy
<https://www.mentalhealthacademy.co.uk/dashboard/catalogue/control-vs-self-mastery-a-key-to-lasting-change-for-a-person-with-a-mental-illness/video> (Accessed 16/06/2020)

 

An Interview with Dr Mark Toh: The Effects of COVID-19 On Dreams

An Interview with Dr Mark Toh: The Effects of COVID-19 On Dreams

 

Amrita Kaur, a journalist from the Straits times interviewed Dr Mark Toh, Consultant Clinical Psychologist about the effects of COVID-19 on dreams. Parts of the following interview was published in the Straits Times on 13 July 2020. 

 

Here’s the interview in full: 

  1. Dr Deirde Barrett, assistant professor of psychology at Harvard Medical’s department of psychiatry, who has studied the dreams of survivors of the Sept 11 attacks, said people tend to have an increase of bizarre, emotional and vivid dreams after crises (such as Covid-19). Can you share your thoughts on why you think this happens?
  2. Some people dream about sanitisers, face masks and toilet paper. Why such particular items? 
  3. What exactly is happening in our subconscious (when we sleep) during periods of stress? How does that manifest in our dreams?
  4. Will such dreams affect the quality of one’s sleep? Why or why not? 


Answers
:
Nearly all trauma survivors experience some type of trouble sleeping such as insomnia. But for anywhere from half to three-quarters of people, it is vivid dreams that make it difficult to sleep soundly. Having flashbacks to traumatic events, also called re-experiencing, is a hallmark symptom of post-traumatic stress syndrome (PTSD). For half of PTSD patients, those flashbacks occur at night while sleeping. Some people have nightmares that are exact replays of the trauma that they experienced, and these are called “replicative nightmares.” Others have nightmares that are related to the trauma indirectly or symbolically. Trauma and stress can disrupt your sleep in many ways. It can set off your body’s fight-or-flight response, and ramp up production of neurotransmitters that keep you awake and vigilant when it is time to sleep. 

The items sanitizers, face masks or toilet paper may be dreamt about because they represent perceived solutions to address the threat of being harmed by Covid-19. Our psyche (our human mind or soul where we deliberate consciously and unconsciously –judge, think, feel– in relation to our sense of self and our sense of reality) is highly concerned about safety and security and therefore, when a threat is perceived, we consciously and unconsciously move in search for items or avenues that promote and restore our sense of safety. 

There are several theories about the role of dreams in our sleep. In the event of stress, it suggests that our unconscious is working overtime in search for safety or to be settled with what may be traumatic, distressing or are reasons for anxiety. Stress is a disruption to our equilibrium and is communicated as an emotional and physiological alert. Because our psyche does not like to be unsettled or be disturbed, we tend to work consciously and unconsciously to settle what may be threatening or disturbing towards safety.

Yes. Trauma and stress can disrupt your sleep in many ways. It can set off your body’s fight-or-flight response, and ramp up production of neurotransmitters that keep you awake and vigilant when it is time to sleep.

 

  1. Dr Rose Gibson, a research officer at the Sleep/Wake Research Centre at Massey University in New Zealand, said that while some dreams can be confusing or distressing, dreaming is normal and considered helpful in processing our waking situation. Can you comment on this?

Answer:
Dr. Gibson is correct. Dreams are a normal part of our sleep. Dreams have been described as hallucinations (defined by Oxford as “an experience involving the apparent perception of something not present”) during certain stages of sleep. They are strongest during REM (rapid-eye-movement) sleep, one of the four stages of sleep. But dreams are thought to have other functions as well: 

    • Dreams are sometimes engaged in settling what is unsettling or disturbing as already mentioned,
    • Since the psyche is particularly concerned about safety and security in the daytime, dreams can represent an unconscious search to address the threat in overtime when sleep is intended. One of the areas of the brain that is most active during dreaming is the amygdala. The amygdala is the part of the brain associated with the survival instinct and the fight-or-flight response. Because the logical part of the brain is less in play in contrast to the emotional during dreaming. Nightmares may reflect attempts to address our fears or to prepare to deal with anticipated threats in waking life.
    • Dreaming may reflect our muse as it facilitates our creative tendencies. A person can be awakened by great ideas for a movie or song that has been deliberated on during awake hours. The awake period could also involve psychological defenses at play such as denial or suppression that prevent certain ideas from emerging. In dreaming, these filters are not as active so that suppressed ideas or fears often emerge then.
    • Besides sorting through complicated and unresolved events or anticipated fears, dreams are also suspected in aiding the storage of important memories and getting rid of unimportant memories as a part of our need to process information triggered during the awake period. Learning new information and being able to sleep on it facilitates recall of lessons learned.
       

 

  1. Do you think extra sleep, or lack of sleep, might contribute to vivid dreams related to Covid-19?

Answer:
Dreams can also be affected by certain health conditions that result in sleep deprivation. Sleeping issues that cause a lack of sleep, such as insomnia and narcolepsy, can increase one’s risk of experiencing vivid dreams. Changes to your sleep schedule, such as flying overseas (and going to sleep at a different time) or getting less sleep than usual, can also increase this risk. Those who are sleep-deprived can lead to parts of the brain being much more active so when they finally slip into REM sleep they are likely to have more vivid dreams. They are also more likely to recall their dreams too.

 

  1. It seems that people are having better memory of their dreams now (An ongoing study at the Lyon Neuroscience Research Center in France found that “the coronavirus pandemic has caused a 35 per cent increase in dream recall among participants, with respondents reporting 15 per cent more negative dreams than usual). Why are people having a better memory of their dreams?

Answer:
The brain during sleep is involved in information processing where unnecessary information is eliminated and important short-term memories are moved into our long-term memories, and dreams occur during this process. As such, some people may recall dreams with a difference in their ability to memorize things in general. Also, memory is affected by recall. Memories that are repeated as perhaps a sign of preoccupation or paranoia are more accessible. 

 

  1. Have you noticed any of your patients having problems with sleeping specifically related to Covid-19? For example, if they are worried about the number of community cases the next day and this worry keeps them up at night, they fear for their jobs, etc? 

Answer:
Difficulty sleeping because of Covid-19 concerns is not a common complaint among my patients. This may be suggested by them not feeling threatened by the risk of infection, or that they feel they are coping with this threat, or that they are not in jobs or situations that are being threatened by the pandemic. 

 

  1. Have any of your patients experienced any dreams related to coronavirus and such fears? If so, can you share what some of such dreams are? 

Answer:
None of my patients have reported dreams related to the coronavirus to me. Those who are more likely to be reactive to the coronavirus are probably those who are vulnerable to anxiety such as those who are obsessive-compulsive in nature.

 

  1. According to National Geographic, Italian researchers found that people stuck in lockdown experienced nightmares that bear similarities with someone going through post-traumatic stress disorder. Can you comment on this? 

Answer:
The hallmark symptoms of PTSD are exposure to a traumatic event; re-experiencing the event or intrusive symptoms (flashbacks); avoidance of people, places, or things that serve as a reminder of the trauma; negative mood and thoughts associated with the trauma; and hyper-vigilance. Trauma is experienced when the perceived threat is overwhelming or life-threatening that leaves a victim feeling numb, helpless, disconnected and having difficulty trusting. Since this article in question is reported by researchers from a particular country (Italian), one has to question the scope of the study. Is the study about the traumatic response to the lockdown found across different countries or is it reported specific to a particular region or town in Italy? It is unclear if the reported trauma is in response to the lockdown itself (which is usually activated as a preventive measure to protect against infection), or that the attempt at lockdown is seen as inadequate because the infection rate is already at such high numbers so that the lockdown is perceived as irrelevant or ineffective. As such, there may be the existence of an extraneous variable to explain how those in lockdown could have experienced this action alone as traumatic. At the same time, once the specific group is defined in the study, the results of the study may be explained by a high and pre-existing inter-dependency on this community to cope together as the norm such that restricting communal support disrupts their coping. Subsequently, imposing personal isolation, which is otherwise highly unusual, is therefore experienced as traumatic. The people in this community feel cut off from a regular method of coping which relies on their dependence on each other.

 

  1. Is there anything people can do to try to control what they dream about? If so, what?

Answer:
This depends on whether they view these dreams as distressing. If trauma is indicated or they could represent disturbing experiences in their past or their present, or difficulties at coping at their anticipated future, I would suggest they seek professional help from those familiar with psychodynamic psychotherapy. Dreams are problematic usually only if they are associated with nightmares or sleep disruption. To sleep better and avoid nightmares or sleep that is not restful, the above factors should be reviewed. In particular: (a) ensure that there is adequate sleep scheduled to avoid sleep deprivation, (b) observe their diet since some studies have found that meals high in sugar, spicy foods, or high in starch, too much alcohol, eating excessively and late are associated with higher reports of nightmares, (c) address reasons for anxiety, (d) address unsettled emotional issues such as trauma or abuse, and (e) develop good sleep hygiene practices. Additional steps can include practising mental relaxation before sleep, recording their anxieties somewhere so that they can resume the next day to avoid rumination of what is worrying when sleep is planned or plan for guidance or support to address the worrying on the next day so they can relax at present.

 

  1. There are some people who have difficulty sleeping due to anxiety about the economy, they worry about losing their jobs and the future. How common can this be, and what can people do to relax their mind before they sleep? Now that people are working from home, some are taking naps in the day. Should this be encouraged? Why or why not? Does this make it harder for them to sleep at night? 

Answer:
For those who tend to have difficulty sleeping because of worries about employment or their future, insomnia is a common occurrence. Some even have chronic insomnia. Various studies worldwide have shown the prevalence of insomnia in 10%–30% of the population, some even as high as 50%–60%. It is common in older adults, females, and people with medical and mental ill health. The consequences of insomnia are significant, such as depression, impaired work performance, work-related/motor vehicle accidents, and overall poor quality of life. The reasons behind insomnia are varied. If the problem of sleep is persistent, they should consult psychiatrists or clinical psychologists. If they are anxious, sleep disruption is a common symptom of poor coping. As such, they should see a mental health professional. But if the question is how to promote good sleep for the average person where the sleeping problem is only recent, consider developing good sleep hygiene practices as a start. The following practices are recommended by the Sleep Foundation:

    • Limit daytime naps to 30 minutes
    • Avoid stimulants such as caffeine and nicotine close to bedtime.
    • Exercise to promote good quality sleep.
    • Steer clear of food that can be disruptive right before sleep.
    • Ensure adequate exposure to natural light. 
    • Establish a regular relaxing bedtime routine. 
    • Make sure that the sleep environment is pleasant.

Since more people are working from home, they should limit their nap time. Their difficulty sleeping at night may be indicative that if they had naps during the day, their nap times may have become excessive. The objectives of those working at home should ensure that they maintain a healthy work-life balance. It is important at this time of disruption and uncertainty over a pandemic that we establish goals to maintain good physical and mental health consistent with building our resilience to cope with the unrelenting demands of living effectively in the present and in the future.


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Overcoming The Fear of Failure

Overcoming The Fear of Failure

At its most elemental level, people avoid the risk of failure for one simple reason – it hurts. Every single person has experienced failure. If you were to interpret failure by its definition in the dictionary, “the neglect or omission of expected or required action”, wouldn’t you, as a child, have stumbled along the way to achieving those long strident steps you take when strutting along the sidewalk? Yet, nobody feels ashamed of failing to learn to walk as a toddler. Why’s that? You could say that no-one in the right mind would expect that of a human child – we aren’t deer, or gazelles that need to shake off the afterbirth and walk – or risk predation. Our success as a species which put us at the top of the food chain negates that need. Fear is a function of the amygdala, yet failure isn’t. There’s a distinction here that we need to be mindful of. If you’re a parent or have access to YouTube, you’ve probably noticed that there’s an innocence in children that can be quite uplifting to watch, as they try multiple times to succeed at a simple task. They don’t puff their cheeks out and sigh in despair, or bury their heads in their hands. At most, they demonstrate frustration.

Shame is learned behaviour that children integrate into their developing moralities, either from being taught or through observation. Studies done on athletes have shown that perceived parental pressure (or pressure from authority figures) have deleterious effects on how sportspeople experience and interpret failure. Simply put, the fear of failure is a construct of how societies function. For some people, the avoidance of shame that failure brings weighs too heavily on them, and that is the crippling fear of failure. Dr Guy Finch puts this rather more succinctly: “fear of failure is essentially a fear of shame”. How then, do we begin to become more self-aware in the face of these deeply ingrained avoidance mechanisms to start building our best selves?

Evidence-based science suggests that the most efficient way to bring oneself out of the debilitating spiral of negative self-talk – one of the most insidious culprits in perpetuating avoidance based behaviours that stymie growth – is Psychotherapy method, Cognitive Behavioural Therapy (CBT). 

After all, overcoming fear of failure is all about reversing negative thought patterns, and Cognitive Behavioural Therapy (CBT) is designed to help you identify the underlying belief that causes a negative automatic thought (which in turn guides the feelings that come with it).

With the help of a qualified mental health professional, which can be anyone from a trained psychologist, psychotherapist or even psychiatrist, you can be empowered to break the circuit of the pervasive vicious cycle of negativity that prevents the unfettering of fear of failure’s heavy chains.

For instance, think of each deeply held criticism that you can’t let go of as a block in a Jenga game with your friends and the tower represents your thought life as a whole. Even though you’ve suffered through failure after failure, you can’t seem to jettison them from your psyche. Can you imagine a game of Jenga that doesn’t end in peals of laughter? It seems that some re-evaluation is needed to turn the way you handle each soul-sucking gut-punching failure from the darkness of your room. The grip of negativity steadying your trembling hand, an extension of your mind, putting each block up on autopilot because you believe you are not good enough. Instead, we suggest turning the lights on, invite someone you trust into your sanctum of despair, to play the game of Jenga with you. As you ease into their presence, you’ll begin to notice that the tower doesn’t look so intimidating anymore. It’s no longer just a congealed mess of all your shortcomings and toxic thinking, but a simpler thing that can be deconstructed. If each block represents a negative conviction you have about yourself that is too painful to touch, reach for the piece that looks more well-shorn and polished (which represents a perceived positive character trait or accomplishment that you hold dear). Put it back on top of your tower. It is yours, isn’t it? Or perhaps let your confidant handle that splintery block. 

Of course, we all know that Jenga isn’t all laughter and grand gestures. There’s physical tension and the cogitation of making the right choice so the tower doesn’t crumble prematurely. Maybe you aren’t too good at Jenga. That’s fine. But if you start thinking of this special game of Jenga as a collaborative effort instead of a competitive one, you’ll start getting the picture. Who would you like to invite to collaboratively play a game of Jenga?

 

 


  1. Sagar, S and Stoeber, J. Perfectionism, Fear of Failure, and Affective Responses to Success and Failure: The Central Role of Fear of Experiencing Shame and Embarrassment. Journal of Sport and Exercise Psychology, 2009, 31, pp 602-627.
  2. https://www.psychologytoday.com/sg/blog/the-squeaky-wheel/201306/10-signs-you-might-have-fear-failure. Accessed 2/6/2020.
  3. Photo by John Moeses Bauan on Unsplash
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