COVID-19 has posed a challenge to everyone, and those more physically vulnerable in our community clearly need our care and attention.
There are also people whose mental vulnerability deserves equal care.
Mental illnesses such as depression, anxiety, and addictions are exacerbated by a pandemic crisis in multiple ways.
Collective family and community fears are (in themselves) contagious; and the constant bombardment of medical and financial bad news, can leave those with mental illnesses lost in a cascade of negative rumination and catastrophising.
The mentally ill and people with addictions commonly have compromised immune systems, and suffer stress or substance, tobacco and alcohol abuse related diseases – leaving them wide open to severe pneumonia with acute respiratory distress symptoms – and other complications from COVID-19.
Isolation, separation and loneliness – caused by working at home and social distancing – are perhaps the worst contributors to: low mood; agitation; irrational fears; moments of panic; self-disgust; resentment; anger; and even rage.
People whose ability to pause, use reason and find practical solutions can be severely compromised. They may find themselves bereft of the motivation, and ability to engage in even the simplest tasks of self-care.
Added to this, listlessness, boredom and frustration can lead to despair. Then self-harm and suicidal thoughts may arise, take hold, and even overwhelm them.
Those in recovery or active addiction may also turn to their compulsive and impulsive behaviours of choice, to sooth and find momentary respite from the moods and thoughts that have hijacked their mind. Triggers, urges and cravings may become relentless and unbearable.
The solution may begin with finding a way out of isolation.
Starting the journey out of this darkness can start with talking to people who can demonstrate unconditional positive regard, show kindness and compassion, and help reframe the situation. Such people can assist those suffering to put a name to and validate their emotions.
In short – therapy can help!
In times of COVID-19, working with a therapist via teleconsultation can be effective using ZOOM, Skype, WhatsApp video and FaceTime.
Although the calming and soothing sensation of the physical presence of a therapist is absent, for those in isolation – distraught with shame and despair – Internet enabled therapy can prove a lifeline.
Isolation can be further broken, using similar Internet methods, by attendance in recovery groups such as Alcoholics Anonymous, Narcotics Anonymous and Sex and Love Addicts Anonymous – all of whom now hold Zoom meetings in Singapore.
These Zoom opportunities in Singapore are supplemented by Zoom, Skype and telephone conference meetings in Hong Kong and Australia (in Singapore’s time zone) and in the U.K. and the US (during our mornings and evenings).
Having broken the isolation, the second step therapists can provide is guidance and motivation towards self-care. This would include tapering or abstinence from the addictive substances or behaviour. A well thought through relapse intervention and prevention plan, specifically tailored to a person’s triggers, will also assist.
Triggers may be particular places, situations, people, objects or moods.
The acronym “HALT” is often used by those in recovery; which stands for the triggers of being: Hungry; Angry; Lonely; or Tired.
When these triggers arise, people are encouraged to
HALT their behaviour;
breathe deeply, with long outward breaths;
think through consequences;
think about alternatives;
consult with others; and
use healthy tools to self-soothe.
Daily mindfulness, meditation, exercise, sleep hygiene, healthy eating and following a medication regime are important aspects of self-care – and for some suffering mental illness – these actions – and time – may be all they need to find their footing again.
Luckily, the Internet gives a vast array of possible self-care options, including things to distract us, soothe us and improve us.
Everything is available from: calming sounds and music; guided meditations; games; home exercise, yoga and tai chi; self-exploration and improvement videos; video chats with loved ones; to healthy food delivery options. They can all be had with a few keystrokes.
Today we live at a time when suffering from mental illness and addictions is commonplace. But we also live at a time when the solutions are literally at our fingertips – if we only reach out for them.
DO I HAVE A SEX ADDICTION? IS MY PARTNER A SEX ADDICT?
These questions become urgent when your or your loved ones’ repeated sexual behaviour cause you acute distress.
It may be that you feel empty, frustrated, anxious, depressed or ashamed by your behaviour. Or you may be a loved one who suddenly discovers their partner is sexually acting out, and you feel betrayed, angry, raging, resentful, humiliated, confused or depressed; and have nagging doubts about your own adequacy as a partner. You may be worried for your children and your family life. Your health – or your finances – may be in serious jeopardy.
Not all sexual behaviour that causes you or a loved one suffering is a sex addiction – even if the suffering is profound and long lasting, or the behaviour is considered by others “deviant” or even “risky”. However, if it amounts to an sex addiction, there is a solution in recovery, and a loved one can play an important role.
It is therefore important to know – is it an addiction? Once sexual behaviour is persistent, it sometimes becomes impossible for a person to know whether their behaviour has become compulsive, obsessive, impulsive or even dangerous or intrusive. People can become confused.
“There is a way through – and that is to take a clinical assessment and discuss the results with a professional therapist, trained in interpreting them. “
Is the behaviour continuing because they consciously choose not to change? Is it just “normal”, “natural”, “justifiable”, or “cultural”? Is it the loved ones or others who are mainly at fault, because they can’t or won’t give the sexual intimacy needed? Is it just “temporary” or “a one off”.
Is it just a product of some unusual circumstances – such as being in a new country, starting a new job, having a baby, going on business trips, or feeling bored, stressed, anxious, lonely, isolated, neglected, or depressed?
If the behaviour has been persistent for a period of time, a person may think that it is safer than it really is, or that the risks of being found out, and the consequences, are minimal, manageable and within their control.
Sometimes a person my think that their chosen sexual partners are freely consenting, or that they enjoyed the experience – but the truth is otherwise.
Sometimes a person may lie, cover up, tell half truths and keep silent about their behaviour, because they want to protect their loved ones. They may not be willing to admit to themselves or others that they mainly wish to avoid the painful consequences of their behaviour.
After a while, they may even become confused or uncertain about what the real truth is. Being persistently deceitful and living a double life, can become a crushing burden.
There are a number of assessments available online. However, some are not thorough or confidential enough, or they cause unnecessary alarm. Many do not provide a clear interpretation; and some do not provide a path towards a workable therapeutic solution.
The International Institute for Trauma and Addiction Professionals (IITAP) provide Certified Sex Addiction Therapists (CSATs) with an anonymised, online questionnaire, called the “Sexual Dependency Inventory – 4.0”. It takes a client 2 hours or so to complete, and a confidential, detailed client report is automatically generated for the therapist to view online – and subsequently share it with the client.
The report compares the client’s responses with the responses of many thousands of other respondents, both with and without sex addiction, to gauge whether the sexual behaviour and preoccupation are likely to indicate a sex addiction.
The report provides the client and therapist with a thorough review of the client’s: sexual behaviour and preoccupations; the consequences; the possible origins of the behaviour; and the potential future course and direction of the behaviour.
The report also helps the client articulate their motivation to change their behaviour.
This report is coupled with a subsequent clinical interview session, that assesses: sexual, medical and psychiatric history; family of origin history; education and employment history; intimate and social relationships; and other information. Together, this information permits clients and the therapist to determine the next steps.
If the client’s behaviour is likely to amount to an addiction, the recovery path has been clearly mapped by the IITAP programme; and CSATs are trained and skilled in helping client’s navigate through their recovery using workbooks, videos, books, articles, and other therapeutic interventions.
The recovery path engenders great hope for those who start on it. Life gets better quickly, and keeps getting better with each recovery step that is conscientiously taken.
What causes the greatest suffering is not knowing. Am I a sex addict? Is my partner a sex addict?
Contact us today to take a free clinical assessment.
HMI Institute of Health Sciences in support of the FestivalForGood (organised by raiSE) invites you to join us for hands-on experiences on caregiving through training simulations and fun activities. Some takeaway knowledge include:
Knowing how to create a safe home environment for your aged parents/grandparents
Safe feeding skills for Caregivers
Understanding Caregivers’ stress & preventing/relieving these stresses
Understanding how your aged parents/grandparents feel
Recognising illnesses & emergencies
Simple skills on CPR
-and many more!
Our Career Coaches will also be around to assist you with information on our training programmes and career services.
Date & Day: 05 August 2017 (Saturday)
3 Sessions: 9:00am · 11:00am · 1:00pm
Venue: HMI Institute of Health Sciences @ Devan Nair Institute for Employment and Employability, 80 Jurong East Street 21, #06-03, Singapore 609607
The increasing prevalence of media multitasking among adolescents is concerning because it may be negatively related to goal-directed behavior. This study investigated the relationship between media multitasking and executive function in 523 early adolescents (aged 11-15; 48% girls).
The three central components of executive functions (i.e., working memory, shifting, and inhibition) were measured using self-reports and standardized performance-based tasks (Digit Span, Eriksen Flankers task, Dots–Triangles task). Findings show that adolescents who media multitask more frequently reported having more problems in the three domains of executive function in their everyday lives.
Media multitasking was not related to the performance on the Digit Span and Dots–Triangles task. Adolescents who media multitasked more frequently tended to be better in ignoring irrelevant distractions in the Eriksen Flankers task. Overall, results suggest that media multitasking is negatively related to executive function in everyday life.
As I mentioned in my first article, the phrase,”reverse roles” was very much what I heard at my first psychodrama workshop. As this was uttered by the group leader, two people on the stage switched places and began playing the opposite role.
“This is it! “, I thought as I began to think of how I could use it in my work. Get people to reverse roles and voila! Well I was sorely mistaken those many years ago. As I began to explore this fascinating form of group work I discovered several techniques that are used in Psychodrama. Here are two key techniques used and an example of how I used them.
Here the Protagonist says a few words in the role of a particular ‘character’ or entity in their drama. The Auxiliary then says these lines to the Protagonist who is in the complimentary role.
In this technique, objects and people are used to represent the scenario the Protagonist wishes to explore.
A Drama using Role Reversal and Concretization
Ken is aged 19, and has a serious problem with drugs and alcohol which he has managed to stop, after going to the alcohol treatment centre. He had just come out of drug rehab in the United Kingdom and was brought to my practice by his concerned father. His father had tried very hard to help him over the years and has now brought Ken to us at Promises. Ken is worried about going out for dinner with his Father and a family Friend, whom we shall call Andy, because he might be tempted to drink again.
I encourage him to enact a scene at dinner with his father and Andy, playing out what he expects to happen. He sets out the chairs and chooses two people in the group to be his Father and Andy. As he greets the two older men rather lethargically, his shoulders slouch and he speaks in a flat voice.
Reversing roles, Ken now plays the part of Andy. He perks up now, smiling and full of energy. ‘Andy’ says, “The last time I saw you Ken, you were a small boy. My how you’ve grown!” Playing the role of his tempter, he urges Ken to “have a drink now as a real man” holding a glass towards him.
Back to being himself after another role reversal Ken’s face reddens and he clenches his fists in agitation. He speaks to me as the Director, saying that he is afraid he might have a relapse. I immediately ask him to take on the role of his father.
As his father, he sits with his arms crossed and says through clenched teeth, “It’s okay, you don’t have to drink. I don’t want to cause a relapse.” As himself, Ken is at a loss for words. I ask the other audience members to do some modeling and try different responses in the role of Ken as he watches.
Ken cheers up as he sees the other group members rising to the occasion. Everyone is animated as they get a chance to act the part and try to tell Andy off. There is much laughter and hilarity as people do and say whatever they think might work. A sort of role training session is underway.
Ken is noticeably inspired by the group and he chooses one response. He stands tall with a cheeky smile and says to Andy, “I’m not drinking today, and I wonder why you are so determined to force alcohol on me!” In role reversal as Andy, he changes the subject and backs down, no longer the magnanimous host. The drama ends. Ken is no longer a deflated doomsday worry wart. Instead he is positive about going out for dinner and knows what he can do later that night at dinner. The group has come to his aid and I once again marvel at the magic of Psychodrama.
In future articles, I shall illustrate more psychodrama techniques with dramas I have directed. It continues to be a privilege to be allowed into the lives of group members and I am continually amazed at the transformations that happen.
At Promises Healthcare, we are committed to helping you through your journey to recovery. Discover a new life and find renewed hope. If you or someone you know needs mental health support, please contact our clinic for inquiries and consultations.