Breast & Ovarian Cancer

The shock of the diagnosis. The uncertainty of treatment, results or mortality. The feeling of everything being out of our control.  

But first… 

What is Breast Cancer? 

A kind of cancer that begins as a growth of cells in the breast tissue. Abnormal breast cells grow out of control and form tumours.  

Breast cancer usually occurs in older women above 50 but can also affect men and younger women. In Singapore, breast cancer is the most commonly occurring cancer among women, accounting for 29.7% of all cancers diagnosed in females. 

What is Ovarian Cancer? 

It occurs when abnormal cells in ovaries or fallopian tubes grow and multiply out of control. It may originate from the ovary or more commonly from nearby structures such as fallopian tubes or the inner lining of the abdomen.  

Ovarian cancer usually occurs in older women above 60 who are in the menopausal stage but can also affect younger women. In Singapore, ovarian cancer was 4.4% of all cancers diagnosed in women from 2016-2020. It is the 5th most common cancer in Singaporean women. 

Mental Health Challenges 

Here are the moments that women may struggle the most in the cancer journey:  

6. Awaiting follow-up results  

• Waiting for the outcomes of follow-up tests 

7. Survivorship phase (Life after diagnosis or treatment) 

• Persistent guilt (about family, children, responsibilities) 

• Fear of recurrence 

• Diminished self-esteem 

• Problems with social acceptance and body image 

• Difficulty in re-entry into previous life 

• Perceived and actual loss of employment and insurance discrimination 

• Concerns about infertility 

8. Symptom recurrence 

9. Facing end of life 

As treatment goes on, distress heightens (with all the physical and social impacts too). It is then no surprise that these can culminate into anxiety, depression, PTSD, or other conditions. 

1. Before diagnosis  

• Noticing a concerning symptom  

• Anxiously awaiting test results 

2. Initial diagnosis  

• Receiving the news of the diagnosis for the first time 

3. Anticipating treatment 

• Waiting to learn about the recommended treatment plan  

4. Leaving the hospital  

5. Completion or adjustment of treatment  

• Fear of finishing a treatment course   

• Adapting to a change in the plan 

How to Cope, Psychologically 

Receiving a diagnosis is never easy. The shock and distress can be overwhelming, and we might not know how to cope with such complicated emotions and thoughts.  

Yet, how we feel, think and cope with the diagnosis and treatment can greatly affect our physical health, treatment progress, adherence and recovery. So let’s take time to prioritise ourselves – physically and mentally.

Here are some ways to cope better: 

1. Find your support pillars 

Lean on those trusted friends and family, they tend to be the reasons we keep going even in tough times. 

Many have also gone through the same journey, and we do not need to fight cancer alone. Consider the links below to find communities of like-minded individuals who may share the same struggles as you:  

• Singapore Cancer Society 

• Women’s Emotional Health Service (WEHS) 

• BCF Support Groups (for breast cancer) 

• Cancer online resource library  

  2. Look back within 

How are you feeling? What emotions can you pinpoint exists? Was it fear, anxiety, shock, anger, regret, or hopelessness?  

What about your thoughts about this journey – from diagnosis to treatment? What do your thoughts tell you about… 

• Cherished things and people 

• Personal hopes and dreams 

3. Stay engaged, moment-to-moment 

We know we bring up mindfulness often, but bear with us. When time seems limited and more precious than ever, we often want to capture and “stay” in the moments we cherish the most.  

This speaks to a part of us that wants more presence, and connection to what is going on around us. To do so, we need pause, observe and engage.  

Here’s our guide to being more mindful (general tips are at the bottom of the article). 

4. Show kindness to yourself 

Your pain and suffering is valid. Your feelings are valid. The journey is not easy, and there is little that others can do to make it easier on us.  

 Yet, how do we respond to our pain and emotions? What our pain and emotions often need is soothing. Like a mother soothing a child in pain, aim to soothe the pain and emotions within you. Here are some ways to soothe and be kind to yourself: 

• Cry it out 

• Calming music or smells  

• Visualise a place that is calming to you  

  • Sunsets, starry night sky, pet café, comforts of a bed or bath 

  • Focus on your 5 senses  

• Repeat personal mantras  

  • “I can do this” 

  • “I got this” 

  • “Take it easy” 

  • “This will pass” 

People differ in how they cope with difficult emotions and painful situations. There is no “best” method here, so find ways that you are comfortable with and personalise your recovery journey in your own way.  

“It is during our darkest moments that we must focus to see the light.” – Aristotle 

How to Deal with Procrastination

“Do I really have to start this task now – maybe in ten minutes...or tomorrow?”

(Fast forward a week later and an hour to the deadline, you realised you barely started on the task – screams panic!) 

Procrastination is a common experience that we deal with on a daily basis, something some of us are guilty of (this author included) - you are not alone! While procrastination may appear harmless, it could be debilitating for some as they struggle to break free from the cycle of procrastination. If you find yourself in this situation, reading on may be helpful to navigate around procrastination.  

Identify Underlying Causes 

Before you embark on breaking the cycle of procrastination, it is important to understand why procrastination happens in the first place. People procrastinate for various reasons. Some individuals hold high standards of their work and fear not being able to achieve that level of perfection. Others may lack motivation to start a task or may have hit the work slump. Identifying the underlying causes or possible triggers of your procrastination could help in developing practical strategies that will be most helpful for you. 

Strategies to Manage Procrastination 

1. Setting Realistic Expectations 

   How do you know when your expectations need to be adjusted? If the task is either too easy or too challenging to the extent that it demotivates you from starting, it is an indicator that your expectations should be adjusted. With a realistic expectation, one would be able to gain the necessary motivation to work on their task and complete it within the given timeframe.  

2. Breaking Tasks Down 

   Complicated and heavy tasks can be overwhelming and it is often easier to push them to the bottom of the to-do list. However, putting them off may often lead to increased stress due to accumulating deadlines. One simple strategy could be:  

   • Breaking down the task into smaller, achievable steps. For instance, instead of attempting to write a 1000-word essay in a single day, break it down into writing 200 words per day. 

3. Scheduling 

   On the contrary, some individuals may find it challenging to meet deadlines when tasks are broken down into smaller steps. They may find that it extends the timeframe of task completion. As such, it could be helpful to schedule a realistic timeframe and allocate how much time is needed for each task. This can be done in the following ways:  

   • Write out a timetable of any existing or new tasks.  

   • Ensure sufficient time is allocated to complete the tasks at hand. 

   • Carve out extra time for any revision or edits. 

   • Time yourself (if necessary) to gauge how much time you actually take to complete tasks.

   • Scheduling also facilitates efficient time management as it holds us accountable and eventually prevents tasks from piling up. 

4. Challenging Unhelpful Thoughts 

   In some cases, people procrastinate due to thoughts of performing poorly or they fear criticism of their work quality. These thoughts are also known as 'unhelpful thoughts' as they hinder any progress on tasks, fuelling procrastination. To address this, try challenging these thoughts by seeking evidence against them or reframing them. For example, you could ask yourself: “Have I received any negative feedback that supports my current view about the quality of my work?”  

   Finding alternative and balanced thoughts may not come easy to all and if you find it difficult to challenge these thoughts on your own, you could consider seeking support from trusted family members, mates or professionals.  

5. Minimise Distractions 

   Keeping your workspace clean and minimal of possible distractions can be beneficial.  You may consider working or studying alone rather than in a group as it may be counterproductive if you are easily distracted.  While some find listening to music helpful to maintain focus, others may be easily distracted by any form of sound. Understanding your own preferences is important in creating an environment conducive to productivity.  

As tempting as it is to say, 'I know what I need to do, and I'll start tomorrow,' it is best to find your prime time and attempt your tasks when you are at your optimum! Breaking the cycle of procrastination is not an easy journey, but with consistency (and doing what works best for you), you will gradually get better at managing it.  

5 hygiene hacks when a shower is just too much

I haven’t showered in days. I know I need to but I can’t get up.  

Showering can feel like a daunting task. Mentally, we’re drained, so it’s not a priority. But we need to clean ourselves for the sake of our physical health. Not only is showering a part of basic hygiene, but it can also improve our self-esteem and even help us relax. The next time a shower is too much for you, try any of these 5 hacks. 

1. Take a seat 

We don’t have to be standing in the shower! Try using a stool or shower seat. Make sure everything – soaps and showerhead - is within arm’s reach. 

2. Set the mood 

Taking a shower may not be something we look forward to. Try pairing it with something fun, like watching your favourite drama. Lying in bed with your phone? Turn on your shower playlist first, and sing along while you soap up.  

3. Take baby steps  

Undressing can feel like the biggest first step of the shower. If you’re not ready, keep your clothes on. Start by washing your face, or washing your hair over the sink. Smaller steps are still steps in the right direction! 

4. Take the shortcut sometimes 

When getting into the shower is too impossible, go for alternatives. Opt for dry shampoo and wet wipes, and use a leave-in conditioner. 

5. Set a goal 

Set a goal for the week. Whether it is taking one full shower or just washing your hair, make it a point to work towards that goal. Reward yourself with a treat after you have accomplished it. You can even get a friend to keep you accountable. 

Taking a shower is a form of self-care. Let’s remember to celebrate the little steps we took – whether it was washing our faces, turning on the shower head, or taking a whole shower! 

Not Knowing how to Live vs Wanting to Die

Why are we here and where do we go after? Thinking about life and death is human.   

At some point, we might feel lost – we don’t know how to live. How is this different from wanting to end our lives?  

Not knowing how to live 

I don’t know what to do with my life. 

Many of us have these thoughts when we face a turning point. We could be going through change and making decisions – like leaving school, starting a new career or losing a family member.  

We feel uncertain as life presents us with a blank slate. With no clear purpose, we are confused. This turns into what is commonly dubbed as an “existential crisis”. This period can feel highly distressing, as we continue to have unanswered questions. 

What can we do when we don’t know how to live? 

• Explore our passions and continue our hobbies 

• Expand our horizons: Read widely and talk to people 

• Know and acknowledge our strengths 

• Accept that this is a period of uncertainty 

Wanting to die 

While we could consider feeling lost to be a normal part of life, it could turn dangerous. Without the plan and intention of ending our lives, the desire to die or no longer exist are considered passive suicide ideation. This signals that we have overwhelming emotions and pain, and we’re in desperate need of relief. 

Passive suicide ideation is a warning sign. Likely, there are underlying issues that we need to address. These challenges don’t just fade away over time. In fact, they can lead to active plans for death. As such, it is best that we pay attention to our thoughts, and get the help that we need. 

What can we do when we want to die? 

• Call the Samaritans of Singapore (SOS): 1-767 

• Talk to someone 

• Consider therapy 

• Make a safety plan: Decide and write down what we will do to keep ourselves safe when we want to die. 

Our existential crises may not be entirely bad – it hints at us to reassess what we’re going through. Perhaps some redirection and exploration can help us find meaning in our lives. But our alarm bells should ring when we find ourselves thinking of dying to relieve our pain. In this case, we can reach out to the available support around us – whether it’s talking to friends, family or professionals.  

Coping with Social Anxiety at the Dining Table

Sit. Eat. Chat. Sounds simple enough, right?  

Yet, for those with social anxiety, joining a meal can feel excruciating. We are confined to a spot, and everyone is focused on each other. However, eating together is a good way to bond with others. Let us explore how we can cope with our social anxiety and bond:  

Think back 

A saying goes “If I had an hour to solve a problem, I’d spend 55 minutes thinking about the problem, and five minutes thinking about solutions”. It could help to first identify our specific fears.

Think back and try to recall what was upsetting:  

Am I boring? 

There are too many people!  

They are judging me! 

Let us jot down our fears so that we know what to work on. 

Prepare 

Has “I’m boring… I have nothing fun to talk about” crossed your mind? We can prepare conversation topics by reading up on current events, the latest books, movies, or games. Alternatively, we can also recall recent memories that we are comfortable to share with others. Note these down so that we can refer to them during our meals! 

Relaxation techniques 

Conversation topics? Check. But what about our emotions? To help manage them, here are some useful relaxation techniques: 

1. Taking long, slow breaths and focus on them. 

2. Noticing our emotions and letting them wash over us. 

3. Progressive muscle relaxation by slowly tensing and then relaxing different muscles in your body, one at a time.  

Find the techniques that work best for you and practise them before you head out! 

Sit firm! 

Is “There are too many diners!” a familiar thought? Let’s start small and first dine with one person. During the meal, remember to use your prepared conversation topics and employ relaxation techniques to bear with the stress. Paying attention to how often the embarrassing situations we are afraid of actually take place will also help us. 

Focus on others 

“Am I appropriately dressed?”, “Am I chewing too loudly?”. There are so many things about ourselves that we can pick on.  What if we focused on others instead? Some things to consider include: 

Do you like their appearance? 

Does their food look tasty? 

What emotions are they experiencing? 

As a bonus, we can even comment on them to keep the conversation going!  

Clarify 

“You look…great.” 

“Why the pause? Oh no…I must look terrible!” 

When in doubt, it can be helpful to clarify. The person could have sincerely meant it and was simply struggling to find thier words! 

Consistently march on! 

Practice makes perfect. Let us try to consistently have meals with others, and when comfortable, consider increasing the amount of people at the table.  

We hope that some of these will help you, and that we will all be able to eat together with our loved ones. Let us no longer be trapped between the rock (anxiety) and a hard place (feeling lonely from missing out on meals with others)! 

Does High Functioning PTSD Exist?

PTSD, or post-traumatic stress disorder, is a mental health condition that severely affects daily functioning. However, some people who experienced trauma may seem like they’re doing just fine. That leads us to the question – does high functioning PTSD (HF-PTSD) exist? 

The answer is yes! While they could seem successful in many areas of their lives, those with HF-PTSD are not living at the optimal. In fact, they struggle internally and are coping through pain. Breakdowns or burnouts are likely to happen with a matter of time.  

Coping methods by those with HF-PTSD 

People with HF-PTSD are likely to cope by blocking out memories of their trauma. They avoid situations and people that remind them of their traumatic experiences. Doing so makes them look “perfectly okay”. While feeling constantly on-edge, they try to ignore the negatives. Instead, they work hard to excel at their work, relationships and other responsibilities. These distract them from the trauma and its effects.  

Healing the trauma 

While seemingly functioning well, living with HF-PTSD is not ideal. Without treatment, one could reach a breaking point. The following strategies can be used in the healing process.  

1. Talking to someone 

Having a listening ear that does not judge can help one feel supported throughout the healing process. It is useful to have an emotionally and physically safe space that gives us opportunities to express our emotions.  

2. Therapy 

Going to therapy is a good option for those with HF-PTSD. The therapist might use the following methods: 

a. Eye movement desensitization and reprocessing (EMDR) 

During EMDR, the client is guided to recall the traumatic event they experienced. At the same time, they emphasize positive beliefs like “I had put in my best effort”. This helps the brain come to terms with their negative experiences.  

b. Exposure Therapy 

People with HF-PTSD frequently avoid people and places that remind them of trauma. Exposure therapy, like its name suggests, exposes the client to these reminders. They learn to cope with their feelings of anxiety.  

c. Cognitive Behavioural Therapy (CBT) 

In CBT, unhealthy thoughts are identified and challenged to change behaviour. This helps the client makes sense of the traumatic event and deal with challenges in a more adaptive way.  

HF-PTSD is a real condition that you or people around you may be dealing with. While sharing the emotional burden with someone can be helpful, the best form of treatment is to seek guidance from mental health professionals.  

A Guide to Healing from Parentification

Let’s take a moment to reflect on our childhood!  

Did you ever have to worry about looking after your siblings? Did you often find yourself acting as a confidant to your parents when they had an argument? Have you been complimented for your maturity in mediating family conflicts?  

If you identify with any of the above,
you might be a parentified child. 

What is Parentification? 

Parentification occurs when a child assumes the role of the parent. A parentified child is robbed of a carefree childhood and takes on hefty responsibilities that are inappropriate for their age. In adulthood, you might learn to only trust and rely on yourself, which hinders you from forming healthy relationships. 

Types of Parentification 

Ψ Instrumental Parentification. This is when a child takes on the physical and tangible duties of the parents. They might take care of their younger siblings, pay the bills or care for a loved one with a disability or an addiction.

Ψ Emotional Parentification. This is when a child provides emotional support for their parents. The parentified child might feel responsible in providing a listening ear or comfort and advice to their parents in times of distress. 

How to Heal from Parentification? 

Fortunately, it IS POSSIBLE to address the parentification trauma. Here are some tips to start embarking on your journey of recovering from parentification.  

Ψ Acknowledge your experience of being a parentified child. Be open to speaking up about your trauma. Accept the reality of a loss childhood and the repercussions it may have in your adulthood. Allow yourself to feel and process the grief and anger. 

Ψ Explore your needs and prioritize them. Reconnect with your inner child and explore these needs. You might need love, attention, or the freedom to play. You are now your own parent and have control over your needs. As a child, you might have missed out on activities that were meant for children. It might be difficult to put yourself first, but you can try with small steps. Start by spending time with friends, listening to music, meditating, or anything that makes you happy! 

Ψ Cultivate self-compassion. As parentification is covert and insidious, it often goes unnoticed. This does not mean that your feelings are any less justified. Don’t be too critical of yourself; understand that it’s not your fault and there’s nothing you could have done better as an innocent child. Tell yourself “I am sorry for what you had to go through, and I love you”. 

Ψ Learn to establish healthy boundaries. Growing up with parents who push your boundaries might impair your ability to establish healthy boundaries. To set boundaries, be clear and direct to avoid miscommunication. While being polite, don’t feel apologetic for wanting to meet your own needs; remember that self-care is not selfish. 

It takes time and patience to allow yourself to heal. Our childhood wounds do not define us, and you deserve to have your needs taken care of. If you need support, feel free to reach out to our team of psychologists!