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.  

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!  

How to Deal with Passive Aggressive Colleagues

Picture this scenario: Jenny is a customer service executive at a logistics firm. Recently, a new employee, Sam, was hired and Jenny is tasked with helping to train Sam. Rather than acting as a mentor to Sam, Jenny instead constantly ignores Sam’s emails, gives him the silent treatment, jokes about him behind his back, and refuses to train him to the best of her ability. Whenever Sam suggests a potential improvement to the workflow, she quickly rejects his viewpoints and gives off an air of superiority. 

These behaviors exhibited by Jenny are considered passive-aggressive ones. But what exactly is passive aggressiveness? 

Passive aggressiveness occurs when a person harbors negative feelings towards an individual and expresses those feelings in an indirectly harmful manner.

A person may feel negative feelings such as anger or jealousy, but instead of communicating honestly, they mask their emotions through indirect hostility.

These are some examples of displays of passive aggressiveness at the workplace: 

• The silent treatment 

• Chronically procrastinating on tasks 

• Intentionally neglecting their share of the workload or shirking responsibilities as a form of “retaliation” 

• Withholding information 

• Disguised insults and non-compliments 

• Downplaying or ignoring other people’s achievements 

• Sarcasm 

• Spreading rumors 

• Being silent, sulky, sullen and resentful to get attention or sympathy 

Passive aggressive behaviors are usually not immediately recognizable as “aggression”. After all, it is easier to notice aggression when people lash out at you. However, in the workplace, such behaviors create a toxic workplace environment, which comes along with a host of negative consequences such as burnout and lowered morale. Considering all these negative consequences, it is therefore important for passive aggressiveness to be carefully and effectively dealt with.

How should I respond to a passive aggressive colleague?

Responding to a passive aggressive colleague is tough and a great deal of patience is usually needed. This often comes with a hefty amount of stress and anxiety on your end too. However, equipping yourself with these skills goes a long way in making you a more confident and effective person!

Ψ Remove the reward

With many kinds of behaviors, a person will be more likely to engage in an action again if it is met with reinforcement. In the context of workplace passive aggressiveness, if you respond to a colleague’s behavior by going tit for tat, your response may actually end up reinforcing that colleague’s behavior such that it becomes even more likely for them to engage in passive aggressive behaviors again.

It can be difficult to resist the urge to respond to provocations by similarly being sarcastic or saying “it’s fine” when it actually is not. However, doing so is unlikely to get you anywhere and may even further escalate the conflict by perpetuating the person’s bad behavior. Instead, try to focus on keeping cool so you will remain composed and not act impulsively. The best way to achieve this is by giving the person objective, emotionally neutral responses whenever appropriate. For example, instead of using “you”, use first-person pronouns such as “I”, “we”, and “our”.

Ψ Ensure that expectations and deadlines are clearly and explicitly set at the start of any task or project

This is a good habit to carry out regardless of whether you have a passive-aggressive colleague or not. After all, communication is key! Ensure that you communicate diligently and set crystal clear expectations on the scope, expectations, and deadlines of any given project. To do this, confirm any discussions that you have about deadlines and actions in writing, send follow-up emails after meetings, or draft a performance agreement.

When this occurs, reasons such as “I did not know” become less plausible and it increases behavioral accountability. By ensuring that all communication is clear and understood by everyone, a passive-aggressive colleague will have to take responsibility for their own actions and have fewer opportunities to blame others for their mistakes.

Ψ Try to adopt an empathetic approach and understand the reasons behind their actions  

Why is your colleague acting this way? Do they derive happiness from making others feel manipulated? It might be easy to simply write off their behaviors as being due to a nasty personality or intentionally being difficult. However, studies have found that passive aggressive behavior is often driven by deep seated fears of being rejected, a lack of self-esteem, as well as insecurity or as a maladaptive way of handling conflicts. When we take on an empathetic approach, this enables us to better understand why people act the way that they do, and to select a more appropriate means of responding.

Ψ Create a Safe Environment

Finally, foster an environment where your colleagues know that it is safe for them to raise concerns and issues with you in an open, direct, and constructive manner, rather than in covert ways. Let your colleagues know that they can always approach you if they are facing any problems rather than letting them bubble beneath the surface. 

Of course, you will have to walk the talk too! You can create an encouraging and supportive workplace culture by fostering genuine, positive relationships with your colleagues.

Should you have any concerns about the well-being of your work team or wish to further support your employees, our Employee Assistance Program (EAP) aims to help employees in Singapore, from staff to managers, manage work- and personal-related issues that may otherwise result in a negative impact on their emotional well-being and job performance.

Coping with Insecurities

Feeling emotionally insecure puts you in a constant state of vulnerability, and this can be exhausting. You may feel a lot of self-doubt, questioning your capabilities and achievements. You may be engaging in negative self-talk – “No one wants to hang out with me because I’m ugly, boring, and useless”.

Interacting with an emotionally insecure person may also be difficult because (1) you may find it challenging to think of an appropriate reply to their expressed negativity, and (2) some individuals can get very defensive when topics of their personal insecurities are brought up, regardless of intentionality.  

Why do people feel insecure?

Ψ Insecure parent-child relationship and attachment

Emotional security develops from as early as childhood, when personal parent-child relationship(s) are critical.

When an individual does not have a secure base during childhood (inconsistent support, caregivers(s) not readily available to meet their needs, lack of validation and comfort during distress, etc), they may grow up with an insecure attachment. An insecure attachment refers to feelings of uncertainty and fearfulness of what is to come. During adulthood, this manifests as individual charactered by a poor self-image and high levels of anxiety.

People who experience high levels of insecurity also tend to have a highly critical inner voice. This critical inner voice may stem from traumatic or painful early life experiences that the individual either experienced or witnessed firsthand, or indirectly through close others.These experiences can be unconsciously integrated as one grows up and expressed as patterns of destructive/sabotage-like thoughts towards oneself and/or others. 

The expression of negative affect from one’s parents during childhood until adolescence also contributes to emotional insecurity. Examples include hostility and/or irritability expressed towards the child or another individual in the presence of the child. 

Ψ Personal experience coupled with internalization problems  

Emotional insecurity can stem from negative experiences encountered by an individual. Examples of such experiences include: failing a task, being rejected by another individual, lack of validation for effort and results). While the effects of negative experiences differ from person to person, we can all agree that being judged by another individual is often daunting and discouraging. 

Ψ Personal difficulties 

An individual with anxiety or depression may be more prone to emotional insecurity due to their core beliefs about themselves and/or others. Perfectionist may also find it difficult to keep up to their high and sometimes unrealistic expectations consistently, which leads to feelings of insecurity. 

Managing your emotional insecurities

We are often our biggest and harshest critic.

“How can I be so stupid?” 

“If only I did this and that, it is all my fault.” 

Sounds familiar?  

Getting out of a spiral of negative self-talk is easier said than done. It may seem almost impossible to manage these discouraging thoughts. They can be loud and incredibly persuasive. That said, with sufficient practice, this can be overcome.

1. Establish a clear boundary when it comes to negative self-talk. Instead of having your inner voice speak in first person, attempt to have them in second person. For example, instead of “How can I be so stupid?”, try “How can you be so stupid?”. This allows you to internally process the critics as external rather than internal criticisms. This may be a tough and emotional first step but trust the process.  

2. Think about what thoughts and feelings are triggered when you speak critically towards yourself in a second person perspective. Does it trigger some memories in the past? Do some of the words sound familiar from early life experiences, be it from your parents or friends? This step is helpful in revealing some root causes of the harsh self-criticism(s) and some discrepancies between your true and critiqued self. 

3. This next step may feel a little awkward or unnatural, but stay with us. Pick up a pen or a recorder and write or vocalize in second person one criticism or insecurity. Answer the criticism or insecurity truthfully just like you would to a friend. This step can help debunk some deep-rooted untrue fact(s) about yourself in the present moment. For example, you could have an insecurity about your bloated tummy after a meal. Think about how much your body has done and is doing for you, and the natural processes that occurs before, during and after a meal. Writing or speaking to yourself just like how you would to a friend can bring out the rational and logical side of you, easing the process of debunking some negative self-talks you may experience in your daily life. 

4. Think about how these negative self-talks are influencing/affecting your day-to-day life. Do you catch yourself being highly defensive when someone speaks to you about an insecurity? Catch how these negative self-talks is affecting your life  in terms of your thoughts, opinions, feelings and actions. 

5. This is the last, and possibly the hardest step. Take small actionable steps to change the influence your negative self-talks have on your behavior. For example, if you are internally thinking: “You are going to be rejected from that job.”, and if this usually deters you for going for a potential opportunity, attempt step three, and go for it. It is time to interrupt those negative thoughts depriving you from new opportunities and experiences, unleash your true self. You will feel some form of internal discomfort, from greater anxiety to louder negative inner voice. However, do not give into those voices, pull yourself apart from what they are telling you and through perseverance, they will weaken over time. Think of negative self-talks as evil creatures trying to lure you into their little bubble, depriving you of potentially good life experiences and fruitful learning opportunities.  

Emotional insecurities are normal… until it’s not 

Everyone goes through periods of uncertainty and doubt for various reasons. So, when do you know that your emotional insecurities are getting out of hand?

Ask yourself the following questions:

• Does it affect your day-to-day functioning?

• Are you able to get out of the rut and move on with your day after getting your work proposal rejected?

Should you find yourself struggling to move on with this feeling of inferiority that is disrupting your daily living, reach out for professional help. Our clinical and counselling psychologists strive to create a safe and non-judgemental space to work with you through this journey towards confidence and well-being. Being your vulnerable authentic self helps your psychologist help you.   

Seeking professional help  

Differing based on each individual’s needs, wants and goals, the psychologist will work closely with you to help you better manage your underlying and present difficulties. Behavioural, cognitive and/or affective approach(es) may be adopted. These approaches all have one overarching aim: 

• To challenge unhealthy thoughts/feelings you may have towards yourself 

• Teaching you techniques to overcome these thoughts/feelings 

• Making actionable steps to change your behaviour caused by those thoughts/feelings 

These insecurities may seem tough, or even impossible to overcome. If you find yourself struggling to get by the day due to those internal voices, do not feel afraid to reach out to a mental health professional. Take it day by step and applaud all that progress you make, regardless of how small it may be. You’re not alone in this battle.  

Coping with Betrayal

When someone you love breaks your trust & heart

Betrayal can hurt as badly as a physical wound. Do you allow the hurt feelings to hold you captive or put them behind you? How do you move past the hurt and begin to heal?

What is betrayal?

Betrayal comes in many forms. Not limited to infidelity, betrayal can include breaking promises, lying or withholding information, not prioritising a relationship, or disclosing information that was shared in confidence. It can be experienced by anyone, and is not exclusive to any gender. 

Why does betrayal hurt so much?

Betrayal entails the violation of someone’s trust and confidence. When people enter a committed relationship, they agree to live by the core values of a relationship (e.g., trust, commitment, respect). When one partner breaks the bond of trust, it erodes the foundation of the relationship. It affects the betrayed partner’s self-esteem and makes them doubt their self-worth. It also leaves the betrayed partner feeling confused as they begin to doubt everything the betrayer has said and done. People who have been betrayed may find it difficult to trust people, which hinders them from forming meaningful relationships.

How do I cope with betrayal in a relationship?

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Ψ Acknowledge the betrayal 

The betrayal might have come as a shock to you. It is often difficult to wrap our minds around how and why a trusted confidante would betrayed you. However, to heal, you need to recognise and accept that the betrayal has happened. This does not mean that you are fine with it but as a stepping stone, you need to acknowledge that the act took place. 

Ψ Name your emotions 

Anger, sadness, disgust, insecurity, and loneliness — You might experience a whirlwind of emotions in the aftermath of a betrayal. These are legitimate feelings of betrayal. Do not deny or suppress them. Label these feelings. You may even want to write them down. 

 Ψ Spend time apart 

Avoid the person physically and electronically, if possible. Taking time away will reduce the intensity of your negative emotions, placing you in a better position to rationally think and process what had happened. You should not feel pressured to make a decision in response to the betrayal.

An example of a thought journal to help you to better understand the links between your thoughts and feelings, and make sense of them

Ψ It’s ok to grieve

Allow yourself to grieve the relationship that you have lost. In some cases, you may also be grieving the future that you had imagined. During the recovery process, you may experience the five stages of grief: denial, anger, bargaining, depression and acceptance. Note that this is not a linear process. You may find it helpful to journal your thoughts and what you felt are your losses.

Ψ Resist the temptation to retaliate 

It is normal to feel the urge to get back at the person who betrayed you and make them suffer. Planning revenge will only delay your healing process, and prolong your pain. 

Ψ Talk to a confidante 

Emotional support from your loved ones will be crucial during this stressful time. Speak with someone whom you trust. If you are not comfortable, you need not share what happened. You can share your feelings and thoughts about the incident, or just seek companionship from your loved ones. It would be best to find someone who can stay neutral, and not add fuel to the fire. 

Ψ Reflect on the relationship  

Examine your relationship, and be realistic about it. Some issues might have existed in your relationship before the betrayal. Your relationship did not turn sour overnight. It would be a good time for you to figure out how much the relationship means to you to determine if you should salvage or end the relationship. After gaining insights into the problems, you could then think about how things need to change should you and your partner wish to continue the relationship. 

Ψ Have a conversation with the person 

When you feel ready, have a conversation with the person who betrayed you. Let the person know how their actions made you feel. To prevent the person from getting defensive, try to focus on the impact on you rather than what they did. One way would be to use the “I” statements which starts with “I”, e.g.., “I felt hurt and angry when you…”. 

Allow the person to share their side of the story too so that you can understand how the betrayal came about. Note if they are trying to defend their actions or genuinely seeking forgiveness. 

Ψ Try to forgive 

See if you can forgive the betrayer. Forgiveness does not mean condoning the action; it is deciding to move past the hurt and move on with your life. Forgiveness is for you, not for the other person. Feelings of resentment and bitterness from the lack of forgiveness will take a toll on your physical and emotional well-being. 

If you wish to continue the relationship, forgiveness will be crucial to bring the relationship forward. You could let the person know that you have decided to forgive them but explain that it will take time for you. 

Ψ Decide how to take the relationship forward 

You have to decide if you want to forgive the person and rebuild the relationship, or end it for good. You may also consider a temporary separation as an option. Some considerations underlying this decision include: 

• Is the person a repeat offender? 

• Was it unintentional? 

• Does the person acknowledge the pain that they have inflicted on you? 

• Is the person genuinely remorseful? 

• Has the person accepted responsibility for their actions? 

Ψ Be kind to yourself 

You may feel somewhat responsible, and wonder what you might have done wrong. Do not blame yourself for the betrayal. The person has to take responsibility for their actions. 

Forgive yourself for saying and doing things on the spur-of-the-moment when you discovered the betrayal. 

Be patient with yourself. Recovering from the hurt is a tough journey. Do not rush yourself to move on. Engage in self-care activities such as eating well, getting enough sleep, and spending time doing things you enjoy. 

Ψ Seek professional help 

If you find yourself ruminating on the betrayal and hurt, or your behaviours have changed since the betrayal and they are impairing your daily life, seek guidance from a mental health professional. Professional help could also address the damage the betrayal has caused to your sense of identity, self-esteem, and sense of security. Seeking help is a sign of strength, not weakness.  

If you are dealing with romantic betrayal, you could speak with our marriage and family therapists (Ling Ling and Wendy) and our clinical psychologists who have experience working with couples who struggle with marriage and family difficulties (e.g., Yuka).  

Moving past from the hurt of a betrayal is a painful and difficult journey. Some days may be tougher than the rest where you just wish to wallow in self-pity and wound the betrayer back. These responses and acute negative emotions are normal. The key is to remain kind to yourself and lean on your loved ones throughout this recovery process.  

Coping with Suicidal Thoughts: You Are Not Alone

Staying afloat in what seems like a rip current

You’re in pain. You feel numb. This is a time in your life that the pain is so overwhelming that it seems like there is no way out. When this happens, suicidal thoughts may swarm your mind, (erroneously) presenting itself as the only solution.

Often, it’s not that you want to end your life, but rather, are seeking an escape from the unbearable pain and numbness.

You are not alone. Many others have experienced this pain and entertained suicidal thoughts – in 2020, Singapore recorded 452 suicide deaths while Samaritans of Singapore (SOS) reported over 39,000 suicide and crisis related calls. 

Many, however, struggle alone with their pain in our local mental health landscape where suicide is deemed taboo. It’s high time we embrace conversations around suicide. Let’s start by going through what may keep you afloat in what appears to be a rip current.

How to Cope with Suicidal Thoughts

Ψ Focus on getting through today

Your pain and suicidal thoughts may seem overwhelming in the moment. You don’t have to act on your thoughts now. You may have had them previously. Recall how the distressing emotions and suicidal thoughts came and left. How you feel today may not be how you feel tomorrow or the week later - feelings will pass.

Ψ Create a crisis/safety plan

The gist of a safety plan is to list the key things you can do to keep yourself safe during a crisis. This is an extremely important step, and we care for you and have created a template for your own safety plan. Fill in the plan and keep it somewhere you can easily access and refer to it whenever the urge to hurt or kill yourself arises.

You could write down the people whom you can contact to help you feel better and the places where you would feel safe (e.g., your bedroom, friend’s house).

Stay away from things that you could use to harm yourself, such as pills and razor or even keys that unlock your window grills. Get a trusted friend or family member to safeguard them on your behalf until you are more in control of your thoughts and feelings.

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Ψ Ground yourself in the present reality

Grounding techniques work when we might feel like our mind’s just spiralling out of control, and we’re being pulled in all directions because of it.

To gather back the control of our minds or focus, take a few moments to try out the 5-4-3-2-1 grounding technique:

• Name 5 things you can see (like the colours on this page),

• Name 4 things you can feel (like the phone or device in your hand),

• Name 3 things you can hear (like birds, music or people talking)

• Name 2 things you can smell (like hand creams, perfumes, coffee)

• Name 1 thing you can taste (like a mint, tea, food)
  

Ψ Engage in activities you enjoy (or once did)

This could look like spending time with your family and friends even if you do not talk about your feelings, going for a walk in the park, watching a movie and playing games. 

Engage in those activities even if your body and mind tell you not to, and note how you feel after.

Ψ Create a gratitude (or ‘reasons why’) list

Make a list of the things that you are thankful for in your life. Think about your family and friends whom you love, the sights and sounds that you can experience and delight in. You could also affirm your strengths.

These are the reasons you continue going, the kind of reality you wish to build for yourself that helps make space for your pain, but also comforts you in the hard moments. This is the version of you, and your life, that you would be proud of.

Ψ Seek support and reach out

Don’t fight this battle alone.

Asking for help is hard, but it is the bravest thing you can do for yourself. Reach out to someone you trust to share your feelings and how you have been coping or struggling. They may be startled when they first hear about it but know that they want to help. Let them know how you want them to support you if you have an idea (e.g., check in on you every night, call the emergency hotline for you during a crisis). 

Besides approaching your friends and family, you could join a support group. It is a powerful tool that helps you feel supported. People with similar experiences would come together to share their struggles and tips to overcome them.

If you find it too hard to talk to a loved one and you just want to hear a voice, call the crisis helpline. They could help to direct you to relevant resources or professional help. 

Lastly, connect with an experienced mental health professional who will work with you to manage your difficult emotions and suicidal thoughts in a safe, nonjudgmental, and supportive space.

How to Cope with Guilt about Breaking Up

中文版: 如何应对分手后的负罪感

It is okay to feel

The Emotional Complexity of Initiating a Breakup

It is commonly misunderstood that people who initiate a breakup will cope better than the person they break it off with. This is not always true. Initiators can experience complex emotions such as guilt on top of sadness upon the breakup. Experiencing guilt for initiating a breakup is common, even if the relationship ended off in amicable terms.

If you have just initiated or are thinking of initiating a breakup and are experiencing guilt, know that it is okay to feel. It is normal to feel this way after a relationship ends. Your emotions are valid but that does not mean that you did anything wrong, or that you deserve to feel this way. While guilt is an empathetic response and a feeling of being responsible for the effects of your actions on them, it can cause a lot of distress.

Here are some ways to cope with guilt about a breakup: “S.E.L.F-C.A.R.E”

S - Seek social support and help (to manage breakup guilt)

Express or disclose your feelings of guilt to a close family member or friend who you trust. Do not be afraid to let them know how they can best support you. It is okay to turn to others for support as you lose your main pillar of support. Be comfortable initiating outings with your close friends and surround yourself with people who care for you.

Going for therapy can help you cope with difficult emotions and address the guilt in a helpful and adaptive manner. If you would like to share and process your emotions with someone, you may consider speaking to our clinical psychologists, like Dr Annabelle and Stephanie, who have extensive experience with providing guidance on relationship difficulties, emotional dysregulation, and equipping clients with the coping skills needed to get through this difficult time. You do not have to go through this alone.

E - Engage in self-reflection (to understand your feelings of guilt)

Reflect on the reasons for your feelings of guilt. Are you feeling guilty about hurting your ex-partner or are you feeling guilty for not trying harder for the relationship? Or perhaps you are feeling guilty because of how your family and friends react to your breakup? Everyone has their own unique reasons and it is always beneficial to be aware of the reasons behind your emotions so that you can take active steps to understand the validity of these reasons.

There may also be times where you do not know you are feeling a certain way after a breakup. When that happens, take the time you need to figure this out yourself, with your loved ones or a clinical psychologist.

L - Look at your relationship objectively to overcome guilt

Guilt can cause you to second guess your decision on ending the relationship and forget about all the negative experiences or the reasons for the breakup. Remind yourself of your intention to leave the relationship.

Grab a piece of paper and pen, and list out the reasons. Refer to them as many times as you need. This can also serve to remind you that building and sustaining a healthy relationship is a shared responsibility; it is not one person’s sole responsibility that the relationship has come to an end.

F - Focus on putting your own needs first

Hurting isn’t a competition. It may be painful for your partner to experience losing you now, but his or her pain is not more important than yours. It is okay to put your own needs first and that does not make you a selfish person. If being in your current relationship is painful or does not serve your needs, you have every right to let it go.

C - Come to realise what breaking up is not

“The only thing worse than breaking up is not breaking up when you know you are supposed to.” - Adonis Lenzy

Breaking up is not a wrong thing to do. It is not disregarding your ex-partner’s feelings. It is not ruining your ex-partner’s life. Ending a relationship does not make you a horrible person.

A - Acknowledge that you are being honest when you end the relationship

You owe your partner honesty and respect; not unwavering commitment when you know you no longer can or will not. It takes a lot of courage to be honest about your feelings in a relationship. It is not an easy decision to make, even if it is the right thing to do. Acknowledge that this is the right thing to do, and this hard decision is the best for both of you, including your partner, in the long term. 

R - Release your responsibility to your ex-partner

When the relationship has ended, release your responsibility to them and focus on healing yourself. You are no longer his or her partner and thus, you are no longer liable for their care, and neither are they.

Ψ Recognize what you can control and what you cannot. What is within your control is your honesty and respect towards your ex-partner. How they respond and take care of themselves emotionally are, unfortunately, out of your control.

Ψ Establish healthy boundaries with your ex-partner. If your ex-partner is causing you distress about the breakup, even unintentionally, maintaining some physical and emotional distance may be necessary. Do not feel obligated to respond when your ex-partner reaches out to you. This is not easy, especially if he or she seems vulnerable or expresses feelings that mirror your own. Remind yourself that you both need time and space to work through those difficult emotions.

E - Engage in self-compassion during and after a breakup

Be kind to yourself.

Ψ Imagine a close friend experiencing the same thing as you, what would you say to that friend? Try using the same words for yourself. Write a letter to yourself.

Ψ Remember that your thoughts are not always accurate reflections of reality.  Notice your critic and remind yourself of the positive effects of ending the relationship.

Ψ Reframe negative self-talk. Changing negative thoughts to positive thoughts can be quite a jump, you can try working towards neutrality first by lowering the intensity of your language. For example, changing “I can’t stand this” to “this is challenging”, “I am an extremely horrible person” to “I am having a thought that I am a horrible person”.

Ψ Practice self-forgiveness. This can be done by expressing remorse and regret instead of shame, viewing the breakup as a learning experience and accepting yourself as an imperfect being, just like the rest of us.

Breakups are never easy, but when you’re dealing with feelings of guilt on top of heartbreak, moving on can feel impossible. If you’re struggling with breakup guilt, acknowledge your feelings, engage in self-reflection, and be kind to yourself — these are all important steps in overcoming guilt and moving on with your life.

How to Practice Active Listening

How to Be A Good Listener

Are you really listening to someone?

Have your loved ones felt worse after sharing their experience with you? Or have you felt misunderstood and not heard by your loved ones after confiding in them?

These are common encounters and it is frustrating to not be able to help our loved ones feel better. So how can we prevent such situations and improve on our understanding of others? The answer is to practice active listening! 

What is active listening?

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Active listening is a technique of listening and responding that encourages in-depth comprehension and enhances mutual understanding. It emphasizes the importance of both nonverbal and verbal behaviours, unconditional acceptance, and unbiased reflection of the speaker’s feelings and experiences.

Active listening is commonly used in situations such as during counselling, training, getting feedbacks, and solving disputes. It is also an important part of effective communication and building trusting relationships! 

The powerful benefits of being an active listener

1. Build trust and stronger bonds through active listening 

Knowing that they will not be judged or interrupted when sharing, people will feel safe and comfortable to confide in you. This is very important when it comes to building trust and relationships. And when you engage in more conversations and sharing with others, you will get to know the speaker more and form a stronger and closer bond together! 

2. How active listening resolves miscommunication issues  

Any miscomprehension of information can be corrected and processed to prevent further misunderstanding. When we ask questions, we are gathering the information we need to solve any communication problems. We will get to clarify the intentions and true feelings of others, which may have come across to us differently.   

3. The role of active listening in capturing and retaining key information 

Research has shown that we can remember conversations better when we are actively contributing to the conversation. Active learning allows us to listen and participate in the conversation such that we won’t miss out on important information and can remember them better.    

4. Emotional benefits of active listening 

Active listening creates a sense of emotional awareness that helps the speakers feel better as the listeners acknowledge their feelings. The neutral setting and non-judgemental environment also help the speakers to keep calm and not get defensive. This also prevents them from bottling up their emotions, which will only make them feel worse and result in more problems in the future.

Now that we know the importance and impact of active listening in our day-to-day interactions, it’s time to learn about the skills involved! 

Mastering active listening skills to become a better listener, for better communication 

Ψ Be Present In The Conversation 

• Face the speaker with an open posture (e.g. arms and legs uncrossed) to show your interest in the conversation and that you are giving your full attention. 

• Maintain eye contact to show respect to the speaker and that you are actively listening.  

• Give small nods or a simple verbal comment (e.g. uh-huh/mm hmm) to encourage the speaker to continue sharing without being interruptive.  

• Avoid turning your attention to surrounding factors and put aside distracting thoughts! 
   

Ψ Do not interrupt when the speaker is sharing 

• Allow the speaker to finish talking before asking questions or responding. 

• Do not prepare to counter with a rebuttal — we are not here to put down anyone or make counterarguments to determine who is right or wrong!  

• Have a short wait time after the speaker spoke as it will sometimes prompt him/her to add on more details that he/she is reluctant or hesitate to share previously  

Ψ Be observant during conversations  

• Observe the speaker’s body language — is he/she showing signs of nervousness or anxiety despite saying he/she is fine?   

• Notice the tone of his/her voice.  

• Listen between the lines — what does the speaker want, how does he/she truly feel? 

Ψ Clarifying questions 

• Does the speaker want solutions or advice from us or simply just want us to empathize with him/her? 

• This allows better understanding as our personal filters, assumptions, judgments, and beliefs can distort what we hear and understand.  

• E.g. “I don’t understand what you meant by…”, “What do you mean when you said...”, “Would you prefer if I suggest solutions or just be a listening ear?”
   

Ψ Rephrase or summarise what you heard 

• This will help you process and reflect on what you heard. 

• The speaker can correct you if there is any misinterpretation. 

• The speaker will feel heard and understood by you. 

• E.g. “Am I right to say that...”, “….is that what you mean?”, “Sounds like you are saying...” 

Fun fact: Did you know that our short-term memory can only hold information for up to 30 seconds?

Therefore, we need to actively listen to one another to make sure there is no miscommunication and we can bring our message across accurately. It is also important to treat others in a way that you think they would appreciate or you would want them to treat you. It takes time and conscious effort to become a better listener, but with practice and love for your loved ones, you will definitely master active listening quickly! 

You may also wish to seek professional help with one of our experienced clinical psychologists together with your loved ones to have an in-depth discussion on how to improve your communication skills and forge stronger relationships! 

Setting Healthy Boundaries

Understanding Healthy Boundaries: What Are They and Why Are They Important?

Boundaries set intangible and tangible limits to life. Boundaries are essential yet often difficult to establish.  

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“I don’t want conflicts, it’s just easier this way.” 

“Sigh, my boss asked me to OT out of nowhere, I already had plans, I wished he told me sooner.” 

“I only gave in to him (intimate partner) because I’m afraid he would think that I don’t love him otherwise.” 

Do these statements sound familiar?

Many times, we struggle to set boundaries in our daily lives in fear that it will cause unnecessary conflicts or it will make us look bad. As a result, we may face inconveniences; be it doing things out of our way or getting bullied into doing things we may not be 100% comfortable with.

This is fortunately very common and you’re not alone for the sole reason that we, humans, are social creatures. We place great value in the relationships around us, and sometimes in the process, may forgo ourselves and our own needs.

However, setting healthy boundaries are essential for our mental and physical health, because your needs matter too! Here are some steps to kickstart creating healthy boundaries in your life:

The Art of Enforcing Boundaries: Tips for Establishing and Maintaining Healthy Limits

1. Take a step back and think about what matters most to you 

Some questions to get the ball rolling: 

1. What is important to you?  

2. What are your values?  

3. What are some things that make you uncomfortable?

4. What are some things you have difficulty asking for?  

This helps you organize your thoughts and understand what you feel strongly for, what your values are, and what your priorities are. Doing so allows you to gain a clearer idea on what boundaries you would like to put in place.  

2. Be clear and precise when stating what matters to you 

You want to be heard and understood with clarity. Allowing others to first understand your boundaries will reduce misunderstandings, and stop the vicious cycle of constantly feeling like your boundaries are being violated. 

Here’s an example:

You may have a personal boundary of not wanting others to invade your personal space. When you fail to let this boundary be known, and get upset or angry when your personal space is being violated, others may misunderstand this as you being upset further violated your personal space with the intention to comfort you. This could result in you feeling more uncomfortable as your personal space is being violated. This can be avoided with the communication of your boundary. 

You may want to attempt this with those you’re most comfortable with, such as your partner, family members, or close friends. 

An example of being clear and precise when delivering your boundaries to others:  

3. Be assertive when stating your boundaries and follow through with the consequences you’ve stated should the boundary be violated 

Avoid engaging in the subsequent feelings of guilt or shame of that boundary, you may waiver in that situation. Not following through with the consequences you’ve stated will reduce the respect one has for the boundary you’ve stated. 

An example of delivering your boundaries assertively:  

In this case, if individual still proceeds with vulgarities, leave the conversation instead of continuing to engage in the conversation.

4. Don’t be sorry or afraid when asking for help, even with the possibility of rejection  

We tend to subconsciously start off a sentence with “I’m sorry but…” when asking for help. It is completely normal to ask for help, so be confident about it. Your needs are as important as other people’s needs. Asking for help does not mean you are incompetent, but rather, a task could simply require additional clarification or it could be out of your area of expertise - this happens to even the best of us.

However, there are times where help may not readily come your way when you need them. Respectfully accept the “no” just like how you would like your “no” to be respectfully accepted and find someone else who can help you.

5. Don’t be afraid to say “no” 

This may be difficult for some in fear of “looking bad” or “being viewed as lazy or not a team player”. However, as much it is important to help others, it should not be done at the expense of yourself. This is in not suggesting that you be selfish or self-centered, but to respect the boundaries of your personal time, personal capabilities, and what may be out of your control.   

Saying “no” can be done assertively yet respectfully.  

Examples of ways you can say “no” assertively yet respectfully:  

6. Be in charge of your own needs  

This will require you to understand what matters most to you. You know yourself best, including your needs. Avoid depending on others to meet your needs or to tell you what is best for you. Setting boundaries based on your own needs is in no way being selfish, but a form of self-love and self-care. Be fair to yourself and be mindful about putting yourself in avoidable situations that may end up being undesirable.   

Establishing clear healthy boundaries may be uncomfortable for some, but remember that your needs matter too. Start off with those closest to you to build your confidence!