How to Encourage a Loved One to Seek Help

Recognising Barriers to Seeking Help for Mental Health

One major obstacle to receiving help is that people who need help the most are usually the least likely to seek it. When we break an arm, we visit an orthopaedic; when we have a cavity, we visit a dentist – we understand that we can’t fix the problem by ourselves. However, this same understanding often doesn’t extend to mental illnesses. There can be various reasons for this, such as stigma, self-reliance, or not wanting to appear weak.   

Another key deterrent is a lack of insight. Many people simply don’t think that their distress is significantly impacting them or realize that they need help. As their loved ones, you may be the first ones to notice that something is amiss. You may find the person displaying a worrying change in their emotions, behaviors, or interpersonal relationships. Perhaps you notice your mother experiencing more intense fluctuating emotions and an inability to function in day-to-day life? Or maybe your best friend has become increasingly withdrawn and has been unable to care for themselves for a significant period of time? You care for these people, so it is understandable that you worry for their well-being. It’s hard to watch someone you care about struggle with their mental health, while knowing that there are intervention options that they can benefit from So, how can you encourage a loved one to seek help for their mental health?  

Overcoming Challenges to Getting Help for Mental Health

1. Approaching your loved one about their mental health concerns

Approaching the topic can be daunting. You will likely require quite some time and patience to persuade a person in need to seek the help he or she needs. A good place to start is by letting them know that you need to have an important conversation with them. 

Time and place is key. Avoid starting the conversation in a public space where others could overhear the conversation. Contrary to what is portrayed on TV shows, staging a large-group intervention does more harm than good. Instead, have the conversation when your loved one is relaxed, and undistracted and in a safe space. This makes the person feel more respected, in control, cared for, and willing to engage in a discussion. 

Use “I” statements and remain non-judgemental. Refrain from pointing fingers or using stigmatizing language. Tell your loved one “I’m worried about you”. Explain specific, objective areas of their behaviors that are concerning, such as “I noticed that you have been rather withdrawn lately and spend a lot of time in your room.”

Approach them from a genuine empathetic space, and not sympathy or judgement. Do not blame or guilt them for ignoring their well-being. Highlight your concerns and care for them as the reason you are having this conversation. If they share their troubles with you, do not discount their distress – it is not a personal weakness and their feelings are real. 

2. When they say “No” 

If your loved one responds with negative emotions like anger, remember that it is not directed at you (although it can sometimes be easy to feel that way!).

Manage your expectations. Not everyone will be immediately receptive to the idea of seeking help. After all, it is a serious thing to consider and your loved one likely needs some time to process and think about it. Don’t get disheartened though! Rather than shutting the door on the topic or forcing them into something they are not ready for, let your loved one know that you will approach them again in the future when they feel more prepared and that they can always lean on you if they would like a listening ear. 

3. Provide emotional and practical support 

The process of getting your loved one to seek help is a lengthy one.  

Continue supporting your loved one – lend a listening ear, validate and empathise with their feelings, ask what you can do to help, and simply be around for them. Be patient and remember to take care of yourself too.  

Being there for someone else can be taxing, so it’s important to ensure that you are taking care of yourself emotionally, mentally and physically too. It is encouraged to establish boundaries and take some time for yourself. By doing this, you model self-care for the person you are supporting! 

In addition to emotional support, practical support goes a long way too. When contemplating seeking help, an individual may get put off as they may not know where to start. This, in itself, can feel very overwhelming. Ask your loved one about their preferences regarding what kind of help they would feel comfortable with and help them to find a suitable therapist that fits their needs. Contact clinics on their behalf and research the specialities of various psychologists to determine a good fit. 

4. Offer to accompany them to seek professional help

Once your loved one is ready to seek professional help for their mental health concerns, you can suggest the possibility of accompanying them to see a clinical psychologist. Some people may feel scared of seeing a therapist alone, so it helps to offer to go with them until they are comfortable. You can sit in the waiting room during their first few sessions. Assure them that you won’t ask any questions about what was discussed during the session unless they wish to share.  

Educating them on what the therapy process entails might also help to ease any worries that they may have. We have a helpful resource on what to expect when coming for therapy that you might find useful!

You may also wish to arrange for a separate consultation with one of our clinicians to further discuss how you can provide support to your loved ones.  

5. Highlight their accomplishments 

Seeking help is one of the best steps that a person can take. It, however, is also one that requires great strength and courage. We’re often so focused on trying to improve ourselves that we may forget to acknowledge how far we’ve already come. Celebrate your loved one’s decision to go for therapy and the courage that it entails. Remember, simply choosing to seek help is half the battle won. Above all, assure them of your continued love and support throughout their mental health journey. 

How to Practice Mindfulness

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What is Mindfulness?

How can I practice mindfulness in my daily life? Understanding mindfulness practice and its importance.

Mindfulness is about being present in your experiences in each moment, whether internal or external. Practising mindfulness is particularly important as too often we go about our days doing things automatically, or we get caught up in our worries, thoughts, or distractions, and fail to be fully immersed in our experiences.

There is no end goal or result in Mindfulness. Mindfulness is about being in the present moment. When we are not engaged in worrying about the past or future, the inadvertent result is that we are likely to feel calm.

Mindfulness can be practised with these simple activities that everyone already does on a regular basis.

Mindfulness Activities

1. Breathing 

1. Sit comfortably in your chair. You may wish to keep your eyes open or close your eyes.

2. Breathe. Pay attention to the air as it enters your nostrils and into your lungs.   

3. Is the air warm? Cool?  

4. Then breathe out through your mouth. Notice your chest and belly deflate as air leaves your lungs.  

5. Repeat these steps for 1 minute.

2. Walking 

1. Start walking. Being in a park or place with lush greenery helps. But it doesn’t matter if you do not have access to such places – wherever you are works just as well. 

2. As you walk, look around and observe your surroundings. There are colours that are dark, and there are colours that are light. Where are they placed within your field of vision? 

3. Breathe. Feel the temperature of the air – is it warm or cool? 

4. Touch your earlobes gently as you hear the sounds that are around you. Isolate a sound that you hear.  

5. Stop walking; close your eyes. Try and listen to that sound for a few moments. What do you hear? 

6. Open your eyes. As you look around your surroundings, observe whatever object your gaze lands on. Notice the level of detail of that object.   

7. Continuing walking. As you walk, what sounds do your footsteps make? Can you feel a breeze as you walk? 

8. Focus on making observations with your eyes, ears, skin, feet, nose:  

   • Where are you walking to? What’s around you? Are there any flowers? How many people are there around? What’s on the floor? Is the floor wet or dry? Is the weather sunny or cloudy? Are there any markings on the floor? Can you hear any sounds of nature despite being in a concrete jungle – are there birds? Which point of your foot lands first? Do you drag your feet? 

9. Notice the movements of your toes, feet, legs, arms, chest. Notice where your eyes wander to. 

3. Washing of Hands 

1. As you turn on the tap, put your hands under the running water. Remain still. Is the water cool or warm? 

2. Rub your hands slowly under the running water. Feel the water in between your hands as you rub, and how your palms touch each other as you rub to and fro. 

3. Listen to the sound of running water. How does the water sound as your hands go under the tap? 

4. Look at your hands: do you recognise the marks, scars, lines, nails? 

5. Focus on making observations with your eyes, ears, hands, palms:  

   • What is the colour of the soap? How would you describe its smell? What is the first action you do when you start washing your hands? Does the soap foam up? What colour does it become? Was the water warm or cold? What colour is your skin turning? Do you see the different shades of colour on your skin?  

4. Mindful Body Scans 

1. Lie on your back in a comfortable position. Face the ceiling or sky if you are outdoors. If you cannot lie down, you may wish to sit on a chair with your feet resting on the floor. 

2. Breathe and be still. If you have to move or adjust your position from time to time, that is fine. As you breathe in and out, notice the rhythm of inhalation and exhalation and the way your chest rises and falls. You don’t have to change the way you breathe or hold your breath but remain aware of your breath as you continue to inhale and exhale. 

3. Now close your eyes. Bring your attention to your body and how it feels. The texture of your clothes against your skin, and the parts of your head, back and legs that rests upon the surface you are on. 

4. Imagine that you are outside of your body and looking at yourself. Look first at your toes. How do you feel as you look at your toes from the outside of your body? Now shift your gaze upwards as you work systemically from the bottom up: 

   • Your toes and the rest of your feet 

   • Lower legs and calves 

   • Knees 

   • Thighs 

   • Your pelvic region (buttocks, tailbone, pelvic bone, genitals); 

   • Abdomen; 

   • Chest; 

   • Lower back; 

   • Upper back (back ribs & shoulder blades); 

   • Hands (fingers, palms, backs, wrists); 

   • Arms (lower, elbows, upper); 

   • Neck, Face and head (jaw, mouth, nose, cheeks, ears, eyes, forehead, scalp, back top of the head); 

   • Lastly the “blowhole” located on the top of your head – imagine a point on head where air goes in and out like a whale’s blowhole. 

5. Mindful Conversations 

This last one is a group exercise. Mindful listening is an important skill as people crave but are seldom fully “heard” or “seen”. Mindful listening also offers us the opportunity to shift the focus from ourselves or own responses onto the person speaking. 

1. Gather around several of your friends and/or family. Sit together in a comfortable space (please observe safe distancing rules!). 

2. Think of one stressful event that you experienced recently. Take turns to speak and share what that stressful event was in the group. 

3. If you are speaking, speak without reservation or fear that anyone is judging you. If you are listening, listen intently without judgment or forming opinions.  

4. Notice your bodily sensations, your thoughts and the feelings that flash through your mind before, during, and after each person has spoken.

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General Tips for Mindfulness: 

1. Set aside a few minutes for each activity (at least 20 minutes for the group activity). This ensures you have sufficient time to fully immerse yourself in a mindful experience. 

2. During each activity, focus on at least 3 of your 5 senses (sight, taste, smell, touch, sound).  

3. Do not try to ‘push away’ unwanted thoughts or distractions 

4. Simply take cognisance or accept the thoughts or distractions that flash across your mind. 

5. Let whatever feeling or emotion you experience simply be. 

6. Then return your focus back into the experience of simply being mindful and aware of where you are. 

7. While it is normal to experience distractions during mindfulness activities, practise bringing your attention back onto the mindfulness exercise. Focusing on your senses helps with redirecting attention. With practice, you will be able to effortlessly redirect your attention onto an experience of your choosing. 

8. Remember to approach Mindfulness exercises in an open and non-judgmental way. Treat your experiences as they are, and acknowledge the distractions, thoughts or even judgments you may experience – these are normal and will arise from time to time. 

What Are Cognitive Biases and How to Deal With Them

As human beings, we often fall prey various types of cognitive biases. As the word “bias” tends to have a negative connotation, many people often think that biases are a bad thing. You may be surprised, however, that these biases have actually evolved to serve many adaptive functions. 

Here’s a list of common cognitive biases and how you can avoid or overcome them:

Confirmation Bias 

We have the tendency to look out for and favor information that confirms our beliefs and values, all while ignoring or dismissing information that tells us otherwise. This is known as confirmation bias. It is in the human nature to want to be right. As such, we are prone to selecting information that aligns with our beliefs, making us believe what we want to believe. 

We have this bias to reduce cognitive dissonance — the discomfort we feel when faced with conflicting beliefs. To reduce this discomfort, our brain fine tunes the information that we take in, such that we only take in bits of information confirming that we are right. This bias also protects our self-esteem as it makes our beliefs seem more accurate. Thinking that we are right boosts our self-confidence and make us have a more positive self-image.  

However, it is important to be open-minded, to let your opinions be challenged, and to consider alternative perspectives. One way to avoid falling prey to the confirmation bias is to surround yourself with diverse groups of people and to be exposed to differing views.  

Hindsight Bias 

“I knew it all along!” “I told you this would happen!”

If you find yourself saying things like these, you are probably engaging in hindsight bias. As the saying goes, “hindsight is always 20/20”. Hindsight bias refers to the tendency to perceive events as more predictable than they really are and this usually happens after the events have already occurred.  

Similar to the confirmation bias, the hindsight bias helps to boost our self-confidence as it feels good to know that we accurately predicted something.  

Here are some things to keep in mind to avoid the hindsight bias. First, we should not only limit ourselves to one outcome but consider alternative outcomes as well. Next, reasoning why an event occurred can also help us realize that the event was not as predictable as we thought it was. For instance, we think that Team A will be the winner of a soccer competition. However, in reality, Team B had better players but their ace players decided to withdraw from the game at the very last minute that day. Team A eventually won and we think that we knew it right from the start. After reasoning that Team A may have won because of unforeseen events, we can see that the event of Team A winning is not that predictable after all. 

Negativity Bias

Negativity bias refers to the tendency to focus on negative events and stimuli more than positive ones. These negative events also stick to our memories for a longer period of time and influence the decisions we make. 

In the past, our ancestors had to hunt for food and compete to survive. Therefore, negativity bias was adaptive as it helped them remain alert to anything that could have potentially threatened their survival and well-being. However, today, this hard-wired tendency to focus on negative events is no longer as helpful to us. In fact, paying too much attention to negative events may trigger negative emotions and increased rumination.  

One way to avoid the negativity bias is to reinterpret negative events in a more positive light. For instance, we can shift our focus to the takeaways we can learn from a particular negative event. This way, we are reframing a negative event into a positive one.  

Self-Serving Bias 

Self-serving bias is the tendency to take credit for the positive outcomes we have experienced, but blame external factors for the negative outcomes. When we take credit for the positive outcomes and events that happen to us, this helps to boost our confidence. On the other hand, blaming external factors when we experience negative events helps to protect our self-esteem. However, the self-serving bias can backfire if we constantly point fingers at others or blame our own poor performance on situational factors - doing so hinders us from learning and growing as a person.

To avoid committing self-serving bias, it is important to learn from our mistakes and reflect on how we can improve. We should also not forget to credit others for our own success as well.  

Fundamental Attribution Error (FAE) 

FAE is the tendency to attribute others’ actions to internal factors and dispositional traits (e.g. their personality), while attributing our own behaviors to external situational factors that are beyond our control. For instance, when the whole class performed badly for an examination, we blame our own poor performance on a bad night’s sleep (an external factor) but think others did not perform well because they did not study hard enough (an internal factor). 

FAE can be adaptive as it protects our self-esteem by attributing negative events we have experienced to uncontrollable external factors but does the opposite for others. This makes us feel better than others and also does not make us feel disheartened when we experience negative events. However, excessive FAE can lead to the creation or perpetuation of stereotypes and prejudice.

To avoid FAE, we have to make a deliberate effort to put ourselves in the shoes of others and try to obtain a balanced view of others.  

Spotlight Effect 

The spotlight effect is the tendency to overestimate how much others observe and judge us. As the term suggests, it is the tendency to feel that the spotlight is on us all the time as though we are actors on a stage, especially focusing on our flaws, weakness and mistakes. The spotlight effect is highly correlated to feelings of nervousness and embarrassment. In some cases, it even leads to social anxiety and withdrawal.  

One way to avoid the spotlight effect is to recognize that everyone is preoccupied with their own matters (e.g. talking to their friends, focusing on their worries). Therefore, contrary to our beliefs, other people are unlikely to have the time to notice us and the things we do. Even if they did, they are unlikely to remember our mistakes for long.  

Being aware of the biases helps!

Interestingly, studies have also found that when people are aware of such biases, they are less susceptible to them. Why is this so? Simply put, when we are more aware about the existence of such biases, we end up making an intentional effort to avoid falling into their trap. Therefore, by simply knowing that these biases exist and exactly what these biases are, we are less likely to fall prey to them. 

Pandemic Fatigue

What is Pandemic Fatigue? What are some signs of it?

“Pandemic Fatigue” refers to a mental state where a prolonged, heightened state of fear & caution leads to a form of burnout. 

Pandemic Fatigue presents itself differently in different people. Here are some ways that it might manifest:

Ψ Feeling physically numb and socially withdrawn
Ψ Becoming irritable, sensitive, or impatient
Ψ Becoming less diligent about COVID-19 prevention measures such as handwashing, wearing a mask, or observing social distancing norms.
Ψ Reduced enjoyment from activities you used to like
Ψ Consumption more “comfort food” or alcohol
Ψ Constantly feeling tired and yet experiencing difficulties getting a good night’s sleep.

Why do we feel this way?

Different people are likely to experience pandemic fatigue at different periods of time. People who were affected by the pandemic or who entered into the heightened state of caution at an early stage are likely to experience an earlier onset of pandemic fatigue. Persons who did not witness first-hand the effects of the pandemic, or who were compulsorily subjected to precautionary or prevention measures without understanding the need for such measures, might also experience pandemic fatigue earlier.  

Feelings of complacency might also begin to emerge due to desensitisation through extended media exposure to COVID-19. Much like the principles behind exposure therapy, repeated exposure to pandemic-related news will eventually diminish the initial feelings of anxiety and caution. Consequently, we may begin to engage in behaviours that were initially inhibited by the anxiety responses such as not adhering to safe distancing rules or washing our hands as regularly as we did before. 

A toll on our emotions and mental health

Pandemic prevention measures such as social avoidance and distancing can make people feel isolated, lonely, and increase stress and anxiety. Long term worries about a pandemic takes a toll on your mental and emotional health and might result in the worsening of mental health conditions and chronic health problems. Changes in mood, tastes and preferences, sleeping patterns, increased use and reliance on substances such as alcohol and tobacco are typical effects. 

A prolonged stress response is also detrimental to the body as it disrupts the body’s natural functions. While natural stress hormones such as cortisol and adrenaline are useful body functions that brings about short term benefits (e.g., enhanced brain function, increased energy for immediate muscle action), long term stress might result in headaches, an inability to focus, digestive issues, insomnia, and a weakened immune system. This ultimately affects our overall daily functioning. 

I’m struggling with this “new normal”. How can I better adapt to this situation?

One suggestion is to adopt a “journey mindset”! Trying to predict when COVID-19 will end can be frustrating as it is surrounded by so much uncertainty; we should focus instead on the quality of the touchpoints in our daily lives. Try and make small improvements to each of these touchpoints, regardless of whether it is directly related to the pandemic (e.g. making an effort to pay more attention to social distancing in public places, not touching your face while in public) or to your own personal growth (e.g. mindful interactions with your interpersonal relationships, picking up a new skill or hobby). It is also helpful to lean on our social circles for mutual support through this difficult time. 

Some other suggestions include: 

Ψ Establishing fixed points in your daily routine (e.g. work, meals, family obligations), & fill up the other times with solo or group activities that you enjoy. 
Ψ If permissible, step outside of your house for occasional sunlight and fresh air, even if it is for a short while.
Ψ Limiting over-exposure to COVID-19 related news, especially when it feels too overwhelming. 
Ψ Managing your expectations of yourself and others. Recognise that the pandemic affects everyone in different ways. 

Don’t forget to create little pockets of fun and joy in your routine by doing things you enjoy such as a baking day once a week, or a self-care hour alternate day, or perhaps a virtual meeting with your friends every Sunday evening over drinks. 

How do I overcome feelings of isolation and loneliness?

In general, feelings of loneliness can be caused by the loss of one’s sense of purpose. This usually happens when boredom is coupled with feelings of a lost sense of self.

Here are some suggestions that you may find helpful in overcoming such feelings:

Ψ Reintroduce meaning and importance into your days by signing up for an online webinar or course to learn a new skill or upgrade yourself.
Ψ Check in with your loved ones frequently.
Ψ Do not be ashamed to ask for help if needed. If opportunities for real-life interactions are limited, connect with others on virtual support groups, communities, and even telehealth platforms.
Ψ Offering a helping hand to others can help us feel connected to others. 
Ψ During this time, there are also others that would benefit from your acts of kindness. Even if you do not feel “100%” or feel that you are unable to offer any real support, the mere act of showing concern and spending a few minutes each day with your loved ones will be deeply appreciated. 
Ψ Keep your mind stimulated with “active” hobbies such as playing an instrument, painting, or cooking, as opposed to more passive activities such as binge watching a Netflix show.
Ψ Turn more passive activities (e.g. reading) into something more engaging by creating or joining a virtual book club with your friends or an online community. 

Do not hesitate to seek help if you feel overwhelmed or when you simply need some guidance or someone to work through your thoughts and emotions with you. Seeking help is especially important if you find that your it is affecting your daily functioning to a large extent for an extended period and/or you are beginning to constantly experience feelings of worthlessness, hopelessness, panic attacks, or other atypical symptoms. 

A Survival Guide for Managing the Holiday Season

As with the trains of the Deutsche Bahn, like clockwork, the holidays are upon us (again) this time of year. Many will be looking forward to the Christmas and New Year breaks; some will be bracing for the impending deluge of parties and festive foods, and yet others may take the opportunity to escape from the madness of it all.

But some associate the holiday season with misery, stress or disappointment. And with good reason.  

Holidays are like a giant (salty) mirror that amplifies our daily struggles with loneliness, existential thoughts, or coming to terms with finances (yes, the holiday season can be expensive). Here are some techniques to help us enjoy the holiday season.

1.       Manage your expectations. Accept that there is no perfect way to enjoy a holiday. Nor does it have to be “as good as last year’s”. As circumstances change and evolve, and so too must our traditions and rituals. Cherish the important ones, but never at the expense of your mental well-being or your wallet. Be flexible about which traditions to change or hold on to. For example, Christmas or reunion dinners do not have to always be at the swankiest restaurant every year.

Back to All Notes

2.       Schedule “Worry” Time. Especially in a group or larger setting, it may be hard to not worry about what may go wrong during the get-together. Common refrains include: “What if nobody likes the food I prepared?”; “Aunt May is going to talk about her son’s PSLE score and ask me how my daughter did…”; or “Grandma is going to nag about my weight.”

To control the frequency of worry, try this.

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First, identify all the tasks or items that are within your “sphere of influence”; essentially, matters that you can do something about. Identify what needs to be done and complete those tasks. You’ll start to feel a whole lot better once you make a checklist and tick them off.

Then tell yourself this: “there are always going to be things that are not within my influence. I am going to allow myself to worry about it, for no more than 10 minutes. But after these 10 minutes, I shall leave my worries for my tomorrow self to grapple with” (or similar words… but you get the idea).

The intent of this Cognitive-Behavioural Therapy (CBT) tool is to compartmentalise and contain worries that are not within your control to a designated period during the day, thereby freeing up your “head space” for important, relaxing or fun activities. This tool has been found to be clinically effective in managing worries.

3.       Social Support. Social support is a powerful tool for stress relief. Interpersonal communication among family members allow us to take each other’s stands and think of how we can help each other. At the same time, it also prevents misunderstanding from arising. For example, gift exchange may be a tradition, but it could be a stressor for one who is going through a financial difficulty. If getting a present for everyone in the household is going to cost a hefty amount, talking to your family member ahead of time about your situation is going to help. This is to seek their understandings and maybe adjust the tradition according to needs. Gift exchange can be changed to “secret santa” such that everyone has to only buy one present.

4.       Coping with Unexpected Situations. Things do not always go in our favour (or similar sounding words to that effect), said Murphy. Plans often go awry.

However, it may be (mathematically) easier to adjust the way you handle emotions than to change the way others react. For example, you can’t control the people who make you angry, but you can control your anger and what you do with it. Here are some ways to cope with anger or stressful situations:

Ψ Emotion-focused coping: Reduce negative emotions (i.e. anger, fear, anxiety, aggression, depression, humiliation) by practicing meditation or by writing them in a journal. Another way could be to picture said others as cartoons while they are spewing offensive things: it takes some of the hurt away.

Ψ Problem-focused strategies: Remove or reduce the cause of the stressor through problem-solving. In time of stressful situations, think calmly of how to change the situation.

5.       Reframe your thinking. As with any social setting involving more than one person, there will be many situations, interactions, and verbal and non-verbal cues that make us susceptible to distorted patterns of thinking (eloquently described in Mandarin as 胡思乱想).

The first step in identifying maladaptive thoughts is to develop an awareness when you start to recognise the patterns of thinking induced negative or stress-inducing patterns of thinking. For example, “They must be gossiping about me”, “Why are they looking at me like this? Is it because I am fat?”, “She is boasting about her son again, I must not lose” and so on. The second step is to challenge those thoughts. Are the things you're telling yourself even true? Also, what are some other ways to interpret the same set of events? Which ways of seeing things serve you better? Instead of seeing things the way you always have, challenge every negative thought, and see if you can adopt thoughts that fit your situation but reflect a more positive outlook.

6.       Avoid conflicts. Sometimes, what is needed is just to walk away. Walk away from your triggers by excusing yourself: “after hearing what you said, I need to defecate” or call a trusted friend to rant.

If an argument is occurring between two persons (and one of them is not you), avoid taking sides. During this season especially, monitor your alcohol intake and keep a clear head about you. Listen if you are called upon to do so but do not share confidential or private titbits with another.

Keep conversations light and optimistic. If you know the person you are talking to is a fervent Trump supporter, don’t provoke that person by invoking the good name of the 44th President of the United States.

7.       Just say no. The easiest the express but the hardest to do. If large gatherings cause you great amounts of stress, it is okay to say no. Just say no. Offer to catch up with those you wish to individually or in smaller groups. Or spread or defer your engagements over a longer period of time. There is no stipulation that says you must visit ALL of your family and friends during the actual holiday period.

8.       Absent family members. Keep in mind that some family members may not be able to attend because of various reasons such as illness, service in the military, studying abroad, financial burden or other reasons. Acknowledge their absence by including them.

If a beloved family member has died, do not ignore or minimise the loss. Be truthful about your feelings and share stories about your loved one. It can be cathartic for family members to mourn together in this way.

9.       Make decisions based on goals, relationships or values. Establish a set of values that you strongly believe in. Then rank your priorities and relationships and make decisions based on them. For example, if controlling your spending has been an issue, make a budget plan and stick to it. If you are a family-oriented person, make more time for your family instead of packing your holiday schedule with colleagues or friends. If you believe that the way you have organising your time is not going to work, change it.

Practising mindfulness and interpersonal effectiveness skills will improve your ability to cope in social situations. Developing an honest understanding of yourself and your emotions, and focus on living in the present.

Coping with Sexual Assault

Credit: Millennials of Singapore

AWARE Sexual Assault Care Centre
6779 0282 (10AM to midnight, Mon-Fri)

KK Women's Hospital
6225 5554 (24 hours)

Singapore General Hospital
6222 3322

Tan Tock Seng Hospital
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Sexual assault is any unwanted sexual behaviour that makes a person feel uncomfortable, threatened or scared. Consent is key - if you did not consent to such behaviour, or withdrew your consent, and the other party continues to make unwelcome advances, that is sexual assault.

AWARE Singapore has also published a helpful resource on what sexual assault is.

If you are a victim of sexual assault, please don’t blame yourself for whatever that has happened to you.

No one has the right to violate you no matter how you dressed, or whether you are unconscious or not.

First Steps

Try and remember as much as you can about your surroundings when the assault occurred; the smallest details can make a huge difference. At the earliest opportunity, try and picture the offender’s face, features or clothing (distinct colours, features or brands for example).

If you were unconscious during the assault, try to remember what you can of what occurred before and after you became unconscious or assaulted, including your surroundings. Find out if there was anyone around whom you can ask for more information of what happened.

Lodge a police report and seek medical attention as soon as possible in case of STIs and pregnancy.

In order to gather and preserve evidence, a sexual assault forensic examination (commonly referred to as “rape kit exam”) can be done at either KK Women’s Hospital, Singapore General Hospital or Tan Tock Seng Hospital within 72 hours of the incident – these hospitals are best equipped to deal with sexual assault.

You are required to make a police report before doing the rape kit exam. If you are under the age of 21, your parent or legal guardian is required for the rape kit exam.

Although it is strongly advisable to make a police report and undergo the rape kit exam, do not feel that you must do so against your will (or at the insistence of your family or friends) if doing so causes you great distress. This may only end up worsening your mental health. Instead, persuade your loved ones to respect your decision.

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Management

It is normal to feel strong emotions such as disgust or shame. Don’t avoid experiencing them.

Accepting that these feelings are unavoidable is the first step to managing what you are going through. When you are ready, open up about what happened to people you trust. In fact, keeping the fact of the assault all to yourself can be extremely suffocating.

There are countless testimonies published online (#MeToo movement) and support groups where survivors share their experiences – AWARE has one for female survivors (16 years of age and above) of sexual assault. You could hear from others on how they coped with their experiences. If you're not comfortable speaking to a group of people, you could share your story online anonymously with AimForZero or speak to a trusted friend. We all need an outlet somehow.

Sharing your experience and seeking comfort in the support of others can help you to cope with the debilitating incident. Here are some benefits of doing so:

Ψ Release pent up emotions
Ψ Receiving support from a support network (family, volunteers, welfare organisations)
Ψ Make sense of your thoughts and emotions
Ψ Greater clarity of what happened during the incident
Ψ One step closer to management
Ψ Spread awareness of this issue in society (without these small contributions, many others may continue to be oblivious)

Even if you really do not feel like confiding in someone, try and seek out at least one or two trusted confidants.

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Acceptance (Not Avoidance!)

While it may be painful, recalling and accepting the incident is important. Avoidance only makes whatever you were avoiding more salient.

The harder you try to avoid it, the more likely that you will be reminded of it, or make it more salient in your head. Acceptance is not the same as blaming yourself for what happened. Rather, it includes being able to accept that what happened was out of your control.

Coping with Flashbacks

It is common to experience traumatic flashbacks. Prepare yourself by developing some awareness of possible triggers (e.g. certain smells). Once you are more aware of your triggers, it will help you make sense of what is happening and why.

During flashbacks, pay attention to physical sensations and what emotions you are feeling during these episodes. After, take steps to calm down, such as breathing exercises. Ground yourself in the present (e.g. tapping your arms, naming the current day) as this will help you realise that it is a flashback and not reality.

Don’t Isolate Yourself!

Stay connected with loved ones and join social activities. You don’t have to constantly talk about sexual assault or things related to it. You can do things that have nothing to do with the trauma itself.

If these activities bring you joy, they can be equally helpful. Participating in joyful activities isn’t avoidance. You can choose to accept that you are feeling low or down, and yet try to do something to lift your spirits.

Seek Professional Help

Sexual assault and trauma is linked to a bunch of mental disorders, depression, PTSD, anxiety disorders etc… If you feel unable to carry on with your everyday life due to the repercussions of the incident, seek help from a mental health professional.

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For friends, family, loved ones of victims

Don’t blame them for whatever that has happened, pass judgments or express doubt on their story.

1. Be a listening ear. Listen to their narration of events, bearing in mind that effect of trauma may have had an adverse impact on their ability to accurately remember the relevant sequence of events.

2. Don’t downplay or trivialise the incident. This will (definitely) come across as doubting or invalidating their feelings. Let them feel whatever they must feel as part of their own process.

3. At an appropriate time, encourage them to seek help whenever they can (e.g. psychologists, counsellors), but let them do so on their own terms. Do not insist for them to seek help. Only encourage them to do so if it seems as though their distress is causing them to be unable to function daily or normally.

4. Provide emotional support whenever you can. A sexual assault experience can be extremely traumatic and effects can last for a long time. Think along the lines of “How can I be there for him/her?” rather than “What concrete steps do I need to take to help?”.

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For others

Tips/Precautions

• Be mindful of your surroundings and the environment you are in. If necessary, take additional precautions if you have to walk in an unsafe area.

• Do not assume that someone else will look out for your safety. In bars or at parties, keep your drink with you. Leaving your drink unattended makes it possible for someone to spike them with date rape drugs or intoxicating alcohol. Know your limits and keep within them, especially when it comes to drinking in unfamiliar places. Being surrounded by familiar people does not make a place “familiar”.

• Sexual assault occurs even if you least expect it. Do not keep quiet if an assault is imminent. The shock may overwhelm and you may be too frightened, but always seek help immediately. Scream or shout for help if you have to.

How to contribute to the cause

• Stay current on sexual assault laws. By educating ourselves on the many forms and types of sexual assault, when they can happen and what safety nets we have in place in society, we become more knowledgeable on the issue and can either help spread awareness, or strive for change in the community.

• Become an advocate for sexual assault victims. You can start small – from sharing with your friends and family about your experiences (if any) and how you survived. You can volunteer for AWARE, join a movement or speak up about the issue whenever you can.

• Know how to respond to sexual assault cases. For example, if a stranger approaches you for help or if you witness something happening, don’t be an apathetic bystander. Help the person. With people being more alert and informed, offenders will be more afraid to act out. Deterrence may not completely stop sexual assault, but it can at least reduce the number of cases and victims.

A Brief Note on Grief

Credit: Megan Devine, Refuge in Grief

中文版

Grief is a natural response to loss

Grieving is a completely normal reaction to loss. The passing of a loved one, the loss of a treasured relationship, or loss of use of a physical ability, or perhaps something more intangible like an opportunity or aspiration.

Everyone’s processing of grief is different, and it takes time. Sometimes, lots of time. There are different theories on the various stages or trajectories of grief a person may go through. Regardless of which, some common emotions during grieving are:

Shock, numbness, disbelief. Guilt. Fear and anxiety. Or sadness; extreme sadness.

Questions such as “What could I have otherwise done?” or “What if this happens to someone else I love?” may fan the flames of the ever-present anxiety usually accompanying grief.

All these are intense emotions that are overwhelming. How to cope?:

Ψ Allow yourself to feel the full spectrum of emotions that awash you. Don’t let anyone tell you that it’s not okay to feel what you are feeling, be it sadness, fear, shock or any other emotion.
Ψ Take care of yourself – remember to eat well and exercise. If you have a routine, stick to it.
Ψ Be gentle with yourself. Forgive yourself for things you may have said or done (or did not say or do). We are, after all, only human.
Ψ Talk to peers. Remember your Tribe, and that you are not alone in this world.

When should you seek professional help?

It may be a good idea to seek therapy from a mental health professional if you feel:

Ψ The intense emotions aren’t subsiding.
Ψ You don’t feel capable of coping with the overwhelming emotions on a day-to-day basis.
Ψ You have trouble sleeping.
Ψ Your relationships are affected by your grief.
Ψ You feel continually sad, depressed or anxious over a period of time.

Therapy centred around coping with grief involves helping you come to terms with what has happened; to process, accept and allow yourself to feel the emotions you are feeling. Your clinical psychologists may also work towards helping you forgive yourself if you are feel immense guilt. Stress management and relaxation techniques can help to cope with feelings of anxiety. You may be asked to think about how your basic emotional needs, such as love and belonging, were met before the loss, how your needs have been compromised by your loss, and how new steps can be taken to meet your needs.

There are, of course, differences in the way each human processes grief; the therapeutic techniques used will vary between persons. However, as with all psychotherapy, processing grief and loss is very much a collaborative effort between you and your psychologist.

A Non-universal Mother’s Day

Mother’s Day is a day of celebration and joy for families as we cherish the many gifts of mothers around the world.

Yet, that might not be the case for everyone. In a healthy mother and child relationship, the bond between mother and child is usually a close and endearing one. For others however, Mother’s Day might be a painful one. For children who might suffer from ongoing emotional, physical and psychological abuse due to the absence of or abuse from their mother, or adults who were abused as children, Mother’s Day might be a stark reminder of that toxic relationship and trigger traumtic memories.

The scars left behind in children who experienced trauma as a result of their mother make it difficult for them to celebrate Mother’s Day. Trauma is directly attributed to any type of abuse a mother subjected her child to. Abuse may take many forms (spiritual, emotional, psychological, physical, or sexual), and can be ongoing throughout childhood and into adulthood. In many cases, the source of the abuse may be an unaddressed mental illness or a personality disorder. Ultimately, an abusive upbringing damages the relationship between the child and the parent. Moreover, all types of abuse are damaging to children and can cause long-term difficulties with their behaviour and mental health.

As we celebrate Mother’s Day this weekend, let’s remember the children whose mothers do not fulfil the ideal role of motherhood. Let’s extend our love and respect to all those battling with such issues today.

For those struggling with Mother’s Day, here are some tips you can follow to make getting through Mother’s Day a bit easier.

Tips for navigating Mother’s Day

Be honest about how you feel  
Acknowledge how you actually feel about this day instead of what you think you should feel. It is easy to skip over your true feelings when confronted with idealistic Mother’s Day messages and people telling you how you should feel about your mom. Even though it’s hard, being honest with yourself about your feelings — without judgment — is an important step in navigating difficult emotions surrounding family-centric holidays.

Take a break from social media on Mother’s Day
Try and take a couple of days of social media to focus and take care of yourself. Being away from social media helps you take your mind off the bombardment of Mother’s Day messages.

Celebrate the positive female role models in your life
Pay tribute to another female in your life instead – a sister, grandmother, female friend, teacher, aunt. Take this opportunity to let this woman know how much her presence has meant to you. You could also turn Mother’s Day into your own personal celebration of strong and powerful women everywhere. Your self-defined version of Mother's Day is definitely worthy of celebration.

Create a plan to take care of yourself
Get out of the house and do something fun to take your mind off things – go for a run, buy yourself some ice cream. You may have a mother-sized hole in your heart, but you can take time today to think about how you can take better care of yourself. Make a commitment to treat yourself with respect, love, encouragement and gentleness.

Spend time with supportive friends on that day
Reach out to a friend who is always willing to lend a judgment-free ear whenever you need emotional support or some companionship.

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Coping With Mother’s Day When Your Mother is Gone

On Mother’s Day, we often honour and celebrate the women in our lives who have raised us, nurtured us, and loved us. However, there is also a significant group of people who won’t get to hug, call, or celebrate this special day with their mother. These individuals often nurse fond memories of what their mother was like before she passed away or find themselves daydreaming about how things might be different if their mothers were still alive. This leads to the experience of a sense of bittersweetness whenever Mother’s Day rolls around.

Losing one’s mother is certainly a painful ordeal, regardless of factors such as how old you were when it happened and how much time has passed. Such feelings are often heightened around significant events such as birthdays, holidays, and Mother’s Day, especially when social media is flooded with photos of celebrations revolving around mothers.

We see you and we see what you may be going through as you navigate this difficult day. For those who are struggling, here are some (more) tips to make it through Mother’s Day.

(More) tips for navigating Mother’s Day

Acknowledge your feelings – they are normal
Especially on Mother’s Day, feelings of sadness, anger, or even envy can be very common. It can be tempting to simply label these feelings as “bad” and run away or push them aside. However, know that these feelings are normal, and attempting to suppress them will lead to them eventually bubbling over. Instead, allow yourself to feel and experience those unpleasant emotions. Let them come and go like waves without struggling with them or giving them too much attention and know that in time, the waves will eventually recede.

Practice self-compassion
Take some time to think about how you can better care of yourself, and commit to treating yourself with respect, gentleness, and love. Be kind, and don’t place yourself under an immense pressure to be OK all the time. You get to decide how you want to spend the day. Make a plan to engage in some activities that bring you joy – go for a walk in the park, cook your favourite dishes, buy some ice cream, or even watch your favourite comfort movies. As long as it brings you some comfort, that’s reason enough to do it.

Write it out
Journaling is a great way of working through and disentangling complicated thoughts and feelings by putting them into words. Alternatively, you could consider writing a letter to your mother and telling her about your thoughts and experiences. While this may feel strange, bereavement studies have found that this helps to validate your emotions and may help you feel closer to your mother. 

Share stories and memories about her
You may have some stories, memories, or old photos of your mother. If you are feeling up to it, you might find it cathartic to share these tidbits with a close friend or family member, especially those who knew her as well. Sometimes, grief can make us feel alone. As such, sharing your stories and talking to others can help to celebrate the memory of your mother and bring everyone closer.

Get support
Know that you are not alone and that it is perfectly fine to ask for help and support in whatever form you find most helpful. Consider reaching out to a support group with others who have gone through similar experiences or speak to trusted family members or friends who can provide you with comfort, support, and a non-judgmental listening ear.

The Authentic Self

You've seen glamorous pictures of their cars, watches, and handbags (and other things from www.uncrate.com - which by the way is an excellent site to while away the time).

Or perhaps watched the latest 'stories' of linen-clad ‘frienemies’ traversing the Moroccan plains atop a camel. Maybe nothing too rich, just a good-looking former colleague armed with her silky-haired squad hitting the clubs every weekend, and you look at yourself, slumped on the couch with a bag of potato chips watching Netflix (or worse, endlessly scrolling through for something to watch).

Yep. We've all seen these pictures and most of us are guilty of it.

Social media platforms such as Facebook and Instagram inadvertently foster comparisons with your peers. You think, “Why can’t my life be as fun and exciting?” And you start to make plans to skip lunches to save up for a holiday to take twice as many photos, with your new skinny body of course. Or you blow your bonus on that much-vaunted 2.55 alligator bag in gold.

But still we constantly scroll through our feeds looking at the polished pictures of our peers. The cycle (and the feed) is endless.

Why?

Like Thanos, we want to reshape reality. We want to convince our friends and family that we are a certain person whether or not that might be true. We might even believe that we are the image that we create for ourselves. In a world of smartphones and selfies, where our identities are equated with our social media profiles, who’s to know what we are or aren’t?

But are we truly living happy lives?

A study conducted in 2015 found a strong correlation between authenticity and self-esteem. People felt better about themselves if they believed they were living authentic lives; if they thought they were true about themselves.

What is an authentic life? One philosopher thought an authentic life involved making choices based on your own values, rather than in accordance with the values of anyone else.

But almost every photograph on Facebook or Instagram is a filtered version of reality – there literally are dozens of filters to choose from to edit a photograph. They are also filtered because people only want the positive on display. Perhaps what wasn’t shown to you was how disastrously smelly that Moroccan camel was, how many times she puked along Jiak Kim Street after Mambo Night, or how many installments are left on that BMW. Our quest to emulate the lives of these people becomes meaningless because the very thing we seek to recreate is not real.

We would all be a lot happier (and richer) if we stopped trying to live like the people we follow on social media. Live life on our own terms, simply and without reference to others (said no professor ever).

In the wise words of Heidegger the philosopher, “The path we follow is always of our own choosing. We should never allow our fears or the expectations of others to set the frontiers of our destiny.”

Dealing with Shame

On a scale of 1-10, how true do the following 3 statements feel?

1. ‘I am a mistake’

2. ‘I am defective’

3. ‘I am unworthy of being loved’

Any score above 8 starts to indicate the problem of shame. Though to be fair, people who are disproportionately ashamed of who they are would have probably wanted to award themselves a thousand more.

What is Shame?

In shame, the focus of attention is on the “bad” self. Shame is a family of unpleasant self-conscious emotions that include embarrassment, guilt and humiliation, which makes us feel awful about ourselves.

Imagine tripping down the stairs and falling face-first onto the ground in a shopping center. Why was your initial thought ‘Did anyone see that?’ instead of tending to your agonizing physical pain first?

Shame is always present in our lives. We are motivated to maintain and achieve a positive sense of ourselves.

The issue with shame comes with a tendency to hide these negative emotions. Who likes to openly humiliate themselves? This makes it hard to recognize shame when it happens. For example, adolescents may superficially laugh off a poor exam result together while privately experiencing tremendous feelings of anxiety about failure.

As we avoid talking about our feelings of shame, we continue to have a lack of understanding about it.

Comparing the Cycles of Shame: Healthy vs Unhealthy

Let us work together to understand the diagram of a typical circumstance for a healthy shame cycle (see diagram on the left). Imagine being called out or reprimanded in a group chat by your manager for a serious error you made at work. You start to feel psychologically stressed as your heart begins to beat faster, your palms sweat, and your cheeks flush with embarrassment. You feel ashamed of your mistakes as you worry about being judged poorly by your coworkers. To alleviate these unpleasant emotions of shame, you are driven to strive more in the future to avoid repeating the same mistake.

Unfortunately, this is not the case for those who struggle with shame (see diagram on the right). Replaying the same event above, instead of trying harder to lessen the feelings of shame, you find yourself in an unhealthy spiral. By having excessive self-critical thoughts, or even indulging in self-destructive behaviours, you inadvertently feed these shameful emotions. You begin to mistakenly ascribe your mistake to a dispositional problem that only arises due to your lack of skill, causing you to get stressed once again.

It is essential to deal with the unhealthy shame cycle as excessive feelings of shame can lead to serious mental health problems. Some of the negative consequences of toxic shame include:

• Fear of letting people in

• Excessively pushing people away

• Feelings of embarrassment and/or humiliation

• Low self-esteem

• Lack of empathy for others

• Cynical thoughts about the future (e.g., believing that bad things happen to bad people)

• Obsessive rumination on self-critical thoughts (e.g., ‘I am unworthy of being loved’)

• Self-destructive/Addictive behaviours (e.g., substance use, self-harm and suicide)

Overcoming Shame

One way to overcome the problem of shame is from an Acceptance and Commitment Therapy (ACT) approach. ACT is a psychological intervention that involves accepting and embracing life events as they are without seeking to change them. It also involves committing to making meaningful steps to improve and enhance your life.

Before we dive deeper into ACT, we need to first understand how an unhealthy shame cycle forms and takes root.

As you get older, you start to develop a better understanding of how your actions affect others through learning from your mistakes. Parents hold an important responsibility to remind you that mistakes are normal. We can use the lessons we have learned from our failures to make better decisions in the future.

However, instead of guiding children through their mistakes, parents may unintentionally send unhelpful messages to the child. They may do so by expressing criticism and/or disappointment directed at the child rather than their conduct:

“Can you stop being the laziest child in the house and do some chores?”
“You just had to be the only student in class to fail that test.”
“Stop embarrassing me and behave yourself.”

This may give the child the false idea that he or she is undeserving of affection, which can lead to shame. Unhealthy shame thus prevents a more positive perspective of oneself, making it difficult for the child to develop a healthy sense of self-worth.

Let’s now look at how the ACT’s 6 key processes can help you overcome shame:

(1)  Acceptance

When we are overwhelmed with unwanted feelings of shame, it is instinctive for us to try to avoid and suppress them. Acceptance, on the other hand, is acknowledging and embracing the portion of yourself that feels “not good enough”, “unlovable” and/or “rejected”. 

Do not get us wrong, acceptance does not mean that you are inviting or seeking feelings of shame. After all, who likes to dwell in their misery? Acceptance simply makes room to experience the agony of shameful emotions.

Soon, you will quickly notice that you are less disturbed by these feelings of shame if you do not attempt to escape from them. Isn’t it funny? The more you want to embrace and accept your shame, the less salient they become.

(2)  Cognitive Defusion

“I am unlovable at home.” “I am not good enough at my workplace.”

These are some common self-criticizing thoughts from someone struggling with shame. Cognitive defusion involves establishing a psychological distance from these self-defeating beliefs, understanding that they are just one of many non-threatening perspectives.

To do so, start by asking yourself this question: Who will have control over your life – you or your mind? Choosing a different relationship with your problematic thoughts allows you to take a step back and not be consumed by them.

For instance, you can recognize a mistake you made at work as it is without attributing them as part of your personality.

(3)  Being Present

Take a trip back home from work or school with me. What do you usually do on the train/bus/walk back home? Are you consumed by social media on your phone? Or maybe you are planning ahead of time on how you are going to rest at home? Notice how none of these options include spending intentional time in the present.

Being in contact with the present moment is also known as “being in the now”. It involves focusing on what is happening to you, and/or in your environment at the present moment rather than on what has happened in the past or what may happen in the future.

When you are faced with feelings of shame, fully embrace them first! Then, acknowledge that past events are irreversible. Although you could have responded better, understand that you cannot change the past. Making mistakes is what makes us human!

When you start to focus more on the present, you spend less time evaluating and criticizing yourself and others.

(4)  The Observing Self

If we are being honest, we sometimes feel ashamed of ourselves in certain situations because we project our worries or past experiences onto the current situation. However, we fail to see that most of these assumptions are irrational and therefore our interpretation of such occurrences is often incorrect.

Hence, the next phase is observing and knowing yourself as part of a context. Think of this phase as objectively looking at your situation from an observer’s point of view. Refrain from allowing your thoughts and feelings to cloud your judgment on the situation.

This is realizing that your thoughts and feelings are a result of the situation, not of your personality. You can experience feelings of shame but you are NOT defined by them!

(5)  Values – What matters to you? 

Whether you recognize them or not, everyone has values. Values are qualities that you believe are the most important. They determine your priorities, guide your personal growth and help you make decisions about how you want to live your life.

The issue with our values is that we are not constantly in touch with them. When life gets in the way, we might lose track of them and become unsure of what they are. This causes our values to become more vulnerable and susceptible to change.

What used to be unimportant to you such as fear of judgment or embarrassment could have unconsciously become your most important value over time.

Hence, we encourage you to take some time to consider:

1)    What are the things that are most important to you?

2)    How would you like to be remembered?

3)    What are the things you strongly object to?

Our values need to be sorted out first before we can come up with a plan to challenge your feelings of shame.

(6)  Taking Committed Actions

Now that you have learned to embrace the unwanted feelings of shame and developed a clearer sense of values you wish to live by, we have now come to the final step of overcoming shame – taking committed actions. This is where you take concrete actions and behave in ways that lead to positive changes in your life.

There are many ways you can do this depending on what you are struggling with. For instance, you can set goals that are in line with your values and beliefs. You could even intentionally expose yourself to difficult thoughts or experiences.

Consistently practice and commit to those behaviours to achieve the goals that you have set out. The key to taking committed actions is to incorporate changes in your life that will align with your established values.

A Final Piece of Advice

We should stress that every human being is radically imperfect and broken in their own way. It’s okay to accept your flaws as everyone has them. Remind yourself that no one is perfect! If you feel comfortable enough, find a friend whom you trust and share your feelings of shame with them. We are positive that they will be more than happy to listen to your struggles!