Supporting a Child with Incarcerated Parents

The incarceration of a parent can be distressing for a child. It comes along with potential economic, social, behavioural, and emotional challenges for the child which is further complicated by the stigma associated with having an incarcerated parent. As such, it is imperative that these children be provided with well-rounded support so they can have the best possible developmental outcomes despite the challenges faced.

Here are some ways to support a child with an incarcerated parent

1. Visiting the incarcerated parent 

Most families endorse the idea that children should maintain contact with the incarcerated parent. Thus, if possible, support should be provided to facilitate communication between the parent and the child, allowing social ties to be maintained. This may take the form of:

Ψ Face to Face Visitations (link to Singapore Prisons Service)
Ψ Tele-Visitations

It is important that visitation takes place in a positive context (e.g., child-friendly, allowing physical contact between parent and child). Visitations that are “colder” and less welcoming tend to increase children’s distress instead. In cases where positive physical visitations are not viable, alternatives include letter-writing between the child and the incarcerated parent.  

2. Parenting Skills Training  

Providing incarcerated parents with training can also be helpful. Although there is no set curriculum for these training programs, most involve equipping parents with better parenting and communication skills. Parental training is most effective when combined with visitations and the opportunity for the incarcerated parent to practice what they have learnt. Undergoing such training has the added benefit of fostering a bond between the incarcerated parent and their family, as well as opens a channel for parental involvement.  

3. Mentoring 

Mentors can help alleviate the challenges associated with having an incarcerated parent by providing a mature figure whom children can trust, confide in, depend on, and learn from. Consequently, mentored children benefit both socially and emotionally (e.g., improved social skills and self-esteem), but the current evidence suggests that there is no academic benefit attached to mentoring programs. 

It is important to note that the effectiveness of mentoring programs is highly dependent on how well-matched the mentor and mentee are. Matching mentees with mentors can be a challenging process — one study showed that one-third of mentees dropped out of the program within half a year. A mentee who does not match well with the mentor is likely to drop out from the program and will therefore be less likely to reap the benefits from mentoring. Research concerning the effectiveness of mentoring programs for children of incarcerated parents is currently mixed.

In conclusion…

There are several methods to support a child with incarcerated parents. In Singapore, Kids in Play (KIP) by the Salvation Army and Friends of Children & Youth (FOCY) by Life Community Services Society provide supportive services for children with incarcerated parents. These support services use a mixture of the aforementioned methods.  

It is important to support children with incarcerated parents because these experiences and its associated challenges can have adverse effects on a child’s mental health. Without support, children face heightened risk of mental health outcomes, which may manifest in behavioural and emotional difficulties.

As an added bonus, visiting an incarcerated parent also helps the parent through their own journey in incarceration and improving rehabilitative outcomes!

The Depths of Codependency

Codependency is like when someone tells you they need a hand, and you don’t know which hand to give so you give both. And then you’re worried maybe they need more, and decide, “How about my feet too?”. But then what if they don’t know how to use them? Maybe I should add a manual.

While that seems like an over-exaggeration to some, the feelings and behaviours exhibited by someone who is codependent are very real. There’s some pervasive sense of responsibility, especially if someone is going through hardship, to the point where personal needs or self-identity just doesn’t matter.

Its Twisted Roots

The strongest root lies in our childhood familial environment. Those of us who grew up in dysfunctional families, are more likely to develop codependency.

Some examples:

Ψ      A family member with chronic addiction or illness. A child is parentified, and grew accustomed to constantly sacrificing freedom, or interests, to care for their family member. “They won’t suffer if I give them my allowance. I’ll be fine.”

Ψ      Abuse. A child believes they are unworthy of love or deserve the punishment. “I need to do more, to get the love or care I wish for.”

Ψ      Domineering or controlling parents. High expectations and harsh punishments. “As long as the expectations are met, I can get approval, affection. Or I won’t be punished. It doesn’t matter what I feel!”

Its Warning Signs

Ψ      Purpose and self-image is tied to relationships with others

Ψ      Self-expression is difficult – needs, opinions, emotions

Ψ      Fear of separation, or abandonment

Ψ      Others’ opinions or approval is a need, not a “good to
have”

Ψ      “Their needs are more important, mine aren’t”

Ψ      “I’m doing all this to take care of them, to rescue them”
(cue need to control)  

The Battle Shields Against Codependency

Ψ      Knowledge: Ignorance is not bliss – recognising the signs and identifying it bears the foundation for everything else.

Ψ      Check: Thoughts, feelings, behaviours about yourself, and your relationship with others – have we lost ourselves in the process of giving away too much?

Ψ      Craft the blueprint: Think - how do we support others without losing ourselves? How much can we give without losing everything? What can we protect or enhance? Negotiate, but clarify what our loved ones need as well – it’s collaborative.

Ψ      Build the shield: It’s not going to be perfect and full-proof, and the first few times will always be rusty. But over time, we upgrade or learn how to do it better. Find what works for us, practice, fail, and learn again!

Humans are interdependent creatures. We can’t survive alone, but we don’t have to live for others as well. We each have our own needs and wants. Although interdependency is like a scale that can never be fully balanced or level, at the very least, it’s not all the rocks on one side.

How do I Find Meaning in My Life?

What did I eat yesterday? Do I need to do laundry today? When was the last time I had a good laugh?  

As the days blur together, do you start questioning what’s the point of, well, anything? Maybe it’s not about routines and monotony. Does getting out of bed seem a little harder every day? Does it feel like you’re no longer living, just trying to survive?   

Don’t worry, you’re not alone. This question about how to pursue meaning or fulfilment in life can be traced back thousands of years to ancient scriptures and philosophers. After years of scholarly attempts to understand how it is experienced, it seems that we’re starting to gain some insight into this abstract concept of meaning. Before we dive in… 

It’s Not Just One Solution

First, there can be many ways to create more meaning in your life. The combination, or number, of ways, is unique to you; no one can (or should) say you’re doing it wrong! 

Next, the 3 established facets of meaning lie in feeling a sense of purpose, existential mattering (“my existence matters”) and comprehension of the world around you.  

1. A Sense of Purpose 

Ever heard of the phrase, “walk with purpose”? Like a compass in life, a sense of purpose guides your actions and decisions based on treasured goals or values. If it is difficult to think about the values you hold at heart, a good start is to think about how you wish to be remembered by your loved ones.  

An example could be, “I hope they remember me as someone who was diligent and driven in their career, but also reliable and responsible.” This answer shows a desire to be resilient and motivated in your occupation while being seen as someone others can trust and count on, taking ownership of your work, actions, or decisions.   

2. Mattering, in the existential sense 

It might seem narcissistic to think you “matter”, or that your actions in life make an impact on the world. Plus, how would you even measure it? Instead, the idea is to focus on how you contribute to others’ lives, whether big or small. Some also seek to leave a legacy for future generations.  

Again, this can be subjective, but the assessment of how you contribute to others need not be objectively accurate. Rather, you should truly believe that you contribute, or do your best to, in others’ lives.  

3. Comprehension about the world 

This one can be hard to grasp. We’re not asking you to make sense of how the world works completely because honestly, no one can. Some events are also very hard to make sense of and trying to may do more harm than good. 

The idea is more about feeling a sense of understanding of how your life seems to fit into a whole. How the people, ideas, objects, and events connect; how they form a larger picture and craft a story; how they played a role in shaping the person that you are today and the values you care for. 

Sources of Meaning  

Remember that everyone finds meaning in different aspects of life with different sources. Find the combination or source that works for you! 

Sources of Meaning
A Positive Affect	While unhappy, people can experience meaning in life. But people who are generally happier tend to experience more meaning.  If you’re struggling to find meaning from other sources, you could try mood-lifting activities, and think about how they help you comprehend the world and yourself better.
Social Connections	Finding meaning in social connections happens through feeling a sense of belonging, interdependency, or beneficence (that they benefit another’s life).  This could be done by forging closer relations with loved ones, joining shared interest groups, or serving your community.
Worldviews (Spiritual, or not)	Spiritual and religious beliefs (or lack thereof) are belief structures that help you comprehend how the world works, basically like knowing the “grand scheme of things”. Typically, religious faith and the concept of a divine plan lead back to each facet of meaning.  For nonbelievers, find meaning in areas of science, nature, meditation, politics, or awe-evoking experiences. Worldviews can be shaped by beliefs in these areas, promoting a sense of purpose or comprehension of the world.
Connecting to  the Self	A coherent life story weaves different elements of life together, helping someone to feel some sense of self. On one level, there is an understanding of how countless experiences have shaped you into who you are. On another level, it involves “true-to-self” action.  Authenticity can be seen with consistency in personality traits or values across time, or understanding the motivations behind inconsistent behaviours or changes in values. For example, understanding that a change in behaviour may arise from adapting to major life events.
Visualisation	The visualization of nostalgic memories, imagining a future meaningful event, and even how well you visualize can be linked to finding that sense of meaning in life.  Detailed mental imagery of nostalgic memories and familiar places can build that foundation for understanding how things in your life link together across time.
Accepting Mortality	No surprise, many would think this source of meaning is paradoxical. The idea that human lives end inevitably would make any pursuit for meaning in life, meaningless.  However, there are some variables which can overpower the crippling effect of mortality and push us on a meaningful pursuit. These include having stable worldviews, routines, perceived progress towards long-term goals, gratitude, and social connection (seem familiar?).

While it doesn’t mean that all our questions about life are left answered, we’re at least in a good place where we’re beginning to unravel some components and actionable steps to build lives that hold more meaning for us. This journey is different for everyone, so don’t feel discouraged if you have yet to find your sources of meaning. Everyone has their own story, journey, and pace in life.  

Can ChatGPT Replace a Psychologist?

ChatGPT is all the buzz lately – an artificial intelligence (AI) chatbot that can help with everything from programming to writing essays (*cough*) and even song lyrics (Jay Chou fans, this song is definitely worth a listen).

With its sophisticated responses and continual technological advancement, ChatGPT 4 has surpassed many previous versions of AI chatbots, raising the question of whether it could one day replace human experts.  

It's tempting to take the easy way out and simply say that ChatGPT can never replace human experts – something that ChatGPT seems to agree with. But as any trained psychologist will tell you, the answer isn't always so simple.

It all depends on your unique needs and circumstances. There are many factors that come into play when deciding whether a chatbot is sufficient. So, before you make a decision, consider the pros and cons and evaluate what's best for you. 

This article isn't going to cover everything, but we're going to highlight some key circumstances where an AI chatbot might be a viable option for your mental health difficulties.  

Ψ You are not yet ready to seek in-person psychological services. 

ChatGPT can serve as an easy introduction to seeking a psychological service. You can use it as your first line of defense, to learn about your symptoms or practice coping strategies. You could say anything you would like to ChatGPT without fear of judgment or reproach. It acts as a safe (virtual) space. 

Ψ You want quick access to information and you don’t know where to look. 

ChatGPT is a convenient way to quickly obtain information about a mental health disorder or symptom. It is also an easy way to read up about the types of psychological therapeutic modalities such as CBT, DBT, Schema, or ACT.  

A basic description of each modality usually accompanies the write up, and you can ask ChatGPT for exercises or examples of how to incorporate an exercise in your daily life. 

Here is one useful description: 

"CBT stands for Cognitive Behavioral Therapy, which is a type of psychotherapy that focuses on changing negative patterns of thinking and behavior to improve mental health and well-being. CBT is based on the idea that our thoughts, feelings, and behaviors are interconnected, and that negative thoughts can contribute to negative emotions and behaviors.” 

If these strategies prove insufficient, you may then be more inclined to consider seeking help from a psychologist.

Ψ You cannot access psychological services. 

If you're struggling to access psychological services in your community, ChatGPT may be a platform you have to consider. For example, if you live in an area with limited psychological services, or if you have financial difficulties.

ChatGPT is affordable, convenient, stigma-free, and can be accessed anytime, anywhere, but it is essential to remember that ChatGPT is not a trained psychologist or counsellor and cannot replace one. 

Remember that there are many free and low-cost public and community resources available in Singapore. Here are some examples:  

• Community Psychology Hub

• Changi General Hospital

• Family Service Centres 

• Shan You Counselling

• Singapore Association for Mental Health

Yet… There are several circumstances when it is highly recommended you speak to a psychologist or any mental health professional instead of an AI chatbot. 

Ψ You have, or are experiencing, severe or complex mental health struggles. 

If you are experiencing a severe mental health crisis that poses a risk of harm to yourself or others, please seek immediate attention and intervention from a qualified professional.  

While ChatGPT can be a helpful resource for understanding symptoms of mental health concerns, it is not designed or equipped to handle such emergencies.  

On the other hand, mental health professionals go through years of rigorous training and supervision to be able to appropriately handle such situations. 

Ψ You find ChatGPT’s resources ineffective or insufficient. 

Complex or severe mental health conditions typically result in a significant impairment in the ability to function in daily life. Things like concentrating, being productive, socialising, can seem difficult. 

Comprehensive and often intensive therapeutic approaches may be required to effectively improve functioning. ChatGPT would not have the ability to provide such in-depth intervention. This is when connecting with a qualified mental health professional can provide you the necessary care and support.

Ψ You find ChatGPT impersonal. 

The resources offered by ChatGPT are likely to be broad-based and will not provide the level of depth and personalization that you might need to effectively implement strategies in your life. You may need more specific guidance and details that it cannot provide.  

Moreover, ChatGPT's understanding of the human condition, including context, morals, and spirituality, is limited to available data and research, which means it might not fully comprehend the unique needs and circumstances of each individual user.  

In contrast, a psychologist has focused training and understanding of how social and cultural values differ per person; how responsibilities can influence intervention strategies; how some individuals lack a supportive home environment to foster good mental health. A psychologist takes these diverse factors into account and designs a personalized therapy plan that caters to the individual's needs.

AI and language processing models are rapidly advancing, creating the potential for chatbots to "replace" or supplement certain microinterventions that do not require a lot of therapist contact or empathizing. While this is subject to legal, data, and privacy concerns, ChatGPT can be a useful resource for microinterventions such as goal-setting, progress tracking, and psychoeducation.

However, chatbots still struggle with understanding context, family background, trauma, biopsychosocial factors, and individual differences - essential factors that psychologists study for years to holistically assess mental health struggles from different perspectives. 

All in all, chatbots lack the human connection and understanding that many users desire. However, they present unique benefits in mental health education that should not be dismissed. Combining chatbots with traditional modalities can result in effective intervention. While clinical research is ongoing in adapting psychotherapy techniques into different modalities, psychologists have already started using digital platforms for psychotherapy. As technology continues to evolve, it will be fascinating to observe how chatbots can be further integrated into mental health care. 

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 like 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.

Gaslighting: Subtle Psychological Manipulation

Have you ever been to a carnival with a house of mirrors?

There never seems to be a way out that you can find without slamming face first into your own reflection. Some mirrors even make you appear distorted, and you begin to questions which parts of this experience are real. To victims of gaslighting, this is an analogy of what it might feel like to be gaslighted.

What is Gaslighting?

(clue: it is not lighting a fire using gas)

Gaslighting is an insidious form of psychological manipulation that can have a profound effect on the individuals affected by it.

Gaslighting is a term used to describe when someone intentionally, and often successfully, manipulates another person into questioning their own memory, judgement, or reality. It is a form of psychological manipulation that occurs over a gradual period where the perpetrator takes advantage of a target by sowing seeds of doubt within them.

So how does gaslighting look like? 

A gaslighter (aka the abuser) may use tactics such as making false statements (which they will strenuously deny if challenged), disagreement with factual information and downplaying emotions, all in an effort to make the victim doubt their own perceptions.

Over time, victims are not only unsure about their perceptions of reality and even their own thoughts, but come to rely on the abuser to tell them the “truth” about.

The ultimate goal of gaslighting is to de-legitimise a victim’s thoughts and to cause them to question themselves. This can occur via a variety of techniques and behaviours that the gaslighter employs, which may look like: 

• Lying – “That’s not what I said, I said this…” 

• Discrediting – Telling people around you that they are concerned about your recent behaviour and that you might be “crazy”. 

• Distracting/Deflecting – “Why did you bring this up? What about the time you….” 

• Minimizing thoughts and feelings – “Why are you so sensitive?” 

• Shifting blame – “I only behave this way because you did so first. I wouldn’t do it if it weren’t for you.” 

• Denying wrongdoing – “I didn’t do anything wrong”  

• Changing the storyline – Retelling stories by changing it so that the storyline is in their favour.  

While gaslighting often occurs in romantic or familial relationships, it can sometimes occur in the workplace, with friends, or in schools. Several teachers in Singapore even complained about being “gaslighted” by an AI Chatbot designed to provide “AI therapy”!

Why do people gaslight? 

Gaslighting is often employed by narcissistic individuals looking to evade accountability.

By redirecting attention onto the supposed flaws or shortcomings of others, it reduces the likelihood of their own flaws being discovered. They might also believe that they are never at fault, naturally it would be easier to put the blame on others when things don’t go their way. As long as the victim believes they are flawed and need help, the gaslighter would never have to take responsibility for their actions and can continue behaving in the way they do.   

What are the effects of gaslighting 

Ψ Isolation  

Being gaslighted can make you feel extremely alone and dependent on the abuser. It may feel as if everyone around you thinks you have issues or even to the extent of feeling crazy, just as the abuser would describe. As you begin feeling more isolated, the behaviour of the abuser becomes more normal since there is nothing else to compare it to.  

Ψ Emotional Trauma 

Gaslighting has significant negative effects and can cause emotional trauma to the victim. Children exposed to traumatic events and abuse in childhood can become hypersensitive to such threats, and reduce their resistance to stressful events in future. Trauma can also lead to difficulties in emotional regulation in adulthood, alongside other physical issues such as somatic symptoms or heart disease. 

 Ψ Reduced self-esteem 

Prolonged emotional abuse can also lead to a loss in self-esteem, as you constantly feel that you’re never enough. You might begin wondering if you can believe in yourself to do anything correctly, or if you’re to blame for everything that has gone wrong. You might feel incapable of judging the situation realistically, and if you can accurately remember the details of situations. You might feel obliged to continue to stay in the abusive situation because it might feel like no one would believe you or want you anyway.  

Ψ Psychological issues

You might even feel nervous or afraid to say things, lest the abuser retaliates or no one believes you. Gaslighting can lead to psychological disorders such as anxiety, depression or even psychosis.  

Signs that you are being gaslighted

Unfortunately, gaslighting can be incredibly hard to detect without an outside perspective which could make it incredibly difficult for victims to identify what’s happening and take action before it’s too late. On the surface, what might seem as an innocuous quarrel between a couple or might in reality be more complex than a mere argument between two individuals.

It can be difficult to spot gaslighting within a relationship as the signs can appear “normalised” to you after some time. Recurring manipulation and abuse, coupled with the feelings of isolation and reduced self-esteem, causes the individual to constantly doubt themselves and the reality that surrounds them.

If you identify with some of these emotions and suspect that you are being gaslighted, the following are several signs that can indicate gaslighting behaviour. 

Ψ Repeated patterns of manipulation  

“Nope, that didn’t happen” 

“Your memory is getting so bad!” 

“You’re being so sensitive”  

These statements are often used by gaslighters to manipulate you.

While they might be common statements used in many arguments, it is important to note that these statements are often used throughout by the gaslighter in the relationship. This happens often enough such that it forms a consistent pattern in a relationship.  

Ψ Being invalidated constantly

When expressing your needs or concerns, the gaslighter often invalidates you by calling you oversensitive, convincing you that you’re unstable, and how everyone around you thinks you’re crazy.   

Ψ Deflection

When it comes to finger pointing, no one can beat a gaslighter. As soon as you bring up a topic that is concerning to you, they either change the topic or manage to turn it around to pin the blame on you for something completely irrelevant.   

Ψ Losing a sense of self 

When you begin second guessing your own judgment and perceptions of events that happened, it almost feels as if you lost your identity and status as an individual. Perhaps you begin wondering if everything the gaslighter is saying is true, that you’re weak and not enough, that you’re too sensitive, and you cannot stand up for yourself. You start to wonder if you’ve been like this all this while. Perhaps it’s true and you begin to accept it.  

Ψ Walking on eggshells

What happens when you start convincing yourself that it is not as bad as it seems? You just have to be careful every time you interact with them and ensure not to say the wrong thing, right? You become afraid to voice your opinions for fear of getting shot down or because you’ve learnt that your opinions don’t matter anymore. You live as though you’re always on the edge of your seat and get spooked by every little thing.  

What can you do if you are being gaslighted?  

Here are a few steps you can take to protect yourself from being gaslighted.  

Ψ End the conversation  

When you find yourself being gaslighted, understand that the abuser might be overwhelmed and unable to control the words that they use. That does not mean that it is okay, hence you should try to end the conversation as soon as possible. Set appropriate boundaries and let them know that you do not wish to continue the conversation if they are only going to continue to berate you.  

Ψ Save evidence for yourself  

Recording conversations and saving receipts of text messages can help you remember that your reality is not based off of what one person says. It helps you recall that you’re not the one that remembered things wrongly or did something that you didn’t. Do be careful when confronting an abuser with evidence, for it might result in an even more explosive outburst.   

Ψ Getting an outsider’s perspective  

When you’ve lived in the world of the abuser for too long, it can be difficult to identify what’s real and what’s not. A trusted individual outside of the relationship (perhaps an old friend of yours) can help to give a different perspective from yours, helping you untangle the web of distortion.  

Being a victim of gaslighting can feel invalidating, dismissive, and most of all, lonely. Keep in mind the abuser wants to make you forget about who you once were, before the relationship. This process can be gruelling especially if you’ve been a victim for a long time. Do not hesitate to reach out to us for help!

Living with A Narcissist

Living with a narcissist, be it a partner, parent, child, or roommate, can have paramount negative effects on one’s mental wellbeing. Leaving a narcissist may not always feel like an option, especially if the narcissist is a loved one.

Does this mean that you have no choice but to quietly tolerate the other party’s behaviours that may at times be selfish, hurtful or manipulative?

We will be discussing what it’s like to live with someone who engages in frequent narcissistic behaviours and what you can do to protect your own emotional well-being.

Are you living with a Narcissist? 

Everyone prioritizes themselves and their own needs to some degree. Putting one’s own needs first is actually healthy when it is not at the expense of others. However, narcissists are self-absorbed to an extreme extent. Some hallmark signs of narcissism is the tendency to disregard the needs and feelings of the people around them and fail to comprehend the effect of their behaviour on others. While narcissism varies on a spectrum, people with high levels of narcissistic traits may have Narcissistic Personality Disorder (NPD) and they exhibit more extreme self-centred behaviours. 

If you are unsure whether you are living with a narcissist, here are some signs in the person that you can look out for – a narcissist often possesses or exhibit the following: 

Ψ Lack of empathy: They are often unwilling or unable to empathize with the needs, wants or feelings of others. 

Ψ Unapologetic for hurting others: As they do not understand the effects of their behaviour on others, they do not take responsibility for their actions. They rarely apologise, unless the apology brings benefits. 

Ψ A grandiose sense of importance and entitlement: They believe that they are superior and have to be treated specially. Others should obey their wishes. 

Ψ Often overreact to criticism: They react strongly or may become abusive to the slightest criticism. 

Ψ Manipulative behaviour: They may gaslight and mislead you into thinking that you or your own experiences were wrong. They might deny saying things or claim that you are being overly sensitive. They might accuse you of misunderstanding the situation. 

How to Cope with Living with a Narcissist

It is natural to feel helpless when dealing with a narcissist. While changing a narcissist could be a potential solution, another more viable solution would be to make peace with the fact that you are living with a narcissist. Here are some suggestions on ways to cope with living with a narcissist:  

Ψ Refrain from blaming yourself 

Narcissism occurs due to a multitude of reasons such as genetics, early maltreatment or abuse, trauma and parenting.  

It is natural and even easy to feel that their behaviours are a personal attack or that you are responsible for their actions. This feeling of responsibility is experienced especially when emotions run high or when the narcissist exhibits blaming behaviour. Such thoughts may occur even if you are fully aware that their narcissistic behaviour has nothing to do with you while you are in a logical and calm state of mind.  

It is important to effortfully and constantly remind yourself that you are not responsible for their actions and recognize that while you can try your best to encourage them to get help or communicate with them, their behaviours are ultimately still beyond your control. 

Ψ Get in touch with your feelings  

Be honest with yourself without any judgement. It may feel uncomfortable at first especially if your feelings have been invalidated for most of your life. Know that it is normal to feel hopeless about your relationship with your narcissistic parent, and helpless that you can’t change them or guilt due to feeling like you should have done more. Be aware of any narcissistic habits you may have picked up from them over the years or any tendencies to be attracted to narcissistic partners. 

If you find yourself experiencing a lot of negative emotions and feeling overwhelmed, instead of pushing them away, simply let yourself sit with these emotions. It is natural to want to shun away from difficult emotions, however avoidance will only cause these emotions to perpetuate or even escalate in the long run. Difficult and negative emotions are like a cactus you hold in your hand. If you try to push them away, the cactus will prick you. But if you just observe it and let it be, you will not get pricked. Try pausing, taking a breath and noticing your emotions. 

Ψ Set healthy boundaries 

Setting firm boundaries on what you are willing and not willing to accept or tolerate. These boundaries are created not with the aim of changing the person, but to build a relationship that is both physically and psychologically safe. Communicating (and reminding) the other party of the boundaries you wish to establish is important. Staying firm with your boundaries with no guilt and shame is important too. Enforcing these boundaries may be difficult especially at the beginning but remember that they are essential. Click here for more tips on setting and enforcing boundaries!

Ψ Seek social support 

Living with a narcissist can be draining, both mentally and emotionally. Surrounding yourselves with people that care for you and are supportive is therefore pivotal. Talk to you close ones whom you trust that would offer you some emotional support and perspective. Let them know how they could best support you.   

Ψ Get professional help 

Whether you are currently living or used to live with a narcissist, we encourage you to speak to a therapist.

Your therapist can offer you a psychologically safe space to offload some of the emotional stress you experience or have experienced. They may offer new perspectives and help you reconcile with difficult experiences. If you are currently living with a narcissist, they can problem-solve with you and help you develop interpersonal skills that are effective when communicating with a narcissist. You could learn how to identify signs of gaslighting, discuss ways to set clear boundaries and develop assertiveness under the guidance of the therapist. They can also help to target any emotional repercussion that may have result due to your living environment. 

Let’s Recap 

Living with a narcissist is not easy. Keep in mind that what you are experiencing is never your fault. Remember that you are not the problem and be gentle to yourself. You may feel alone but remember that there are options and support. While you have less control of the narcissist’s actions towards you, you are in control of the solutions you seek for yourselves. It’s okay to seek help from a professional or create strong boundaries for yourself to protect your mental well-being. 

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.  

We're Mental Health Workers but our Mental Health Matters Too

Rising abuse towards mental healthcare workers

Working in healthcare has never been an easy calling. With the added demands brought about by the pandemic, healthcare worker abuse has been dominating the headlines in recent times, in both public (https://www.straitstimes.com/singapore/politics/more-healthcare-workers-in-public-institutions-getting-abused-or-harassed) and private settings (https://www.todayonline.com/singapore/clinic-assistants-abuse-patients-gps-be-better-protected-1878696).

 In April 2022, a video (https://www.todayonline.com/singapore/police-probe-clinic-staff-kicked-pram-woman-flung-brochures-1878606) of a clinic assistant shouting and damaging the property of a customer surfaced and made its way around social media. It was later reported that the clinic assistant had suffered physical and verbal abuse from the patient prior to her outburst. 

As a mental health clinic, we empathise with the distress that our patients face. Many of the issues that might bring a person into a mental health setting are immense and debilitating. 

But abuse of healthcare workers, including mental healthcare workers, is also a concerning issue and has been on the rise in recent years. 

The Different Types of Healthcare Worker Abuse

Though we often think of physical abuse as the only form of abuse, abuse presents itself in many guises. The most common form of physical abuse is when a patient makes physical contact with a healthcare worker or throws objects at them. These actions are often unprovoked and can result in serious injury and embarrassment to the healthcare worker.  

More commonly in a mental health setting, healthcare workers experience verbal abuse. Verbal abuse can occur either as outright verbal abuse or what is sometimes known as 'borderline' abuse. Outright verbal abuse happens when a patient berates healthcare workers by shouting, hurling expletives, or making discriminatory or racist remarks. 

Borderline abuse is often less obvious but equally insidious. Such abuse often arises from backhanded or snide comments to healthcare workers, insulting their abilities and qualifications, or being disrespectful. While borderline abuse in isolated incidents might not seem to be as damaging or severe as outright verbal abuse, such abuse can have long-lasting on healthcare workers if sustained over a period of time. 

Mental Health Impact of Abuse on Healthcare Workers

We often forget that healthcare workers are human too.  

We experience and go through the same emotions that you feel. When a mental healthcare worker is constantly dehumanised or verbally assaulted by patients, it takes a toll on our mental health. 

In 2021, the Ministry of Health reported 1,400 cases of healthcare worker abuse, a 16% increase when compared to 2019, prior to the Covid-19 pandemic. In the same span of time, healthcare workers seeking counselling services have increased by 169%. Separately, it was also reported that the safety and well-being of front-line healthcare workers in private clinics are often overlooked as compared to those working in the public healthcare setting. 

Prolonged abuse and lack of appreciation can be traumatic for healthcare workers, resulting in mood and emotional difficulties. Healthcare workers suffering from constant abuse from patients are left feeling unmotivated to carry on with work or plagued with feelings of dread, increasing the possibility of occupational burnout as well. More importantly, such difficulties affect the ability of healthcare workers to provide their best at providing healthcare services to patients and reduce the quality of care received by patients. 

The frequent toll of abuse ultimately results in resignations or leaving the healthcare industry altogether. This phenomenon can have a lasting impact on the healthcare industry, such as longer waiting times due to a lack of manpower, overworked healthcare workers that can compromise on providing a quality healthcare service, and rapidly rising healthcare costs. In the long run, abusive patients ultimately result in lower healthcare quality.

Why do patients abuse healthcare workers?

There are several reasons why patients might unknowingly abuse healthcare workers.  

Some patients might act out due to mental health conditions or because they are not used to seeking medical help. Others might be angry about their condition or the lack of progress made, and some might have faced abuse in similar settings and are projecting their anger onto healthcare workers. 

When someone you care about is suffering from a mental health condition, it's difficult not to be worried. The unknown and a lack of understanding about a medical or mental health condition and its prognosis can be frightening. This overwhelming fear coupled with limited healthcare resources might lead to patients and their caregivers believing that a healthcare worker has uncaring attitudes toward their needs. While this perceived neglect varies by patient and caregiver, they may feel justified in expressing their anger if they feel their medical or psychological healthcare needs are neglected. 

Whatever the reason, it is important to remember that healthcare workers are not responsible for the patient's condition, and abuse towards them will not result in a better outcome for the patient.

Help us help you

At times, it might feel as if the staff is deliberately resisting a patient’s wishes, especially when a patient request is not in line with legal regulations or an internal policy.  

We ask that patients understand that mental healthcare workers have a duty of care to all patients and must follow certain ethical and legal guidelines in order to ensure quality care for all. These guidelines are in place to protect patients, staff, and the healthcare organisation from potential harm. 

Sometimes, what a patient perceives as mistreatment might be adherence to guidelines. For example, a therapy modality might not be clinically indicated or advisable or a patient might want to see a specific healthcare worker when it is not possible due to scheduling conflict.  

Other examples might include:

1. not being able to perform a requested therapy modality, assessment or test.

2. not being able to support a diagnosis or management plan where it is clinically inappropriate.

3. seeking a parent or guardian's consent in respect of a minor before providing non-emergency services.

4. in a private healthcare setting, enforcing a last-minute no-show or cancellation policy to ensure that patients have fair access to limited healthcare services.

5. an obligation to verify that a patient has consented to receive a healthcare service.

How can we work together without abuse?

Healthcare workers usually choose to work in this demanding industry because of our passion for helping those in need. It is important to remember that healthcare workers and patients work on the same team; both share a common goal of providing every patient with the help and support they need.  

If you are feeling frustrated, try to communicate your feelings in a calm and respectful manner. We want to help you, but we can only do so if we can understand what you need. If you remain unhappy with a response made by staff, we recommend that you speak to a manager or supervisor about your concerns rather than expressing their frustrations to the healthcare worker in question.  

We take each and every complaint seriously. When a complaint is received, our management conducts a thorough investigation into the circumstances of the complaint. If a complaint is valid, we will take the appropriate disciplinary action against our member of staff. Disciplinary outcomes for staff include counselling, supervision by managers and/or clinical supervisors, compulsory refresher or training courses, issuance of verbal and written warnings, being placed on administrative leave, or in appropriate circumstances, being asked to leave the organisation. 

At the same time, we have an obligation to ensure that our colleagues feel safe in their work environment. We do not tolerate any form of abuse towards our staff whether physical or verbal. We will refuse service to anyone who engages in abusive behavior. 

We're Mental Health Workers but our Mental Health Matters too.

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.