Struggling With Food During Festive Seasons

Coping with disordered eating during festive seasons

Food has traditionally facilitated social interactions throughout human history.

It is no surprise then that food is integral to many holidays we celebrate, such as Chinese New Year reunion dinners (cue lou hei celebrations – but no verbal exhortations whether or not auspicious or propitious!), Thanksgiving feasts (think Turkey), or Iftar (or more commonly known as “buka puasa”) where we get to stuff ourselves with the delicious rendang that Nenek makes. 

Having to face these delicious foods would make most drool, but for someone with an eating disorder, festive seasons could be viewed as terrifying experiences. Being in a situation abundant with food is likely to trigger anxious thoughts in someone with an eating disorder, especially if they have only just begun the recovery process. The enticing smell of good food, abundance of appetising snacks, pressure of having to eat and judgment from relatives adds stress on top of the person’s struggle to handle their eating disorder. For example, people with binge eating urges might find it difficult to control their urges when faced with large amounts of food. Coupled with the provoking questions relatives tend to ask (“ah girl ah, you so thin why you never eat anything at all ah?”), it is only normal that negative thoughts begin to surface.  

What are eating disorders? 

Eating disorders are psychological conditions characterised by unhealthy and disordered eating habits and are often associated with anxiety and depression.


Social media’s relentless portrayal of extreme thinness as the ideal standard of beauty has been named as one major factor responsible for the increasing prevalence of eating disorders. Another major cause of Eating Disorders is the desire for absolute control over an aspect of their lives - especially the individual has little to no control over other things. 

An Insight into Anorexia, Bulimia, and Binge Eating

The common presentations of eating disorders are: 

Ψ Anorexia Nervosa: persistent restriction of energy intake below minimal requirements

Ψ Bulimia Nervosa: binge eating with compensatory behaviours to prevent weight gain such as purging, fasting, or excessive exercise

Ψ Binge Eating Disorder: binge eating without compensatory behaviours

 
 

Helping Those with Eating Disorders Cope

So how can we cope or help those around us cope with their eating disorders during the festive seasons? Here are some tips you can adopt or help your friend with.

1. Form a support network

One doesn’t have to go through the struggle alone. If you’re suffering from an eating disorder, turn to a friend and reach out whenever you experience your triggers. Share your feelings and talk about them.

If someone close to you is going through a tough time, be there for them. Ask about their thoughts and feelings at the moment and actively listen to what they have to say. Acknowledge and validate the feelings that they are experiencing. It’s okay if you don’t understand what they are going through, just being there is enough for them. Avoid making judgments about their body shape or passing commenting on the choice or quality of food (eg. fat content, calories, etc).

2. Come up with a sustainable plan   

Come up with a plan for situations you anticipate might be stressful and list ways to overcome them. Think about your potential triggers and come up ways to cope. For example, if sitting near a particular relative triggers your urge to watch what you eat for fear or judgement or reprisal, it’s alright to (politely) move away and sit someplace else.

Your plan can also include foods you want to eat or wish to avoid. Employ helpful coping statements such as “I don’t have to eat all of this food now because I am in control of myself” or “I don’t have to restrict myself from having this food because I have a plan, and I know that my plan works”.

Give yourself permission to eat whatever you feel like eating, within reason of course. By unnecessarily restricting your intake of certain foods, it could lead you to feeling out of control and powerless around food. Instead, give yourself permission to enjoy the food in front of you and remind yourself of your coping statements.

3. Practice mindful eating  

Enjoy your food in a different manner. Slow down your eating process and think about what you’re eating and where your food comes from. Describe them in terms of their taste, texture or smell and savour the experience. Choose a few foods and repeat this process, each time thinking about what and why you enjoy them. This way, you can improve your relationship with food.

Mindful eating is also recognising when your body is full. Our bodies send a signal to our brains when it is full, but this signal arrives at our brain only after about 20 minutes. Learn to recognise and differentiate what are your body’s hunger signals versus your emotional hunger triggers.

4. Cultivating self-compassion  

It is incredibly brave to face a situation like this head-on. Recognise that you are stepping out of your comfort zone and challenging your unhealthy thoughts and behaviours. It’s alright if you don’t succeed at first in your plans. You are strong and extremely courageous for doing this!

Instagram Therapy

Is it Therapy?

Is Instagram therapy enough?

It is important to first clarify is that “Instagram therapy” is not a form of psychotherapy. In fact, it is not “therapy” at all!

What is Psychotherapy?

Psychotherapy requires committed engagement with trained psychologists who utilise evidence-based techniques and approaches to investigate a mental health concern and work with the client collaboratively to reduce or minimise the impairment or impact of the mental health concern. Therapy must be specific and customised as no two persons are completely alike; we each have unique life experiences and circumstances.

Psychotherapy vs. Instagram Therapy

This means that the content or engagement published on Instagram or Facebook should not be regarded as therapy. At best, such content should be regarded as a type of psychoeducational content.

And as with all other kinds of purported educational content, we must think about how the content is delivered and whether they are credible or helpful.

According to the internet, there are roughly 1 billion users on Instagram, 1.2 billion users on Tik Tok, and 2.9 billion users on Facebook. Social media has become a ubiquitous medium for content consumption that can be harnessed for a good cause.

But not everything you read might be applicable or useful, or worse, true.

Navigating Instagram Therapy: Differentiating Psychoeducation from Professional Help

Many users of social media use these platforms to follow or create interesting content, advance personal or professional goals, or associate with like-minded people. It should come as no surprise that content creators want to create content that users want to consume, focusing on the usual metrics of increasing likes and followers or monetising their followers. There is a ton of mental health information that is shared online every day, often by self-proclaimed experts with little experience, research, or actual clinical practice, often with the aim of gaining followers or likes.

Over time, many come to rely on these celebrity psychologists for their ‘daily dose’ and mistaking that as a connection with the psychologist on some level, or worse, regarding that content as online or group therapy.

Some say that mental health channels on social media are like self-help books: addictive, unhelpful, and designed to keep you coming back for more.

It is against this backdrop that we should analyse mental health information that we consume on the Internet.

So when you next scroll through the pages of your favourite Instagram Therapists or Psychologists, please bear these in mind:

Ψ Is the content from a reliable source?
Ψ What are the factors motivating the content creator to produce this content?
Ψ Does this person spend more time on clinical practice or on social media?

Social Media Ethics in Mental Health

It is important to note that:

Ψ Social media is not a substitute for therapy.

  • Reading mental health information online can help you understand or learn something about yourself, but it is not a replacement for formal therapy.

Ψ No therapy can be done over social media.

  • While well-meaning psychologists might create content to psychoeducate the general public, others blindly produce or reproduce material to attract likes and followers with the intention of aggressively promoting their services.

Ψ Social media should not be relied upon during a crisis.

  • Mental health content should be viewed purely for what they are – generic, non-specific and informational in nature that serves a vital psychoeducational purpose within the community.

  • Because non-mental health professionals are very likely the target audience of such psychoeducational material, it must go without saying that psychologists and other mental health professionals should abide by regulatory, professional, and ethical guidelines when dispensing mental health information whether on online or during clinical practice.

Psychology on Social Media: A Tool for Destigmatizing Mental Health Issues

When presented responsibly, psychologists on social media help to break the stigma associated with mental health. They break down complex mental health conditions into digestible bite chunks for any person with a smart device to consume. They explain difficult psychological disorders and concepts with infographics, animation, and beautiful pictures. The amount of useful information that is put out by some of these professionals who have dedicated years of their lives to acquire their knowledge and expertise is staggering.

And of course, some are visually beautiful presented and simply a delight to consume.

Keep calm and scroll on!

 

Annabelle

Dealing with Work Stress

Work Stress

When stress becomes excessive

中文版


Navigating Work Stress

It is important to know that it is normal to feel stressed from time to time. Some people find that stress is an excellent motivator at work, but there can be too much of good thing.

Sources of Work Stress

There are many reasons why work might be a source of stress. Perhaps a relationship at work is causing us sleepless nights, or we were passed over for that promised promotion, or our ever-increasing workload has become a problem. In our new reality, given that working from home has become part of our working lives, we might struggle with working from home because of an unconducive home environment. Or perhaps we might struggle from how different everything has become after the pandemic.

Whatever the reason, it’s important that we identify and address these stressors. Do any of these symptoms of unhealthy stress apply to you?

Identifying Unhealthy Stress Symptoms

Work Stress Management: Strategies for Maintaining Mental Wellness

If work is causing you to experience unhealthy levels of stress to the point that it impedes your daily functioning, there are some practical steps you can take to address work stress:

Ψ Speak to your employer. Have a conversation with your line manager and openly discuss any problems you’re having at work. Stress often decreases your ability to work productively – your supervisor has an incentive to ensure your health and comfort. 

Ψ Talk to a trusted friend or family member. Often times, accepting help from loved ones could allow you to manage stress better. You might feel better if you have a strong support system to rely on when things feel difficult. 

Ψ Establish boundaries. Consider some level of separation between your personal and professional life. For example, not being contactable at weekends or not checking work e-mails at home. Establishing a work-life balance takes time and effort, but the results will pay off eventually. 

Ψ Take some time off work. It is important that you take time off for yourself occasionally. Doing this prevents overwork and burnout. Disconnecting in a way that fits your needs and preferences allows you to return to work in a better state. 

Ψ Reconsider negative thoughts. When you’re stressed, it’s easy to develop tunnel vision. You might start overgeneralising (e.g. everyone is always like this), magnifying (e.g. I couldn’t do this and therefore I’m incompetent), or minimising (e.g. My boss complimented me but I’m sure he didn’t mean it). These thinking patterns are unhealthy and may lead to further stress. But with conscious effort you can reconsider and reframe negative thoughts, thereby relieving stress. 

Ψ Develop healthy coping mechanisms. It might be tempting to crack open a beer or reach for another cigarette, but these coping mechanisms might lead to negative consequences like poorer health. You might consider exercising more often or other relaxation methods to deal with your work stress instead. 

If you do not find that these methods work for you or if you are concerned about the high levels of stress you are facing at work, our clinical psychologists at Annabelle Psychology are here to help and work with you in an empathetic and collaborative manner to help you best cope with the stressors you experience at work. Should you have any inquiries, please feel free to contact us and find out more!

How to Forgive Someone

The Art of Forgiveness

How do I forgive someone when they have brought me so much hurt?

Who hasn’t been hurt by the actions or words of another? Be it from your family or friends (or even a stranger!), we are likely to encounter situations where others say or do something that hurts us deeply. When this occurs, it is normal to experience and to cling onto feelings of anger, resentment, and pain. On the other side of the same coin, forgiveness is challenging – in fact, it is one of the toughest things to do.

What is forgiveness?

Even the term “forgiveness” is a tricky one. Forgiveness does not necessarily mean entirely forgiving the person or condoning their actions. Instead, forgiveness means that you make an active decision to accept what has happened rather than hanging onto the “could’ve” and “should’ve”. It involves letting go and freeing yourself from the hurt and pain that others have caused. Forgiveness can even lead to feelings of understanding, empathy and compassion for the one who hurt you and brings a kind of peace that helps you go on with life.

Why should I forgive others? Why should I make the effort to forgive when holding onto the negative feelings seem so much easier? 

Forgiving someone can certainly be difficult and it is even harder when the other party does not seem apologetic. Despite this, forgiveness is the healthiest path forward. Forgiveness comes with an array of positive benefits on our mental and physical well-being, including increased self-confidence, optimism, reduced stress, and having a more positive outlook on life.

How do I forgive someone? Understanding and Letting Go of Anger and Resentment

One way to look at the situation is from an acceptance and commitment therapy (ACT) approach. ACT involves acknowledging and accepting unwanted experiences that are beyond your control and committing to engage in concrete actions that will improve and enrich your life instead.  

ACTing Towards Forgiveness

Let’s take a look at how the 6 core processes of ACT can be helpful with the process of forgiveness:  

1. Cognitive Defusion  

Cognitive defusion involves learning to recognize that thoughts, memories, feelings, and other cognitions are simply bits of language and images that are nonthreatening, nor are they hard truths and facts. To do so, take on a third-person perspective when looking at what is going on in your mind – just like stepping back and viewing your reflection in a mirror! Separate the unpleasant and unwelcome cognitions from yourself. The opposite of this is known as cognitive fusion, where you get entangled in your thoughts, memories, and feelings. 

Rather than replaying the event and wallowing in anger, there’s a better way to cope. One method is through journaling, which turns thoughts and worries into mere words that are not related to you. 

It sounds difficult, that’s for sure. But with practice, you should ultimately learn to face negative experiences and come out the other side with a decreased fixation on the hurt and pain experienced.

2. Acceptance  

When others cause us any form of hurt, it is normal to experience negative emotions. In fact, it is often these intense emotions that make it so hard to forgive someone. Whenever we experience hurt and anger, it is practically instinctive for us to try to avoid it and quash them. After all, no one enjoys wallowing in negativity. Rather than suppressing those emotions, try practicing accepting them instead. Acceptance involves allowing those unpleasant experiences to exist and embracing them without trying to deny or change them. It does not necessarily mean endorsement or justification, but simply acknowledging that you don’t have power or control over the past. 

For example, you may feel resentment towards your parents for failing to spend time with you as a child. You may feel upset and resentment as a result. However, it has already happened and there is nothing you can do to change the past. So, if you’re feeling angry, it is okay to acknowledge that you feel that way.  

By opening up and allowing your unpleasant feelings to come and go without struggling with, running from, or giving them undue attention, we find ourselves much less bothered by them. This also enables those feelings to move on more quickly, instead of hanging around and bothering us. 

3. Contact with the Present Moment  

How often do you find yourself mindlessly going back in time, revisiting something that happened and imagining all the other ways it could have panned out? 

This step requires you to re-focus on your present environment and self in a non-judgemental manner, and less on what has happened in the past or may happen in the future. When you experience the present world with more openness, interest, and receptiveness, you will have a greater ability to behave in a manner that is more in line with the values that you hold. 

Let’s say you are upset at a friend who stabbed you in the back. You may spend time reliving the moment, critiquing your friend’s actions, or regretting not telling them off.  

Although it is natural for negative experiences to grab our attention (this is known as the negativity bias!), we also have to acknowledge that past events are irreversible. You could have responded better, you should have known better, but you cannot change the past — so why not try to accept what is happening right now? As you immerse yourself in the present, describe events to yourself in an objective manner as they occur without placing any judgments or labels on them. Doing so will free you from the hurtful past (or future) and give you more control over your behaviour. When you start focusing more on the present, you spend less time judging and criticising both yourself and others. 

4. The Observing Self 

When we think of our self, what commonly comes to mind is our physical self (our body) and our thinking self (our mind). This “thinking self” is always hard at work as we try to understand the world and problem-solve whenever we can. However, there is another part of our self that steps back and simply observes without getting involved in the battle of our thoughts. This is the “observing self”. 

The observing self is not a thought or a feeling per se, but more of an awareness that you are thinking and feeling because you are aware of your thoughts and emotions.  

“I am my body, and I am more than my body; I am my feelings and I am more than my feelings; I am my mind and yet I am more than my mind.” 

As we go through life, our thoughts and feelings constantly change: at times you feel anxious, sad, angry, or frustrated. Instead of dwelling about your thoughts and judging your own emotions, why not try to simply observe and be aware of your own flow of experiences without attachments and investments? When this happens, defusion and acceptance is fostered. The observing self will allow you to observe difficult thoughts, feelings, and memories as peripheral aspects of ourselves, but as they constantly change, they are not the essence of who we are. By engaging the observing self as we encounter unpleasant experiences, we often find that things we were dreading become much less bothersome than they were before, giving us the capacity to disidentify from pain and unhappiness, making experiences more bearable. 

5. Values – What matters to you? 

Now that we’ve learnt to embrace our internal experiences and to observe them non-judgementally, the next step is to get to doing. 

How do we do this? We use our core values to guide our behaviour. Think of values as the qualities you care the most about. They have to do with what sort of person you want to be, what principles you want to stand for in life, and what you ultimately experience as your true drive that you choose to work towards. Values help you to steer your actions toward what is meaningful to you and is important in motivating you to make significant changes so you can lead a fulfilling life. When we are guided by our values, not only do we experience a greater sense of purpose and joy, but we also see that life can be rich and meaningful even when “bad” things are happening to us. 

Sometimes, when we get caught up with life, we may lose track of our values or even be unclear of what they are. Although this is not ideal, we can acknowledge that it happens, and make an effort to be mindful of our values moving forward. 

How then, can we be mindful of our values? One way is to take some time to think about how you want to be remembered, or the things that you would disapprove of if others did them. Perhaps you may realize that you value empathy and compassion. While these values may clash with the hurt that you are experiencing, the reality is that we sometimes must prioritize one value of another, asking ourselves “What is most important at this moment in my life that will help me be the person I want to be so I can lead a meaningful and fulfilling life?”

6. Take Committed Actions According to your Values 

You’re almost there, this is the final step! 

Now that you have a clearer sense of the values you wish to live by, the last step is to engage in actual behaviors that are guided by your values even in the presence of obstacles. You can do so by setting goals that are in line with your personal values and beliefs. This allows you to create a fulfilling and satisfying quality of life! 

Committed actions means engaging in large patterns of effective action that are driven and guided by core values. To be effective, you must be willing to be flexible. Life will inevitably change, throw different kinds of challenges at you, and there will be occasions where your behaviours fall short. Being flexible means that you take the time to reassess your actions and get them back in line with your values. This can be achieved by setting realistic goals based on your values and gets easier with time and practice!

Indeed, forgiveness is challenging. The thought of forgiving someone who has hurt you comes along with a host of overwhelming emotions stemming from both the person and the event itself.

Conversely, forgiveness is also powerful. While we’re unable to change the past, we can control how we respond to future events. Applying these strategies will initially be tough, and that is alright. Your feelings and reactions are normal (and shared by many people in similar circumstances). Know that with patience and time, it will get easier!

Supporting a Person Whose Friend or Family Completed Suicide

How do I help someone who lost a friend or family to suicide?





In 2019, 400 lives were lost to suicide in Singapore, and suicide is the leading cause of death for those aged between 10 – 29 years old. 

There are at least 2 sides to every suicide: The person who took his or her life, and those left to grieve.

It can be challenging to support someone who has lost a family or friend to suicide. What should I say? What if I say something that only makes them feel worse? Should I even say anything? These worries are perfectly understandable. After all, many people struggle to talk about suicide. While we may feel awkward or uncomfortable when talking about suicide, this should not stop us from showing support and offering assistance.  

While it may be challenging, your support can make a real difference in helping a person through their loss. 

Supporting Those Affected by Suicide Loss: A Guide for Compassionate Responses


Here are 3 key areas that that we will cover below that will guide you in your efforts to support someone who has lost a friend or family member to suicide: Being a good listener, the do’s and don’ts of what to say, and warning signs to look out for. 

How do I be a good listener to a grieving person? 


One of the most helpful things you can do for a grieving person is to simply lend a listening ear. This means to sit with him/her and listen to their feelings in a non-judgemental manner without imposing your personal opinions. Do not try to problem solve either.   

ACTIVE LISTENING is a great way of doing so!  

While our conversation partner is still speaking, we often get caught up in trying to formulate our response. A consequence of this is that we end up failing to fully grasp and understand what the other person is trying to convey. Instead of trying to find the right words, it is more important to let the grieving person express themselves and share with you the nature of the loss. Here are some useful tips on being a good active listener to a grieving person: 

  • Accept all feelings. Let him/her know that is okay for them to cry in front of you, break down, scream, or even laugh. They may be struggling with a whole array of new and even conflicting emotions like guilt, despair, blame, anger, and regret. These can be uncomfortable emotions, but it is better to let them out rather than bottling it up. Accept the emotions that they are experiencing and know that it will pass. There is no correct way to feel about loss. Ultimately, the person should feel free to express their feelings in a space that is free of judgement, argument, or criticism. 

  • Silence is okay. Be prepared for moments of awkward silences. Do not force the person to speak if they are not ready to. Instead, be willing to be present and show that you are ready to listen when they are ready to speak. 

  • Offer comfort without minimizing or trivializing the loss. Statements such as “It could be worse” do not help. Do not give unsolicited advice, claim to know what the person is feeling, or compare your grief with theirs. Such words are rarely helpful. Instead, let the person know that what they are feeling is okay and that it is a normal reaction to the situation.

What should I say to a grieving person? 

  • Acknowledge the situation and check in on how the grieving person is feeling. Do not assume to know or understand how the person is feeling. Assumptions often worsen the situation as they invalidate a person’s intense emotions. Instead, start off by acknowledging the situation so the person knows that you are willing to openly discuss the loss they have experienced. Next, give them the opportunity to express their feelings. For example, “I heard that ___ died by suicide. I’m sorry to hear this happened and I’m here when you need me. How are you feeling?” 

  • Reflecting and paraphrasing. This is a really useful way to show the grieving person that you are hearing their story! It helps to foster a better empathetic connection, which makes the person more comfortable in continuing to share their thoughts and emotions with you. For example, the person might say “I don’t even know where to start, everything feels terrible.” In response, consider saying something along the lines of “It sounds like you feel very overwhelmed and upset, this situation is taking an emotional toll on you.” See how you would be reflecting their underlying emotions back to them? 

  • Do not use cliches or platitudes to comfort. We often feel compelled to comfort the grieving person by saying things such as “time will heal” and “they are in a better place now”. While it comes from a place of good intentions, such words can minimize the depth of the person’s pain, leaving them feeling misunderstood and more isolated. Instead, check on how they’ve coped so far and explore what resources they've tried so far. 

Samaritans of Singapore Hotline: 1800 221 4444 

Institute of Mental Health’s Helpline: 6389 2222 

Singapore Association of Mental Health Helpline: 1800 283 7019 

You can also find a list of international helplines here.

Keep an eye out for warning signs 


It is not uncommon for a grieving person to feel depressed, angry, or disconnected from others. These emotions usually decrease in intensity over time. However, it might be indicative of a bigger cause for concern if the intense emotions don’t subside over time and the person does not appear to be capable of coping with the overwhelming emotions on a day-to-day basis. They may also display significant distress or impairment in social, occupational, interpersonal, or other important areas of functioning. Here are some other warning signs to look out for: 

  • Extreme focus on the death 

  • Talking about wanting to escape the pain / statements indicating they are considering ending their life 

  • Withdrawal from others 

  • Diminished experience pleasure from the things they used to enjoy 

  • Feelings of hopelessness 

  • A lack of concern for personal welfare or hygiene 

  • Excessive consumption of alcohol or other substances 

  • Trouble sleeping 

If you are concerned about a person in distress, it can be helpful to recommend that they see a psychologist. Let them know that it’s absolutely alright to seek out other additional help they may require.

Remember, everyone’s healing process is different, and healing takes time.

Sometimes, lots of time. 

Grief after losing someone to suicide can feel like a rollercoaster, but with support (from someone like yourself!), the ride can become significantly less scary. 

Recognising Suicide Risk

Recognising Suicide Risk, Protecting Human Lives

What are the signs associated with suicide risk?




Sucide Rates in Singapore

In Singapore, suicide is among the leading cause of death among the younger population aged 10 to 29. In fact, there has been a rising trend of suicide, with the reported figure of 397 in 2018 being a 10% increase from 2017. This figure is 2.8 times higher than the number of transport accidents in the same year.

What are the warning signs of suicide?

As concerned family and friends, we must be attuned to some of the signs associated with increased suicide risk:

Ψ Health Conditions: 


People with chronic or terminal illnesses, as well as mental health conditions, may experience a sense of hopelessness about their life and future. Hence, those with physical and mental health conditions are at a higher risk of suicide. 




Ψ Situational Stressors: 


People who are going through difficult and stressful events, such as divorce, unemployment, imprisonment, or exposure to violence and death, are at a higher risk for suicide. These events may also place the individuals at a higher risk for developing psychological disorders that could affect their perception and further heighten their suicide risk.

On top of that, people with a history of substance abuse, physical or sexual abuse, social isolation, and past suicide attempts are also at a higher risk for suicide. 




Ψ Verbal Cues: 


Regardless of what you may think about suicide threats, never take them lightly. When someone you know says that they don’t want to live anymore, it should be taken as a warning sign. 

The following are other common verbal cues associated with clinical depression and suicidal ideation to look out for: 

  • Using more first-person pronouns (e.g., I, me, myself): This is reflective of someone who is focused inwardly, which is typically observed in people with high awareness and experience of psychological pain. 

  • Using more absolute terms (e.g., always, never): People who are clinically depressed tend to hold a black-and-white (or all-or-nothing) thinking pattern, suggesting impaired judgement and reasoning. 

  • Speech characterised by guilt and self-blame, isolation and loneliness, as well as feeling tired, trapped and being a burden: When someone is experiencing a lot of pain, each day may seem like a recurrence of the one before and they can find it increasingly difficult to get by as they are unable to break out of the negative loop. 




Ψ Behavioural Signs: 


Take note if you notice someone you know starting to withdraw from others, neglect their physical appearance or lose interest in activities that they used to find pleasure in. People who have thoughts of suicide also typically give away their treasured possessions, or make a conscious effort to visit their family members and close friends out of the blue. These are common signs of suicide preparations, such as having closure or saying goodbye to loved ones. Other forms of suicide preparations include writing a will, researching on suicide methods, or writing a suicide note. 

Understanding suicidal ideation and suicide attempts

Numerous studies have found that: 

  1. Most individuals who have suicidal ideation have mixed feelings about suicide; and 

  2. They may seek help before a suicide attempt. 

As such, we are able to intervene before a suicide attempt is made.

How Do I Help Someone Who Is Suicidal? 

Contrary to popular belief, talking about suicide will not increase suicidal thoughts, or put the thought of suicide in their heads. In fact, speaking about suicide helps individuals know that there are people who are concerned about them, and who would want to support and help. 

Granted, many of us are uncomfortable with the topic of suicide and we may not know how best to start a conversation about it. How then can you help someone who is suicidal?

Here are some helpful tips when talking about suicide: 

  • Invite the troubled individual to talk about their difficulties and listen without judgement. Withhold the urge to problem-solve or give quick solutions. Remember, they are not looking for advice.

  • Check on what the troubled individual have been doing to cope, and what resources they have available. 

  • Ask directly: “Are you having thoughts of suicide?” 

    • If they are, encourage them to seek immediate help. For example, they can contact the 24-hr suicide hotline provided by the Samaritans of Singapore (SOS). 

    • If they are not, do still encourage them to seek help from professionals, such as counsellors or psychologists. Offer your support by sourcing for suitable services together, or even accompanying them for their appointments. 

Singapore’s decision to decriminalise suicide attempt from 1 January 2020 was widely applauded as a move to support, rather than prosecute, people who are so overwhelmed by their difficulties that they attempt suicide. Indeed, when it comes to suicide prevention, much can be done to promote mental health awareness and encourage help-seeking. We can start by doing our part to support the people around us, and helping to protect the precious lives of those we love. 

How to Encourage a Loved One to Seek Help

How can I help? What should I say?

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

What is Mindfulness?

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


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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.

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. 

Supporting Someone who has Been Abused

What is Abuse?

How can I help someone who is being abused?

Abuse refers to any forms of violent, cruel or demeaning acts against another person or animal to cause harm or distress.  

Types of Abuse 

“Physical abuse, sexual abuse, emotional abuse… that should be about it right?”

There are actually many more types of abuse than we think. There are at least 5 different types of abuse. The different types of abuse can be further subdivided according to: 

Ψ The nature of the abuse (e.g. physical, emotional, financial, or sexual)
Ψ The demographic of the victims (e.g. elderly, children, or intimate partners) 

Here are some types of abuse and the warning signs you should look out for.

Physical Abuse 

What are the signs?  

Some signs of physical abuse include sustaining physical injuries and wounds (e.g. battered faces, bruises, or cuts). In more serious cases, one can have broken bones, internal bleeding, or even punctures. More subtle signs include the perpetuator not allowing anyone to visit the victim, or isolating the victim, to prevent others from knowing about the abuse. 

What is physical abuse?  

Physical abuse refers to causing bodily injury to others intentionally. Bodily injuries can be inflicted by any violent acts such as kicking, hitting, scalding, strangling, choking, pushing, or slapping the victim.  

Physical abuse is often associated with domestic abuse or child abuse where battered partner or children find it difficult to break free from helplessness and passivity.

Emotional Abuse

What are the signs?  

Signs of emotional abuse include intimidation, manipulation, humiliation, criticism, name-calling, blaming, false accusations and trivializing of one’s concerns. Victims can also show signs of emotional agitation, excessive self-consciousness, social withdrawal or anxiety, and non-responsiveness to the perpetuator.

As seen from the examples above, verbal abuse is usually intertwined greatly with emotional abuse, whereby words are used to hurt someone emotionally. Other forms of non-verbal emotional abuse include neglect, love withdrawal and silent treatment.  

What is emotional abuse?  

Emotional abuse is often also called psychological or mental abuse.  

Emotional abuse refers to non-physical abusive behaviors that are aimed at undermining one’s mental well-being such as one’s self-esteem, dignity and sense of identity.  

Financial Abuse

What is financial abuse?  

Unlike the aforementioned types of abuse, financial abuse is less frequently heard of. Financial abuse refers to controlling or restricting one’s ability to use money or other financial resources. Victims are often excluded from financial decision-making as well.   

Financial abuse is common in domestic abuse and elder abuse where the spouse’s or elderly parents’ access to financial resources are being controlled. Financial abuse traps victims in the abusive relationship as they do not have the resources to survive by themselves.  

What are the signs?  

Some signs of financial abuse include controlling expenses and allowance without seeking one’s opinion or advice, have access to one’s bank account, creating joint bank accounts, using one’s money without permission or agreement, or sabotaging one’s opportunities to acquire a job or promote. 

Ways to support someone I know who is being abused:


1. Help them prioritize their safety 

Safety of the victim is of utmost priority. Help victims of abuse stay safe, especially those who are physically abused and/or are isolated at home. Check in with their safety at times and ensure that they are okay.  

In the case where you cannot contact them for a few days or if you see that the victim has incurred serious physical and psychological hurt, please inform the police so that the victim can be separated and kept safe from the perpetuator.

You can work together with the victim to come up with a safety plan as well. A safety plan is a code used by the victim to signal that they are in danger. This code should not be revealed to the perpetuator to ensure the safety of the victim. 


2. Help them seek professional help if needed 

Encourage them to approach someone who can offer professional guidance and advice. If they are willing and consent to getting professional help, you can help them contact the relevant helplines if necessary.   

If consulting relevant professionals seems intimidating and overwhelming for the victim, offer to accompany them for the visits as well.  


3. Lend support to them  

Lend them a listening ear and let them know you are there for them. Support is important for the victims as they will know that they are not alone and they can turn to someone else for help.   

Often, perpetuators of abuse aim to make the victims feel bad about themselves so they can easily manipulate them. They tend to limit the victims’ access to social or financial resources (e.g. through isolating them from their friends or preventing them from getting a job) so they have no choice but to be dependent on them. Victims then develop learned helplessness and often find it hard to leave an abusive relationship. Knowing they have someone else to rely on other than the perpetuators is thus a great source of strength and courage to them.  

What should I not do if I know someone who is being abused? 


1. Do not trivialize and invalidate their experiences and feelings 

Opening up and sharing about being abused take a lot of courage. If an abuse victim confides in you, treat their call for help seriously and do not make insensitive jokes or remarks that would make them feel worse about themselves and more afraid to approach others for help. Always be emotionally accessible and non-judgmental when a victim shares about their experience.  

 

2. Do not blame them for their abuse 

Victims are never responsible of the other party’s abusive behaviors as we are all accountable for our own actions. Instead, help victims know that we are all deserving to be treated with respect and dignity, and abuse should not be justified by any reasons. 

 

3. Do not make decisions for them   

They have the right to make independent decisions for themselves. Do not force them to leave the perpetuator. It is difficult for victims to walk out of an abusive relationship, especially if they are emotionally, legally or financially tied to the perpetuator.  

However, regardless of their decisions, let them know you will be here for them. Try your best to reason with them and talk them through calmly, but ultimately, they have to make the choice for themselves. 

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. 

Biases are essentially mental shortcuts. As we are constantly bombarded with information, these shortcuts allow us to make quick decisions and judgements to help us prevent information and cognitive overload.  

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.