Self Harm and How You Can Help

Self harm is a serious issue affecting many young people today.  Sadly it has become a common coping mechanism of youth who are feeling overwhelmed, anxious or depressed.  Beyond Blue Australia reports 12% of young people will engage in self injurious acts with average first times act occurring at 12-14 years. Whilst not a suicide attempt, the risk of suicidal ideation increases with the longevity of self harm, as does the risk of hospitalisation due to self harm.

For most, the idea of engaging in behaviours such as cutting, burning, hair pulling or hitting oneself seems shocking and difficult to understand.  If your child or anyone you know is engaging in such behaviours it is important to ask them to help you understand and that you are free of judgement or reproach.  The young person is in need of help from a professional and family and friends.

Explanations for self harm include the young person feeling so numb and disconnected that to them the act of self-harm provides an opportunity to feel, therefore reducing frightening and isolating feelings of numbness.  A second reason cited is that the individual is so overwhelmed that cutting creates a release for the internal pain and chaos they are experiencing.  Others use self harm as a means of self punishment in response to feelings of self loathing and judgement caused by depression. The injurious behaviour may provide temporary relief for numbness, overwhelm or self-loathing however they soon returns as the core issues have not been resolved.

In the absence of healthy coping mechanisms self-harm can become habitual and increase in frequency.  Therefore maintaining constant and open communication with our adolescents is essential for providing avenues for them to talk about the challenges they are facing.  Remember, adolescence is a time of great self-exploration and growth, with heightened emotions and at times debilitating self-doubt.  Add to this school pressure, social media, romantic relationships and the complexity of teen friendships, you can see there are many factors that can result in teens feeling overwhelmed, alone and scared.  Find opportunities to talk with your teens when they are receptive, for example driving together in the car, walking, doing a task without other family members.  Let your teens know that you want to know about their good and bad experiences. Also provide the opportunity for your child to speak with a professional counsellor if you sense that they are struggling or there has been a change in behaviour or mood.  

Ensure that your adolescent develops healthy coping strategies such as exercise, regular study breaks, healthy eating, fun activities, reading, journaling, meditation and most importantly adequate sleep. Explore avenues for expression of intense emotion such as boxing classes, drama, art and high impact exercise.  Listening to sad music or watching sad movies can provide a means of emotional release, as can comedy.

Don’t be afraid to talk to your child about self-harm and ask if they have ever thought about it or if any of their friends do it.  Maintain a caring nonjudgmental approach to this but let your child know that it is serious and you are their to help them or their friend get the help they need.  It is important that your child believes you can handle whatever it is they are going through, reassure them that you are there to support.  Self-harm is something to be concerned about, but with the appropriate help, lots of love and patience it can be overcome.

Please see the resources below for further information

www.beyondblue.org.au

A Bright Red Scream – Marilee Strong

The Parents Guide to Self-Harm, What Parents Need to Know – Jane Smith

Stopping the Pain: A Workbook for Teens Who Cut and Self-Injure  – Lawrence E. Shapiro

Cutting: Understanding and Overcoming Self-Mutilation by Steven Levenkron

 

Written by

Rachel Upperton
B. Psych (Hons) PhD.
Registered Psychologist, MAPS

Emotional Hijacking: Why it happens and what we can do about it

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Have you ever had a time your emotions took control over you?  Maybe you reacted without thinking, said something you wish you hadn’t or done something impulsive you regretted afterwards.  When moments like this happen people often say they “weren’t being themselves” or they weren’t thinking straight. Why does this happen and how can we train the different parts of our brains to be more integrated?

Our brains in a nutshell:

  1. The Reptilian Brain (Primitive Brain) – this is the part of our brain we are unconscious of.  This includes breathing, body temperature and heart rate, but also our survival instincts.  When the body perceives it’s in danger or imminent threat this part of the brain takes over and prepares to fight, flee or freeze (shut down) to optimise survival.
  2. Limbic Brain (Emotional Brain) – this is the part of our brain that contains the amygdala, the part that assesses external or internal stressors and determines whether we need to go straight to survival mode (fight/flight/freeze) or can consult the thinking part of our brain, the neocortex.
  3. Neocortex (Thinking Brain) – this is the part of our brain that makes us human and the last to develop over the life span.  It is responsible for complex/abstract thinking, language, logic, creativity and empathy.  The Neocortex is slow to respond to the signals of the emotional brain and therefore shuts down when life-threatening stress occurs or is perceived.

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Why emotions take over:

When we experience emotions such as fear, anger or stress our limbic system can perceive it as life-threatening (whether or not we are actually in danger).  The thinking part of our brain shuts down and we act on impulse to keep ourselves “safe” and our reptilian brain takes over (heart rate increases, muscles tense, blood flow increases etc) to prepare our bodies to respond to the “threat”.

How can we train our emotional brain to get the signals right more often?:

We can regulate our nervous systems to work more efficiently by becoming more aware of the emotional and physical cues from our bodies.  If we can tame our emotions and aroused states, we can keep our Thinking Brains online and make better choices in responding.  Regulating our emotions and body signals sends the message to the limbic system we are not in danger and allows the Thinking Brain to think!

We can regulate our emotions and physical sensations by changing the pace of our breath, grounding ourselves, doing something active like walking or cleaning the kitchen, practicing mindfulness, yoga, or reaching out to others in support.  People who have had multiple traumatic or stressful life experiences or insecure attachment figures often get dysregulated more often, however we know our brain’s neural pathways can change throughout the lifespan. The more we practice ways of calming ourselves (no matter what our history is) the better our limbic system can be at judging real vs perceived danger.  Having trusting relationships, secure attachments histories and safe living environments are protective factors for an integrated nervous system.

Resources:

About Paul D. Maclean’s Triune Brain Theory

Dr. Dan Siegel writes a few books to help everyday people understand the neuroscience behind our psychology and offers strategies for parents, teenagers and adults, particularly Mindsight and Brainstorm.

 Check out Dan’s Ted talk about mindfulness and neural integration for more understanding on this topic.

Written by

Kady Leibovitz
MA Clinical Social Work
BA Psychology
Licensed Clinical Social Worker  

What is Being Mild to Yourself?

This is a translation of a Dutch Piece out of the book of Edel Maex (Mindfulness, 2006) named:

“Wat is mildheid?”, meaning “What is Being Mild to Yourself?”

“Mildheid” is translated as Mildness, being mild, gentleness, a mixture of kindness and compassion, not being too hard or too harsh on yourself.

 

Being mild is what most people feel when they see any young child walk for the first time. With a mixture of compassion and encouragement you watch how the child tries to stand up, keeps its balance, enjoys its first success and then falls, and then stands up again and…

When the child falls you are not angry. You give the child space to develop itself and find his/her own way. That’s how we learn. When it enthusiastically and eagerly extends out with its hands to you, you reach out your hands and give the child the opportunity to grab them and enjoy it if he/she reaches his goal.  

Most people don’t treat themselves that way. How often do you lose yourself in criticism and disapproval? If things don’t work out you give yourself an extra punishment. As if it is isn’t hard enough already… This way you actually can’t learn, you only make it worse.

How can you be mild to yourself? What is being gentle for yourself? If someone would judge and blame you in exactly the same manner as you are doing to yourself, you would perhaps not put up with it. Hopefully you have enough self-respect to realize that you really don’t need accusation.

What is mildness? The best way to find out what mildness is, is your own desire. How would you want someone else to treat you when you are going through a tough time. Are you longing for accusation and humiliation or for understanding and respect? Someone who listens to you or someone who tells you that you should do everything differently (as if you didn’t know that already)?

Being mild is a conscious decision. You choose to not continue with the destructive pattern of self-blame. What do you notice? First of all, you notice how deep this pattern of self-criticism is. The judgements and blame come automatically and you can’t stop them. You tend to judge yourself for this failure.

This is THE moment to remind yourself that you choose for gentleness. Condemning yourself for a lack of mildness would be more of the same. So… what can you do? Look at yourself the same way as you look at a child who falls and stands up. To your deep automatic patterns that you can’t stop, to your pain, to your desire. It doesn’t change the patterns, at least not immediately. The thoughts remain the same. But by changing the way you handle and look at it is in itself a radical change.

Written by

Flo Westendorp
Registered Clinical Psychologist
Extended Healthcare Psychologist Certificate MSc & BSc (Clinical Health Care Psychology)

Grief in Children

As per the dictionary definition ‘grief’ is ‘keen mental suffering or distress over affliction or loss; sharp sorrow; painful regret.’

In children, grief is a process that happens when one loses something dear to them. It’s helpful for a child to have adequate time to heal from the loss. Grieving can happen in many situations ranging from relocation, divorcing parents, loss of a pet, a close family member or loss of anything dear to them. Children grieve differently in different situations. There is a high possibility that a child’s grief gets overlooked because of the inability of the adult involved to identify and support him/her.

Over time it has also become increasingly clear that children grieve in different ways or express their grief differently to adults. “Kids often grieve in spurts because they can’t seem to tolerate grief for long periods of time,” says Susan Thomas, LCSW-R, FT, Program Director for the Center for H.O.P.E. at Cohen’s Children’s Medical Center of New York.  She explains that, “Kids seem to jump in and out of grief.” This means that they can often distract themselves, but when something happens, all the emotion they’ve been pushing away appears back.

Silence isn’t golden during grief. Children may not verbalize their feelings as they may have felt that sharing their feelings could be hurtful or could bring more sadness. It is also not uncommon for children to experience guilt following loss. Reassurance by a trusted adult and having ongoing conversations may help them deal with the grief.

Some signs of grief and loss in children that may show up after the loss are:

  • Loss of interest in day-to-day activities
  • Fear for personal survival
  • Increase in separation anxiety
  • Impaired ability to make emotional attachments
  • Lack of sleep, loss of appetite, loss of self-esteem
  • Prolonged fear, worries, anxiety
  • Regression in younger children, e.g. wanting to be carried, being clingy, wanted to be fed by an adult, etc.
  • Change in behavior e.g. either being aggressive or passive
  • Withdrawal from friends or family
  • Sharp drop in school performance or school refusal

Psychologists agree that if the grief is not resolved in the early years, it may well last into the adult life. Studies show that emotional distress in adolescent and adulthood including depression, anxiety, alcoholism and suicidal ideations are often linked with bereavement suffered in childhood. If you are witnessing some of the above mentioned symptoms in your child, it’s beneficial to seek out help from a professional.

References :

  1. Helping Children Cope with Separation and Loss by Claudia L. Jewett
  2. https://www.dougy.org/grief-resources/how-to-help-a-grieving-child/

 

Written by

Vinti Mittal
Director SACAC Counselling Pte Ltd
Clinical Member SAC
SAC Registered Counsellor
CMSAC, Reg, CLR, MSc (Counselling), Grad Cert. (Counselling)

 

 

Will I ever trust you again?

“A happy Marriage is the union of two forgivers” – Ruth Bell Graham

Three building blocks are the foundation of good relationships: trust, honesty, and compassion.

It is only when our partner has been unfaithful that we realise how fragile these building blocks can be.

The common belief is that affairs are about sex or intercourse, but with the introduction of the Internet, the definitions of affairs or infidelity become more complex. In fact, affairs are most often about secrecy, sexual attraction and sexual activities that violate the monogamous vows.

The affair might be a terrible crisis but the Chinese symbol of “Crisis” is made up of two words: “Danger” and “Opportunity”. If the couple is committed to dealing constructively with the affair and size on the Opportunity part of the crisis, their relationship will find a deeper meaning and grow stronger.

Few steps in working through the affair and towards recovery are useful to know:

1. The Discovered has to end the affair and cut all ties with the third party.

2. The Discovered needs to be transparent about his/her relationship with the third party by answering the Discoverer’s intense questioning. Defensiveness and shame will hinder the couple’s recovery process. The Discoverer’s intense questioning aims to clarify the reason(s) why the partner had been unfaithful. The Discovered needs to show empathy and compassion towards the Discoverer while answering the questions, however excessive details can be traumatising to the Discoverer. A word of caution to the Discoverer: focusing solely on the third party means failing to look closely at the couple’s own relationship.

Also to help rebuild the trust, the Discovered needs to offer full access to call records and messages on their digital devices.

3. The couple needs to uncover deeper motivations that had led to the path of the affair through insight and honest discussion.

The equation:

Problem + Poor communication + Temptation = Infidelity; highlights the necessity for both partners to learn new communication skills.

Through commitment and intense learning, the crisis of unfaithfulness will offer to both partners the opportunity to create a new durable partnership.

 

Written by

Sanaa Lundgren
MS (Counselling), MS (PolSci)
Collaborative Family Practitioner (SMC)

Why are dyslexia and dyscalculia so different?

Dyslexia is the name for a persisting difficulty in learning to read and write, in spite of adequate instruction. It is widely recognized as a problem for up to 10% of young children starting to learn and for some of them later on in their learning. In Singapore children who have more than usual difficulty learning to read and write get help in their school, or through a wide range of tuition centres or through the Dyslexia Association (DAS), which teaches them in small classes for 2 hours a week. The DAS stands as an example of the kind of community social structure that validates difficulty learning to read and write.

Dyscalculia is the name for a persisting difficulty in learning to use numbers. It is much less widely recognized – some estimates suggest around 6% of students experience it but there are significant variations between countries. Unlike reading and writing, difficulty with numbers tends not to become evident until later, often not till age 9 or 10. There are of course tuition centres in Singapore specializing in helping children with maths difficulties and some schools also provide extra classes and specialist teaching. But there is much less specialist support, and far fewer children are identified as having dyscalculia. There is as yet no national Dyscalculia Association in Singapore.

Literacy is a universal gateway to all other learning; numeracy also leads to other kinds of learning but more narrowly. It is easier to see that learning to read and write is not much to do with intelligence – many children who struggle with reading are evidently bright. Maths seems more closely tied to intelligence – it is the first kind of logical reasoning that most children face; we suspect that if you cannot understand the logic of number relations you must be stupid. But is logical thinking the only criterion of intelligence? The arts generally, language and expressive ability and even some aspects of construction arguably do not require logical deductive reasoning. So you can have difficulty with maths but have many other strong and useful abilities.

Many adults are happy to confess they found maths really difficult at school – but usually they won’t “come out” until they have left school! Isn’t it time we paid more attention to maths learning difficulties for school students? How can we help students who find maths harder than usual without making them feel stupid? Do we need community associations to gather and focus support?

Let us know if you agree this is a problem and what should be done.

 

Written by

Dr Tim Bunn
EdD, MSc, BA (Hons), PGCE
Consultant Educational Psychologist

Raising Emotionally Intelligent Children

All of us struggle with our emotions at times. For children, the intensity or complexity of their emotions can feel overwhelming, and may result in challenging behaviours. Understanding our emotional experiences underlying behaviour is a key aspect of what is known as Emotional Intelligence: the awareness, understanding and ability to express and manage one’s emotions. Research carried out by Gottman and colleagues has found that children with greater emotional intelligence are more able to self soothe, have greater friendship success, better concentration and as adults have greater life satisfaction and intimate relationships.

Parents play an important role in teaching children the skills of emotional intelligence. To assist, Gottman and colleagues have developed a five step framework known as Emotion Coaching.

The 5 steps to Emotion Coaching

  1. Become aware of the child’s emotion
  • Their body language, facial expressions, gestures
  • Look for lower intensity emotions such as disappointment or frustration
  1. Recognise the emotion as an opportunity for intimacy and teaching
  • An opportunity for you to connect with your child and teach them how to self soothe
  1. Listen empathetically and validate the child’s feelings
  • Reflect back to your child what you’re hearing
  • Let them feel the emotion and know that it is okay to feel all emotions
  • E.g. “no wonder you feel sad” “It’s really frustrating when..” “I wish you could stay in the swing all day”
  1. Help the child verbally label emotions
  • Give a word for the emotion so it doesn’t feel so overwhelming
  • E.g. “It sounds like she made you feel angry”
  1. If necessary, when your child is ready, set limits while helping the child problem solve
  • Communicate that all feelings are acceptable, but some behaviours are not
  • Set limits, consequences
  • Discuss alternate ways that they could manage their feelings
  • E.g. “It’s okay to feel angry but it’s not okay to hit your brother”

The skills of emotional intelligence can be carried from toddler and childhood years into adulthood as they navigate life’s challenges. If you are interested in practicing the 5 steps of Emotion Coaching with your child and would like further information, check out the following websites:

https://www.gottman.com/blog/category/emotion-coaching/

http://www.ahaparenting.com/

Written by

Dr Thea Longman
DClinPsych/MSc, BPsych (Hons)
Registered Clinical Psychologist

 

Omega 3 on Mental Health

We have known for years that many possible factors play a role in mental health and there are various proposed antidotes to improve upon it. This can span to a nutrient rich diet, adequate exercise, building a good support system and altering other lifestyle components. But new research has been demonstrating that one nutrient in fish might actually be more effective against depression, anxiety and other mental health conditions than the traditional antidepressants and other mood stabilizers. The nutrient is an omega-3 fatty acid called EPA (eicosapentaenoic acid). Omega-3 fatty acids are also known for contributing positively to overall general and physical health, as well as cardiovascular health.

The American Heart Association recommends people eat fish at least twice a week, which, on average, would give individuals the recommended dose of 500 mg of DHA (docosahexaenoic acid) and EPA daily. But most adults and children get closer to 100 mg or lesser than this recommended intake.

Numerous studies have shown that there is a link between anxiety, depression and low blood levels of Omega 3 fats; and empirical facts support this as research reports statistics of much lower rates of depression and anxiety in countries where fish consumption is high. Reported in the Archives of General Psychiatry, scientists administered daily doses of EPA to a group of patients with chronic depression. Three months later, more than 75% of patients reported a 50% reduction in their symptoms—predominantly emotional states of sadness and pessimism, inability to work, insomnia and low libido. All patients had previously tried other medications, including Prozac, other SSRIs and tricyclics.

Studies on ADHD demonstrated similarities. These fatty acids participate in brain development and are necessary components of brain cell plasma and membranes. As such, scientists believe that essential fatty acids may contribute to the absorption or release of neurotransmitters – i.e. chemical signals – between brain cells, which has many implications for people struggling with attention-deficit/ hyperactivity disorder (ADHD) or similar symptoms. Additionally research also found that children with ADHD have lower levels of omgea-3 fatty acids in their blood, compared with kids who don’t have the condition.

Although current research is promising in this area, the pure dependence on these omega fatty acids in replacement of everything else is not advisable but it will be a good idea to incorporate these supplements into one’s diet even for general overall health.

Written by

Dr Felicia Neo
PhD (Clinical Psychologist & Neuroscience)
PGDip (Clinical Psychology), BA (Psych & Mass Communications)

Clinical Psychologist, Neuroscientist

 

 

MINDFUL PAUSES

Many of us struggle with stress and overwhelm from our extra busy, fully packed professional and personal lives. It is also often difficult for people who need it the most, to find the time and energy to do time-consuming self-help exercises. The following exercise is a concise and relatively easy way to include bite sized self-care and mindfulness amidst your daily hustle bustle. These are all simple activities, but when done consistently and consciously, can provide a welcome breath of relief and inner calm in navigating through a chaotic outer world.

The exercise is to include MINDFUL PAUSES in your day – not just at the beginning or end of your day, but at regular intervals through the day. You are free to determine the frequency of these pauses based on your schedule, but ensure that you put them in your calendar, set a reminder and as much as possible plan your tasks around it. Ideally, take a break for 10-20 minutes every 2 hours. The concentration span of the human brain is limited so if 2 hours seem too short, think again as by then your brain would already be fatigued and aching for a break.

During the mindful pause:

  • Stop – Stop what you are currently doing (physically and mentally), get up and get out of that space – out of your desk, out of the room – allow your mind and body to recognise that you are taking a break. Get some sunlight and fresh air if possible, if not simply go to a different area of your workspace.
  • Check in – How am I feeling, what am I thinking, how am I breathing? In that moment, instead of engaging in the thoughts or fighting your feelings, simply observe, accept and let them pass for the moment as you give yourself a time out.
  • Stretch – give your body some movement, take a short brisk walk if possible, notice and consciously relax any areas of tension in your body. A quick body scan with stretching and relaxing the main muscle groups will help.
  • Hydrate and provide nutrition that your body may need.
  • Breathe – bring your focus to your breath, practice long slow deep belly based breathing for a few minutes as you allow your mind and body to get centred.
  • Refocus – Choose what you are going to focus on and identify what you seek to accomplish in the next 2 hours and channel all your attention and energy into that specific task. Do a quick plan or visualization of how you will be utilizing the next two hours and begin work from a clear and calm state of being.
  • Repeat after 2 hours.

When you have a lot on your plate, it can be difficult to imagine taking out 10 precious minutes from your already crazy, stretched thin schedule. However, in all likelihood you will find yourself lighter, fresher and more productive at the end of this short break, enabling you to engage with the rest of your life with more energy and positivity.  Give it a try!

Written by

Mahima Gupta
M.A., MSPS, CRT, C.Ht.
Registered Clinical Psychologist

 

 

Anxiety, stress and bullying in Singapore

About 3 weeks ago, the results of the latest PISA international comparison study’s chapter on well-being were released. As usual, in the main part of the study, released last year, Singapore did extremely well. In fact the 5825 Secondary 3 and 4 students, including 290 students from International schools and Madrasahs, came top in reading maths and science, an amazing achievement. But now we learn that Singapore is also third from top in a less happy ranking: our students are more anxious about grades and tests than comparable countries, they are more anxious to be one of the best in their class, and they also report more ridicule (verbal bullying) and more ostracism (being intentionally left out by peers) (the detail is readily available on the web and from various reports on ST 20.08.17 and 27.08.17).

The Singapore Ministry of Education was concerned and said it was working to reduce the stress around PSLE and to training school staff to be aware of bullying issues. However, it also suggested caution about interpreting the results: the questions may not mean quite the same to students in different cultures. The MOE was also quoted as saying (ST 27.08.17) “Research has shown that stress at appropriate levels can be a motivating force to energize us for the challenges we face… While we are encouraged that our students are highly motivated to learn and achieve, we are cognizant that this must not come at the expense of their well-being. Hence, we put in much effort to help students understand the meaning of their learning, instead of just focusing solely on their achievements.”

It is salutary to be reminded that there may be a considerable price to pay for striving so hard for academic excellence, and that students at all ages continue to need to learn to support each other as well as better themselves.

Counsellors and psychiatrists are reported to be seeing more stress-related problems here in recent years. The support they provide is probably only a small fraction of what schools, parents and Singapore’s leadership can and must do. I welcome your thoughts and comments – in a busy world of many voices, what are the most important things we can do individually, as parts of families and as members of school and larger communities to help our students deal with their social relationships and anxieties?

Written by

Dr Tim Bunn
EdD, MSc, BA (Hons), PGCE
Consultant Educational Psychologist