Foggy brain?

I am pretty sure I have always been a bit foggy. My teachers told me at 9 that I was sometimes great and sometimes a big muddle. They were right. I didn’t ascribe it to any special condition – it was just me!

But maybe it wasn’t just me. Recently, a wind has been blowing which blew some surprising goods, COVID-19, of course. Studies of people with long COVID-19 have found that about half of those may have brain fog. What is good is that brain fog has been noted and discussed for a long time, in relation to a wide range of conditions, such as chronic fatigue, allergies, menopause, ADHD, kidney failure as well as anxiety and depression. COVID-19 has helped to make clearer that persistent difficulties with memory and concentration, a lack of clarity, may have a specific cause.

So far, however, it has not been possible to pin down just what is causing the foggy symptoms. There is considerable variation in the symptoms and their severity, but one study suggests on average a cognitive deficit of about half a standard deviation, with difficulties tending to be around executive functioning (planning, organising, concentrating, etc). 

The neurophysiology underlying the problems has not been clearly identified either, with suggestions of inflammation of some areas or reduced ability of some brain areas to obtain nutrients. Nevertheless, COVID-19 has spurred research in this area. However, it also seems likely that the COVID-19 cases will improve – the fog will not be permanent. Sleep, diet and exercise are very likely to help reduce the problems. Occupational therapy may also help to relearn new ways to do some things.

Sabrina Brennan has written “Beating Brain Fog” about the broader condition, and if like me, you do sometimes forget everyday routines and facts, it might be worth checking it out. It may play an important but neglected role in understanding other conditions, too.


Sukel, K. (2022). Lifting the fog. New Scientist, 254(3390), 38–41. 

Written by:

Dr. Tim Bunn

Consultant Educational Psychologist

SACAC Counselling

Waiting for the New Normal

We are waiting for things to go back to normal; or maybe, not exactly how they were, but a slightly different set of routines and expectations, the “new normal”. The pandemic has stressed everyone, whether or not loved ones have been lost; many people have lost jobs and have had to switch to something new. Many have volunteered to help in the health crisis, with all the attendant strains. We are tired of it and want our old lives back. But will that happen?

I was shocked to discover a few days ago that one of the most common ways of thinking about the world was completely new to me: VUCA. It is an acronym for Volatility, Uncertainty, Complexity, and Ambiguity, originating in the US from business and military strategy, it suggests the world is getting harder to predict and understand because things keep changing in complex ways. Have things really changed or is it just that we have more sophisticated ways of looking at them? I don’t know, but it seems to strike a chord with many people. It suggests that any new normal will not be straightforward.

I grew up in the post-war world dominated by the danger of nuclear war and the conflict of values between capitalism and communism. The planet was expected just to chug along – we didn’t know much about plate tectonics or greenhouse gases. After the collapse of the USSR in the early 90’s, for a while things seemed to be settling down to a new global normal. But the rumblings of climate change have got louder and louder, then there was the Wall Street housing finance crash and then the pandemic threw us into a spin. It does all seem to be changing too fast.

We want stability and predictability but we seem to be in “exciting times.” Can we transition to a sustainable world, in which most people are safe enough and have their needs met, without too much fighting, without too much loss? I am not sure but I hope we can. A lot rides on that word “hope.” We undoubtedly need it, but it has to be intelligent hope, based on the reality of what we can achieve. We have seen how bioscience has achieved minor miracles to vaccinate us quickly. We need many other scientific breakthroughs in food, materials, energy, and transport. We also need leadership, vision, and solidarity. We need good people to share their visions of how we can create a new world. It won’t be the old normal. It has to be better.

Written by:
Tim Bunn
Consultant Educational Psychologist
SACAC Counselling

Who are you and who are you becoming through COVID?

We may all agree that the topic of COVID is getting tiring and exhausting,

I understand that you all may not want to talk about COVID anymore. We are all soaked about it. It has lasted too long, impacted too much, and taken too much of our energy and time. But believe me, it can be beneficial in some ways.

Maybe to start with, we can put COVID aside for a while and let you take place first. Let’s talk about you, your personality, and your identity. 

You have probably asked yourself before about who you are. Identity, contrary to what some might believe, is not a fixed category. It evolves all the time and is continuously changing, although it can sometimes seem predetermined or predictable.

According to behaviorism and other contextual behavior sciences, personality is not something that dictates our behavior, but it is part of it. The dichotomy between mind and body is outdated. What makes a person unique and singular results from her/his relationship with culture, including ontogenetic and phylogenetic processes. Therefore, identity is what we do, how we react, how we feel, how we think, and how we process things.

Besides behavioral psychology, the ideas of Social Psychology, the Materialism Historical, and the Dialect Method point out that human action in the world changes the material simultaneously as it changes the subject. Object and subject become a unity of contrary, moving culture, history, and human condition forward. “(…) All sensation or perception is an interaction between subject and object; the bare object, apart from the activity of the percipient, is a mere raw material, which is transformed in the process of being known. Knowledge in the old sense of passive contemplation is an unreal abstraction; the process that really takes place is one of handling things”. (Wambui, 2011, p.3)

Now that you know that your identity is mainly a social construct that evolves along with life, we can (sorry!) go back to COVID.

Like it or not, COVID has brought the emergence of unique needs, distinct ways of doing things, and new rules. The world is now different. As the theories above explicate, COVID has changed not just our environment but how we are as individuals too. We have been lonely, down, committed, open to new things, insightful, missing our family and trips, feeling hungry, feeling different, depressed, marginalized. And it depends on where in the world you were when it all started and where you are now. And I don’t just mean the physical world. It depends on what you choose to be when COVID happened and as it continues. Determinations are constant, but they are not everything.

Even if you can’t acknowledge these changes, COVID has impacted you somehow. And to overcome and find your journey in COVID times, I invite you to look deep within yourself and embrace this new context, not in a passive way but in an active, intentional way. It is not about being positive; it’s about being realistic. It’s not about being altruistic; it is about being human, being you, your only you. This period is about understanding your role, the power of your actions, and the power of your being. It’s not about denying determinism; it’s about accepting it and finding your best version of yourself. In the end, it is about giving yourself your best. And as a result, it is about giving others your best. It is to learn how to exist and co-exist.

All in all, we can only be ourselves because of others. And you can choose your path wisely, even knowing that freedom is not absolute and there is no control for all that affects us. But there are choices, there are fruits, and there is happiness, even in dark times.

In the end, I hope we can all look back on this period with some sense of relief, something to own, some new insights into ourselves, and maybe even something to smile about. Perhaps even being able to say, “I did it my way,” as Sinatra sings.

Just one last thing: if you need guidance in this process of deciding for your best version of yourself, please feel free to contact us. We are here to help.

Wishing you good luck and tenderness through this inevitable journey.

Written by:
Andrea Fernandes Thomaz
Counsellor & Psychotherapist
SACAC Counselling


Vygotsky, L. S. (1978). Mind in Society: The development of higher psychological processes. Cambridge: Harvard University Press.

Wambui, M. W. (2011). Dialectical Materialism and Historical Dialectics of Karl Marx. Munich, GRIN. Verlag, Retrieved from:

Mental Health Maintenance in Repeated Lockdowns

Until tightened restrictions took effect over the past weekend, many in Singapore were just regaining their sense of hope and ability to thrive. Since the end of December, we were blessed with near-normal lives that allowed us to dine in at restaurants, gather with family and friends in groups as big as 8, and return to working in offices. With new safety measures in place through at least the next month, concerns about ability to cope are bound to shroud the minds of many. In order to maintain mental health as we enter another lockdown, we can aim to achieve a balance in 3 key dichotomies.

Virtual World and Real World

We cannot deny the internet’s multitude of wonderful functions; it keeps us connected with others, it is a rich sea of information and learning resources; it provides us with vicarious experiences we are otherwise unable to access, and much more. However, excessive or maladaptive device usage can contribute to feelings of isolation, derealization, lower self-esteem, anxiety, and unhealthy misconceptions stemmed from misinformation. Be mindful about how much time you spend on devices, and what need you are trying to fulfill by being on your device. Make time to regularly engage in real world activities like going for a walk outside, preparing an enjoyable meal, or doing some arts and crafts. If you have difficulty feeling connected with real life activities, try to incorporate mindfulness to enhance your level of engagement.

Individual and Social Activities

Loneliness and feeling stifled living in close quarters with others are difficult, yet common experiences in lockdowns. Opportunities to socialize with people of your choice can ward off feelings of loneliness, boredom, and provide a refreshing change of social scenery for those who live with others. While it may not be advisable to meet in person, we can still arrange time to regularly socialize with friends and family virtually. If you get bored of simple video calls, get creative by asking each other to participate in online games, quizzes, simultaneous movie streaming, playlist collaborations, or learn a new skill together through an instructional video. For those who live with others, it is important to draw boundaries to retain your sense of autonomy and individuality. Safeguard your “me time” by letting those you live with know you won’t be available at that time.

Productivity and Rest

People tend to bounce between extremes of productivity and rest during lockdowns. Sometimes, work bleeds into what is meant to be our personal time off, causing disturbance to sleep routines, impairing our ability to engage and enjoy personal activities, and preventing us from feeling sufficiently recharged. All of these can quickly lead to lower work performance and burnout. On the other extreme, some abandon all duties and fall into a state of stagnation. We may feel frozen when overwhelmed by so many limitations around what we do and how we do it. Motivation can also wither away when usual sources of accountability are no longer present. Maintain a healthy work-life balance by setting regular work hours for yourself. Consider having accountability partners for both work and your personal time. This way, you can encourage each other to remain consistent with starting/ending work on time, and have meaningful engagement with time spent either working or resting.

As difficult as this period may be, we must remind and accredit ourselves for persevering through the lockdown last year. Let this fuel a sense of hope that we can withstand another one. Give thanks to yourself for every effort exerted to maintain your physical and mental wellbeing, and have self-compassion on the days when those efforts fall short.

SACAC Counselling wishes for everyone to stay safe through this trying time. If you have difficulty coping, please reach out for professional help.

Written by:
Michelle Chak 
Clinical Psychologist
SACAC Counselling

Together is Better: The Social Nature of Learning and Problem-Solving

The research is abundant regarding the superior results of working, problem-solving, and studying together. When faced with multiple assignments, exams, and/or problems with friends and family, teamwork always makes things more manageable, and the determined results more efficient and effective.

Knowledge is gained and created both faster and better when we participate as members of a team. Socially guided problem-solving
results in solutions which are of better quality.

Over this past year, we have been separated from family, friends, colleagues, and fellow students. Within only a few weeks my students went from viewing the lockdown as an extra holiday to realizing how many benefits they were losing through learning in isolation from their classmates. They reported that they were experiencing increased difficulty in thinking and in studying in isolation.

Many fellow educators believed that because of the technology available, students would not suffer any real harm because of the lockdown. While educators were trying to convince themselves and others that learning in isolation would not cause any negative impacts, the students themselves, talked about learning being constructed through active engagement. They remembered what we had told them about the exploratory nature of building knowledge. They did not require a degree in psychology to remind us of the sociocultural aspects of coming to know something new. They surprised me with how quickly they told me that because they were lacking the collaborative processes, their learning was not going deep. Without the discussions with others, without hearing multiple perspectives and ways of solving problems, they were losing confidence in their ability to find novel and creative ways to move forward. They were finding the quality and strength of their solutions to be lacking.

One student told me that only a few months before the lockdown had they come to realize and appreciate their infinite capacity to learn. They continued by saying that it was likely they would have never come to this understanding without the collaborative work that they had done. They saw that their personal evolution into a thinker and a problem solver was being shortchanged by the epidemic. The student lamented the fact that they only had a few of the answers. The process of refining ideas and skills they saw as a continuous learning and relearning, a process of making connections between themselves and their world. The changing, adapting, and improving was slowed by not learning together with peers. They were adamant that coming together through technology was a poor substitute for the real thing. The attitudes that are known to promote learning, such as perseverance and organization of thoughts, assignments, and materials were also more difficult to gain outside of the social context of the classroom. The students went on to tell me that self-esteem and self-confidence came more quickly and effortlessly when observed in others. They reported that enthusiasm is contagious. Getting along with others is something that they are being told is now indispensable. Social development and social responsibility are only learned through social interaction.

Another girl shared that it was through discussion that she became brave enough to share her own beliefs and values. Hearing others ask for clarification of concepts and requesting help provided her with the courage to do the same thing. She then smiled and added, that it was only through the support of teachers and classmates that she became able to clarify, elaborate, and dig deeper into ideas.

It will be years in the future before we have an accurate accounting of all that has been lost due to our planet-wide epidemic. The lost opportunities to learn and think as members of a team is something we need to work to limit in every way possible.

In closing, I want to remind us of the well-known dangers to our student’s learning in isolation. Students working alone are more prone to acquire mental illness. Multiple surveys tell us that seven out of ten teens reported mental health struggles. Being isolated impairs executive functioning skills. Social isolation is associated with a 50% increased risk of dementia. Learning in isolation has many negative, and cognitive consequences including difficulty in thinking and remembering information. We are a social species. We really need each other to survive.

Written by:
Ms. Vivian Colvin
Tutor & Mentor
SACAC Counselling

Restoring Positivity for 2021

2020 was a year that posed monumental challenges for all of us. The Australian bushfires, Beirut explosion, police brutality exacerbating racial tensions, and of course, the pandemic – the list goes on. Even among those whose health and safety was not compromised by the circumstances of 2020, many experienced loss of job, family/relationship conflicts, mental health struggles, and more. Although we have entered a new year, the negative experiences gathered from 2020 still weigh heavily on us. When combined with our natural proclivity towards negativity bias, this can make us feel defeated by 2021 before it has barely begun.

There is an evolutionary rationale behind negativity bias, the human tendency to focus on and remember aversive experiences. In our primitive days, it was crucial to remember that time we were bitten by a snake, or fell ill from eating a poisonous plant so that we could recognize and avoid these dangerous stimuli in the future. We lean into this bias because it protects us. However, if left unregulated, negativity bias can ultimately cause more damage than good by developing into maladaptive thinking patterns. We may become hypervigilant when there is no real threat present, positive experiences slip by without the acknowledgment they deserve, and we lose our sense of hope. So how do we counter negativity bias as we proceed with 2021?

  • Gain awareness of positive experiences as they happen.
    Sometimes the enjoyment of an experience may be very obvious, such as if you were to laugh so hard that your abdominal muscles cramp up. Sometimes your enjoyment maybe more subdued, such as if you were to notice the smooth velvety texture of a chair that you are using, or if your regular coffee shop barista greeted you by your name and with a smile. No matter how small, it is important to consciously register these experiences, otherwise your mind may distort the day to seem much more negative than it really was.
  • Practice fair reflection on a daily basis.
    Think of your positive and negative thoughts as two children in your mind, each itching to tell their stories from the day. Your job is not to decide who has the best stories, instead you play a role of ensuring that each child feels heard and acknowledged. If you notice the child sharing negative experiences is highly distressed, take time to assess and tend to needs as you deem necessary. However, do not dismiss the contributions of the child who shared positive aspects of the day.
  • Be proactive to incorporate activities that will make your day more pleasant.
    Try to set aside some time purely to engage in activities you find relaxing or enjoyable. This might be that regular run that gives you a rush of endorphins, or your daily soothing skincare routine. It could also be something new to you, like trying out rock climbing, pottery-making, or a live online concert for the first time. Having some variation in your arsenal of pleasurable activities helps keep things stimulating. On days when free time seems nonexistent, small adjustments can enhance the experience of tasks on your to-do list. Play a podcast or music at you enjoy as you do your chores, or throw on that shirt that makes you feel like a million bucks when you wear it.

Entering 2021 when many impactful factors remain out of our control, it is crucial to empower ourselves through the factors within our control. This can make a significant difference in how we experience challenges that all of us are subjected to. Every time you try out one of the aforementioned suggestions, give yourself a mental note of appreciation for taking a step (regardless of how big or small) towards enhancing your quality of life. Lastly, remember that you do not have to face these struggles alone. Reach out to social support, such as family members and friends, and seek professional help when necessary.

Written by:
Ms. Michelle Chak
Clinic Psychologist
SACAC Counselling

Is wearing masks getting in the way of social interactions?

Wearing a mask is becoming the new norm of the post-coronavirus society. With what consequences on our social interactions and our understanding of others?

Prof Ursula Hess, facial expression and emotion researcher, provide some answers based on her research in an interview conducted by Stella Marie Hombach.

In her research, Prof Ursula Hess observed that recognizing emotional expressions is no worse when our mouth and nose are covered. Thanks to our multitude of facial muscles involved in facial expression, the observation of the eyes area is generally enough to recognize someone’s feelings. Only fear and surprise caused confusion as we usually rely on the way the mouth is open to differentiate both emotions.  

Indeed, the eyes are a powerful vector of expression, but, being sad, scared, angry, or happy is also expressed by the way we speak and move. We are feeling and carrying our emotions with our whole body. Our attitude, gestures, rhythm and modulation of our voice are enough clues for the observer and listener to understand our emotional state. 

In her research, Prof Ursula Hess observed that covering mouth and nose does not seem to prevent social mimicry, which is when we naturally mirror the other’s behavior. This makes us feel closer and judge the interaction more positive. In the study, participants imitated the smile of another person even when this smile was hidden.

Children of primary school age are barely less able than adults to recognize emotions. However, for toddlers, seeing faces that look different, disrupts their bearings and can, therefore, be stressful. Parents can familiarize their children with the mask in a playful way, for example, by placing it in front of their face for a short time, then removing it again. Toddlers learn quickly and get used to the new situation.

Prof Ursula Hess suggests that wearing a mask as a sign of solidarity and as an expression of mutual consideration for others, can bring us together and create a sense of community.

Article based on an interview by Stella Marie Hombach in Scientific American’s German-language sister publication Spektrum der Wissenschaft.

Prof Ursula Hess is a facial expression and emotion researcher, deputy dean for international affairs at the faculty of life sciences at Humboldt University of Berlin.

To read the full article in English:

To read the full article in French:

Written by:
Lucie Ramet

Clinical Psychologist

Narrating the new normal

As we begin to have restrictions eased throughout Singapore and the Circuit Breaker slowly winds down, we all are waiting anxiously for our lives to return to normal.  Yet all around, we hear the phrase, “the new normal.”  As I have been contemplating my own integration back into a regular routine that allows me to leave my home, I wonder about stepping into the new normal and how that can be done so with intention.  

What can we take from our recent experiences that will allow for a more purposeful, intentional life?  What can we take from our collective contraction?  What can we leave behind as we move forward into a new expansion? How do we continue to evolve so that a more positive and heartfelt experience can emerge from this global blow to humanity?

In order to really feel as though we have grown and developed from our experience during this pandemic, it seems essential to build a new narrative for ourselves; one that incorporates and honors our individual experiences during this time, one that recognizes the benefit in our personal and collective experiences, one that allows us to continue to engage in those things that provided us benefit and have kept us going through this time of crisis.

While many people have had experiences of isolation, anxiety, sadness, anger or boredom during the circuit breaker, it is important to look at how those emotions may be seen as having molded or shaped us for the better.  What positive can we gain from experiencing these negative emotions?  In experiencing the positive side of emotional challenges we need to feel them, not resist them.  Undesirable emotions have an evolutionary aspect as well as an ability to provide insights and thus they do have something to teach us.   One way in which to begin to shift our perspective on our negative emotional states is to write a gratitude letter to that emotion for what it has provided us, if the feeling is isolation, perhaps it has given you a greater ability to listen to internal thoughts, perhaps it has given you a new appreciation for your family, maybe being isolated has taught you a new skill.  In any case, being able to examine and be with our challenges can be a great tool to assist us in creating a narrative of our time that holds value.  

Another aspect of taking value and creating a story that holds richness is how we take new positive experiences with us into the new normal. During this circuit breaker, some of us have had increased time with family, more time to read and incorporate creativity into our lives through painting, writing, learning a new skill or hobby. Or we have been able to increase our physical health with at home workouts.  Once we begin to go back out into the world, ensuring time to continue these activities can be essential to build a new narrative of living life with intention.   Plan your week and “pay” yourself first.  If you have enjoyed game night with your family, put that in the calendar, block time for your workouts, even time to read or paint should be included in your schedule; whatever refuels us needs import. These activities have kept us sane, and grounded when things felt unknown and because of the value, keeping these pastimes is a way to ensure that our story is grounded in an appreciation for how this global pause has stretched us.  

In all of the things that we have gone through collectively, it is important to remember that our journey is not an isolated one, our story has a cast of characters that include our friends, family as well as all of those individuals affected by this pandemic (and we have all been affected).  With that in mind, the recreation of our narrative should include honoring and finding appreciation for those people in our life. Include them, use them to process those challenging emotions, include them as part of your “payment” to yourself.  The way to move forward and ensure that our new narrative is intentional and lasting is to have support in our new normal to support others in theirs.

Written by: 
Kimberly Fisel
Marriage and Family Therapist

Building a 3S-Inside-Out Survival Toolbox Amidst the Coronavirus Pandemic

The coronavirus pandemic has thrown countries and individuals into the throes of newfound challenges and stress. While the initial waves of the pandemic were focused on mitigating the spread of the viral contagion, there is increasing focus on the mental health implications of the pandemic experienced by individuals, families, and whole communities. Some individuals may experience heightened anxiety, anger, frustration, or ruminate about their own health and that of their loved ones. Others may find that these negative feelings manifest themselves in physical and behavioral ways ranging from gastro-related issues to more severe expressions such as substance use and abuse, self-harm behaviors, and suicidal behavior.

In this blog, we will focus on building a survival toolbox that addresses your needs both within yourself and externally. The ways that we have utilized for comfort in the pre-pandemic days may not be available to us now. However, we now have opportunities to build a toolbox and grow new tools for survival. Use the 3S-inside-out survival toolbox checklist included at the bottom of the blog to help you identify and monitor your areas of strength and need.


With the stay-home restrictions, you may experience your feelings more acutely in the absence of everyday distractions. One way to self-regulate is to identify the feelings you are experiencing and connect with them instead of pushing them away. For example, you could say to yourself ‘I feel sad.’ Invite yourself to experience the negative (examples include anger, pain, disappointment) and positive feelings (examples include content, peaceful, joyful) throughout the day and identify at least three emotions daily. You could verbally say these feelings to yourself or journal them, and while you may be curious as to why you are feeling a certain way, why’s not important in this process. Owning and accepting your feelings is an important part of self-regulation.

Another way to regulate yourself is to breathe. Although this is seemingly basic, breathing is a powerful tool for enhancing circulation in your body, supplying your body with oxygen to do its important work in your body, pairing with the blood in the system to provide energy and remove waste material. However, deep mindful breathing can also refresh your brain and mind. One breathing activity you may try is to take a deep breath in through your nose and take your time to exhale all of that breath through your nose. Allow yourself to breathe deeply during intervals throughout the day especially when you feel overwhelmed or experience an emotional roller coaster. Perhaps you could also try breathing into your feelings.

Support Networks

Humans are social creatures and are ever inclined to connect with others. One of the major implications of the pandemic is that it breeds a sense of isolation with the lack of face-to-face social interactions. Some individuals live with friends, roommates, their families, or significant others but there are others who live all by themselves. The felt sense of isolation may not only be experienced for those who live alone but may also apply to those who live with others and yet feel alone and disconnected.

Brene Brown (n.d) defines connection as the energy between individuals when they feel seen, heard, and valued; a non-judgmental space is created where they can both give and receive freely to each other and enjoy the nourishment from this relationship. When individuals experience this connection, there can be significant gains. For those who are living with others, there may be opportunities to foster connections by creating or building some rituals daily. Simple rituals may take the form of joining by preparing meals, enjoying take-out food together, or even having a dance chores party. As long as the rituals happen at about the same time daily and are enjoyable activities, one can benefit from these events. For those who are living alone, there may be opportunities to reach out to family and/or friends via Zoom or other virtual technologies to engage in a casual conversation or join interactive online games together. All is not lost if we do not have people we can connect with. With the onset of the pandemic, new support groups have been created and people are now meeting virtually to provide connection and support to each other during these times in the community. Additionally, you can reach out to a therapist to build your support network during these uncertain times.


Self-care is commonly associated with ideas that are grandiose in nature such as going for a spa treatment or a vacation. However, taking care of yourself in small ways is also a form of self-care and during this pandemic; these small ways of caring for yourself may be more significant than before. Some of the less common self-care ideas include movement and bursts of hope. Movement can range from gentle stretches to high-intensity workouts. How about incorporating movement in your day if you do not enjoy exercise? Gentle stretches can invite energy into your body and awaken your senses. Have you tried including bursts of hope in your day? Bursts of hope can take the form of finding an inspirational quote and jotting it down for the day or finding one good thing that has happened throughout the day. Reflecting on these bursts of joy can make for a heartfelt experience.

You have what it takes to build your inside-out survival toolbox. There are no limits to growing new tools. Try it out!

My 3S-Inside-Out Survival Toolbox Checklist

Place a check against each of the key and sub-key items and see what your survival toolbox looks like in terms of areas of strengths and needs!

□      Are you self-regulated?
– Are you taking at least 5 to 10 deep breaths daily?
– Are you in touch with your feelings? Identify at least 3 emotions a day.
– How are you expressing your feelings (journaling, talking to someone, etc.)?

□      Are you well-supported?
– Do you have family and friends to connect with in-person or virtually at least once a day?
– If not, are you a part of a community support group?
– If not, can you identify a community support group to join?
– What other supports can you think of?

□      Are you engaging in self-care?
– Are you taking care of yourself physically?
– Are you including bursts of hope daily?
– What are other ways of taking care of yourself?

Mental Health America. (2020) Owning your feelings. feelings?fbclid=IwAR2I2rp37g48q3jtbF-uzzJGQljX37OyXLdQnxmlqs4DQIFfXV8flDjAkf8K1c
Munzel, T., & Daiber, A. (April 28, 2020). Public mental health: A key factor in dealing with COVID-19. Open Access Government.   mental-health-a-key-factor-in-dealing-with- covid19/86125/?fbclid=IwAR1djmDtygDtIsU4j1lkXvT0Z9LN7FIo1wiFtCE3U08Lrt2X        AXMBRnMpct8
Onneby, H. (2019). A first aid kit for when life falls apart. Tiny Buddha. apart/?fbclid=IwAR3Lw_v97LPEPOgo9XeqCLTg5-Kn3bMH3XWpst_qYcciOPff-apDQJcWlJI

Written by:
Isabelle Ong, Ph.D., LCMHCA, NCC (USA)
Clinical Mental Health Counselor & Psychotherapist for Individuals, Children, Adolescents, and Couples

The effects of COVID-19 isolation and what you can do about it

Anxious, bored, frustrated and lonely are some of the emotions people have described since the COVID-19 circuit breaker first began in Singapore. These emotions are not uncommon as many around the world have reported similar feelings since COVID-19 reached pandemic proportions this year.  There is now a growing body of research that demonstrates the effects of imposed isolation on psychological and physical wellbeing, and more importantly, offers ways of managing and countering its effects on our human psyche.

Brooks and her colleagues (2020) at King’s College London recently conducted a review of studies investigating the psychological impacts of quarantine adopted during the periods of Ebola, SARS, MERS and H1Ni influenza. Their review revealed that some of the common effects of long-term quarantine and isolation comprised anxiety, low mood, depression, stress, irritability, insomnia, and acute (and post-) traumatic stress symptoms. Factors that were observed to heighten people’s psychological distress included longer periods of quarantine, fears of infecting self and/ or others, loss of physical and social contact, loss of usual routines, having inadequate supplies, and lack of clear and adequate information from health and other government agencies. These effects were observed even three years after the quarantine and were most pronounced among those who had direct exposure to the high-risk situations (i.e., healthcare workers) or a history of psychiatric illnesses.

What might the reasons for this extent of psychological distress? Firstly, Slovic and Peters (2006) reported that certain factors are more likely to increase (perceptions of) fear such as when the threat is novel or unfamiliar, there is a lack of control over the threat, and when the threat involves a sense of dread. Further, Holman and colleagues (2014) described that while communication of information is essential and useful, we need to be mindful the amount and type of exposure to information because stress and anxiety can be exacerbated by too much media. Management of stress is therefore crucial (Garfin, Thompson, & Holman, 2018) especially since imposed isolation can increase the likelihood of negative psychological outcomes for individuals, especially if the quarantine period is extended or indefinite with no clear time limit (Brooks et al., 2020). Imposed quarantine can be an oftentimes isolating and lonely experience, with those who have strong social relationships 50% more likely to survive compared with their peers who have poor or insufficient social relationships (Holt-Lunstad, Smith, & Layton, 2010).

Given these facts, what might we do during quarantine you may ask? You may wish to observe the 3Cs of Choice, Control and Certainty in making this period of imposed isolation a little more comfortable..

Choice: Imposed isolation and social distancing is not a pleasant experience for most, so let’s instead choose a more helpful mindset  – perhaps this can be an opportunity for reflection and taking a step back from the hustle and bustle of our daily lives, or a time to practice gratitude for the little joys and pleasures that we do have. Keep in mind that this sacrifice that we’re taking is one that will keep ourselves, loved ones and others in our community safe.

Control: Continue to exercise control over aspects of our lives that we reasonably can, such as picking up a new skill or activity, setting goals you can work towards during this period of working from home. Intentionally make varied and intentional choices when it comes to meal times in what you may cook or choose to takeaway or Grabfood.  Don’t forget to control your intake of COVID-related news and limit it to reputable reporting sources.. keep a rein on that wandering mind and don’t let it catastrophise!

Certainty: Create a routine for yourself and stick to it – remember to include both achievement-oriented and pleasurable activities including exercise and leisure. Make dates with your loved ones, friends and family to Zoom or Skype, or to play Animal Crossing together, and consciously maintain your social support and friendship networks. Rest a little easier in the certainty and security that you’ve got your act together, and that life still goes on in spite of all the uncertainty around you.

So make realistic and flexible choices that allow you to maintain control and achieve certainty. Remember, we are all in this together.


Brooks, S. K., Webster, R. K., Smith, L. E., Woodland, L., Wessely, S., Greenberg, N., et al. (2020). The psychological impact of quarantine and how to reduce it: rapid review of the evidence. The Lancet, 395, 912-920.

Garfin, D. R., Thompson, R. R., & Holman, E. A. (2018). Acute stress and subsequent health outcomes: A systematic review. Journal of Psychosomatic Research, 112, 107-113.     

Holman, E. A., Garfin, D. R., & Silver, R. C. (2014). Proceedings of the National Academy of Sciences of the United States of America, 111(1), 93-98.

Holt-Lunstad, J., Smith, T. B., & Layton, J. B. (2010). Social relationships and mortality risk: A metanalytic review. PLOS Medicine, 7(7): e1000316.

Horesh, D., & Brown, A. D. (2020). Traumatic stress in the age of COVID-19: A call to close critical gaps and adapt to new realities. Psychological Trauma: Theory, research, practice and policy, 12(4), 331-335.

Netburn, D. (2020, April 29). Feeling drained by coronavirus quarantine? Science can explain why. The Los Angeles Times.

Slovic, P., & Peters, E. (2006). Risk perception and affect. Current Directions in Psychological Science, 15(6), 322-325.

Weir, K. (2020, March 16). Seven crucial research findings that can help people deal with COVID-19. Retrieved from

Written by:
Dr. Daphne Goh

Clinical Psychologist