The Dark Side of Being Perfect

In an increasingly competitive world, there are constant demands to improve one’s performance.  In addition to meeting external demands, many people also experience internal pressures to succeed or perform to a certain level or established standards.  This desire to meet high standards motivates one to achieve goals and perform effectively. However, the healthy pursuit of excellence crosses the line into an unhealthy striving for perfection when:

  1. The standards (for yourself and/or others) are “high beyond reach or reason” (Burns, 1980)
  2. One’s self-worth is judged based largely on one’s accomplishment, productivity and ability to achieve such high standards
  3. One continues to strain or strive to meet these internal expectations despite experiencing negative consequences or a lack of satisfaction because one’s performance is not good enough

In clinical perfectionism, functioning at work, home, and in interpersonal relationships can be negatively impacted.  At an individual level, perfectionism have been shown to detrimentally affect one’s physical and psychological well-being.   It has a negative impact on the stress and coping process which in turn affects one’s health behaviours. Perfectionism have been associated with poorer physical health and an increased risk for poor adjustment and disease management of chronic illnesses (Molnar, Sadava, et al., 2012).

Perfectionism has been implicated in the aetiology and maintenance of eating disorders, anxiety disorders and depression with research demonstrating a clear association between perfectionism, psychopathology and negative treatment outcomes (Shafran & Mansell, 2001).  For example, perfectionism is a:

  1. Risk factor for developing eating disorders
  2. “Destructive” force in depression and strongly associated with suicidal thoughts and behaviours
  3. Robustly associated with anxiety disorders, especially obsessive-compulsive disorders.

The aim of treating clinical perfectionism is not to lower or remove striving for personal standards.  Instead, it is aimed at reducing self-evaluation being exclusively based on meeting personal standards, and the associated self-criticism when the standards are not met (Egan, Wade & Shafran, 2011).  It is only through striving to overcome a difficult situation or experience that helps us to experience success and a feeling of competence. By focusing on being perfect all the time, if humanly possible, we never learn or develop the capacity to trust ourselves.   

Given the dark side of perfectionism, I’m contented with the beauty of just being good enough.  After all, as Winnicott puts it, “good enough” is far better than being perfect or the “best”.


Burns, D.D. (1980). The perfectionists’ script for self-defeat. Psychology Today, November, 34–52.

Egan,S. I, Wade, T.D, & Shafran, R. (2011). Perfectionism as a transdiagnostic process: a clinical review. Clinical Psychology Review, 31, 203-212.

Molnar, D. S., Sadava, S. W., Flett, G. L., & Colautti, J. (2012). Perfectionism and health: A mediational analysis of the roles of stress, social support and health-related behaviours. Psychology and Health, 27, 846-864.

Shafran, R., & Mansell, W. (2001). Perfectionism and psychopathology: A review of research and treatment. Clinical Psychology Review, 21, 879−906.

Written by:
Velda Chen
Clinical Psychologist
MClinPsych, BA(Hons), Registered Psychologist (Singapore)
SACAC Counselling

Supporting the Individual, and not the Disorder

Obsessive Compulsive Disorder (OCD) is an anxiety disorder characterised by obsessions and compulsions. Obsessions are recurring unwanted and intrusive thoughts, impulses and images that one experiences. Compulsions are repetitive behavioural and mental rituals that one feels compelled to perform. Compulsions are usually performed in response to an obsession, with the intention to reduce anxiety or to avoid a feared outcome. For example, repetitive handwashing in response to thoughts of contamination.

OCD is the third most common mental health condition in Singapore, and runs a chronic course if left untreated. Treatment for OCD usually involves a combination of medication and psychotherapy. People who suffer from OCD are usually aware that their thoughts and behaviours are excessive and irrational, but finds it difficult to control or resist them, leading to increased distress. OCD can dominate one’s life by taking up a lot of time in a person’s day, and affect their abilities to cope with work, school and relationships. For family members, living with a person suffering from OCD can be difficult, demanding and exhausting. It is not uncommon for family and friends to constantly reassure or to become deeply involved in the individual’s rituals. Often, they may also assume responsibility and care for daily activities that the person is unable to undertake.

How can family members or friends be more supportive and helpful to the person who is undergoing treatment for OCD?

  1. Learn more about the condition and treatment. It is easier to be more supportive, understanding and compassionate towards the person, whose behaviours or requests may sometimes come across as demanding or unreasonable.
  1. No one likes seeing a loved one in distress. However, the best way one can help is to assist your loved one resist doing something that relieves the anxiety quickly. In other words, it may be more helpful to agree with your loved one that you would not provide reassurance and help with their compulsions while he or she is working on the OCD.
  1. Be encouraging if setbacks occur. It is not uncommon to have setbacks during and after treatment.
  1. Symptoms of OCD can exacerbate during periods of stress or major life events. During treatment, try to reduce other sources of conflicts and stress as much as possible.
  1. Allow your loved one to maintain some control and predictability over treatment. Encourage him or her to increase the intensity of treatment, but also to respect his or her pace and not force the individual into doing something he or she does not want to.

Sometimes, despite your best effort, supporting your loved one may be challenging and stressful. In this case, seeking avenues of support and caring for yourself will be equally, if not more important.

Written by:                                                                                        Velda Chen
Clinical Psychologist                                                                    SACAC Counselling


What does my life look like after my pregnancy and delivery?

Having a baby is one of the biggest life changing experiences in someone’s life. Is it always only love? Is it as fantastic as everyone says it is?

A lot of mothers say it is the most beautiful thing they experienced in their life. After birth you probably get a lot of messages saying: “Enjoy this wonderful time together with your baby (and your partner)”. A few people may add something like: “And thinking of you in this hectic, tough and insecure period”.

That last message seems to be left behind by a lot of women when they talk about their newborn experience. It doesn’t mean you love your child any less by telling someone that it is also a tough period. Besides the overpowering feeling of love there can also be other feelings that you may not be prepared for.

If you feel this way this is not a shortcoming from you as a mother and you don’t have to feel guilty about your feelings. Having other emotions besides the love for your child is very normal. This is also called the baby blues and is experienced by 50-80% of all women. If the feelings of emotional instability continue, don’t get less over time and/or get more severe, it is good to check with a specialized health professional on weather this is developing in a postpartum depression (PPD), also called postnatal depression.

Postnatal depression is not always recognized, but 10-20% of the women develop this condition after birth. What people don’t know is that a postnatal depression can also develop after a miscarriage, the adoption of a child, an abortion and not only with the first pregnancy. Also men can experience a postnatal depression.

The onset of the symptoms: during pregnancy or few weeks or months after the life-changing event.

Some common symptoms of postnatal depression are:

Sleeping problems or excessive sleep, appetite changes, frustration/irritability, restlessness, feeling overwhelmed, hopelessness, anxious, lack of interest and pleasure, loss of energy, difficulty concentrating, withdrawing, feelings of guilt or shame or worthlessness, trouble bonding with baby, feeling inadequate, extreme tiredness, the inability to carry out everyday activities, thoughts of harming someone.

Causes and risk factors for developing a postnatal depression are a combination of biological, social and mental health factors. Examples of these risk factors are:

  • Biological:

Hormonal changes, genetic predisposition for mental health diagnosis, previous depression, sleep deprivation.

  • Psychological:

High expectations of your environment, difficult pregnancy, high demands on yourself, difficulty setting boundaries and saying “no”, difficulty in expressing and sharing emotions, difficulty in asking and accepting help.

  • Social:

Traumatic or rough experiences in your past, unprocessed grief in the past, a traumatic delivery, premature deliveries, health issues of your child or yourself or a loved one, relationship/work/ financial problems, medical complications during delivery or pregnancy, miscarriage, abortion, loss of job/loved one, lack of social support system, inadequate nutrition, unplanned or unwanted pregnancy, immigration, temperament of the child.

What to do when you experience above symptoms:

Creating plenty of rest, finding fulfilment again, leave the to-do’s for the moment, have a well-balanced diet, exercise, find a social support network (you are not alone out there), ask for help, don’t be too harsh on yourself, set small realistic expectations towards yourself/ your baby and others, make time for yourself and your relationship, have bonding time with your baby, express your emotions, set your boundaries, set priorities, go outside and seek professional treatment.

There is a lot of guilt and shame around this subject. I hope this blog helps you to be less harsh on yourself, creates more awareness around this subject and helps people to consider asking (professional) help. It is easy treatable if you take that step to seek treatment. It is not a failure of you as a mother and hopefully this can be less of a taboo in the future. I personally think it shows great courage and a great mom to take that step towards treatment. By asking help you are kind to yourself, put your own blockages aside and set the need of your child as a priority.

At SACAC Counselling there are a lot of psychologists and counselors that are highly qualified in treating postnatal depression and adjustment to motherhood. Together we will see how the biological, social and psychological factors have influence on your feelings. We will work on the challenges of the transition to motherhood, how to deal with this identity change that you are going through and how to grief a part of you that you lost or has changed.

Counsellors at SACAC Counselling that treat postnatal depression are: Felicia Neo, Saveria Cristofari, Sanaa Lundgren, Vinti Mittal, Mahima Gupta, Nina Stevens and myself (Flo Westendorp).

For more practical information and contact information (clinics, websites, support groups, counseling services) in Singapore see the blog “Maximising Mental Health and Wellbeing Post Birth as an Expat” of my former colleague Dr. Rachel Upperton, link:


Written by:

Flo Westendorp
Registered Clinical Psychologist
SACAC Counselling


“I have a bit of OCD!”

A“I have a bit of OCD”, “she is so OCD”. These are statements we hear banded around a lot.  There is a familiar notion that Obsessive Compulsive Disorder (OCD) is a set of quirky characteristics claimed by or given to people who are controlling of things, perfectionists, excessively conscientious or fastidious about cleanliness.   There is even a bit of pride being expressed by some claiming with a smile to be ‘a bit OCD’ with an acknowledgment that there is some underlying anxiety.  We often use the word ‘obsessive’ when we talk about people who do things over and over e.g. she is obsessive about shoes, for someone who talks about them and buys a lot.

Many of the general population have intrusive thoughts, images and at times their content can seem similar to those with OCD e.g.  having an urge to push someone under a train, thinking about throwing something, thinking about shoplifting, thinking about a disgusting sex act (Purdon and Clark 1992) are all common. The difference between a normal intrusive thought and an obsessional thought lies both in the meaning that individuals with OCD attach to the occurrence or content and then their response to the intrusive thought or image.

So what is Clinical OCD?

An obsession is an intrusive usually unwanted thought, image or urge that repeatedly enters the mind, causing feelings of anxiety, disgust or unease.

A compulsion is a repetitive behaviour or mental act that you feel you need to carry out to temporarily relieve the unpleasant feelings brought on by the obsessive thought.

David Veale 2007 has described the most common obsessions as;

  • The prevention of harm to self or others resulting from contamination (e.g. dirt, germs, bodily fluids, faeces or dangerous chemicals.)
  • The prevention of harm resulting from making a mistake (e.g. leaving a door unlocked, or the oven on)
  • Intrusive religious or blasphemous thoughts
  • Intrusive sexual thoughts (e.g. of being a sexual deviant or committing a sexual crime)
  • Intrusive thoughts of violence or aggression
  • The need for order or symmetry

Compulsions are actions that are repeated to avoid discomfort. Common compulsions are things like washing, checking, counting, hoarding, mentally repeating phrases, repeatedly seeking reassurance, rituals and avoidance. Compulsions are never pleasurable.  A diagnosis is given when the obsessions and compulsions consume excessive amounts of time (over an hour or more), when they cause significant distress and they interfere with social activities, work, or relationships.

A study in 2010 from the Institute of Mental Health and Ministry of Health into mental health found that OCD in Singapore was prevalent at a higher rate compared to the USA or Europe with around 3% of population having OCD.

When does it start?

It can start at anytime and is found in both men and women.  It can start in childhood but is often developed around puberty and young adulthood.

OCD symptoms can go unnoticed as children are unable to verbalise their ‘intrusive thoughts’ or understand that their actions don’t make sense.  Like adults, they may experience secrecy resulting from shame regarding their thoughts or behaviours.  Parents can also avoid seeking treatment as they think the behaviours are just a phase. OCD can be successfully treated and evidence suggests that the sooner it is treated the better the outcome is likely to be.

What causes OCD?

Biological explanations suggest some families have a genetic predisposition to anxiety which make them more likely to develop OCD.

Psychologists recognise that something called ‘thought action fusion’ occurs, whereby if a person thinks of harming someone, they think they will act on the thought or might have done in the past.  People with OCD also have an inflated sense of responsibility for harm and its prevention.

There are some conditions that can appear with OCD these include;

Trichotillomania (urge to pluck hair), Hypochondriasis (fear of suffering from a serious illness), Body Dysmorphic Disorder (a preoccupation with being ugly or having a defect in your appearance) and Tourette’s Syndrome (vocal adn motor tics).


A combination of Cognitive Behavioural Therapy and Medication in the form of antidepressants (selective serotonin reuptake inhibitors SSRI’S) has been found to be the most effective treatment.  It is also important to work with the whole family in the management of OCD as this is seen to aid recovery. OCD is treatable.



Veale 2007, Cognitive- Behavioural therapy for obsessive- compulsive disorder, Advances in Psychiatric Treatment, vol 13, 438-446.

Purdon & D, Clark 1992. Obsessive intrusive thoughts in non clinical subjects. Part I Content and relation with depressive, anxious and obsessional symptoms. Behaviour, Research and Therapy 1992: 31: 713-20.

Prof Chong Siow (principle investigator) Singapore Mental Health Study (SMHS) 2010- Institute of Mental Health and Ministry of Health, Nanyang University.

Photo of hand washing

Written by:
Dr. Ronina (Nina) Stevens
Clinical Psychologist
SACAC Counselling



Body Dysmorphic Disorder

Are you genuinely content with what you see in the mirror? We all have things we wish we could change, large nose, acne, discoloration of our skin, and the list goes on. Most of us are able to live with the flaw(s) in our lives and not allow it to become a nuisance in our everyday lives but someone with BDD it becomes the focal point of their life, overtaking every moment, thinking and figuring out solutions to their flaw.

When you suffer from body dysmorphic disorder (BDD), every imperfection that you feel will become an obsession. It debilitates your everyday life where your thoughts are controlled by concealing these imperfections, seek verbal approval on your physical attributes even though every compliment that someone gives you, will never be genuine to you, social isolation, and depression and anxiety usually forms due to the constant need for perfection. BDD afflicts men and women equally and usually begins in adolescence. It is usually characterized by a flaw that is imagined or hardly noticeable by the general population. It causes the individual to lose their quality of life because that one flaw is perceived as the main focal point of one’s life. People who tries to work on that flaw whether through excessive exercising or extreme cases, plastic surgery to fix the flaw, are still not satisfied with the result which causes them to have multiple visits with the plastic surgeon.

The difference between an eating disorder where you are preoccupied by your overall body shape and weight, BDD is focused on a specific part of the body. The obsession over your flaw affects your interpersonal, work, and family relationships.

Some of the most common symptoms of BDD include acne on your skin, size of your breasts, hair on your head, size, shape and symmetry of your face or body part. People with BDD portrays behaviors and obsessions such as checking their flaw in the mirror several times a day or on the other side, avoiding mirrors, wearing excessive makeup to hide or distract from the flaw, undergoing medical procedures often specifically plastic surgery to minimize the flaw but with non-satisfactory results. seeking verbal praise or reassurance from others, excessive exercising, and obsessive thoughts throughout the day that affects your work, school or social life. If this disorder is untreated it can lead to emotional problems such as anxiety and depression. Unfortunately, this disorder goes untreated or unnoticed by many specialist and clinicians since BDD individuals are able to hide their compulsions and obsessions very easily from the general public. They can also be misdiagnosed for a social phobia or depressive disorder.

What causes someone to have BDD? Researchers believe that it’s a combination of genetics and environmental factors. Factors that increases the chance of having BDD stems from childhood situations such as bullying, having low self-esteem, growing in a household where adult figures emphasizes the importance of physical beauty, and placing strong societal pressure of what is perceived to be beautiful. The treatment for BDD is therapy and medication. Cognitive Behavioral Therapy along with anti-depressants have worked greatly in treating this disorder. Cognitive Behavioral Therapy which focuses on recognizing irrational thought patterns and replace these negative/irrational thoughts with a positive one has been a great tool for people suffering from BDD. As clinicians we need to recognize this disorder especially with our adolescent clients and provide a safe environment for them to express their feelings on their self-worth and image.


Phillips, Katherine, A Body Dysmorphic Disorder: recognizing and treating imagined ugliness. World Psychiatry. 2004 (Feb); 3(1): 12-17
What is Body Dysmorphic Disorder (BDD)? International OCD Foundation

Written by:
Meesha Chan

Clinical Therapist
SACAC Counselling


Is Autism on the rise?

Since the first documented cases of autism conditions by Leo Kanner in 1943 and Hans Asperger in 1944, conceptualization of autism spectrum disorders has shifted greatly. It is now evident that it is not a rare childhood disorder. In the 1990’s a marked rise in children being diagnosed sparked fears of an ‘autism epidemic’, increasing numbers diagnosed is a pattern which has continued today.


During the 1990s many made links between increased diagnosis of autism and the administration of MMR or other childhood vaccinations. Although these links have proven to be unfounded (Stehr-Green, Tull et al. 2003; Thompson, Price at al. 2007), the concerns regarding vaccinations have not yet faded.  Over the past three decades, billions of funds have been invested in to researching and understanding the causes of autism spectrum disorders.  However, research to date has not produced a single causal link but built a complex picture of associated biological, environmental and neurological causal factors. What has been confirmed through empirical research is that there are a number of genetic variations in individuals with autism (Abrahams and Geschwind, 2008), and neurological differences in how the brain develops (Courchesne, Carper at al. 2003).

It is also important to note that our general understanding of the brain and how it works is still limited. It is therefore somewhat naïve to assume that the neurological difference reported is as simple as typical (non-autistic) versus atypical (autistic). The range of individual difference can vary so much across the ‘autism spectrum’, that a well-known phrase best encapsulates this; ‘when you’ve met one person with autism, then you’ve met one person with autism’. There is such a variety of inter-connecting variables from genetics, cognition, environment, personality and other factors that carrying out research into causes has proven challenging.


There is no blood test, brain scan or any other objective test that can diagnose autism. Clinicians rely on observations of a person’s behaviour and a developmental history to make a diagnosis. In the US, UK, Australia, Singapore and much of the western world, the criteria for diagnosing autism are laid out in the Diagnostic and Statistical Manual of Mental Disorders (DSM) or International Statistical Classification of Diseases and Related Health Problems (ICD). The core criteria are problems with social communication and interactions, and restricted interests or repetitive behaviours. Both of these ‘core’ features must be present in early development.

Current Prevalence

The Centers for Disease Control and Prevention (CDC) estimates that 1 in 68 children in the U.S. have autism, which is likely to be similar worldwide. The prevalence is 1 in 42 for boys and 1 in 189 for girls. This estimate of autism prevalence is up 30 percent from the 1 in 88 reported in 2008, and more than double the 1 in 150 rate in 2000. In fact, the trend has been steeply upward since the early 1990s, not only in the U.S. but globally.

So why have numbers increased?

Autism didn’t make its debut in the DSM until 1980. In 1987, a new edition expanded the criteria by allowing a diagnosis even if symptoms became apparent after 30 months of age. In 1994, the fourth edition of the DSM broadened the definition of autism even further, by including Asperger Syndrome on the milder end of the spectrum. The current version of the
DSM (5th edition) was released in 2013, and collapsed autism, Asperger syndrome and pervasive developmental disorder-not otherwise specified (PDD-NOS) into a single diagnosis. These amendments are in line with an increased understanding of autism. Prevalence studies of autism in the past have not included those diagnosed with PDD-NOS and Asperger Syndrome, therefore this will have an impact on future figures using DSM-V criteria.  It should also be noted that it is becoming increasingly recognised that women and girls are hugely under-represented; as diagnostic tools have been developed around male studies. It is believed that the ratio of 1:4 (girl to boy) ratio is likely inaccurate, and recognition and diagnosis in the female population is increasing.  In addition to changes in diagnostic criteria, inclusion criteria and terminology of prevalence studies account for the variation in figures reported between studies and countries.

Increased awareness of knowledge of autism among paediatricians, psychologist, teachers and other professionals, alongside more accurate diagnostic tools has contributed to growing earlier recognition and diagnosis. Subsequently there has been a decrease in diagnosis of intellectual disability since the 1990s. In the US and UK during the 1990s, inclusion of ‘autism’ in Special Educational Needs codes of practice lead to an increase in diagnosis, as this meant more access to resources and support for these children. Currently variation in diagnosis between US states and UK local councils vary, depending on how local governments allocate funding to children with additional needs.

Biological factors may also contribute, for example, having older parents increases the risk of autism. Due to changes in societal norms, many couples are now older when they start a family. Children born prematurely also are at increased risk of autism, and more premature infants survive now than ever before.

 Is there no real increase in autism rates, then?

Tracking back to ascertain whether there has been a rise in numbers is near impossible.
Awareness and changing criteria probably account for the bulk of the rise in prevalence. Steve Silberman in his book ‘Neurotribes’ provides the most accurate examination of this reported ‘epidemic’ to date. He surmises that although numbers appear to have increased, it is more likely due to changes in our recognition, diagnostic tools, support and inclusive practices, genetics and societal views has shifted widely over the years.


                                                                                                                                      Written by:                                                                                                            Dr Jennifer Greene
Consultant Educational & Child Psychologist                                      SACAC Counselling



Abrahams B.S., Geschwind D.H. (2008) Advances in autism genetics: on the threshold of a new neurobiology. Nat Rev Genet, May; 9(5): 341-55

Courchesne, E., Carper, R. & Akshoomoff, N. (2003) Evidence of brain overgrowth in the First Year of Life in Autism. Journal of American medical Association, Vol290, no.3

Jaarsma P, Welin S (2011) Autism as a Natural Human Variation: Reflections on the Claim of the Neurodiversity Movemnet. Health Care Anal. 20(1): 20–30

Are You Depressed or Stressed?

If you are feeling overwhelmed by stress, you are not alone. Stress is good if it motivates you but not, if it wears you down. Many reasons can contribute to your stressful experiences, and this can cause changes in your body that affect your overall physical, mental, and emotional health. Depression is more detrimental than stress, and necessitates a different kind of help.

In a 2010 survey by the American College Health Association, 28% of college students reported feeling so depressed at some point they encountered issues functioning, and 8% sought treatment. It is said that “’People can become deeply disappointed. These people are unhappy, not depressed”. So what is the difference?

Depression is a chronic condition that can have numerous clinical components like a neuro-chemical imbalance or a genetic predilection. Unhappiness is a state of mind associated with a individual’s perspective of the world. Stress can be a major contributor. Whilst a bit of stress is ordinary, acute stress can be problematic and an antecedent. Additionally, certain areas of functioning be impacted. For stress, this can be short-term whereas depression, this can be long-term.

Common Signs – Stress

  • Trouble sleeping
  • Feeling overwhelmed
  • Problems with memory & concentrating
  • Change in eating habits
  • Feeling nervous / anxious
  • Feeling angry, irritable / easily frustrated
  • Feeling burnt out
  • Feeling that you can’t overcome difficulties in your life
  • Trouble functioning in class or in your personal life

Common Signs – Depression

  • Withdrawing from others
  • Feeling sad and hopeless
  • Lack of energy, enthusiasm and motivation
  • Trouble making decisions
  • Being restless, agitated / irritable
  • Change in eating & sleeping habits
  • Trouble in concentration & memory
  • Feeling bad about yourself / guilty / anger / rage / that you can’t overcome difficulties in your life
  • Trouble functioning in your class or in your personal life
  • Suicidal ideation

Remember, high levels of stress, depression and other mental health conditions are nothing to be ashamed of. It is not a sign of weakness, and seeking help is a sign of strength. Telling someone you are struggling is the first step toward feeling better.


Written by:                                                                                                              Dr Felicia Neo
Clinical Psychologist, Neuroscientist                                                            SACAC Counselling




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
Clinical Psychologist, Neuroscientist
SACAC Counselling




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
Consultant Educational Psychologist                                                              SACAC Counselling


Preparing your Emotional Bags for the Holidays

blog pic

The holidays are coming. For some it is the end of the school year, for others it is the mid-year break.  The holidays bring a change from the usual daily routine. This change carries a whole mix of enthusiastic expectations and stressful anticipations, an emotional journey in of itself.

Let’s take a look at some helpful thoughts for preparing your emotional bags for the holidays:        

  • Be prepared for the PLACE.  Are you staying home?  Are you travelling to visit family or families? Are you travelling to a holiday destination with your nuclear family? Think of the place that you are going in terms of human interactions. The better prepared you are for the family dynamics (eg. meeting your extended family or for being with your nuclear family in the same place for an extended period of time), the better you will be able to handle the family interactions.          
  • Be prepared for the WEATHER.  What kind of emotions flare up when you are with your family members?  In others (extended or nuclear family) or in yourself? How can you deal with those emotions when they come?  Like the weather, emotions come and go.  As you take an umbrella during rainy weather or stay indoors during stormy weather, think of which steps you would need to take care of yourself or others during periods of sadness, anger and any other emotion.         
  • Be prepared for the UNEXPECTED.  Can you remember a time when no matter how well prepared you were, something unexpected happened?  During any kind of journey, unexpected situations happen. Whether they surprise or shock us, the first reaction is to gasp.  Think about what could be your first step after that gasp. A suggestion would be take some conscious breaths to calm down, and then decide what steps to take next.              
  • Be prepared to ASK FOR DIRECTIONS. Can you remember a time when you were lost?  Or either you or someone going with you faced the dilemma of asking for directions?  If anything gets out of control during the journey, it is important to ask for directions and support. Think about where you could find that support, it could be in trustworthy family members and/or professionals (either in person or online).

In summary, it is important to prepare your emotional bags in order to handle difficult emotions appropriately, and to keep enjoying the positive emotions with your loved ones, during your holidays.

Written by:                                                                                                                      Yana Ricart
SAC Registered Counsellor                                                                                      SACAC Counselling