All posts by huibee

Are you a jealous person?

Think that you are always jealous? Think that your partner is always overly jealous and controlling? Obsessively checking his/her facebook/instagram? Always fighting because of “unimportant” persons? Constantly wondering what s/he is doing when he doesn’t reply to your message?

Here is a quiz on jealousy, it is possible to do it “on behalf of” your partner when you suspect that your partner might not be “healthily jealous” in your romantic relationship (yes, some level of jealousy is good and healthy to your relationship, but not when it turns detrimental to your relationship).

I do want to apologise that the questionnaire has assumed that every person is in a heterosexual relationship.

 

N.B. Feel free to contact me regarding the results by leaving your email in the form or leaving a comment below. However, I would say that the result of the questionnaire is not the main thing, instead, look at those items and find out if your partner’s or your jealousy is detrimental to your relationship, and if the answer is yes, do get in touch to find out what can be done.

Statistics: Smoking Status Among Malaysian Adults

  • In 2015, about 22.8% of Malaysian adults (aged >15) were smokers. (That’s more than 1 in every 5 adults!)
  • In 2011, 23.1% of Malaysian adults smoked, so yes, it had reduced slightly.
  • 43% of men and 1.4% of women smoked.
  • The prevalence among female smokers has increased from 1.0% in 2011 to 1.4% in 2015.
  • Among the smokers, a third (34.9%) smoked 25 or more cigarettes, 24.2% smoked 14-24 cigarettes, 18.5% smoked 10-14 cigarettes, 16.4% smoked 5-9 cigarettes and 5.9 smoked less than 5 cigarettes a day.
  • Among the three main races, the Malays had the highest prevalence at 24.6%, followed by the Indians at 19.7% and the Chinese at 15.4%.
  • Overall, 37.1% of Malaysian adults were exposed to secondhand smoke at home (not including children yet!)
  • More than half (52.3%) of adult smokers had tried to quit smoking in the past 12 months.
  • Smokeless cigarettes used has increased from 0.7% in 2011 to 10.9% in 2015.
  • (Worldwide) Tobacco use, a major preventable cause of premature death and diseases, kills 6 million people worldwide annually, 10% of these deaths were among non-smokers who were exposed to the second-hand cigarette smoke.

Unless otherwise stated, all these data were reported in 2015, retrieved from National Health & Morbidity Survey 2015. 

寻求关注 & 社交网站

记得大学时,在读到关于厌食症的时候,列在课本中的其中一个厌食症的原因是“寻求关注” (attention seeking)。当时候的第一个反应是,谁那么可怜,把自己弄这那样,就为了要别人的注意,要父母的照顾,要家人的陪伴(就算只是带她去看看医生而已)。毕业后的几年职业生涯中,我发现自己开始发现、并理解缺乏关注,正是引致很多心理问题的根源之一。

他人的关注,是人类作为群体动物需要的。想象要是一个人完全不需要别人的关注,没有因为别人的关注而快乐或满足,也没有因为缺乏别人的关注而失落或难受,那这个人将消失,从进化论而言,他也会绝种。

而缺乏归属感(sense of belonging),缺乏存在感的人,需要特别寻求别人的关注,可惜的是,我们给予任何一个人的注意力,似乎是与生俱来的,就像你看见一间餐厅,里头空无一人,其隔壁是个座无虚席的餐厅,你本能地会愿意走进隔壁这间… 我们给予别人的注意力,很多时候也是这样的,令人喜欢的人,越是令人喜欢,缺乏朋友的人,越是交不上新朋友。

所谓归属感,就是重视的人给予的正面的关注。所以如果一个家让你感到孤独寂寞,没有归属感,那很可能这个家(过去)没有给你正面的、你所需要的关注。

本来事情已经可以相当复杂,从年纪很小就说谎、青少年时期的叛逆,到厌食症、自残、抑郁症等,“缺乏关注”或“缺乏归属感”都很可能是诱因之一,这二十几年科技的发达,近十年社交媒体的普遍,让事情更复杂,更、难、搞!

社交网站使一切变得“方便”(也变得非常不真实)。你可以从中获得许多关注,你也可以自由地、“偷偷地”去关注其他人。

但是,在许多比较极端的情况里,如果没办法使别人喜欢我,那我宁可被讨厌、被生气、被害怕,我也不愿意被忽略,我也不愿意没有人关注我(因为至少当这些人在讨厌、生气、害怕我的时候,他们是正在关注我的!)

所以这些寂寞、不快乐、缺乏归属感的人,可以是危险的,可能造成伤害或犯罪。当然这也包括美国的大规模射击(mass shooting)。网络的出现,让缺乏归属感的人可以轻易地、快速地获得成千上万、甚至全世界的关注。或许我们应该停止“奖励”这些犯罪行为,因为他们要的,正是大家的关注(行为强化理论来说,这就是奖励)。

那我们该怎么办呢?该怎么应付这些缺乏归属感、寻求关注的人们呢?

不是在事故发生后,才去关注他们,这往往只强化了他们的不正常行为。而是在平时,放下手机、截断网络,面对面坐下,坦诚地交谈、关心彼此。或许这个文明病的处方,就是每天一小时,和你重视的人,get offline(离线)一起相处!

Has OCD started as an Evolutionary Advantage?

It is kind of obvious that it is?

Checking is good, double-checking is good, tidying up is good, washing is good, trying to be perfect is good, counting is good, being attentive is good, thinking thoroughly is good, requiring precision is good, getting reassurance is good … …

From the evoluntionary perspective, are people who are attentive, careful, clean, thoughtful (etc) more likely to survive? Obviously, yes? It’s very much needed in ancient societies, as survival skills.

How if these careful people get married and have children? Do they produce even more “careful” children? And then next generation, and next, and next…

And it’s not just the genes from both lines of the “careful” ancestors, but also the upbringing environments provided by these attentive parents, they certainly continue to reinforce such behaviour… We were taught many of these acts as children, by our parents, older siblings and teachers in the school, weren’t we?

Then as the behaviour continues to be reinforced and developed and advanced… there you go, OCD? (This is just a hypothesis)

It’s just my random thought… But we are surely seeing more and more OCD clients in our clinic these days. Not just that, it’s got harder and harder to treat as well (the illness has got more stubborn and sticky).

Imagine that this theory is somewhat 70% true (another 30% of factors that’s beyond the knowledge of this psychologist in the modern days), OCD is going to get stronger and stronger, right? It can become a real big (detrimental) issue, especially in Asian culture…

What can we do? How do you bring up a child that strive to be better and better, but not aiming to be 100% certain for everything s/he does?

OCD – A Devised Theater Piece

Tap. One two three four five six seven eight nine ten.
Tap. One two three four five six seven eight nine ten.
Goodnight Papa. Papa goodnight. Papa goodnight. Goodnight Papa.
Papa goodnight. Goodnight Papa. Goodnight Papa. Papa goodnight.

No, no, no. Not right! Mama is going to die. Mama is going to die.
Again, Again, Again. From the start.

I went to see a performance on OCD last night. It was great, filled with tears and laughter, anxiety and tension, very much. I can’t help thinking about many OCD clients I have seen in my clinical work, especially those that I’m still seeing this week, and some earlier on. They are living in this every, single, day, and, night.

The actors have done very well, sharply and vividly demonstrated the intense emotion felt by OCD sufferers. I highly recommend anyone who doesn’t really understand OCD to see it, especially those who think “I’m just a bit OCD” to see it. Check if the tickets are available here.

Before I went, I even thought about inviting my clients to see it. Now I’m really wondering for those who have been suffering from it for more than 5-6 years, how they would feel when they see this…

A few things that I want to point out regarding OCD, which are nicely and clearly presented in this performance…

  • It is always about “making sure”. They can’t tolerate uncertainty. Yet in this world, there is no such thing as 100% sure.
  • It’s always about “feeling right”. The comfortable, right feeling is what they are seeking. They can’t tolerate discomfort, that leads to anxiety and fear, so much anxiety and fear that are unbearable.
  • Quite often the sufferers find their own thought (obsession) and behaviour (compulsion) are ridiculous too, but they still can’t help it. It’s not about reasoning on an intellectual level, but it’s the psychological and emotion impacts on them.
  • It can be highly disrupting to the sufferer’s life, and more, to their immediate family.

Things that I want to add…

  • The best psychological intervention is “Exposure Response Prevention” (it’s a very straightforward treatment, refer here)
  • But before the treatment begins, a lot of preparation has to be done, being motivated enough to tolerate the discomfort when one is not allowed to perform the rituals.
  • Seek help as soon as you can. Many patients that we see, came to us around 3-5 years after some initial signs showed. By the time they were here, the disorder is rather aggressive and disabling, and surely, difficult to treat.
  • If you can overcome your longstanding OCD, you can overcome anything. This is what I think. And I sincerely believe it.

Positive Symptoms of Schizophrenia: A Patient’s View

She was referred to me by a consultant psychiatrist, diagnosed as schizophrenia, and taking some medication for the past few years. She is compliant with the medication, even though the medication makes her struggle to wake up every morning. She has a job. She completed a degree few years ago, and has been able to hold her job most of the years despite her illness.

I remember during our first session we talked quite a lot about the symptoms of schizophrenia. She used to have paranoid delusion (suspecting that a fellow friend from the uni is following her and trying to do her harm etc), but now has only auditory hallucination (hearing voices of the ex-coursemate).

The consultant psychiatrist and I always thought that she had good insights into her symptoms and illness. Until it was the 4th session, she disclosed that she never thought she had any illness. Why was she taking the medicine? Because it helps her emotionally, feel calmer. I suddenly realised that it was true in her case, because her antipsychotic drugs have never reduced/ceased her voices.

Sometimes it seems that the voice is like a friend to her. We have discussed that if there is no way to remove the voices right now, how she can live with the voices, and she seems ok with it (sometimes). But after more discussion, I realised that her problems with this voice is because the voice broadcasts her thoughts. She always thinks that others can read her mind, and it’s due to this voice. She can live with this voice if there is no way to get rid of it, but she can’t live with this voice telling everyone else her thoughts…… (she gave quite some good examples of others knowing her thoughts and responding accordingly, and she thinks all these were too much a coincidence).

She believes that the voice in the mind is machinery operated, and this machine is controlled by the ex-coursemate. Once during a breakdown, she even went to confront the person, and the person denied having done that to her. Now when she’s relatively well, she thinks there is no point to confront the person, because the ex-coursemate would surely deny (and she wouldn’t believe that).

From the Psychology’s perspective, both delusion and hallucination are common positive symptoms of schizophrenia. They also tend to happen together.

From the client’s perspective, it’s more complicated than that. Because she doesn’t think they are two separate symptoms of an illness. They are one thing, the voice (hallucination) broadcast her thought (mind being read – delusion).

I surely didn’t attempt to argue with or convince her that it was just her illness. I’m not being irresponsible or denying my job and role as her therapist (I can and will still help her in many other ways), but consider this carefully, is there any point at all to do that in her case? (especially that she’s almost fully functional and is taking her medicine regularly and attending therapy session monthly). After all, who knows she might be right and I might be wrong? Who says everything I learnt in my degrees must be right when the so-call anti-psychotics are not ceasing/reducing her positive symptoms? Who is the expert in one’s illness?

 

Additional knowledge:

Positive symptoms of schizophrenia: Delusion, Hallucination, Racing thoughts

Negative symptoms of schizophrenia: apathy, lack of emotion, poor or non-existent social functioning

Cognitive symptoms of schizophrenia: disorganized thoughts, difficulty concentrating and/or following instructions, difficulty completing tasks, memory problems