Category Archives: Basic & General

心理问题/精神疾病病友互助小组(吉隆坡/巴生)

在国外,不管是什么疾病,互助小组(support group)都是蛮常见的,比如抗癌勇士、强迫症患者等。过去也曾有好一些病人问过我,在马来西亚有这种小组吗… 所以在这里我提出一些意见,有兴趣或有其它看法的人,欢迎联络我…

互助小组类型:

  1. 抑郁症、情绪障碍
  2. 强迫症
  3. 焦虑与焦虑相关障碍
  4. 精神分裂,妄想、幻觉相关障碍
  5. 照护者、患者家属

什么是互助小组?做些什么?

  1. 每个月或每两个星期见一次面,大约一小时
  2. 认识和你面对一样或类似问题的人
  3. 轻松讨论一些主题(由我引导)
  4. 彼此分享、鼓励、支持、学习

语言

  1. 英语
  2. 中文/广东话

地点

  1. 吉隆坡欧阳专科医疗所(Jalan Pudu)
  2. 巴生Manipal Hospital Klang (Bukit Tinggi)
  3. 巴生河流域一代的咖啡馆

必要条件:

  1. 病人的意愿(不是被逼的;愿意出席、参与、讨论、分享、聆听)
  2. 至少三人才能进行
  3. 尊重其他人、尊重隐私权(不泄露其他人的隐私)
  4. 承担费用(行政、材料、场地等)(若有)

目前这只是初始阶段,如果你有什么意见和想法、或者有兴趣参与的话,请留下联络方式,也可以电邮 hello@huibee.com 或致电/whatsapp 017-2757813

英文版本:http://huibee.com/2017/08/support-groups-in-kl-klang/

Support Groups in KL / Klang

I’ve been asked about support groups quite a few times and been thinking how I can start this. It’s definitely something very common in western countries, I’m not sure how it will work here in Malaysia. Now I’m proposing the idea here, and for anyone who reads this and is interested in any of the support groups, please get in touch, let me know what you think and how we can start this and get it going!

Support groups for:

  1. Depression or mood related problems
  2. OCD (Obsessive Compulsive Disorder)
  3. Anxiety or stress related problems
  4. Schizophrenia and psychotic related disorders
  5. Carers (immediate family etc)

What is it? How does it go? What do we do?

  1. Meet monthly or every fortnightly for an hour or so
  2. Getting to know people who share the same or similar problems
  3. Casual discussion following a theme that we set (led by me)
  4. Sharing, supporting and learning among/from each other

Languages:

  1. English
  2. Mandarin / Cantonese

Venues:

  1. Klinik Pakar Au Yong, Jln Pudu, KL
  2. Manipal Hospitals Klang
  3. Some cafes in Klang Valley?

Requirements:

  1. Patient’s willingness! (is not forced by others to join us; willingly attend, participate, share and listen to others)
  2. At least 3 to form a group
  3. To treat others with respect and maintain confidentiality
  4. To share the cost of a small administrations/materials/venue fees (if any)

These are just some ideas for now, if you have some ideas or are interested, please do leave your contacts (email or contact numbers) below or get in touch by emailing hello@huibee.com or calling/whatsapp 017-2757813

Sleep and Dreams

  • All people dream when they sleep, including people who think they don’t (more…).
  • According to sleep and dream expert Rubin Naiman, good dreaming contributes to our psychological well-being by
    • supporting healthy memory
    • consolidating memories
    • retaining information
    • warding off depression
    • expanding our ordinary limited consciousness into broader, spiritual real
  • Sleep generally occurs in 90-minute phases repeated throughout the night. Each phase moves from non-REM sleep to REM sleep. At the beginning of the sleep cycle, the REM phase lasts only a few minutes, but in the last phase before awakening, the REM phase can last  up to 40 minutes, and these late-stage dreams often stay in our memories as we awaken.
  • Dreams are largely confined to the REM, or rapid eye movement, phase of sleep.  In REM sleep, we are also in a type of paralysis, and if this paralysis doesn’t occur for whatever reason, a deadly acting out of our dreams can take place.
  • The longer your REM cycle, the more intense your dreams (more…)
  • When someone is sleep deprived we see greater sleep intensity, meaning greater brain activity during sleep; dreaming is definitely increased and likely more vivid (Mark Mahowald, director of the Minnesota Regional Sleep Disorders Center in Minneapolis.)
  • It has been observed that dream deprivation causes effects such as:
    • waking dreams (visual and auditory hallucinations)
    • interference with memory and learning
    • a loosening of associations
    • impaired waking ability to do tasks requiring focused attention
    • difficulty maintaining a straight line of thought
    • creating irritability and suspiciousness.
  • High dream recallers are more reactive to environmental stimuli [during sleep], awaken more during sleep, and thus better encode dreams in memory than low dream recallers. (more…)
  • Whatever people are exposed to during the daytime will have an impact on their dreaming at night.
  • You can have a negative impact on your dreams if you’re surrounded or getting exposed to negative things throughout the day. But, on the flip side, you can also have a positive impact on your dreams if the last things that you’re thinking about are positive things. (Dr. Shalini Paruthi)
  • How to have better dreams: While we can’t have 100 percent control over our dreams, there are things we can do to influence them in a positive direction, experts say. Among them:
    • exposure to pleasant smells and sounds while we’re sleeping
    • avoiding spicy foods
    • not smoking
    • eating healthy and exercising regularly
    • improving our daytime thought patterns
    • In simplistic terms, if you want good dreams, sleep well and think happy thoughts. (Dr. Shalini Paruthi)
  • In Dr. Naiman’s view, your complaint of feeling tired the day after dreams disturb your sleep is not usually the result of dreaming, per se, but of attempting to deny, resist or fight the dreams. It is this struggle that can leave you exhausted. He notes that occasional bad dreams and even nightmares are a normal part of one’s dream life, also to keep in mind that even a negative dream can have a positive effect on one’s life.

 


About SLEEP

  • According to Antrobus, factors that can lead to poor sleep include:
    • consuming alcohol before bed
    • experiencing stress and having a disturbing day
    • keeping electronics like cell phones, televisions or computers in the bedroom
    • eating, exercising or consuming caffeine too late
    • having an uncomfortable bed or sleeping environment
    • keeping an inconsistent sleep schedule.
  • Dr Shalini Paruthi’s advice on getting a good sleep:
    • sleeping in a room that’s dark, quiet and cool (18 to 22 celcius degree)
    • taking a bath and reading a book before bed
    • practicing relaxation exercises
    • avoiding stressful or stimulating activities before sleep
    • napping early in the day (or not at all)
    • exercising earlier in the day
    • avoiding alcohol, sugar and large meals before sleep
    • maintaining a regular sleep schedule
    • going to bed when we’re tired.

 

Seeking mental health help leaving permanent record?

This thing has been ongoing from day one I started my job, it is usually with parents who are a bit concerned taking their children to get professional mental health care services, whether it is psychiatric, psychology, counselling services.

Their main concern is that this will leave permanent record/impact on the patient, affecting his/her future education and career opportunities and developments. So I have met parents who wouldn’t take their child to see us, or parents who argue over it, or parents who wouldn’t register their child’s name in our system and want us to use and call their (parents’) name instead.

I’m not sure what happens in government hospitals. But as far as I’m aware, all of the information we hold here in our systems is private and confidential. Unless we have the consent of the patient (or of the guardian for children or those that are less capable), or it is required by laws, we can never disclose anything to anyone, no matter if it’s their spouse, parent, supervisor from workplace or faculty head from college. I’d always add that if the patient has a very high risk of harming the self or others, we might need to do something about it (it’s often contacting the next of kin, which is a contact provided by the patient, who is already aware of patient’s condition and aware that s/he is seeing us).

So I can’t emphasise enough that seeking professional mental health care and help will not leave you with any permanent damage and record. If you allow the condition and symptoms to worsen, things can be a lot worse than what it is now.

However, with the patient’s consent, we do write medical reports, stating the patient’s mental condition and functionality. A medical report usually serve a specific purpose, like when one’s trying to apply for insurance (written to insurance company), trying to take a gap year from studies or work (written to his/her college or workplace), trying to change teaching location (written to ministry of health) etc. This is the part we can never guarantee. For insurance company, I would just hope that they deal with those reports professionally. And for a college, a company or a government department that holds one’s medical report, it does seem possible to leave a permanent record and affect one’s future. I remember there was a student requested to have a letter written to her favour, and few years later contacted us again to ask if it is possible to write another letter to waive off the previous letter… Surely it is not possible. Even if you’re now healthy and fit (even with 0.0001% chances of relapse), your previous record becomes your mental history, it doesn’t disappear and can never be removed that way. So, do take a deep consideration, before you request for any report submitted to anyone anywhere.

面对焦虑

焦虑就像一只老虎,你为了避开它,减少它可能对你造成的伤害,你给了它一块肉,希望它吃了肉可以离开。是的,它可能离开一会儿,可是,猜一猜,给了它那块肉以后,它真的不再回来了吗?可能一两个小时,可能一两天,这回它又饿了,可能更饿了,更强大,要更多更大块的肉。

焦虑也一样,你越是逃避它害怕它,越是为了它作出不必要的牺牲(害怕在社交场合被拒绝,干脆不去参加舞会;担心无法把工作做好,花更多的时间在担心而不是完成工作,甚至最后真的无法完成),它下一次再出现,只会变得更强烈,让你更不舒服、更恐惧、更害怕。

可是如果你选择和焦虑处在一起,它固然让你感到不舒服,但它并不危险,一段时间后,你的焦虑感会开始下降,下次再面临一样的处境,你也不再那么焦虑,即使还是有一定程度的焦虑,你的头脑也能告诉你,基于上次相处的经验,其实这个焦虑感可能让你感到不舒服,但它并不危险,你并不用逃避它。

那不逃避,就是怎么做呢?如何直接面对它呢?如何接受情绪呢?首先告诉自己,这感觉可能让你感到不舒服,但是它不会对你造成伤害。你可以感受一下它处于身体的哪个部分,比如胸口闷闷地,颈项后方有点紧、心跳有点快、或肚子有些不舒服等,识别它们,并容许、允许它们存在于那里,就像一个朋友带了一个你不太喜欢的客人来到你家一起聚餐,但你并不因此把他赶走,或者为了他一个人,不去招待其他客人,你还是允许他的存在,继续享受你的聚餐、继续做你想做的事。对任何情绪,其实都一样,都可以这么做。

Muscle Relaxation

Core principles of muscle relaxation:

  • Non-doing: you can’t do muscle relaxation. It is a ceasing of doing. A ceasing of effort.
  • There is always a deeper level of relaxation (people underestimate how much they can relax)

Here is a recording of muscle relaxation skills training:

Muscle Relaxation Recording (English) 

It starts around 6 seconds later. Basically you will be asked to tense various muscle groups in turn, then relax them as deeply as possible.

In general only a few practice of this would be sufficient to develop awareness of muscle tension during the day, then you can just use the cue words (in the recording) to relax any muscle group during exhalation any time of the day, anywhere once you notice the tension. This means that you will not need this guided audio in the long run.