Category Archives: Issues & Debates

Female Vs Male Clinicians (Psychologist, Therapist, Psychiatrist, Doctor, Specialist etc)

Note: This is a very different post, it consists of mainly (think-out-loud) personal feelings and opinions, not so professional but I no longer have a personal blog to write this. So please do skip if you’re here for more proper topics and information.

I used to feel quite frustrated as a female therapist, kind of like vulnerable not being able to do home visits as needed. Because of this, I turned down quite some people and felt bad couldn’t help those who are not able to leave home.

Until two days ago, this news of a male psychiatrist “sexually harass his rape victim patient” became viral. (I’m not sure if it’s really viral, as in, if I were not in this field, would I come across this piece of “news”?).

I’m a visiting consultant in the same private hospital with this doctor (no, not the one where the victim consulted him). I don’t know him personally, in fact, I have never met him. But we have referred cases to each other, spoken over the phone for a number of times, and exchanged emails.

After a discussion with my male psychiatric colleagues, we suspect that we know who the victim is, she has consulted each of us before. (Two years ago she found me online, some weeks later I referred her to see one of the psychiatrists, and then not long ago she came to see another one of them).

Yet, I don’t know what happened, and having said so much, I don’t intend to talk about this news. Though I hope the psychiatrist will be found as soon as possible, whether or not he has done it. (It’s fairly unprofessional for those major medias to simply take the information from worldofbuzz and reported it as news as if everything that was said by the victim was 100% true).

No I’m not siding anyone. Not that because he’s my colleague or we are from the same field that I’m siding anyone. But, this incident makes me realised, how vulnerable those clinicians, especially the male ones can be. Because I’m sure 99.99% of the people who read about this news would find the doctor disgusting. (Similar to the politician case, who was accused by his maid of raping).

No I’m saying who’s right or wrong or indicating anything. I’m just saying, it’s important to listen to both sides of the story, if possible, especially before you condemn anyone, or leave strong comments. (Of course, it wouldn’t be possible if the person is missing… Well, then any conclusion can be drawn?)

As of now, I feel lucky, because I’m a female therapist. Of course females do molest and sexually assault others! But at least the stereotype and prejudice are not there to begin with.

I’ve also heard of cases of doctors-to-be or specialists-to-be, during their studies or trainings, were complaint of sexually related wrong-doing (convicted or not I can’t be sure), yet eventually they were still allowed to graduate or to start practicing. I think universities are not there to just educate and train their students to become doctors, it’s also very important to determine, whether or not this person can be a doctor, in that sense. It’s not just about passing the exams academically. HEY med school professors, you are putting the patients out there at risk, if you know and do nothing about it.

So, if I may, I have three hopes here:

For the med schools, your roles are more important than just education and training.

For the law-makers, I think we need sexual offenders register (or sex offender registry in the US) in this country. Not just the child one (which was launched earlier this year, bravo!).

I hope all the doctors and therapists and counsellors out there learn to protect themselves, male or female.

Addiction to Pornography (and masturbation in Muslims)

Disclaimer: I’m writing this post with a lot of compassion (i.e. acknowledging the suffering of certain group of people and hoping to help them to reduce their suffering). In no way I intend to belittle or criticize any person or religion. If you’d like this post to be removed, please be in touch hello@huibee.com

I previously came across a 20 year young man who wrote to me asking about therapy for addiction to pornography. When we first met for an assessment, this is his “addiction” – he watched porn and masturbates for about 1 to 1.5 hours a day, almost every day, other than that he has been functioning pretty normally with his work and sports activities. He doesn’t experience any urges or problems in the day. When I was attempting to validate his experience, saying that many people of his age have much stronger urges and if it isn’t affecting his life, perhaps he shouldn’t see it as an addiction. Then he revealed his guilt as in his religion, masturbation is not allowed, at all. (I’m sorry to have been so insensitive, not knowing that masturbation is prohibited in Islam). He also understands that some of his friends did this when they were younger, not so sure about now.

He never talks to anyone about it, even to his religious mentor or his father. But he has been suffering in pain for few years, trying various ways including throwing all his gadgets away so that he has no access to porn. But normally it came back much stronger when he managed to suppress it for few days. So he fell into this vicious cycle of urge → reacting to the urge → guilt → suppress → stronger urge → reacting → more guilt → trying harder to suppress → even stronger urge……….. I believe it must have been so much pain that he finally made up his mind to seek help from a Chinese therapist. In the beginning, there was some “conflicts” regarding the client’s goal, as he’s looking for “complete termination”, whereas I see it as something natural and normal so a reduction will be more appropriate (yes I subsequently realised my mistake. Therapy is about the client, not about the therapist).

In the end we have come into a conclusion of the goals and some tasks. I’m now working with him on self-compassion, and we are using techniques from aversive therapy for the “addiction”. For the past few months it has been going well.

If you’re also a Muslim who’s suffering from similar issues (porn watching & masturbation, compulsive or not), and if you’re willing, please get in touch, I can connect you guys virtually (online, without meeting each other) to support each other to go through this together.

Suicide with a Hostile Intent

In the past, whenever we talk about suicidal clients, it’s normally due to depression, they feel hopeless about the future and see themselves as a burden to the family and society, and see that ending their lives as the only solution to their problems.

But things changed. Today I’m not writing about suicide bombing or attacks, but suicide with a hostile intent, on a personal level.

So recently I’m seeing more and more young people who are suicidal, who have self-harm issues, or who have attempted suicide. Or, there are also some who have done any self-harm, but they are always telling others that they don’t want to live no more.

It’s not just me. When I was teaching suicide risk assessment in Beijing, many of the students (who are teachers/psychotherapists/counsellors themselves) express the same concerns. They are seeing more and more students and young people like that. They don’t quite seem to be depressed, but they are expressing suicidal thoughts, seem to be as a mean to obtain something, usually from their parents.

It’s difficult. Because you can’t really provoke these youngsters, by telling them that “stop seeking attention! You don’t really want to die! You say it to manipulate your parents” etc. Some of them are willing to “sacrifice” their lives, to make you regret and feel guilty all your lives, just because you don’t give them what they want. Sometimes I feel they don’t appreciate and love lives as much as the previous generations (Why?!).

It’s difficult. Because any expression of suicidal ideation is important and worth our attention, we can’t simply make assumptions and then ignore it. (But do you realise, it’s also because of this, we are reinforcing their behaviour… So they get what they want, they can continue to threaten or blackmail us etc.)

We can help them as much as we can, by being more emphatic and having more compassion. But I’m just wondering, what happens to our society, parenting and education systems, why are more and more entitled children growing up, who are fairly self-centered and do not care much about how others feel?

 

N.B. I don’t mean to discount the importance of helping anyone with suicidal ideation. Here I’m only talking about a small group of people who use suicide to blackmail or manipulate around, but there are definitely plenty of people out there who are really suicidal and in need of attention and help.

Please give yourself a second chance. Malaysia suicide hotlines:

The Befrienders
03-7956 8144/ 03-7956 8145
www.befrienders.org.my

Life Line Association Malaysia
03-4265 7995
http://lifeline.org.my/cn/

Agape Counselling Center Malaysia
03-7785 5955 / 03-7781 0800
http://www.agape.org.my

核心自我是不能被评估的…

new doc 2018-07-04 14.26.14-1

 

这是基于 Albert Ellis, 史上第一个创始了认知治疗的心理学家所说的“人们不能评论自我,只能评论行为”所画的。

如果一个人因为做了一些糟糕的事,而把自己或被别人标签为“糟糕的人”,那这个人要怎么改变自己呢?

只有通过只评价行为,不评价个人,只改变行为,而个人就只是存在着的,是无法被合理公平地评价,无法被改变的。

所以从现在开始,不再评价自己,也停止评价别人,更拒绝被别人评价。

核心自我(core self) = 体验式自我 (experiential self) = 觉察性自我 (awareness self)

LGBT in Malaysia

Everyone has been talking about the change of government since the GE14 in May. Yet my blog seems so cold about this whole shift as if I don’t care, because I have not mentioned it at all so far, but this does not represent how I personally feel about it.

This morning I heard on the 89.9 BFM regarding LGBT in Malaysia. Some were hoping that with the new government, “something” can be done for this minority group. Today I’m not commenting on the Sharia (Islamic) law or how pervasive the discrimination towards LGBT is in Malaysia, I’m writing this as a psychotherapist who works in private psychiatric clinics and private hospitals. I do not represent one or any of them.

In the year of 2007, statistics showed 8% of the Malaysia population thought that homosexuality should be accepted, while in 2013 there was 9%. One of the lowest rates of acceptance in the world.

I’m pleased to see some of them appearing on the newspaper and in the public sharing their stories occasionally. But those were just a very small percentage of the people. From time to time, the clinic and myself received phone calls and emails from people suffering from them. They do not contact us because of mental distress, they get in touch because they want us to “change them back to normal.” They do not want themselves to be like this.

Yes you can set up any law to control their appearance in the media or even in the public. You can also stop them from entering your country. You can prosecute them for cross-dressing and other behaviour. Your law enforcers can also assault and humiliate them however they like it without getting into any trouble. etc. etc.

You can pretend that you don’t see them and disallow them to appear anywhere you don’t want them to be seen, but they don’t just disappear. They suffer. They continue to suffer. In silence. They seek help from private services like us. They avoid the general or government hospitals. Many of them even never speak to their family members about it. They do their best to hide it.

No I’m sorry I can’t change them back to normal. Because who is there to decide what is normal and what isn’t. Not me. Not you either. I can help them though, with all the anxiety and depression that stem from the discrimination and problems in their everyday lives.

So I’m really hoping that whatever laws and regulation the new government may come up with, consider each of these unique individuals, how the interests of the public and theirs can be served, and how can there be less suffering for all. And for the public, I’d really like to urge everyone to be more open, you don’t have to accept them or like them or befriend them, but just bring an open heart and mind, and see what happens.

 

Related read: Can we help with Sexual Orientation “Issues”?

Why do I need Psychotherapy on top of Medication?

Case 1:

My OCD client. She used to take medication many years ago, and has stopped after her condition was well under control and they were planning for pregnancy. The symptoms came back quite aggressively during her pregnancy, but with the support of her husband and family, she didn’t take any medication till her delivery, then she found me. We started psychotherapy (mainly mindfulness and Exposure Response Prevention) few months back, if you ask her what her advice was based on her experience, she would tell you, “I should have started psychotherapy when I was taking medication. That was when my symptoms were less intense with the medication, and the exposure would have been much easier. That way I could learn the techniques and use it later when I no longer medication. I wasted the opportunity. When my symptoms returned and I couldn’t take medication, I don’t know what I can do at all. I struggled till my baby was delivered.”

Case 2.

My anxiety client. She was referred to me by a psychiatric consultant, when we first met, she was rather cheerful and calm, and was tailing off the medication instructed by her doctor. Then she never came back for follow up. Till two months later, she texted me saying she had been so anxious and was unable to sleep for the past nights. We had our second session where she learnt some coping skills. When I followed up with her over the phone, she told me she was much better practicing what I told her to, and was able to sleep. Another month gone, and I received her text again saying she was under much stress and worrying a lot. She asked if there was anything she could do to stop worrying and being so anxious about things. I told her to come back for a follow up session.

 

Psychotherapy doesn’t work like tranquiliser. You pop the pill into your mouth, within 15 minutes or so you get much calmer. Psychotherapy doesn’t work like anti-depressants either. You take the medication regularly for few weeks, your depressed mood, your anxiety and OCD symptoms subside significantly.

However, psychotherapy equips you with coping skills and techniques, if you practice regularly, it becomes YOURS. You become your own therapist. When you spot the early warning signs and symptoms, you can treat yourself, without medication, without any wait.

So when you get much more stable after taking medication, it’s always good to start psychotherapy, which help you tail off medication more easily, understand yourself and the illness better, and prevent future relapse better.