Category Archives: Schizophrenia & Psychotic Disorder

用于精神病患的接纳与承诺疗法 (ACT)

近几年在北京当助教和翻译的时候,常遇见学生问说除了药物以外,还有什么方法可以帮助精神分裂患者,尤其许多患者用药虽然很重,但还是有幻听(auditory hallucination) 和妄想(delusion) 的症状,严重困扰着生活。

其实现在有越来越多的研究表明接受和承诺疗法(ACT)对于精神病患者很有帮助。作为干预,ACT不是特别针对症状减轻,而是强调对精神病症状更灵活的反应,以鼓励价值驱动的行为(就是你的生活由你的生活意义和价值来决定,而不是完全被你的病状所控制)。许多的案例研究显示,用ACT帮助偏执狂 (Paranoia),妄想 (Delusion) 和相关的情绪障碍,虽然症状没有完全缓解,精神病依然存在,但却相当程度的减轻了患者的痛苦,而且生活的功能性和基于价值的活动(Value-based activities) 显著增加。

所以如果你,或者身边的家人或朋友患有精神分裂症,尤其幻听和妄想的症状在用药后依然对生活造成相当的困扰,可以考虑留言或电邮联系,因为只要患者有心改变,6到10次基于 ACT 的心理治疗就可以学习新的应对方式,减轻痛苦,活得更有意义。

Support Group is running now!

Yes, since my post written in 2017, I’ve finally managed to organise the first meet-up for Support Group for Anxiety and related problems. It went really well and we were all very pleased to meet each other and made this happened together, despite our levels of anxiety! We will continue to meet monthly and welcome new members.

Meet-ups for Depression and other problems will follow soon…

If you’re interested, please fill in the google form here:

https://goo.gl/forms/PaFNW2LBfOkOOeUv1

 

A few criteria to fulfill:

  • You’ve been assessed or diagnosed with the problem you specified by a mental health professional (be it a psychiatrist or psychologist or GP or…).
  • You’re attending and participating in this willingly, not being forced by others.
  • You are able to arrange your own transport and pay for your expenses.
  • You are able to pay a small fees for administrative/materials purpose.
  • You demonstrate the ability to treat others non-judgmentally and with respect, and maintain confidentiality.
  • In between our monthly meet-ups, we stay connected in Whatsapp group, however, you will only be able to join the group after first showing up in the meet-up.

 

To read more about it, please check out my previous post:

Support Groups in KL/Klang

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

我穿越疯狂的旅程:一个精神分裂症患者的故事

在吉隆坡的书局找不到这本书,所以去中国工作的时候,请那里的同事帮我买的,人民币40元。有兴趣看的人,可以和我借,或网上买。

By Elyn R. Saks

By Elyn R. Saks

情况允许的情况下,我不爱看翻译书,但是这次却选择了看这本原著英文的中文书,其中是为了一些病人还有他们的家属,希望我可以给他们介绍一些这类型的中文书,而我之前看过的都是有英文版。如果读者还有知道任何关于精神疾病患者自传的书的介绍,请留言让我知道,谢谢!

大部分时候,广大民众听说的精神分裂患者,一般都是在新闻上,显然这些新闻报道的也不是关于他们的什么好事情,通常都是一些伤害了自己或别人的新闻,也很容易让人误以为精神分裂或精神疾病患者就是有暴力倾向,对社会造成危害(研究显示,事实并非如此,甚至相反)。

而本书的作者,是一名法学院和精神病学教授,明显发病的时候,还是一名大学生。所以,是的,她在“成为一名精神病患者”后,再经历多年的坚持和努力,经历无数的挫折,才有今天的生活,依旧正在吃抗精神药物和进行谈话治疗。

这本书蛮厚的,同时也表示她写得挺仔细,其中她在早期也患有厌食症(anorexia)、强迫症(OCD)、抑郁症(depression)、疑病症(hypochondria也称“健康焦虑症”health anxiety)。它不只帮助读者更了解精神分裂症从患病初期,否定诊断拒绝治疗等,到后期的选择性接受,整个心理路程与经历,也可以从患者的角度,去看到社会、医疗、教育等的不公。

作者谈到住院经历(身体和四肢长时间被固定在床上):

在我最后的两次住院经理中,医生对我的预后诊断分别是“很差”和“危重“。假如没有那些非常熟练的、非常敬业的谈话治疗师–精神分析师–对我进行治疗,那么我肯定还停留在医院所预言的那种悲惨的生活之中。

关于接受这个疾病并与它共处余生,

如果你是一位患有精神疾病的人,你所面临的挑战是找到适合你的生活。然而,事实上,难道这不是我们所有人所面临的挑战吗?无论我们是否患有精神疾病。我的幸运之处不是我已经从精神疾病中康复。我还没有康复,我也将永远不能康复。我的幸运之处在于:我已经找到了自己的生活。

心理问题/精神疾病病友互助小组(吉隆坡/巴生)

更新 2/4/2019:

吉隆坡焦虑症互助小组已经在2019年三月开跑了,抑郁症互助小组也很即将开始,但是暂时只有英语作为媒介语的。

如果有兴趣参与任何互助小组的话,请填写这个表格:

https://goo.gl/forms/PaFNW2LBfOkOOeUv1


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

UPDATE 29/10/2018:

To keep things simple and organised for me, please fill in this form if you are interested to join the support groups!

PLEASE FILL THIS FORM >> https://goo.gl/forms/PaFNW2LBfOkOOeUv1


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?
  4. (NEW) Some cafes in Johor Bahru / Batu Pahat?

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)
  5. It’s mainly for people who are undergoing treatment (medical/psychological/other) and need some support along the way, NOT a platform to vent your emotional problems and personal frustrations. 

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