Quick Update: I have been fairly occupied after starting my lecture role in May, plus my other therapy and supervision work. So some of you might notice that I haven’t been updating my blog as regular as I used to. I’ll be writing more regularly again as I slowly adapt.
Today I’m starting this page to share some mindfulness recordings by me, I intend to update this list from time to time.
Brief Mindfulness (8.5 minutes)
簡短正念 （8分鐘）
COPYRIGHT ©2016 Cengage Learning
Although there is no one best way to approach a situation where suicide may be a possibility, the guidelines that follow may be helpful:
1. Treat the person as a normal human being.
2. Don’t consider the person too vulnerable or fragile to talk about the possibility of suicide. Raise the subject yourself by asking the person directly. For example, “It sounds like you are feeling depressed. Have you been thinking about harming or hurting yourself or committing suicide?”
3. Show the person you care about them even if you don’t know them very well.
4. Help the person talk about and clarify the problem. Those who are depressed may have difficulty pinpointing the problem and may feel frustrated and confused.
5. Listen carefully. People who are considering suicide are in mental and/or physical pain, although you may not be able to guess the type of pain or the source of the problem. Be there to help the person talk about the issue. You don’t need to fix the problem.
6. Suicide is often viewed as the final solution to an overwhelming problem. The person who is depressed may have difficulty sorting out alternative solutions to the problem(s) he/she faces.
7. Encourage the person to seek professional assistance. Crisis hotlines are available in many communities. If an immediate danger of suicide exists, do not leave the person alone. If the crisis seems to be improved for the moment, be sure you have a plan of action regarding professional help before leaving the person. Have the person promise to call you before doing any harm to him/herself. Offer to accompany him/her to see a mental health professional.
8. If the person refuses help, you may need to contact someone close to him/her such as a family member to share your concerns.
9. Maintain contact with the person.
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
N.B. The guideline is adapted from Cengage Learning’s materials. This week I’m teaching Mood Disorders and Suicide in the Abnormal Psychology module. I’m going to tell the students to share some suicidal prevention information, hence I’m also doing this myself.
Early last week I experienced some flashers and increase of floaters in my left eye, which as I knew, could be signs of retina tear or worse, retina detachment. I got quite worried about the eye, but was quite reluctant to go to the hospital straightaway during this movement control order due to Covid-19. At that time I had stayed home for more than 3 weeks without leaving the front gate.
Just like many of my clients, I googled to understand more about the symptoms, possible causes, treatments, and prognoses. I also started to imagine if I had only my right eye left, how my life was going to be, how long it would take me to adapt. I thought about relearning a lot of skills that require the coordination of both eyes, like touching the finger tips of each hand, driving and playing badminton.
I noticed how my family was worried about me. Normally my parents have the tendency to delay doctor consultation and treatment, and prefer the natural ways of healing, but this time it didn’t happen. At one point, I realised it seems that I was the only one who was still more chilled about it. (I mean of course I know the severity, but at the same time I was observing the symptoms closely and I didn’t wait for more than 3 days till I saw an ophthalmologist).
This reminded me of some books and research I came across long time ago. People often underestimate their emotional resilience and ability to adapt. People without a disability rate the utility or value of life with a particular medical problem significantly lower than those who actually live with the disability. For example, blindness is thought to be much worse by those who have sight compared with those who have lived without sight for years. (refer to Gilbert et al., 1998).
I mean, I had taken some time to imagine what might happen, and even done a little practice pretending it happened. If what I imagined really came true, I have had some time to be prepared for it, and to adapt to that psychologically first. So to me who has been experiencing all this, things seem easier (mind you, it isn’t that easy as I have to sleep sitting for 1-2 months). But for people who only imagine it, it all appeared harder.
This is something I often want to explain to my clients, especially those with generalised anxiety and OCD, those who over-worried about what might happen in the future. Things often seem much harder when you imagine it, and people have the tendency to underestimate the ability of adapt and cope! So I often say, “When it really happens, you will do just fine. Of course it’s not going to be easy, but believe me, You Will Adapt!” (What more, quite often the things they worry won’t happen anyway).
Immune neglect doesn’t just lead to more worries about things that people believe they won’t adapt, but also have big impact on our important decision making, this might include decisions to seek medical testing, get divorced, or file for personal bankruptcy (refer to Hoerger, 2012). Do have a thought about these examples!
So really, believe that you will adapt if unfortunately what you worry about really happens.
(To those who care about my eye: At the time of writing, my left eye is still in the beginning of a recovery process following laser procedure to treat the three retina tears. I’m still seeing a lot of floaters (and blood) in the left vision.)
I talked about Euthanasia (or “mercy killing”) about two years ago. This is from Wikipedia about the Act in Netherlands,
[…] euthanasia and physician-assisted suicide are not punishable if the attending physician acts in accordance with criteria of due care. These criteria concern the patient’s request, the patient’s suffering (unbearable and hopeless), the information provided to the patient, the absence of reasonable alternatives, consultation of another physician and the applied method of ending life.
– Euthanasia in Netherlands
It doesn’t just apply to physical illness, but also mental issues, as long as the criteria (including those abovementioneds and some other) are fulfilled.
Whereas in the state of Oregon, they have Oregon’s Death and Dignity Act (ODDA). The decision will be assessed by at least two qualified psychologist or psychiatrist, that the person is capable of making such decision and to rule out impaired judgement due to psychiatric illness. In other words, people who suffer from psychiatric or psychological illness will be denied of this aid-in-dying, because the illness can cause impaired judgement.
The interesting thing is, when asked, most psychologists and psychiatrists said they are not qualified to complete this death-with-dignity evaluation (1/3), or they will refuse or refer to another colleague (53%).
I mean… psychiatrists and psychologists are trained to prevent suicide (talking about us therapists and clinical psychologists). Doesn’t this Act put clinicians in the Oregon state in a very awkward position, if s/he is called upon to carry out the assessment? They would be thrust into a position of being part of this physician-assisted-suicide…
But then the other thing is also that I always believe that any chronic illnesses, especially those that grow in severity over time, if nothing is done to them, will quite often lead to depression. Be it mental, like suffering from OCD for 15 years or more or Panic Disorder for few months or more, or physical illness like arthritis or cancer, we see that people’s emotional wellbeing and quality of life can really deteriorate over time. So how about the chances of the person having quite severe clinical depression, and hence they will be denied of the aid (in Oregon but not in Netherlands)? Wouldn’t this apply to most if not all of the people who’re requesting for the aid?
In Malaysia “active” euthanasia is strictly illegal. But we’ve heard about animals being euthanised by the vets, by the state governments, by some animal societies etc. The restriction isn’t much (if any), the decision doesn’t seem as difficult (surely still very difficult if it’s by a pet owner but still incomparable to that of a human’s)… Why? Especially when humans decide to do that, most of the time, isn’t it for the benefits of ourselves? (governments can’t let the stray pass the disease, owner can’t see their pets suffer or no longer able to look after it etc).
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
这年轻的女生于去年7月左右与我联系，告诉我说她不认为自己有严重的心理问题，但需要帮助。当我第一次见到她时，她说她想重考SPM考试，但一直缺乏动力。而且已经拖了2-3年还没去考。
我不太习惯接受相对“健康”的来访者／患者。通常，我的大部分患者的任何抑郁/焦虑或情绪困扰量表上的得分都很高。但是那时我想接收一些不同类型的来访者，所以我和她开始合作解决她的问题，例如拖延症，处理愤怒和恐惧等负面情绪，处理忧虑和负面思想，建立常规和练习好的生活习惯，还有一些冲动行为的问题。
我们并没有花费很长时间或很多次咨询，大多数治疗目标均已实现。我最近与她联系，她说她目前在等待SPM的成绩的同时正在做咖啡师的工作。
我意识到这原本就像我常在治疗快结束时（当病情稳定得多时）或当他们正在服药并由精神专科医生转介给我时（他们第一次见我时，症状已相对缓解），常做的事情。我还认为，这其实是很多人需要的，尤其在他们积累了很多无法解决的问题之前，对自己的感觉越来越糟之前，开始陷入沮丧或其他心理问题之前，就该得到的帮助。
因此，我决定写这篇关于“生活教练”（或生活指导, life coach）的文章，给予一些不见得患有心理问题，但需要一些生活上的帮助、引导的人。一般上，可以使用催眠、基于正念的CBT（认知行为疗法）和ACT（接受和承诺疗法）来得到帮助。
如果您希望达到以下目标，请在下方评论或与我联系（电子邮件hello@huibee.com或whatsapp 0172757813）：
I talked about letting go of thought VS chucking it away in a 2016 post: Let it go OR Chuck it away. Now, let’s look at this:
The behaviour that Pooh and Piglet do are the same, i.e. they both don’t think about the scary dream. But what Pooh is doing, is “letting go”, whereas piglet? He’s trying hard to chuck it away.
Quite often people overlook this key distinction, they think they copy the same behaviour, and will then achieve the same results. But the beliefs and intention behind the behaviour are important too. Are you worrying about the dream so you don’t think about it? Or do you not care about it so you don’t think about it?
Similarly, on anxiety, are you practicing relaxation because you think anxiety is bad and you can’t tolerate it? Or are you practicing relaxation because it helps you perform better when you’re less anxious? It’s the beliefs and intention behind that differ, the behaviour done or presented is the same.
It’s like on “acceptance” (a word I tend not to use with clients). Do you accept the pain because it doesn’t really matter anymore, or do you accept it because you have no choice (is it still acceptance?)?