Monthly Archives: April 2020

Aid-in-Living & Aid-in-Dying

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

Sexual Orientation: Uncertainty or Unacceptance

This post is intended to be written without judgement and with all due respects to any and everyone. 

For the past two to three years, I have received more and more enquiries that are LGBT related. One of the “categories”, is people who contacted me for their family members, i.e. not the client who reaches me for his/her problem.

In the beginning, I always assume that it’s the client who seeks help, because they are unsure, because they want to be “normal” again, because of the anxiety and/or mood problems that arise with his/her sexuality. Or, on top of all those who have approached me for those reasons, it also occurs that their issues are completely not related to their sexuality, it’s just that they think I have worked with people of similar backgrounds to theirs so I’d understand them better and we will get along well (put it simple, they wouldn’t need to worry about being judged by me because of the variety of clients I have come across).

But then, there are also more and more who approached me for their family members. And it’s not because their family members have any problems listed above. I remember seeing this lady in her mid-twenties, alone, only she and I. She completed the depression/anxiety scales on the table, which were looking more normal than me, and told me she has no problem, nothing to discuss. She said she came because the mum told her to, and she doesn’t know why they want her to come (…?). I was like… “Okay, I will call your brother and mother in then”, since it was the brother who booked the appointment with me.

What happened next, it’s not difficult to guess. She recently came out to her family, and none of the members can accept it. They said she was confused, she was affected by her group of friends and especially her partner of 6 years, she has low self-esteem, she always daydreams about having a handsome boyfriend who treats her like a princess, she has no other experience in romantic relationship etc etc.

I looked at her when the family was telling me what’s “wrong”, she was rolling eyes. I won’t deny that I was rolling eyes inside as well. (okay, only inside, it’d be unprofessional to do it…….)

The family wanted me to change her “back”, to help them to convince her “back”. It’s possible that she’s confused, but I like what I recently wrote to someone who’s enquiring for her partner:

“From my point of view, this is not something that people choose (just like I’m a straight, but I didn’t choose to become a straight person, likewise to anyone in the LGBT community). So it’s unless when people are confused (which rarely happens, unless they are still quite young and found that they seem to be different from the rest), then such [sexual orientation test] tool might be used. If the person herself, in this case your girlfriend rather clearly knows what sex/gender or who she likes, then nobody knows better than her, not her family, not you, not me, not any psychologist.

I have seen many family who insist that their family member should see me, and found out that it was more of the family’s non-accepting issues, not the client him/herself that’s having problem. In cases like this, I normally do psychoeducation with the family, and to a smaller extend, also with the client. It is a journey of acceptance for the family, and this can take a long time, especially for some traditional parents. ”

Yes I believe the person knows it best, and nobody else shall question that. You can care about him/her and ask him/her about it, but not questioning or criticising or convincing etc. (Of course it can be very confusing for people who are too young, or people who thought they were straight or homosexual but in the end found that they could be bisexual, but remember that for all of us, it’s a journey of exploration, nothing should be “certified”, let’s just be open?)

Yes, I don’t think people choose their orientation, neither do I think that there’s right or wrong. It DEFINITELY is not a mental problem. It happens naturally, just like for any straight person. But people who aren’t straight go through a lot more doubtful thought and painful emotion due to the “norm” in the society. And that’s not their fault, we owe them more support and care, and less judgement and prejudice. There’s nothing wrong with them. Be kind, treat them like how you’d like to be treated.

Book: “The Mind is Flat”

The Mind is Flat: The Illusion of Mental Depth and the Improvised Mind, by NICK CHATER

Mark R. Davis gave this book to me. If you, like me, saw how excited he was after reading this book, you’d know why I’d highly recommend anyone to read this book.

Have you ever thought that perhaps there’s no depth in our mind? Let me ask you, what’s your favourite food? … Have the answer? OK, now, why do you like it? Spend a bit of time to think about the answer.

Ok, how did you find the answer? You went inside your head to look for all the possible reasons of why you like, say, Japanese Ramen, right? That’s what we all think we do. But no, the author, Nick Chater, with scientific findings and references, tells you that’s all folk nonsense, your brain actually invented all that as it went. There is no underlying beliefs, desires, fears…

The rich mental world we imagine that we’re “looking in on” moment-by-moment, is actually a story that we’re inventing moment-by-moment.

Nick Chater, The Mind is Flat

It’s also one of the books that I mentioned to my friends and clients most. If you do read it, let’s have a discussion! 🙂