Category Archives: Depression

Should your therapist give you advice?

“What? Isn’t that what I go to therapy for?”

No… Not really. Psychotherapists and counsellors are normally taught not to give advice (for important decision making) to their clients. We do not want our clients to become dependent on us, instead, we guide them and equip them with the skills to think more rationally, realistically and in ways that are helpful to them.

I remember there are few occasions when clients first came to see me, and they told me about how previous psychiatrists/therapist/counsellors had advised them to do certain things like leaving a boyfriend or a job or moving house etc, how they still ruminating about it today and still don’t think it was the right thing to do. Here, I’m not blaming the therapists or consultants. It’s both ways… Because quite often, clients want quick fix, they want the answer now… And the therapists feel the urgency to help and provide the quick fix.

But there are times when we do give advice, and that’s on severely depressed clients, and on suicidal prevention. We do advice the subject and the family around him/her what to do.

Also, I do provide psychoeducation to family members of most of my severe OCD clients. In a sense, sometimes there are family members who cannot rationalise how they are reinforcing the OC symptoms, then I will just advise them what and what not to do.

So right, your therapist should be there to teach you how to fish (how to solve your problems, how to handle your negative emotions, how to make decision etc), but not to just keep giving you fish. If it’s the latter that they are constantly doing (it’s quite normal to do it in the beginning of the therapy or when your condition doesn’t allow independent decision), at some point you are going to realise that you can’t live without them…

What reinforces Suicidal Behaviour?

Suicidal behaviour doesn’t just mean the attempt or act of killing oneself, but also includes talking about it, thinking about it, threatening others about it, imagining it and even fantasising about it.

Here are some common reinforcers of suicidal behaviour:

  • relief from pain (even just thinking about it can lead to some instant relief from pain)
  • overt avoidance (can stay away from situations that one doesn’t want to be in)
  • diminished responsibility (people expect less from the person)
  • attention
  • forgiveness
  • identification with hero or idol
  • distraction from other issues
  • revenge (I wrote about this before here)
  • prevent abandonment (“if you leave me, I’m going to kill myself”)
  • escape punishment

 

Maybe you want to read about this too: Euthanasia

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

How to respond to Worrying?

  1. Refocusing Skills: Notice that you’re distracted and refocus back to the present moments. Most of the traditional mindful breathing mindfulness exercises will help developing this refocusing skills. You can try the Benson’s method here.
  2. Observing Worries: If you happen to be in a private setting, try observing your thoughts. You can try leaves on the stream or the mind-train, being the observer of your experience and thought, realise that you have choice and control to not react. It requires some practice, and usually only possible to do it in private, not like when you’re in a social situation)
  3. Rapid Unhooking Skills (noticing, naming, refocusing) notice and name them “that’s my mind worrying” “that’s I’m not good enough story” “that’s something bad will happen story”, then refocus back to what you are doing.
  4. Acceptance of Physical Sensations: Quite often we are pulled to focus on thinking, worrying, being in our head, in order to run away from unwanted feelings and sensations in the body. Notice that you’re pulled into your head, then check feelings/sensations (e.g. sweaty palm, heavy chest, upset stomach, racing heart, numb fingers) in your body then try to allow those sensations.
  5. Use it as a trigger to reconnect with your values: if you’re worrying about your health, then obviously your health is important to you, decide how you want to treat your body, decide the behaviour to improve that, take actions, rather than just thinking about it over and over again.
  6. Reminder to practice Self-Compassions: life is difficult, a lot of challenges, obstacles and loss, acknowledge that it’s not easy and be there for myself, soothing yourself.
  7. Cue to start Problem Solving: Worry = fruitless problem solving. If it’s an important topic and a solvable matter, how about finding a time to sit down and properly solve it?

The Evolution of Human Mind

Why does my mind keep thinking negatively?

Why is my mind always looking for problems and threats?

Why is my mind always warning me when I’m trying to step out of comfort zones, and making me worry a lot?

Why is my brain always predicting the worst?

Why am I always thinking about the painful memories?

Why am I so scared of rejection and not fitting in?

Why is my mind always comparing myself to others?

Why do I never feel enough or contented with what I already have, and wanting more more more?

Watch this cute animation by Dr Russ Harris that might answer your questions, from evolutionary terms:

Did you realise that what your mind does is completely normal and natural? It’s just trying to keep you safe!

Support Group is running now!

UPDATE 13/2/2020:

Hi all, it’s unfortunate that due to current situation (Covid-19), the support groups are not running, however, please do fill in the google form to register your interest: https://goo.gl/forms/PaFNW2LBfOkOOeUv1

You will be contacted once they are running again. Thank you.


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

Suicide Survivor Support Group

Due to my attempts of organising support groups in Klang Valley (more details here), I have encountered people who are searching for support groups for all sort of things.

I just happened to come across this from Befrienders. Please go get in touch with Kenny at 03-7957 1306 or admin@befrienders.org.my if you or someone you know might be interested to attend.

suicidesurvivorbefrienders