Category Archives: Issues & Debates

Sexual Orientation: Uncertainty or Unacceptance

Issues & Debates, ,

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”

Issues & Debates, Review - books movies series
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! 🙂

给“发现”家里有同性恋者的你：

Issues & Debates, ,

请你慢慢地看，仔细地思考，或许过几天再回来重复看。如果我说的不对，你可以留言告诉我、纠正我… 

－喜欢什么人、哪个人、什么性别，是自然发生的事，事实上也不是他的“选择”。我们无法选择自己喜欢的人的性别，不管你是异性恋还是同性恋都一样，不是我们的控制范围。回想过去的你，不也自然发生吗？

－你希望他改变的话，就请将心比心，想象你要强迫自己改变性向，那会怎样？快乐吗？痛苦吗？

－你希望他健康、快乐，对吗？

－没有同性恋倾向的成人，不会被蒙骗／迷惑／影响而变成同性恋。（若有，是因为他原本就很可能是，只是自己也无法面对或对自己坦诚，那他也只是被影响下而敢于面对）。

－或许他曾经不是同性恋，或许他从小幻想自己和异性交往结婚，甚至曾经交往异性几个或多年，可是这世上有很多人，爱的是“那个人”而不是“他的性别”。而我们从小接触的书本、故事、卡通、周遭的人，几乎都是异性恋，所以那些幻想也不代表什么。很多人自己也无法接纳自己是同性恋，而选择和异性交往，做所谓的“正常人”。

－或许你认为你那“正常”的路比较轻松。那，你希望他走一条辛苦但快乐的路，还是走一条轻松但他并不快乐的路？一辈子的路很长…

－你对他的担心和劝告，甚至愤怒和责备，背后都是关心和爱，因为这条路可能真的不容易，我想代替他，谢谢你。但是从来没有人保证异性恋情和婚姻就会比较轻松比较快乐，不如请他让自己强大起来，提高抗压和应对能力，走这条好像比较不容易走的路，有能力应付别人的眼光和批评。

－他们告诉我，外面的人如何看待他们其实一点也不重要，对他们而言，最重要的是你，你的认可和接受比什么都珍贵。每一天，他们都在期待或许哪天能够与你坦诚相对。

－请他答应你：以一种好奇和开放（curious & open）的心态，继续探索、继续了解自己，继续成长和变得更成熟。

－你最希望的，是他健康、快乐，对吗？

－我想告诉你，如果他有选择，他也想选择一条社会普遍认可的轻松路…

－希望你也以一种好奇和开放的心态，去了解这个世界上各种不同的人，学习了解他们，与他们相处，接纳不同的人，甚至，喜欢他们。他们只是有些地方和你不一样，但他们并不坏，和大部分人不同也不代表是心理问题，并且他们和你一样很努力的生活和了解自己、做自己。

谢谢你愿意看完这些话。

Should your therapist give you advice?

Depression, Issues & Debates, Treatment Approaches, ,

“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…

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

Basic & General, Issues & Debates

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)

Anxiety Disorder, Clinical Case Studies, Issues & Debates, Treatment Approaches

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.