Is psychotherapy for me?

Basic & General

Psychotherapy is for you if…

  • you have some insights to your problems and conditions; and even if you don’t, you’re willing to learn about them
  • you believe that psychotherapy can help you
  • you are willing to try hard to commit yourself to the therapy (e.g. completing the homework given between the sessions)
  • you can work co-cooperatively with the therapist
  • you don’t think psychotherapy or the therapist is magic
  • you can have realistic expectation of what psychotherapy can and cannot do (e.g. can understand that you may not recover completely but still, it will help you to develop some useful and practical skills so that you live a more meaningful life)
  • it doesn’t matter whether you’re seeing a psychiatrist or taking psychiatric medicine, but do take note that psychotherapy is not a substitute for psychiatric drugs, quite often they work well together; so do not stop the medicine unless advised by your attending doctor (quite often the psychiatrists have their rationale and expertise while prescribing those medicines to you, and it’s not down to any other doctor or therapist to comment).

 

Psychotherapy is NOT for you if…

  • you don’t think you have a problem, you’re here because your family/partner/parent/friend make you come.
  • you think the therapist will make you recover and there’s nothing much you need to do
  • you aren’t willing to put an effort to help yourself
  • you can’t work cooperatively with the therapist
  • you are in too great distress that you can’t think, can’t reason, can’t pull yourself to do anything
  • you don’t believe that psychotherapy can help you
  • you think psychotherapy can replace your psychiatric drugs completely (or from the very beginning)

In the news: Mum killed for asking son to take psychiatric medication

Issues & Debates, Schizophrenia & Psychotic Disorder

I heard this news on the radio this morning. It just somehow worried me wondering whether it was one of our patients, and I had this mother in my mind.

She used to consult doctor on behalf of her adult son and collect medicine for him. All the while she brings medicine to her son but according to her, the son doesn’t think he has any problems. The son isn’t very keen to take those many tablets and liquids, but she can always make him take them.

Recently she insisted to bring the son to come to see psychiatric doctor, despite the son saying he has no problems. She said he’s willing to come. But hey, if you think he has no problems, why would you come to see a psychiatrist? Are you being forced to come?

In our job we came to know a lot of family members who have to supervise the patient’s medicine. Though we never encourage forcing patients to take medicine. So this morning when I heard this news I was worried about some old parents who are very caring but also too anxious and sometimes stubborn being involved in this kind of tragedy.

We are not asking you to stop caring about your mentally ill family, but sometimes they’re no longer themselves when their mind is taken over by the psychiatric illness, you don’t know what they’re going to do, you can’t make usual expectations as if they are not sick. So please seek professional help! And no, you don’t have to take them with you, or force them to come with you!

TheSunDaily: Mum killed for asking son to take medication

What do you really want?

Basic & General, ,

Deep down inside, what do you really want?

Happy? Rich? Healthy? Successful? A perfect husband/wife? A great job?

It’s the first day of 2015. Usually people are setting goals around this period of time. New year, new resolutions!

But this year I’m going to ask for some changes, how about not setting goals, how about asking yourself, what do you really value in your life? What’s most important to your life?

So what are values?

  • Our heart’s deepest desires: how we want to be, what we want to stand for and how we want to relate to the world around us.
  • Leading principles that can guide us and motivate us as we move through life.
  • Values are not to be evaluated, but serve as the chosen standard by which other things can be evaluated.

Why values and not goals?

  • A value is a direction we desire to keep moving in; an ongoing process that never reaches an end
  • A goal is a desired outcome that can be achieved or completed. Once achieved, it can be crossed off the list.
  • So if you want to get married, that’s a goal; But if you want to be a caring and supportive person, those are values. Values such as these are way of acting within your control, rather than consequences that are in part, down to external factors or up to chance.
  • Connecting with our values gives us a sense that our hard work is worth the effort. Values provide a powerful antidote: a way to give your life purpose, meaning and passion. Unlike goals, you may one day achieve a goal you desperately working hard for all your life and feel so lost not knowing what to do next.
  • Once you have had your values set, you can then work out your goals based on your values.

So now, sit down with a pen and paper (or your tablet/smartphone), take some time to really think what you really want and value in your different aspects of your life, imagine when you’re 80 years old and reflecting back on your life…

You’ll realize that values are like compass of your life giving you sense of direction! 🙂

I’m Lunatic!

Basic & General, Issues & Debates, Schizophrenia & Psychotic Disorder

I learnt this word – lunatic – from one of my patients. The first time I heard it, he was saying to me “you’re lunatic!” I didn’t know the meaning, but I thought it was related to “lunar”, so I was thinking the word may be saying someone whose emotion fluctuates a lot (just like how the moon changes every day). Of course he was just having fun by saying that.

But that day I heard it a second time, and checked it online later, the online free dictionary says:

1. Suffering from lunacy; insane.
2. Of or for the insane.
3. Wildly or giddily foolish: a lunatic decision.
4. Characterized by lunacy or eccentricity.”

At the same time coming out from the search is a BBC News – “How offensive is the word ‘Lunatic’?” and it mentions that the word originally “referred to a kind of insanity that recurred according to the cycles of the moon“. Hahaha so I was right to think about the moon, but still get the meaning wrong. It reminds me of Dragon Ball (hahaha) and other werewolf movies.

Anyway, it was inappropriate to use the word to “normal” people. But when my patient said that to me [jokingly], I [jokingly] said back “You’re lunatic too!” He just laughed and continued to repeat that I was lunatic…

My whole intention of this post wasn’t actually about introducing the word “lunatic”. It’s in fact an introduction…

I realized there have been quite a number of this so-called “mad” people in my life, mainly due to my work. I have also been talking quite a lot about stigmatization people hold towards those suffering from mental health problems. Whenever I thought about helping and standing up for these people, my patients come across my mind.

I thought I no longer hold these stigma and prejudices like everyone else. And I was wrong. The other day I went to Wood Green, and there was this man, I probably have seen him a few times, who was talking loudly in front of Morrisons, what he talked makes no sense. I avoided standing too close to him like everyone else, but undeniably I think he was mad, he was dangerous. (although I work in a forensic ward, but no, people with mental health problems are no more likely than “normal” people to commit crimes, or to hurt others!)

No matter how many “mad” people I have met, and how much fact about “mad” people I come to know, when I walk on the street I behave like everyone else. I’m not saying that I’m wrong behaving this way. But I realized I can only be confident to work with people with mental health problems, in a safe environment or, with patients I already know for a period of time, in any environment. I don’t have the ability to approach a [“mad”] stranger on the street and attempt to help him/her.

What can we do about this? Create a safe environment any and every where, change everyone’s attitudes towards the mental illness and the people who suffer from them.

How do we achieve that?

N.B. This post was first published in huibee.blogspot.com by the same author, when she was still working in the North London Forensic Service, UK

Is hypnosis for me?

Basic & General, Hypnosis & Hypnotherapy, Treatment Approaches, , ,

Is hypnosis/hypnotherapy for me?

Try these!

Exercise 1 – Postural Suggestion:

  1. Stretch both of your arms in front of you at shoulder level, palms facing up. With eyes closed, imagine a pile of books being stacked on your right palm.
  2. Imagine a couple more books, and then a couple more books being stacked on top of those books on your right palm. Feel the strain in your arm as it gets heavier and heavier, heavier and heavier.
  3. Now imagine a huge balloon filled with helium has been tied to your left wrist and is tugging it up into the air ….higher and higher ….higher and higher.
  4. Open your eyes and notice where your arms are relative to each other.

Exercise 2 – Postural Sway:

  1. Stand up with your eyes closed and imagine holding a big heavy suitcase in your left hand.
  2. Imagine bigger and bigger suitcases weighting down your left side, pulling you over.
  3. After 2 or 3 minutes, open your eyes and notice any changes in your posture.

Make sure you read the instructions clearly, then only you close your eyes and try them.

Most people who try these two exercises notice that their bodies/arms move at least a little in response to these suggestions (Exercise 1 works particularly well for me). If you don’t notice any movement, practice the exercises a few more times. If you still don’t notice even the slightest amount of movement, hypnosis may not be for you!

Also, some contraindications of hypnosis include people who are disorientated due to organic brain syndrome or psychosis, people who are severely mentally retarded, and people who are paranoid or hypervigilant. So these people shouldn’t be performing self-hypnosis or being hypnotised.

Supportive Family VS Inconsiderate Patient

Clinical Case Studies, Issues & Debates

When this man got really depressed with suicidal thoughts, the sister took him in to live with her family in her living room, looking after him, bringing him for treatment, and giving him all kind of support and warmth.

The sister has a son and a daughter. Initially they are all very helpful towards this uncle, especially the daughter, buying him everything he had asked for, and bringing him around for tours.

Over the past few months the man has got much better, and maintained well with medication. He has some savings from his past business work and EPF. The sister has been planning to send him back to hometown where their eldest sister has a house for him to stay in and spend his life. Afterall it’s not so convenient to stay in her house’s living room with her husband and children.

However, the patient used all kind of excuses to delay the date to go back to hometown. He doesn’t want to go back.

One day, the sister saw some receipts falling out from the patient’s trousers. She went through them, and saw that the patient has been travelling to casino, almost every day, and those were the receipts of him changing gambling chips with cash, some RM500-RM1,000 which made up a total of over 10,000 ringgits worth of money spent in the casino in just the past 2 weeks. It appears that the patient has been going to gamble once he has got better with treatment and medication.

She knows her brother has a long history of gambling before he got depressed. But she didn’t know the brother has been doing that behind her back recently, while lying to her saying that he was following his friends to do sales in different states. She was disappointed and felt betrayed, with all those supports she and the family have provided him with, this is what he has brought himself back to.

Just when the sister was thinking to confront the patient, she came to know from her nephew that the patient was keeping a knife with him.

She surely doesn’t want anyone in the family to be hurt, but she is then stuck in the dilemma of how to persuade the brother to go back to hometown without confronting him. She doesn’t regret to have offered help and provided a place for her brother, because she believes that’s how family should be like, but now, she doesn’t know what to do…

Sometimes we see a lot of family who give up on those mentally ill patients (especially longstanding ones), and because we weren’t them, we couldn’t speak for them, we also couldn’t call them selfish. However, when we have those supportive and caring family members, it doesn’t mean they can then wish for reciprocal favour.

What would you do if it were you?