Good afternoon, folks!

As previously mentioned, being a good listener can be helpful, especially to loved ones in need. One key skill in practicing active listening is paraphrasing


Paraphrasing

To be an effective listener, paraphrasing is a key skill for you to use.

To paraphrase, use these steps:

1) Listen to the main points of the message.
2) Main points can include the content or emotion of the speaker.
3) Through your own understanding and words, say it to the speaker.
4) Keep your paraphrase short and simple.
5) The speaker clarifies what’s missing in your paraphrase, or agrees and elaborates further on his/ her message.
6) You continue paraphrasing.


Practice Examples

Statement 1

“My therapist just told me that it’s alright to get it wrong when listening to others. It is more important that I take the effort to understand what the speaker is trying to say, and to clarify further through paraphrasing”.

Paraphrase: “Understanding and clarifying what is being said by someone is more important than getting it right”.

Statement 2

“Psychologists often use paraphrasing to communicate well with their clients. I want to try this out too!”

Paraphrase: “Therapists use paraphrasing often in their line of work”.


Continuing the paragraph

One other great way to apply active listening is through a listening technique called continuing the paragraph.

I've written more about it in the article below (including some practice examples). Keen to learn more? Click in here:

https://people.my/how-to-be-a-good-listener...a-psychologist/


That's all for this week, folks! See you again next week.

Hi Bidu88,

I'm happy that you liked my posts. Thanks for the encouragement!

From your post, I've identified 2 questions. (1) is about counseling fees and the necessity to go for them, and (2) is about if you have depression.


(1) Is it necessary to go for counseling? Fees are expensive.

I do agree with you that therapy sessions may cost quite a bit, and the fees you quoted are about right. Your concerns are common among people considering therapy. As such, a lot of developments has been happening in research on therapies in making them more efficient and time-limited.

Short-term therapy (within the range of 6-12 sessions) has shown significant effects on a person's depression. I attempted to link you to research articles, but you'd most likely encounter a paywall to read them, so I suppose you'd just have to trust the words of a psychologist, lol.

An important part of therapy will be goal-setting. If you have cost limitations and would like targeted goals to achieve (e.g. I want to lower my depression and then stop therapy in 8 sessions), that is something that you can bring up with your therapist. A good therapist should be able to collaborate with you on goal-setting, which includes cost as part of the consideration.

At 8 sessions, the total bill will come up to RM2000.

Let's consider the value of RM2000.

If you did not receive treatment and instead persist in an episode of depression for at least, say, 6 months. It would mean that you are trading RM2000 for 6 months of feeling lousy.

So in this case, we'd have to weigh if it is worthwhile to go through 6 months of depression as opposed to paying RM2000 for therapy sessions to address it (with a good therapist).

We'd also want to take into consideration that while depressed, we tend to lose professional productivity (lose money) or perform avoidance coping (such as impulse purchases, binge eating, substance use - lose money... and health).

I understand that the cost to treatment is still expensive for most people. I do not have a good answer to that, as this is a systemic issue that is a mix of policy, economics, etc.

But, if you're feeling depressed or anxious that it is affecting your life, looking at it objectively, the emotional, physical, and psychological loss will cost much more than the monetary investment of RM2000.

Not to toot my own horn (well, I guess I sort of am), the psychologists at my practice can all work competently within the amount of sessions I've stated above (6-12 sessions). This is currently the gold standard to therapy.

Hope this answers your question!

(2) Do I have depression?

Social stressors, such as interpersonal conflict, job loss, etc., can be a trigger for a depressive episode.

I am unable to determine if you fulfill the criteria for a depressive episode or not via text. But, while it sounds like you have certain emotional and behavioral responses that is similar to a depressive episode, what depression really is, is a more severe or longer-term impairment to functioning.

What's most important is that if its identified as depression, the main goal is to restore your functioning and improve on your quality of life. So, when reflecting on your needs and mental health, the most important question to ask is: am I functioning (e.g. relationships, emotional well-being, productivity, etc.) at a level to which I'm satisfied with?

We all go through difficulty. At times, we can get over it easily than other times. Sleeping in more, bingeing, having negative thoughts...these too happen to people every now and then. But, if these persist for too long, or impacts the person's personal/ professional life too much, then it is best to get them addressed.

What psychologists typically work with will be those times when the client finds it difficult to function without support. Once that support is received, the client will then start to be able to practice independence again.

You may think of this as like a seasonal flu. Sometimes, you smelt something that tickles your nose, and you sneeze to get over it. Sometimes, you get unwell for a couple days and you're fine thereafter. Occasionally, you get sick for longer than usual. That is when you see a doctor for meds.

It's the same with your mental health and your relationship with a psychologist.

Hope this makes sense.

So, you may want to consider that you're having a "flu" that is worth professional attention if:

a) You are unable to function well in areas of life that you were able to previously (e.g. job, relationships).
b) You are unable to function well in taking care of yourself (e.g. personal hygiene, physical health, performing daily tasks)
c) You are unable to manage your emotions well (e.g. feeling depressed all the time, feeling overwhelmingly anxious often)

In developed countries where mental health is not so much a stigma, a visit to the psychologist when you feel emotionally unwell is seen similarly like a visit to a doc when you have a flu. I think its an apt analogy to provide here.

Please let me know if this isn't the answer you're looking for! I've just been typing non-stop after a cup of coffee, lol.

Hope this information helps you assess on your needs and your mental health!

Merry Christmas and Happy Holidays everyone!

Without a doubt, this year has been a very challenging one.

Instead of preparing a mental health post this week, I'd like to take the time to congratulate you for doing so well and getting so far into the year.

It has been tiring, it was stressful, but you made it!

It doesn't have to be perfect (this year is far from perfect). It doesn't necessarily need happy memories (I personally have more bad than good).

But, what's most important is, despite a pandemic going on, you are here today, getting into the holiday season and wrapping up a rollercoaster of a year! This is a clear sign of mental resilience, perseverance, and hardiness. You have certainly grown this year.

Congratulations once again

Looking forward to providing more (I hope) helpful content in the coming new year.

Till then, enjoy the holidays, take the time to connect with others, deep breaths always, and see you next year!

Hello everyone, and welcome to 2021!

I'm wishing for the vaccine to come sooner, and hoping that we can begin moving into normal life 2Q 2021. Although, I think that's rather wishful thinking. 3Q 2021 should be a good start to normalcy

A reader of the forum had submitted a question, which goes like this:

How does divorce affects children's development? Are children with two loving parents better off?

This is a great question. It is all the more relevant in current times, because rates of divorce are at an all time high. About half of marriages end up in divorce (US statistics). In Malaysia, this is much lower, but at an increasing trend, averaging 4.5 - 7.6 divorces per 1000 people.

Research on the effects of divorce on children

In general, the research evidence supports better well-being for children who have parents that are not divorced.

Here is a literature review of the evidence presented. You may have a read, it's a free full article:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4240051/

You may head on over to the part of the article that highlights the key points of the effects of divorce on children.

With that being said, this is by no means an endorsement of couples staying together for the sake of the child even when the marriage is not working out (for example, in cases where there is clear evidence of abuse).

Children are better off having divorced parents than parents staying together but are constantly bickering. Putting a child in a toxic environment is more harmful than an environment to which there is an absence of a parent.

There has been much development in understanding changing family structures, especially with the growth in numbers of single parents and stepfamilies. Such family structures will eventually be normalized, with understanding on how to nurture children to thrive under such conditions to continue to develop.

Recommendations

1) If you are considering divorce, but are thinking of the kids' well-being, consider the reason for divorce. Is it irreparable (e.g. abuse in household, severe financial mismanagement)?
2) If the marriage is not working due to reasons that cannot be fixed without extensive intervention, and is affecting not only you but the children, then divorce may be one of the options to consider.
3) Children are better able to thrive when they have happy parents compared to unhappy ones. If staying in the marriage is going to keep you miserable, angry, and depressed, this in turn has a direct effect on the children at home. Parents often take out their frustration of their marriage on their children (much like a pawn in a game of chess between both parents - in therapy, we call this "triangulation"). Such an environment will not produce happy children, even when the parents are staying together.
4) If there are signs that the marriage can be repaired - that there are opportunities in developing better ways of communication, to develop better understanding of each others' ways, or to rebuild on trust after it has been broken - then do seek a mental health professional who is able to assist you in working on these issues with the both of you. Having a third (objective, well-trained, and impartial) party can be helpful in changing habits in the relationship that has been leading to these breakdowns.
5) If you are considering divorce due to (1) and (2) highlighted above, it may still be helpful to have a few sessions speaking to a mental health professional, so that you're able to gain better insight and clarity over the options that you have - and to make preparations and decisions that are best for you.

Hoping that this information helps. See you all again next week!

Hello everyone, and Happy New Year!

Much has been happening. To be honest, I've just been busy firefighting at work with all the changes that's been implemented. Hoping that everyone is well and safe.


A question by a forumer brought me out of my cave, and here it is:

Can mindfulness meditation really help with mental illness? Or is it just pseudoscience?

An interesting question, this one! And all the more relevant, as mindfulness practice is really starting to gain mainstream popularity.


What is mindfulness?

Mindfulness is defined by a leading figure in the field (John Kabat-Zinn) as "the awareness that arises from paying attention, on purpose, in the present moment and non-judgmentally".

In practice, what mindfulness means is a practice where a person spends time and develops a habit of purposefully paying attention to what's happening right now.

This sounds easy in theory, but super difficult in practice.

The theory goes, our mind isn't often in the present. Our attention often wanders onto the future or onto the past, making us feel more anxious or depressed than we should. We create stories of what had happened or what's going to happen in our minds, and as a result, our body responds to that.

There are a variety of ways to practice mindfulness. Any activity that brings your wandering attention back to the present is a practice of mindfulness. Most people find it helpful to spend some time daily focusing on their breathing (we are constantly breathing, so it's an easy "object" to bring your attention to).


Is mindfulness pseudoscience? Does it work?

In my line of work, what "works" is when there is strong research evidence (usually randomized controlled trials, or RCT) that shows using a technique/ method A produces an effect B. And, this happens not by mere coincidence (using mostly good research methodology and statistics).

To put it briefly, mindfulness interventions have a strong evidence-base in its efficacy. There are a variety of therapeutic approaches in psychology right now that either uses parts of mindfulness techniques or in its entirety as an intervention for a range of clinical disorders. Primarily, most evidence suggests efficacy for depressive and anxiety disorders.

You may refer to this link herefor more info.

There is also evidence to show that some approaches that uses some mindfulness elements can also be helpful in treatment for Borderline Personality Disorder (BPD). or more common issues such as chronic pain management.


VERY IMPORTANT CAVEAT

The thing about scientific research is that we have to be careful of how we generalize results. When I say that there is strong conclusive evidence that mindfulness is helpful for a variety of clinical issues, what I mean is that mindfulness, applied as per what is done via published research, is effective for X or Y clinical issue.

I certainly do not mean to say that practicing mindfulness as per Life Coach A or Guru B will help with depression or anxiety (well, it may or may not, but someone has to publish research onto said practice to determine its effects).

So, I can confidently say that, yes, mindfulness practice with its methodology as per published research, does produce effects. Usually, this is in a form of intensive therapy spanning at least 8 sessions by a qualified and well-trained psychologist.

But, I wouldn't say the same about the life changing claims that you will experience in a 3 day mindfulness retreat, as organized by a self-help guru. Catch my drift?

In the scientific world, this self-help guru would need to demonstrate his/ her retreat's efficacy via an RCT with good research methodology, and results published in a reputable journal.


Conclusion

With all things considered, mindfulness can be a helpful practice to include in daily life. I do it casually too. There is good enough evidence to suggest that it can be helpful.

However, if you are suffering from more serious conditions (such as depression, an anxiety disorder), do seek professional help. He/ she may utilize mindfulness practice, but it will be based on best practices found from research*.

*if you were to meet a reputable and well-trained psychologist...such as psychologists at *ahem* People Psychological Solutions.


Have a great week ahead!

A new question via PM:

"I feel scared, weak, and stupid to work" - I was overwhelmed at work, and I have resigned. Is it the right choice?

While I cannot provide advise with whether or not a choice that was made was a right one (nasi sudah jadi bubur, as they say), but I think what I can highlight from this question is the process to which such an issue can be addressed from a psychological standpoint.

1) Emotional management

This can be done by identifying emotions and their function in our daily life, when such emotions are activated in daily events, and how to effectively manage them.

This typically involves a variety of behavioral changes that can be done to daily life, or skills that can be developed to manage emotions better.

Example:

Anxiety:

1) The client learns the function of that emotion (to fight or run away from a threatening situation).
2) The client learns to be aware of when anxiety happens in daily life.
3) The client learns relaxation techniques to be applied to reduce such emotional responses.
4) The client learns how to notice the thoughts that activates such a feeling (e.g. I'll never get this work done, I am not capable, etc.)
5) The client learns how to manage such thoughts.

and the list goes on...

2) Decision making
Decision making is a skill that is developed. With most important decisions in life, there is oftentimes not a clear option as to which is the best one.

A psychologist can work with the client in applying thinking skills. This can even be something as simple as sitting down with the client and evaluating pros and cons. It sounds simple, but people rarely take the time to do it.

The psychologist can also explore not only the concrete outcomes of each decision, but also how it resonates with a person's values, or its consequences not only to themselves, but others. There might be behavioral experiments that can first be done to test certain assumptions (e.g. "My boss is totally unreasonable - he wont give in to a raise. I might as well quit!" - test by having a conversation about a raise with the boss first), and then arriving at the best option based on evidence gathered.

Conclusion
Mental health isn't something as simple as getting a yes/ no answer from an authoritative figure. Instead, it is oftentimes a collaborative process, to which the psychologist is able to work with the client on difficult issues, develop skills to managing them better, or to learn more about such issues from a scientific viewpoint.

As a result, the client is better able to manage such issues him/ herself.

In this scenario, as an end outcome to therapy, the client could develop better communication skills at work, higher assertiveness, better emotional management, and/ or decision making skills.

But, just like all things good, it takes time (and a good therapist). I'd advice for anyone overwhelmed at work and find it difficult to come to a decision on whether to leave or not - why not get help from a therapist first?

Hope this helps!

I'M BACK: NEW YEAR, NEW ME, NEW RULES

Hello there!

First off: my apologies for the (very, very, very) delayed response! Work and life got incredibly busy, and I unfortunately couldn't keep up with having good social media/ online presence. Unfortunately, this meant not logging into this forum for such a long time.

Given that I am still a probationary member on these boards, I am unable to edit the 1st message of this thread.

However, I intend to still use this thread to answer any questions that you may have. But for now, a slight revision to how I wish to operate:I may answer questions each time I log into this account. Feel free to PM me or to post a message here. I'll try my best to assist!

Disclaimer: Please take note that any information that I provide on these boards will not be a replacement for actual medical/ psychological service. I may provide assistance and information that could help you, but any therapy and treatment can only be done in consultation with a mental health professional.

Lastly, I noticed that I wrote too much in previous replies! I will try my best to get straight to the point and keep my responses as brief as I can.

Hello there,

Unfortunately, there isn't such a passive method to diagnosis of mental disorders. This is because mental health/ disorders are multifactorial and consists of biological, psychological, and environmental factors, and as such, isn't as straightforward as observing something under a microscope. So, diagnosing someone requires extensive background information (usually through interviews) and administration of psychological tests/ screening tools. With a variety of different information retrieved, the clinician will have better knowledge as to the diagnosis that can be made.

Actually, this is quite similar to the work of a medical professional. They too will engage in the process of differential diagnosis (e.g., determining which is the correct diagnosis out of a variety of diagnoses). They might order additional tests so that more information can be generated to make the right diagnosis.

For example, a complaint of a headache could be due to a variety of reasons. The doctor will need to rule out the most obvious reasons first, and if not due to those reasons, will then go to reasons which are more rare/ less likely. That is when more extensive tests may be ordered. A clinical psychologist or psychiatrist works in the same way, but for mental disorders.

Hope that helps!

Good evening and thank you for your question.

I had not sat through the whole video (it is too late at night), but I get where he/ you are coming from. I will not discount the potential of future innovations in mental health. This may include more convenient and effective diagnostic methods. In fact, at the rate of how fast humanity is progressing, I am very certain that how we will assess and diagnose mental disorders 50 or 100 years from now will look completely different than what we are currently doing.

There is basis in looking for biological indicators (e.g., such as brain activity or genetic markers) to mental disorders. This is because there is always a biological factor to a person's (mental) functioning.

Nevertheless, as much as clinicians try to find standalone biological factors to mental disorders, the fact remains that mental health remains to be a complicated interaction between biological, psychological, and social factors. This means that our genetics/ family history, how we process information and behave, and our environment, all play a role to either promote or negatively impact our mental health. Among the 3 factors, only biological factors could be effectively assessed through physical tests, such as brain scans, blood tests, and the likes.

However, based on what we know, some mental disorders weigh more heavily on biological factors (such as schizophrenia), while others weigh more heavily on other factors.

At the end of the day, we'd still need to rely on what is best practice based on current empirical evidence. This fact may change in the future as new evidence emerges. For now, clinical interviews still form a strong foundation to a mental health assessment.

This is my two cents!