Whether you’re mourning the loss of your pre-COVID life, adjusting to a new home or trying to maintain a healthy relationship with your spouse, you may have reached a breaking point. Luckily, there are specialists who can help – from grief and family therapy to marriage counselling and family therapy, and addiction support. Here, counselling practices shed light on the benefits of seeking professional therapy in Singapore, and some of the most common struggles and mental health issues they’re seeing right now in the expat community.
As a parent, it can be distressing to hear statements like “I wish I was dead” or “I won’t be a problem for you much longer” come out of your child’s mouth. But, before dismissing it as “just acting out”, know that self-harm and suicide is not reserved for adults. In fact, it’s more common in kids than you might think. And, in Singapore, it’s the leading cause of death among people aged 10 to 29.
That said, it’s critical for parents to get attuned to the state of their children’s mental health, explains DR SANVEEN KANG, a clinical psychologist and founder of Psych Connect. The specialist psychology clinic helps families manage all kinds of mental health issues, and provides comprehensive psychological testing, family therapy and individual therapy in Singapore for kids as young as two, up to early adult years.
Here’s what parents can do
While many of these threats are not actually carried out, Dr Kang still urges parents to take these comments seriously. Sadly, she says that the youngest age she has known for a child to take their own life intentionally is six years old.
“Every year there are tragedies in which children and teenagers take their own lives after making these threats – and everyone asks themselves, ‘How could this happen?’ and ‘Why didn’t we take the threat seriously?’”
In addition to verbal threats, other indicators to be aware of include:
- changes in eating or sleeping habits;
- frequent or pervasive sadness;
- withdrawal from friends, family and regular activities;
- frequent complaints about physical symptoms such as stomach aches and headaches;
- a decline in energy levels and in the quality of schoolwork;
- an inability to think clearly or concentrate;
- preoccupation with death and dying;
- not caring about activities or things that previously mattered;
- engagement in risky behaviours and carelessness with safety; and
- increased irritability.
Individual & family therapy in Singapore to the rescue
Luckily, you don’t have to deal with this alone. “Reaching out for professional help is important for your wellbeing and the wellbeing of your child,” says Dr Kang.
“When parents accept their child’s reality and seek help, they can steer them toward a healthier place, which can help prevent dark feelings from bubbling up later on.”
At Psych Connect, the team of psychotherapists, psychologists and counsellors have years of experience helping families manage all kind of mental health issues and challenges. Psychotherapy (also known as talk therapy), she says, is one of the most effective treatment options for depression in children. Cognitive Behavioural Therapy (CBT), Acceptance Commitment Therapy (ACT), Solutions Focused Therapy and Art Psychotherapy are among the psychotherapies used.
“The eventual goal is for our clients to be psychologically healthy and lead meaningful lives.”
10 Winstedt Road, #03-07/12/13/17
6493 0244 | psychconnect.sg
EXPAT MENTAL HEALTH CHALLENGES
“While the expat lifestyle can have a glamorous veneer, challenges often lie beneath. The experience of living overseas can be difficult and demanding, adding unique stressors to everyday living,” explains KRISTI MACKINTOSH, psychotherapist at Promises Healthcare, which provides holistic mental health and addiction treatment and recovery services to adults, adolescents and children suffering from all types of disorders. The clinic’s team of multidisciplinary specialists – including psychologists, psychiatrists and therapists, all with different expertise and specialisations – treat both local and expat patients on a daily basis.
In fact, studies show that expats as a group are 40 percent more likely to develop mental health conditions like depression, stress and anxiety, as compared to those who never move abroad.
“The challenging environment and less support than at home often leads to an increase in drinking, smoking, drug abuse – yes, even in Singapore – or self-harm to try and distract from the negative feelings.”
What’s more, the loss of the informal network of support from friends, family and acquaintances back home only compounds the stress and anxiety.
“Expats may often feel like they can’t share their difficulties because it seems like complaining or admitting to a failure. Isolation can lead to depression, and restrictions on travel and socialising because of COVID may have exacerbated feelings of social isolation for many expats.”
How counselling can help – and tips to cope
“It’s important to be aware of the unique set of challenges that come with expat life and ensure you’ve got a good support structure in place,” says Kristi. “One of the most important things you can do is connect. Humans are social beings. While it may require more emotional honesty or reliance on those around you than you might usually be comfortable with, connection and support from others is important.”
Additionally, you can help reduce stress by:
- getting enough sleep to help regulate your mental and physical health;
- eating a balanced diet to prevent deficiency in minerals that may cause low mood;
- staying active;
- trying not to over-drink, over-eat or smoke; and
- doing something that brings you joy – from reading a book to trying a new restaurant.
If you feel that you’re not coping or you’d like some extra support with your mental health, reach out to your GP or a professional counsellor or psychologist for therapy in Singapore.
#09-22/23 Novena Medical Centre, 10 Sinaran Drive
6397 7309 | promises.com.sg
Any existing issues you’ve got before moving overseas are, unfortunately, likely to worsen with the pressures of living abroad, explains HO SHEE WAI, registered psychologist and director of The Counselling Place. The practice offers a range of services including individual and marriage counselling, family therapy, life coaching, crisis response, workshops, support groups and psychological testing.
Marriage counselling & couples therapy can help
Relationship counselling such as couples therapy or marriage counselling, she says, can be instrumental in helping partners work through the emotions that come with life’s challenges. Here, she shares three common concerns that couples are facing these days – and how marriage counselling or couples therapy can help.
#1 Navigating hybrid working arrangements
“Just when couples had gotten used to the work-from-home model, they’ve got to figure it all out again. This is especially challenging for families with childcare arrangements to sort out.” But, it’s more than figuring out a new routine, says Shee Wai. Couples are needing to figure out boundaries – for instance, “Are we together too much or too little as a couple?” and “Are we doing enough bonding when we are together?”
“Couples therapy or marriage counselling can help open up conversation and negotiation about what’s working and what’s not for both partners, and facilitate the couple to come to an agreement that both can live with.”
#2 Money matters
This is a major challenge for many partners, often starting with each partner managing their own money. This kind of works until they have joint financial responsibilities such as children, or if one partner loses their earning power or one partner earns substantially lower than the other, says Shee Wai. And, even when partners manage their money separately, they’re still likely to have strong opinions about the other’s money management.
Shee Wai says marriage counselling or couples therapy can help the couple deal with their issues of trust, fear and independence. Marriage counselling can also help the duo find a joint financial management model that works for both, taking into account each person’s goals, values and needs.
#3 Intimacy issues
“After years of routine, a relationship can feel stale,” says Shee Wai, “and many couples report that they feel the intimacy has disappeared, be it sexual or emotional. They think they know what their partner will do or say, and just react in anticipation to that. Curiosity about who their partner is as a person disappears because they think they ‘know’.”
“Couples therapy or marriage counselling can help the couple to find the spark in the relationship by introducing new behaviours, activities, and communications to try,” she adds. “It asks questions that the couple has forgotten to ask each other or never thought to ask each other in the first place. Additionally, counselling can identify past issues that may impact abilities to be intimate with each other, sexually or emotionally, and find ways to overcome them.”
The Counselling Place
#11-00 The Octagon, 105 Cecil Street
Trailing spouse troubles
Depression is particularly common in “trailing spouses”, who may have left their jobs and reliable support systems to move abroad to support their partners, explains clinical psychologist DR TSAO I TING. At Redwood Psychology, she and the team of multilingual psychologists and counsellors work with expats and locals to navigate life challenges. Among the psychotherapy services they offer are individual counselling, couples therapy and marriage counselling, and family therapy in Singapore.
Removed from their usual confidantes back home, trailing spouses are expected to adapt quickly to an unfamiliar environment and maintain some forms of normalcy and stability in their new home, explains Dr Tsao. This is after an already stressful international move. Work responsibilities, frequent business travel and limited contact with loved ones back home only heighten feelings of anxiety and seclusion, and can even trigger pre-existing mental health issues. This can lead to loneliness, resentment and identity crises for trailing spouses in any life stage.
Why it’s a top reason for expats to seek therapy in Singapore
“Trailing spouses without kids may find that they receive less community support, as they are not immediately plugged into the school system or social activities that bring children and parents together. However, such spouses are also at greater liberty to immediately attend to their own mental health needs, rather than focus on children’s needs,” says Dr Tsao.
Meanwhile, trailing spouses with kids face different challenges. “While they might have instant access to a school community for support and resources, they can face greater pressure to ensure their children adjust well to the new environment. For many of these spouses, the focus is on their children, which means they may lose their sense of self over time.”
What’s more, she says that couples and families who make major decisions to relocate usually have expectations of how life will turn out in the new environment. But, when those expectations fall short, internal and relational conflicts can arise.
“Seeking professional therapy in Singapore can help to clarify the sources of conflict and adapt more meaningful ways of approaching them. Individual counselling, family therapy and couples therapy can help the family unit emerge stronger in the midst of it all.”
#06-11 High Street Centre, 1 North Bridge Road
8885 5424 | redwoodpsy.com
GRIEVING THE LOSS OF SOMEONE – OR SOMETHING
TANJA FAESSLER is a certified coach and counsellor at Counsellingconnectz. The practice provides therapy in Singapore for individuals to find balance, empowerment, independence and direction in their lives. The team of certified counsellors use a broad range of techniques to provide emotional and mental health support to individuals of all ages who are struggling with various challenges.
Tanja says that there are many different kinds of losses throughout life – and different ways to grieve them. Physical loss may be most familiar. Examples include miscarriage or stillbirth, death, or losing one’s home. However, she says that we can also grieve abstract loss. For many expats, it’s mourning the loss of the life they left behind in their home countries.
“We can mourn the loss of dreams or an imagined future, or an old way of being before everything changed. We can mourn the loss of opportunities, of hope, or even our sense of identity as we navigate life’s challenges.”
Talking to a therapist
No matter what it is you’re grieving – whether it’s someone or something – she says it will likely be a process that takes time to unfold, and won’t be the same from day to day.
“There are no fixed timelines for this process, and no unacceptable emotions. Ignoring or arguing with pain will not make it disappear. Instead, grief needs only two things from us: time and compassion,” says Tanja. “If we can find patience and compassion for our transition, however, change can be a precious opportunity to discover something about ourselves. Talking to a therapist is one way to receive support as you make meaning of your experience.”
Counsellingconnectz’s team uses a broad range of techniques to provide emotional and mental support to individuals of all ages who are struggling with grief and loss. In fact, the Counsellingconnectz team has profound experience supporting couples who’ve experienced the loss of a baby. Other areas of expertise include depression, anxiety, burnout, change and life transitions, coaching, cognitive behaviour therapy, marriage counselling, family therapy, trauma and stress management, and acceptance and commitment therapy in Singapore.
Feel what you feel
It’s important to allow ourselves time for our emotional reality to catch up, says Tanja.
“Give yourself permission to feel what you feel – even if that’s resistance or denial. It’s completely normal in the wake of upheaval and change to feel angry, panicked, depressed or even numb.”
She suggests taking time every day to ask yourself how you’re feeling, and practice listening to your answer with kindness. Journalling, prayer, walking or sharing with others can also help you work through your emotions.
#16-07 Far East Shopping Centre, 545 Orchard Road
ANGELINE KIN is an art therapist and counsellor at The Center for Psychology. The practice provides psychotherapy and counselling services including art and family therapy, marriage counselling and psychological assessments. Currently, Angeline is seeing many of her teen clients coming in with relational, self-esteem and gender identity issues, as well as trauma.
Another top issue she’s encountering with her teenage clients is obsessive compulsive disorder (OCD), a mental health condition that frequently starts during adolescence, but can begin during childhood, and affects quality of life.
What is OCD?
While OCD might bring to mind excessive cleanliness and compulsive hand-washing, there are many other ways that the condition can present, explains Angeline.
“Obsessions are frequent, unwelcome intrusive thoughts that cause marked anxiety or distress. Themes may concern contamination, aggression, sexuality, hoarding, superstitions or magical, somatic, religious and miscellaneous themes,” she says.
“Compulsions are repetitive behaviours, rituals and mental acts in response to those obsessions. The teen feels driven to perform these behaviours according to rigid rules in order to reduce distress or prevent some dreaded occurrence. These behaviours are time consuming, very distressing and impair the teen’s functioning in all areas of life.”
Of course, the pandemic only worsened OCD symptoms, or created the onset of new ones, for people with the condition. One study in BMC Psychiatry looked at young people aged seven to 21 specifically, and found that 45 percent experienced a worsening of overall symptoms in 2020.
Managing OCD with therapy in Singapore
The good news is that OCD can be controlled when treated properly, says Angeline.
“A combination of art therapy, Acceptance and Commitment Therapy (ACT) and Exposure Response Prevention (ERP) can help the teen build motivation, insight and self-regulation tools in order to distance themself from the obsessions, ‘surf the urge and resist compulsions’ and, instead, act from their core of authenticity, strengths and values.”
She says recovery work also includes embracing mindfulness, a growth-mindset and self-compassion.
The Center for Psychology
#04-01 Valley Point Office Tower, 4918 River Valley Road
6733 2893 | center4psy.com
Having a baby is a major life transition that can cause abrupt physical, social and emotional changes. This, of course, can significantly affect one’s mental health.
Postpartum depression is a form of depression that occurs within the first year after childbirth, explains LINDA VAN LAER, a counsellor who specialises in pre- and postnatal therapy in Singapore at Alliance Counselling. The practice provides a wide range of counselling and psychotherapy services for individuals, families and couples, including Gottman Couples Therapy, family therapy, psychological assessments and more. She and the team of pre- and postnatal counsellors have an in-depth understanding of the needs of new and expecting parents.
She says that for some mothers, postpartum depression develops immediately. For others, it develops only after additional stressors are added to the mix, such as their return to work, illness or a loss – or, indeed, a pandemic! “Up until 2020, Singapore reported a gradual decline in the number of mothers who sought support for postpartum depression. However, since the pandemic, cases of postpartum depression have been rising both in numbers and in severity. This is likely due to an increase in social isolation, financial worries and other stressors.”
Signs of postpartum depression
Lack of sleep, relationship problems, lack of social support, work stress, difficulties during pregnancy or childbirth, breastfeeding problems and caring for a baby who is unwell are all triggers that can exacerbate the condition. Of course, the mix of contributing factors will be different for each mother who experiences postpartum depression.
Symptoms, too, will be different for every woman. Signs to look out for may include the following:
- mood swings
- feeling “down”
- trouble sleeping
- feelings of helplessness or worthlessness
- trouble bonding with baby
- thoughts of harming yourself or your baby
These symptoms can range from mild to severe and make it difficult to cope with daily life.
Battling the baby blues with professional therapy in Singapore
Luckily, it’s possible to feel better with the right support, explains Linda.
“A counsellor can provide a safe and non-judgmental space where you can share your unique experience, address your emotions and discover what works best for your specific case. This may include strategies for self-care, engaging your support network, improving relationships and reducing work stress.”
Additionally, she says the counsellors at Alliance can help you strengthen your bond with baby, improve your self- confidence as a mother and process any difficult or traumatic experiences that may have occurred during pregnancy or birth. The practice also facilitates Mindful Mums, a free, monthly support group where parents can share their stories and realise they’re not alone.
#04-03 & #03-02 Cluny Court, 501 Bukit Timah Road
121 Upper East Coast Road, #02-01
6466 8120 | alliancecounselling.com.sg
ALCOHOL ABUSE & ADDICTION
DR GLENN GRAVES is a psychologist and professional life coach with over 17 years of experience counselling expat families on a variety of issues – from post-traumatic stress disorder, substance abuse, sex addiction, marital conflict and divorce to anxiety, anger management, sexual abuse, body image disorders and grief. At Counseling Perspective, he and an international, multilingual team of counsellors utilise psychotherapy, cognitive behavioural therapy techniques and other therapies to treat addiction and other mental health issues across five clinic locations – including the brand-new wellness centre at The Oasis (87 Science Park Drive, #03-01).
Since COVID, Dr Graves has seen a rise in mental health conditions across the board, from depression and anxiety to suicidal ideation and self-harm in all age groups.
He says that he’s also seen a drastic increase in reports of angry and aggressive behaviours, including physical and verbal abuse. This often goes hand-in-hand with substance abuse, as “unhealthy coping mechanisms like alcohol can lead to impatience and much more volatility”.
Approaching a loved one
Dr Graves says that the majority of clients who reached out for support were women asking for help with their spouses who were possibly abusing alcohol – exhibiting anger, poor communication and intentional withdrawal from their relationships.
He suggests confronting a partner or family member in a non-judgmental, compassionate and concerned way. He also says it’s imperative to hold firm to boundaries that feel healthy to you.
“Be clear about what you will not accept. Holding to healthy boundaries in the relationship will ensure that the dysfunction is not enabled. Enabling the issue to continue by avoiding or diminishing the impact is only going to create a greater negative impact in the long-term sustainability of the family.”
Addressing alcohol abuse & addiction with therapy in Singapore
Additionally, Dr Graves recommends seeking the help of a counsellor. This may include individual counselling, couples therapy or marriage counselling, or even family therapy, which can be useful in building support for the addict and addressing any issues caused by his or her behaviours.
If the family member in trouble is unwilling to consider individual or marriage counselling, or family therapy, he says that the concerned family member can still take action.
“We can guide them to find the best way to communicate and make their loved ones more aware and open to seeking help.”
Dempsey Hill, Katong, The Oasis, Raffles Place and Sentosa
9636 8060 | counselingperspective.com
Characterised by feelings of energy depletion or exhaustion, increased mental distance from or feelings of cynicism related to one’s job, and reduced professional efficacy, burnout is defined by the WHO as a “syndrome conceptualised as resulting from chronic workplace stress that has not been successfully managed”.
It’s not just in the boardroom
These days, burnout’s certainly not confined to the boardroom. It can impact anyone, says REENA GOENKA, a trauma and communication specialist, and director at Insightful Counselling & Training. The practice offers a range of counselling and psychotherapy services including family therapy, couples therapy and marriage counselling, and individual counselling to help with everything from depression, grief and trauma to stress management and body image issues.
Burnout is currently among one of the major issues that clients come in with. Reena says that even before the pandemic, burnout was on the rise – with increased use of internet and cloud technology playing a big role in blurring the work-hour boundaries. Of course, COVID only further complicated this work-life balance for many people working from home, resulting in an exponential rise in burnout cases.
These are some of the burnout symptoms that can impact quality of life and relationships with family and friends:
- sleep problems
- disinterest in activities that were once enjoyable
- distancing from loved ones
Beating burnout with therapy in Singapore
Seeking help from a qualified mental health therapist or counsellor, says Reena, could avert damage to personal relationships, and prevent the progression of burnout into chronic anxiety or depression.
To help her clients overcome burnout, she employs a range of therapeutic techniques, depending on the individual’s unique situation. Transactional Analysis is among the tools she uses to understand the inner workings and behaviours that “catapult exhaustion” – for example, an inability to say “no” or a fear of failure that constantly pushes an individual to perform despite the exhaustion.
Once a client’s triggers and patterns are identified, Reena works with them to understand intra- and interpersonal communications with EMDR therapy, Brainspotting therapy, Hypnotherapy and Gestalt therapy in Singapore. She also uses inner child work and other techniques.
Insightful Counselling & Training
Block 308, #02-05 Phoenix Park, Tanglin Road
8328 7060 | insightfulcounselling.com
This article first appeared in the October 2022 edition of Expat Living. You can purchase the latest issue or subscribe, so you never miss a copy!