DR SARA DELIA MENON is a clinical psychologist at Alliance Counselling, and an experienced practitioner in addressing low mood and anxiety, abuse and interpersonal problems. She’s particularly interested in the overlap between trauma and neurodiversity, and why many adults seem to fall through the cracks of meaningful diagnosis and treatment. There are support groups and counselling in Singapore that can help – but let’s first look into the different areas more closely.
What is neurodiversity?
Neurodiversity refers to individual differences in our brain’s structure and function. It includes clinical conditions such as ADHD and autism but can also refer to acquired brain changes due to trauma from experiencing life-threatening events, or abuse.
There is also a great deal of overlap with conditions such as ADHD and autism with anxiety or depression. People who are neurodivergent tend to have more challenging interpersonal relationships, which can lead to trauma from rejection or abuse. Many adult clients present with symptoms along this continuum, which makes the process of assessing the core issue and working out a meaningful treatment plan fascinating.
What makes neurodiversity hard to spot?
Through our counselling in Singapore, we work with a very high-functioning client population, many of whom have not explored how neurodiversity could account for their persistent struggles – they have done such a wonderful job of coping, surviving and a lot of the time excelling!
Over time, though, the anxiety, depression or social disconnect becomes more evident, and this is often why these clients engage in therapy as adults.
Research shows that women are underrepresented in conditions like ADHD and autism. Why is this?
Yes, this is unfortunately true. Diagnostic approaches have tended to consider male presentations of these conditions, so women are more likely to be underdiagnosed, or misdiagnosed.
For instance, girls may present with more inattentive versus hyperactive symptoms within ADHD or have less apparent social difficulties within autism. They are more likely to be treated with anxiety or depression, and years can go by before underlying conditions are recognised.
The good news, though, is that there is more awareness now, and assessment approaches are being updated to accommodate gender differences.
You also mentioned that trauma can change the way our brain functions. What does this mean?
There is significant evidence from neuroscience to show the effects of trauma on brain development. This is especially crucial in early childhood and adolescence, both times where our brain goes through rapid periods of growth.
Abuse, maltreatment and neglect all influence brain development, which can result in emotional and behavioural difficulties. Many adult clients I see might be caught in survival mode – they are hyper-attuned to potential “threats” in their surroundings.
Threats can be criticism or rejection, or even something as paradoxical as warmth or closeness. Any of these can set off a trauma response, which might lead the person to persistently act out, shut down or avoid, all of which gets in the way of living a fulfilling life.
Understanding what trauma means for each person is key to unlocking these stuck patterns, and as adults we can learn healthier ways to self-soothe, make more honest choices, and build more intimate connections with others.
Tell us more about the women’s support groups run by Alliance Counselling in Singapore.
I run a support group for adult survivors of sexual abuse, and my colleagues at Alliance run a support group for new and expectant mothers. Both groups run monthly and are held in-person, at a safe and private space. The groups are free to attend.
We encourage anyone who is struggling with either challenge to join these communities. You can find information about how to join on our website. The most powerful thing about being in a support group is the realisation that you are not alone, and the experience of non-judgemental acceptance. If you can find your voice and engage with other members, that’s a bonus.
How does being in a support group with strangers help?
You know, so many women in the support group say it’s the first time they have ever been able to say what they’ve buried so deeply for so long. When something is this painful and personal, it can be hardest to share with someone you know!
The Holding Space Sexual Assault Survivor Group is in its second year now; the support group is a complement to individual therapy and does not replace it.
I’m not sure if I can articulate this well enough, but I’ll borrow from something a member once said: “No matter how useful therapy has been for me, it cannot offer me what being in a community of other women who have gone through what I have does.”
About Alliance Counselling in Singapore
It has three locations in Singapore (two in Cluny Court and one in the Upper East Coast), and a team of 30 multilingual, multi-cultural counsellors and psychologists. Since 2009, they’ve provided counselling for children and families, teens, adults and couples. Methodologies include Gottman Method Couples Therapy, Marathon Couples Therapy, Sex Therapy, Pre-postnatal Therapy, Walk and Talk Therapy, mindfulness-based practices and psychological assessments. They also curate corporate employee assistance programmes and training workshops.
About Dr Sara Delia Menon
Dr Sara works with adolescents, adults and couples. Her interests include trauma and self-harm, neurodiversity and adult psychological assessment. A Singaporean with mixed Indian-Filipino roots, and influenced by her own family experiences, she has a keen eye for diversity and human behaviour.
This article first appeared in the September 2022 edition of Expat Living. You can purchase the latest issue or subscribe, so you never miss a copy!