March 2021 - Promises Healthcare
ENQUIRY
Discipline: What Parents Get Wrong, and How to Get It Right

Discipline: What Parents Get Wrong, and How to Get It Right

Spare the rod and spoil the child – is this a sensible justification for the use of physical punishment in disciplining a child? What is discipline really all about? To some parents, discipline is associated with corporal punishment, such as by caning, slapping or spanking. In extreme cases, it may include forcing hot sauce into a child’s mouth as punishment for swearing. Sometimes, it becomes difficult to draw the line between reasonable corporal punishment and physical abuse. 

Not many parents will admit that they cane or spank their kids. But a survey conducted by an international research agency YouGov found that close to 80 percent of parents in Singapore adopted such physical means of punishment. Does caning still have a place in modern-day parenting? In some way or another, we are all shaped by different life experiences, cultures and familial backgrounds. It shouldn’t be a surprise that we each possess differing opinions and perceptions. Some of these parents themselves may have been parented under strict and harsh supervision, where they had grown accustomed to physical forms of discipline and do not view them to be problematic. However, there is an increasing need to recognise that the act of disciplining children can take on many other forms. While we do not have the right to correct your teaching methods, we hope to convince you, as well as other parents out there, that corporal punishment is not the only mean to teach a child good behaviour. 

Why Corporal Punishment Isn’t The Best

We acknowledge that parenting isn’t easy. When your toddler “accidentally” smashes that one precious family heirloom, or when your underaged teenager gets caught for drinking, you might fly into a rage and rush to pick up the cane. However, corporal punishment has been proven to be ineffective and potentially harmful. It may serve its purpose of an immediate response to an undesirable behaviour and to curb it temporarily, but it will leave a long-lasting psychological mark on your child. As published in numerous research journals, physical punishment may bring about more harm than good. Let’s break it down:

  • Deteriorating Relationships
    Consider the message that you’re sending your child as you’re hitting him. While you may think nothing of it in a fit of anger, your child may – whether subconsciously or not – internalise that he is unworthy of love, or that he is worthless. Over time, this will also strain your relationship with your child.

  • Increasing Your Child’s Susceptibility to Mental Disorders
    Physical aggression often ties in with psychological aggression. At the end of it all, your child may develop a flawed belief that using violence to achieve desired results is completely acceptable. Not only does corporal punishment increase a child’s aggression, it may also lead to antisocial behaviour, as well as other mental health disorders. Long-term use of violence against a growing child can lead to the development of depression, anxiety, personality disorders, as well as intellectual disabilities. In particular, it may also cause a downward spiral of your child’s self-esteem.

  • Failing to Induce the Desired Behavioural Change
    Corporal punishment does not develop compliant behaviour, it simply stops undesirable behaviour temporarily. This may give parents a false sense of security, and trap them into thinking that they’ve successfully steered their children away from unwanted behaviours. However, the reality is that children may only stop immediately for the fear of being punished further. There is always a chance for such behaviours to return. Assuming your teenager picks up a bad habit but is afraid of being punished, she may instead resort to various means of hiding it from you. As you can see, the unwanted behaviour isn’t eradicated at all.

 

By now, you’re probably curious about how you can encourage behavioural change more effectively without physical punishment. Here, we’ll share some useful tips in regards to educating your child the right behaviour. 

When your child misbehaves, you can consider withholding or removing certain privileges from him. This is certainly less harmful psychologically and physically as opposed to spanking him. For example, if your child leaves his toys lying all over the bedroom floor, you can opt to confiscate them for a day or two. Do note that this will be particularly effective if the consequence is directly linked to the unwanted behaviour. In this case, it wouldn’t be ideal to punish the child by banning TV time for a day.

Needless to say, positive reinforcement plays a huge role in disciplining your child too. If your parenting style solely includes punishments and no rewards, your child may grow up feeling resentful, unhappy and lack a sense of self-worth. Be equally generous with praises and rewards when deemed fit – balance is key! If possible, you may also tie in a reward system with a certain behaviour that you want to encourage. Let’s say you want your child to develop a habit of returning home no later than 10pm. The consequence for not sticking to the curfew may be grounding her for the next two days. However, if your child adheres to the rules and returns home by the stated curfew for the entire week, perhaps you can reward her for being responsible and consistent. This could mean giving her an additional hour out during the weekends, or bringing her out for her favourite meal. 

One major issue with corporal punishment is that apart from inflicting physical and psychological harm, it does not direct your child towards the desired behaviour. Discipline should be aimed at teaching. Ensuring your child learns from the event and to correct themselves in the future is what really matters. With that said, sometimes teaching them new skills can go a long way. If your child throws temper tantrums, teach him how to calm himself down and to deal with his frustration instead of spanking him. Such problem-solving and emotion-coping strategies will certainly help your child to build emotional resilience as well. 

The environment around us can influence the way we grow and behave too. If you have children or teenagers at home, lock the cabinets to the heavy liquor. If you want to foster a non-gambling home environment, keeping items such as poker cards away from sight can also be beneficial. Small changes to the surroundings can have more influence than you may think, and will also prevent the need for any serious punishment. 

Above all, it is necessary to be consistent with what you say and encourage your children to do. Be consistent with the rules you put forth and stand your ground, it is important for a child to know that the consequences and rewards aren’t selectively enforced. Guiding children away from misbehaviour can be a tough feat at times, but just as you’re about to reach for the cane, we hope you’ll think twice.

 


References:

  1. https://www.straitstimes.com/singapore/education/most-parents-here-dont-spare-rod-on-kids-at-home-study (Accessed 22/02/2021)
  2. https://www.apa.org/research/action/speaking-of-psychology/disciplining-children  (Accessed 22/02/2021)
  3. https://www.healthxchange.sg/children/parenting-tips/child-discipline-physical-punishment-psychological-marks  (Accessed 22/02/2021)
  4. https://www.apa.org/monitor/2019/10/child-discipline (Accessed 22/02/2021)

 

Understanding Grief and Bereavement

Understanding Grief and Bereavement

Grief is like the ocean; it comes in waves, ebbing and flowing. Sometimes the water is calm, and sometimes it is overwhelming. All we can do is learn to swim.” – Vicki Harrison, Author.

Losing someone we love is possibly one of the toughest, most dreadful things we will ever experience in our lifetime. The feelings of sadness, confusion and anger can be immeasurable, dominating our days and causing us to withdraw from the real world. For those blindsided by sudden losses, it can be especially traumatising to realise that we never really know when life may throw us a devastating curveball and crush our dreams, forcing a new reality upon us. Whether through bereavement or other types of losses (eg. divorce, relationships, financial and health losses etc)  grief can pose a major threat to our mental state. As painful thoughts and emotions spiral, some may begin to question the comprehensibility of life or doubt their own competence when they find their core beliefs of a secure and benevolent world challenged. Without adequate psychological buffer and defence, the world feels shattered and we may be overwhelmed by loss. 

Psychiatrist Elisabeth Kübler-Ross’s grief model noted there are five stages commonly experienced in grieving. 

  • Denial: Avoidance, confusion, shock, fear and disbelief.
  • Anger: Frustration and irritation.
  • Bargaining: Struggling to find meaning in life, or constantly telling yourself, “If only i had…”
  • Depression: Feeling helpless, lonely and wanting to withdraw from life. This stage is also the most commonly associated with grief.
  • Acceptance: Exploring options, putting new plans in place and trying to move on.

It is important to note that these stages are not necessarily linear nor do they illustrate a complete picture of grief. Many who are grieving feel emotionally or physically numb as they subconsciously block painful memories to protect themselves. Some may experience a roller coaster of emotions and are drained of energy as they process the loss. Everyone’s experience with grief is different and very personal – it all boils down to how we cope with crisis and the resulting emotions. Don’t worry if you find your grief experience taking longer than others to complete. Grief is a normal and natural response to loss. We need to be gentle and compassionate with ourselves during the season of grieving

Practicing self-care is a great place to start. Though painful thoughts may flood your mind and you may find yourself wanting to withdraw, taking care of your body is crucial. This can mean maintaining a healthy diet, going for walks in nature, exercising, and ensuring that you get good sleep. Listen to your body and don’t hold yourself back from enjoying the activities that you usually find pleasure in, just because you are still in the grieving process. If you like to read, take a trip to the nearest library. If you find comfort in being around animals, go visit a cat or dog café. These activities help provide much-needed relief and prevent you from being consumed by grief. 

Art can also be a meaningful outlet for repressed emotions. Some people may find themselves ruminating over perceived missteps, or wishing they could have done something to change the outcome. It doesn’t matter if you lack artistic talent; painting, drawing, poetry, or even creative journaling can serve to declutter your mind. The creative expression of emotions can be a therapeutic process for grieving individuals to connect with their inwardly-held emotions. Story-telling through art enables them to express deep seated emotions that would have otherwise been hard to access or articulate. 

When ready to be more social, it could be good to catch up with family and friends. Some also find it beneficial to join grief support groups and share their experiences. These groups help them feel less isolated and offer emotional support and encouragement as they witness others along different stages of their grief journey. While social support can help take the weight off your shoulders, it can be tough to confide in others when you’re mourning a loss. Fears of having others gossip behind your back or having others pry into your personal privacy, divulging every minute detail – these are completely valid understandable concerns and professional therapy might just be the safe environment you need to work things out.

In professional therapy, you can rest assured that your privacy is kept strictly confidential while receiving professional guidance to help you through difficult times. Therapy is an incredibly valuable and effective way to help yourself heal from your emotional wounds.  If you find yourself stuck in an unhealthy loop of distress over unresolved issues and experience difficulty adjusting to losses, a professional therapist can work with you to make sense of the loss and navigate your way through grief with greater emotional resilience. The therapist can also help you discover constructive and authentic narratives that enable better integration of the loss and meaningful transition to life after the loss. 

Working through bereavement can be very confronting and prolonged symptoms that are left unaddressed may lead to Complicated Grief Disorder (CGD). Therefore, don’t force yourself to cope alone – embrace the emotional support that others can offer, and take comfort in your social circles or a therapist. Finding a renewed appreciation for life following the loss of a loved one may seem almost impossible, but we will get there, slowly but surely. 

 


References:

  1. www.sciencedaily.com/releases/2018/10/181022153512.htm (Accessed 05/02/2021)
  2. https://www.psycom.net/depression.central.grief.html  (Accessed 05/02/2021)
  3. Edmondson, D., Chaudoir, S.R., Mills, M.A., Park, C.L., Holub, J., & Bartkowiak,J.M. (2011) From shattered assumptions to weakened worldviews: Trauma symptoms signal anxiety buffer disruption. Journal of Loss and Trauma, 16 (4), 358-385
  4. Janoff-Bulman R. Shattered assumptions: Towards a new psychology of trauma. New York: Free Press; 1992. [Google Scholar]
  5. Neimeyer, Robert & Burke, Laurie & Mackay, Michael & Stringer, Jessica. (2010). Grief Therapy and the Reconstruction of Meaning: From Principles to Practice. Journal of Contemporary Psychotherapy. 40. 73-83. 10.1007/s10879-009-9135-3. 
Types of Psychotherapy Methods (DBT vs ACT) Used To Treat Depression

Types of Psychotherapy Methods (DBT vs ACT) Used To Treat Depression

Many of us are absorbed in an endless, self-defeating rat race. The nature of modern society has instilled in us a “winner/loser” mindset, and its systems highly prioritise external rewards and punishments as measures of our personal success and social worth. This oftentimes forces us to shift our perception of self-worth from the satisfying efforts of personal endeavour, to the critical imperative of achieving yardsticks of success defined by the rest of society. When we are constantly striving to win a race while focusing on external factors largely beyond our design or control, we’re surely putting ourselves at a disadvantageous position.

The overwhelming pressure to conform to societal expectations, or to outrun others in the race of life, can make one particularly susceptible to depression if negative emotions are not managed well. As we aim for perfection – as most people would – we need to understand that total perfection is unattainable. The more we believe that we have failed to reach a certain state of “perfection”, the greater the extent to which we experience low self-esteem, self-hatred, and depression. Depression can be extremely debilitating to one’s mental health. Apart from the diminishing enthusiasm for life and self-esteem, depressed individuals may self-isolate and pull away from their social circles, making it all the more difficult for them to get the help they need. 

Perhaps one of the healthiest things we can do for ourselves is to accept who we are. Self-acceptance might just be the antidote to excessive self-resentment and discontentment. It is important that we fight against influences that force us to conform to certain standards rather than to accept ourselves.  Presented below are a couple of talk therapy methods that we use to guide you towards achieving that. 

What is ACT?

Acceptance and Commitment Therapy (ACT) is a form of talk therapy suitable for the treatment of individuals displaying symptoms of depression. As its name suggests, it’s core aims are to help individuals accept whatever is beyond their control, and to commit to actions or habits that will serve to enrich their quality of life. ACT helps us to clarify what is genuinely important to us (i.e our values), and thus assists us to set more meaningful and life-enriching goals. Along the way, it also guides us to practise useful emotion-coping strategies such as mindfulness in order to equip us with skills to handle negative emotions effectively and healthily. While the number of ACT sessions may differ for each individual, the benefits acquired by clients are largely similar:

  • Learning to be fully present in the “here-and-now”, and to stop obsessive worrying over the past or future
  • Become aware of what they are avoiding (be it consciously or subconsciously), and to increase self-awareness
  • Learning to enjoy greater balance and emotional stability, and to be less upset by unpleasant experiences
  • Learning to observe thoughts such that one does not feel held captive by them, and to develop openness
  • To develop self-acceptance and self-compassion
  • Clarifying one’s personal values and taking the appropriate action towards his goals.

You may be wondering, does it really work? The good news is that ACT is considered to be an empirically validated treatment by the American Psychological Association (APA). Through program evaluation data, research has also shown that Veterans who completed ACT treatment phases displayed a significant decrease in depression in addition to improved self-awareness and a better quality of life.

 

What is DBT?

Apart from ACT, another alternative for the treatment of depression is Dialectical Behaviour Therapy (DBT). While originally used for the treatment of Borderline Personality Disorder, DBT has since been adapted to treat other mental health conditions including depression, anxiety, and post-traumatic stress disorder. A type of cognitive behavioural therapy, DBT aims to help individuals who struggle with emotional-regulation and are exhibiting maladaptive or self-destructing behaviours. It is not an uncommon sight for persons with depression to engage in substance-abuse or self-harm. As such, DBT helps to build on distress tolerance, such that people who struggle with these are able to handle negative life-circumstances better and to avoid falling back on such devastating coping methods.

DBT can be considered a holistic approach to depression treatment. Apart from tackling maladaptive behaviours, it encourages a shift in the clients’ perspective on life, for it equips them with the necessary skills to cope with intense emotions. In short, it empowers you to cope with them with a positive outlook. DBT also recognises that interpersonal effectiveness is key, and hence it strives to help these troubled individuals to reconnect and enhance their relationships with others. 

 

ACT Versus DBT

ACT and DBT are both highly effective methods of treatment for depression. Both forms of psychotherapy allow for individuals to tackle the notion of suffering head-on, and to avoid suppressing undesirable or uncomfortable feelings. Both promote psychological flexibility, and encourage people to behave in a conscious or effective way towards their life-choosing directions. The practice of mindfulness is also a commonality between both therapy methods, and it plays a crucial role in ensuring that persons are well aware of their values, goals and emotions.

However, overlaps between the two are considerably limited too. The main differences between ACT and DBT would be that DBT leans towards a more educative approach while ACT emphasises an experiential one. Perspective wise, DBT adopts a biosocial perspective on behaviour while that of ACT is contextual. Moreover, the underlying philosophy behind each form of therapy also differs. DBT philosophy is dialectical (i.e using logical reasoning and analysis), while the philosophy behind ACT is functional contextualism. With that said, the analysis of clients’ experiences, the use of languages as well as experiential exercises will be different for each type of therapy.

Seeking professional help can be rather daunting, but we need to recognise that psychotherapy is called for if one struggles to accept himself. Don’t deal with depression alone, lean into your support systems and mental health professionals when you need to – your future self will thank you.

 


References:

  1. Richard Hill, The Rise and Rise of Depression in a Competitive Winner/Loser World, video recording, Mental Health Academy

<https://www.mentalhealthacademy.co.uk/dashboard/catalogue/the-rise-and-rise-of-depression-in-a-competitive-winner-loser-world/video> (Accessed 13/02/2021)

  1. https://www.mentalhealth.va.gov/depression/act-d.asp  (Accessed 13/02/2021)
  2. https://behavior-behavior.org/act-fap-dbt/ (Accessed 13/02/2021)
The Science Behind Habit Formation : Change Your Habit, Change Your Mind

The Science Behind Habit Formation : Change Your Habit, Change Your Mind

Overspending your way into debt? Depending too much on sleeping pills or other sedatives? Snacking non-stop, even when you’re not hungry? Old habits die hard – as personal experience would reflect, we all know that it can be extremely challenging to break a habit, much so to maintain a good one. According to a rather appalling statistic, it was revealed that approximately 9 out of 10 individuals who have undergone heart bypass surgeries as a result of poor health were still unable to change their unhealthy lifestyle habits, even with their lives on the line. Whilst not all habits need to be broken, learning to overcome unproductive ones and replacing them with healthier habits can be vital towards a more fulfilling existence. 

As defined in the dictionary, a habit is “an acquired mode of behaviour that has become nearly or completely involuntary”. Some neuroscientists posit that the brain is fundamentally lazy, so where possible, it would program our thoughts, emotions and behaviours into circuits where they would be automated and turned into “shortcuts”. The process of habit formation essentially takes place in the basal ganglia, a group of structures embedded deep within the cerebral hemispheres of the brain. Apart from being responsible for motor control, emotions and behaviours, this region also plays a key role in reward and reinforcement, as well as addictive behaviours. 

What occurs in the brain when we try to form a new habit? Habit formation bases itself on neural pathways, involving countless nerve cells connected by extensions known as dendrites to form a larger network. As the frequency of a particular behaviour performed increases, so does the number of dendrites, and the connection between brain cells strengthen. Over time, neural pathways are developed and the messages sent through the same neural pathways are transmitted faster and faster, thus allowing for certain behaviours to become automated with enough repetition. In simpler terms, the more you perform a certain action, the more it gets wired into your brain. This adaptive quality of the brain is also known as neuroplasticity.

On the flip side, when you successfully quit a bad habit, synaptic pruning occurs. Synapses are small pockets of space between the neurons which allow for electrochemical messages to be sent through your neural pathways. Synaptic pruning can be likened to throwing out the old clothes in your closet to make space for new ones. When you no longer perform certain actions, these synaptic connections weaken. At the same time, more resources are allocated towards building the neural pathways of other important or prioritised habits, thereby strengthening them. This means that it is completely possible to rewire your brain to support healthier habits! 

 

How can I develop good habits?

It is not uncommon for people to be ambitious when it comes to seeking positive lifestyle changes. Especially when a new year begins, many of them would have prepared a long list of new year resolutions, such as wanting to make exercise a habit or to meditate on a daily basis. The problem is, how many of them would follow through with it? Enthusiasm is not the issue here, but commitment is. Keep in mind to take things one step at a time. In order to develop a good, sustainable habit, refrain from tiring yourself out even before it takes flight. It can be very effective to focus on just one clear goal at a time and to commit to it every day (or as per your ideal schedule), even if it means only doing it for 10 minutes each time. As you go along, you can then build on your habit according to your pace and your desired end goal. 

Another tip is to “stack” your habits. You probably already have a few strong daily habits that you never fail to execute, such as brewing a cup of morning coffee, taking a walk after lunch, or brushing your teeth at night. Leverage these strong connections and use them to your advantage to build on new ones. For example, if you’d like to pick up meditation, tell yourself, “After I brew my morning coffee, I’ll meditate for 5 minutes”. If you aim to cut down on screen time at night before bed for better sleep quality, tell yourself, “I’ll turn off my devices before I brush my teeth”. By creating a link between your new and old habits, you’ll find yourself more likely to stick to new changes and behaviour. 

Create frequent reminders of your goal if consistency is something you struggle with, or if you tend to be forgetful. Out of sight usually means out of mind, but that’s natural! You can easily put reminders on your calendars, set alarms on your mobile phones, or even have post-it notes around your house if you will. Sharing your goal with someone else can be an added source of motivation too. Be it a friend or a family member, working together with others who are also striving to pick up on the same habits will act as a catalyst and spur you on. If they aren’t keen on making the commitment, that’s fine too. Instead, let them serve as an accountability partner. Let them in on your goals and progress – when you are accountable to someone for doing what you said you aimed to do, you are more likely to stay committed.

Of course, identifying a goal is easy. But remember to stay mindful and have a clear understanding of what you want to achieve at the end of the day. Apart from asking yourself what you want to achieve, ask yourself how it will look like and how you will feel when you get to the end. Most importantly, remember to set your mind to your goal and take active steps towards it. Instead of merely browsing through tons of self-improvement posts or looking up “quick hacks” for golden tips on Google, focus on the actual tasks that need to be accomplished. It may be a rather mundane, time-tested process at first, but it will eventually bring success and satisfaction.


References:

  1. https://www.fastcompany.com/52717/change-or-die (Accessed 30/01/2021)
  2. https://www.huffingtonpost.com.au/2017/11/20/how-neuroplasticity-can-help-you-get-rid-of-your-bad-habits_a_23283591/ (Accessed 30/01/2021
  3. https://healthtransformer.co/the-neuroscience-of-behavior-change-bcb567fa83c1 (Accessed 30/01/2021)
  4. https://www.themantic-education.com/ibpsych/2019/09/27/synaptic-pruning-and-neural-networks/ (Accessed 30/01/2021)
  5. https://medium.com/swlh/to-break-bad-habits-you-really-have-to-change-your-brain-the-neuroscience-of-change-da735de9afdf  (Accessed 30/01/2021)