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[Radio Interview on CNA938] Always Online: The Struggle of Singapore’s Smartphone Obsession

CNA938, SINGAPORE, 10 SEPTEMBER 2025 – Always Online: The Struggle of Singapore’s Smartphone Obsession

From March 2026, South Korea will ban mobile phones and digital devices in classrooms nationwide, a bold step to tackle rising concerns about social media and smartphone addiction among youth. The move highlights a global conversation on digital dependence – and raises an important question: What is the smartphone addiction situation like in Singapore?

In a recent interview on CNA938’s The Morning Report with Andrea Heng and Hairianto Diman, Tom Maniatis, Senior Addictions Therapist at Promises Healthcare, shares his expert insights on the challenges of smartphone overuse, how it affects mental health and daily functioning, and what can be done to manage this growing issue.

🔊 Listen to the full interview here: CNA938 – Always Online: The Struggle of Singapore’s Smartphone Obsession

The Dangers of Conflating Drug Use: A Call for Clarity in Singapore’s Addiction Response

In response to Channel News Asia’s recent news article (CNA, 12 July 2025), on the troubling rise of “K-Pods” – vapes laced with drugs like etomidate, I was heartened to see the growing much-needed attention to this issue in Singapore.

Etomidate, a potent anesthetic, is indeed a dangerous and emerging substance of abuse. However, I was also dismayed by one comment featured in the article, suggesting that methamphetamine may be more desirable “because you know what you’re getting”.

While perhaps intended to illustrate the unpredictability of new substances, such statements materially misrepresent the danger to public health and law and order of each of these substances – and creates serious unintended consequences for measured, effective and efficacious responses to them in our community.  

This is not a sematic issue. As clinicians working on the frontlines of addiction treatment, we have seen how oversimplified narratives around “drugs” contribute to confusion, stigma and misinformed policies.

Conflation of Psychoactive Substances Harms Public Understanding

CNA’s article echoes a persistent trend in media and public discourse: the conflation of vastly different psychoactive substances – methamphetamine, heroin, ketamine, nicotine, THC, caffeine, and now etomidate, into a single undifferentiated category. While all are psychoactive, they differ drastically in their pharmacology, harm profiles and therapeutic potential.

This conflation risks skewing public understanding and undermining evidence-based responses. It also fuels unhelpful stigma that can deter those in need from seeking much-needed support.

Not All Drugs Are the Same

For example, methamphetamine and heroin have no accepted medical use in Singapore, and are associated with high rates of dependence, psychosis, organ damage and death (UNODC, 2022).

In contrast, other substances discussed in the article do have legitimate medical applications:

  • Etomidate is a short-acting anaesthetic used in emergency intubation.
  • Ketamine is used in Singapore under strict clinical protocols to treat treatment-resistant depression (Singapore General Hospital).
  • Tetrahydrocannabinol (THC), the psychoactive compound in cannabis, has been used under specialist control in limited medical cases such as treatment-resistant epilepsy (National Academies of Sciences, 2017).
  • Nicotine itself is not the major cause of smoking-related illness. The harms of smoking largely come from the combustion of tobacco and inhalation of carcinogenic byproducts (World Health Organization, 2019).

Nicotine and NRT: A Case for Public Health

Nicotine Replacement Therapy (NRT), available in Singapore’s pharmacies – mimics the psychoactive effect of smoking, helping smokers gradually taper off their dependence.

NRT products have been endorsed by the World Health Organization for over 45 years, as a central pillar of public health efforts against the global epidemic of cigarettes and inhaling burning tobacco.

Demonising all nicotine products, including harm-reduction tools like NRT or regulated vapes, undermines decades of global public health efforts.

The Real Crisis: Methamphetamine and Heroin

Singapore’s Central Narcotics Bureau (CNB) data paints a stark picture. In 2024 alone:

  • Methamphetamine (“meth”) accounted for 61% of all drug-related arrests
  • 75% of new drug users arrested used meth
  • 90% of youth below the age of 20 drug arrests involved meth use
  • 1,931 meth users were arrested – a 20% increase over 2023, and a 33% increase since 2022

In contrast, arrests for heroin and cannabis declined by 14% and 27% respectively (CNB Drug Situation Report 2024).

These figures point to a concentrated crisis. Methamphetamine demands urgent, targeted, and compassionate responses.

Don’t Blame the Device – Focus on the Substance

There has also been growing alarm over vaping devices. But we must be careful not to be mistaken the tool for the problem. Vaporisers, like water pipes or even cigarette papers, are delivery mechanisms. The public health concern lies not in device, but in what is consumed through it.

Banning the device without addressing the root cause of substance misuse distracts from meaningful solutions and creates enforcement challenges without reducing them.

A Call for Science-Based, Compassionate Policy

At Promises Healthcare, we advocate for a public health response to a substance misuse that is science-based, balanced and compassionate. Sweeping generalisations about “drugs” are not helpful. Nor is sensationalism or moral panic. What is needed instead is education, honest dialogue and access to professional, evidence-based care.

Etomidate is a concerning new substance of abuse. It is unpredictable in its addictive potential, and families should be aware of the risks. But we must not let one emerging threat overshadow the far more widespread and entrenched crisis of methamphetamine and heroin use.

We urge a shift toward science-informed, clinically sound, and compassionate public discourse. Here is to what an effective response should look like:

  1. Stop conflating vastly different substances. Treat heroin and methamphetamine as the serious threats they are, but distinguish them clearly from substances with legitimate clinical use.
  2. Focus on treatment and education. Addiction is a health issue, avoid sensationalism, public awareness is vital, but should be based on fact, not fear. Support should be accessible, stigma-free and professional.
  3. Support families and communities. Addiction affects more than just the user. Families deserve clear information, guidance and seek help.

A Better Way Forward

Families affected by substance use need support, not shame. Individuals struggling with addiction need clinical care, not condemnation. And policymakers need clear, differentiated insights – not blanket assumptions to make informed decisions.

Let’s commit to deeper understanding, better education and a public narrative grounded in science, compassion and truth.

If you or someone you know is affected by addiction, please reach out to trained professionals. Recovery is possible, and help is available.

References

  • National Academies of Sciences, Engineering, and Medicine. (2017). The health effects of cannabis and cannabinoids: The current state of evidence and recommendations for research. National Academies Press. (Source: https://www.nap.edu/read/24625/chapter/1)

How can one overcome addiction to etomidate? 

Addiction is rarely just about the substance; the importance of guided support, therapy, and understanding. As Singapore moves to regulate etomidate, Promises Healthcare continue to be proactive at the front, contributing and voicing our insights to the national conversation, with Dr Munidasa Winslow, Senior Consultant Psychiatrist, sharing his expert insights with CNA.

Dr Winslow highlights a crucial truth: recovery isn’t just about stopping the addiction. It’s about understanding the why – the emotional pain, stress, or trauma that led to it – and replacing harmful coping mechanisms with sustainable, healthier ones.

We are committed to stepping up our services to support recovery. From therapy to integrated support systems, we help individuals navigate addiction with compassion, structure, and evidence-based care.

Extract from CNA article titled ‘CNA Explains: Why Singapore wants to ban etomidate’

Editor: Erin Liam, Journalist at CNA Digital

Published Date: 21 Jul 2025 at 07:49PM

How can one overcome addiction to etomidate? 

Dr Munidasa Winslow, a senior consultant psychiatrist at Promises Healthcare clinic, said that people who use etomidate should know that they can get help and recover. 

“Substance use is rarely just about the drug. It is often tied to deeper emotional or psychological roots,” he said.

Users who find themselves wanting to seek help should start by talking to someone they trust. After that, they should speak to a qualified healthcare professional. 

“Avoid the instinct to quit abruptly on your own,” he advised.

Etomidate is a potent sedative and its misuse can have unpredictable and potentially dangerous effects.

Depending on how often it is used, stopping suddenly might lead to withdrawal symptoms and may increase the risk of relapse.

Dr Winslow also said that recovery must be approached with a plan, for example, through therapy or a support group. 

“What is more important is understanding why it became a crutch in the first place, and how to replace that with healthier, more sustainable ways to cope.”  

🔗 Read the full CNA feature: https://www.channelnewsasia.com/singapore/etomidate-k-pods-vaping-cna-explains-5249546

The Neurobiology of TMS

by Dr Sean David

In the 1800’s, world renown English physicist Michael Faraday discovered the principles of electro-magnetic induction. Fast forward to the 21st century, Faraday’s discovery was harnessed into the clinical practice of transcranial magnetic stimulation (TMS) for the treatment of mood disorders. Based on Faraday’s Law, TMS is able to stimulate brain neuronal circuits with tiny electrical currents induced by a changing magnetic field.

Principles of Transcranial Magnetic Stimulation (TMS) where the coil and its magnetic field induces current in the brain tissues (Nele De Geeter, 2015), source link: https://www.researchgate.net/figure/Principles-of-Transcranial-Magnetic-Stimulation-TMS-where-the-coil-and-its-magnetic_fig1_277583502

In Singapore, the practical application of TMS is employed in the form of repetitive transcranial magnetic stimulation (rTMS). In rTMS, magnetic pulses are delivered in trains at certain frequencies. “Fast” (high frequency e.g. 10Hz) stimulation increases cortical excitability for treatment of depression. Whereas “slow” (low frequency e.g. 1Hz) stimulation reduces cortical excitability for treatment of anxiety disorders.

Furthermore, TMS can be targeted at focused regions of the cortex for superior precision treatment of specific conditions e.g. rTMS at 1Hz to the right orbitofrontal cortex (OFC) reduces intrusive obsessions in obsessive-compulsive disorder (OCD).

Source link: https://www.mwihealth.org/tms-therapy/

Mood disturbances such as depression are increasingly understood as disorders of connectivity in neural networks linking cortical and subcortical grey structures of the brain. Functional brain imaging has shown dysfunction in cortical regions such as the dorsolateral prefrontal cortex (DLPFC) and anterior cingulate cortex (ACC), as well as deep grey matter structures including the amygdala, nucleus accumbens, hippocampus and hypothalamus.

These brain circuits are pivotal for executive functioning, regulation of emotions, reward processing and preservation of memory and cognition. They also link the nervous system to the endocrine system, which mediates the body’s response to stress.

Source link: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2811%2960602-8/fulltext

Evidence suggests that TMS induces neuroplastic changes in these circuits. Neuroplasticity is the ability of the brain to reorganize itself by forming new neural connections. TMS helps readjust neurotransmitter (e.g. serotonin and dopamine) levels in a variety of brain regions. TMS also appears to exert a neuroprotective effect on the brain.

Research has shown that TMS decreases brain inflammatory factors reducing oxidative stress on the brain. TMS also boosts the levels of brain-derived neurotrophic factor (BDNF), encouraging neuronal growth in regions such as the hippocampus which is vital for learning and memory. It is postulated that the anti-depressant properties of TMS may also help in normalizing the body’s neuroendocrine stress response system.

Source link: https://lighthousehealthflorida.com/neurostar-tms/

rTMS has achieved its place on international treatment guidelines as an augmentation treatment modality to be strongly considered in treatment resistant depression. It is reported that 30-40% of depressed patients may have inadequate response to anti-depressant medication treatment. The direct neuronal effects of rTMS may explain why rTMS may work for this group of patients.

In May 2022, the U.S. Food and Drug Administration (FDA) approved the use of the NeuroStar TMS system as an adjunct for treating adult patients suffering from OCD. Promising research is ongoing for the clinical application of TMS in treatment of Post-Traumatic Stress Disorder (PTSD), addictions, chronic pain, insomnia and many other neurological disorders.

With further advancements in TMS research and the incorporation of TMS in routine clinical practice, there is strong hope for recovery and regaining of optimal functioning for patients afflicted by complex neuropsychiatric conditions.

References

  1. Transcranial Magnetic Stimulation, Clinical Applications for Psychiatric Practice. 2018 American Psychiatric Association Publishing, First Edition.
  2. The Science of Transcranial Magnetic Stimulation, William M. Sauvé, MD; and Lawrence J. Crowther, Meng. Psychiatric Annals, Vol44, No.6, 2014.
  3. Repetitive transcranial magnetic stimulation increases serum brain-derived neurotrophic factor and decreases interleukin-1b and tumor necrosis factor-a in elderly patients with refractory depression. Xiangxiang Zhao, Yanpeng Li, Qing Tian, Bingqian Zhu and Zhongxin Zhao. Journal of International Medical Research 2019, Vol. 47(5) 1848–1855.
  4. What is repetitive transcranial magnetic stimulation and how does it actually work? Paul Fitzgerald, Professor of Psychiatry, Monash University. The Conversation AU, published May 13 2021.

Anxiety & The Body

Anxiety & The Body (by Dr Sean David)

Fight or Flight?

Anxiety refers to a state of anticipation of alarming future events. Anxiety is usually a normal transient response to stress and may be a necessary cue for adaption and coping, the body’s protective mechanism known as the ‘fight or flight response’.

Image 1 – Anxiety & The Body (Blog Article by Dr Sean David), image source: https://cbt4panic.org/anxiety-symptoms-stem-from-the-very-helpful-fight-or-flight-response/

However, anxiety can become pathologic, where it is excessive and inappropriate to the reality of the current situation. It is often described by many as a distressing experience of dread and foreboding.

Anxiety is manifested in the affective, cognitive behavioural and physical domains. The affective states could range from edginess and unease to terror and panic. Cognitively, the experience is one of worry, apprehension and thoughts concerned with emotional or bodily danger. Behaviourally, anxiety triggers a multitude of responses concerned with diminishing or avoiding the distress.

Physical Manifestations of Anxiety

The stimulation of the autonomic nervous system results in an array of bodily perturbations.

Image 2 – Anxiety & The Body (Blog Article by Dr Sean David), image source: https://www.anxietycentre.com/anxiety-disorders/symptoms/

Several nervous system structures are involved in fear and pathologic anxiety.

Image 3 – Anxiety & The Body (Blog Article by Dr Sean David), image source: https://www.xcode.life/genes-and-health/how-anxiety-affects-brain/

The amygdala is responsible for initiating the fight-or-flight response. When activated, the amygdala triggers a series of changes in brain chemicals and hormones that puts the entire body in anxiety mode.

Image 4 – Anxiety & The Body (Blog Article by Dr Sean David), image source: https://cbt4panic.org/the-fight-or-flight-response-symptoms/

Left untreated, over time the affected individual’s body physically responds more frequently and intensely to worries. Co-morbid depression often sets in. One’s ability to meaningfully function academically, occupationally and socially gets hampered, leading to a deterioration in quality of life.

Treatment of Pathologic Anxiety

The first point of contact for many patients would be their general practitioners or even the hospital Accident & Emergency department. It is important to evaluate and rule out underlying medical illnesses that may mimic an anxiety disorder such as thyroid disorders, heart rhythm disturbances, gastrointestinal diseases or alcohol withdrawal.

The doctor may order some basic investigations such as a thyroid function blood test or an electrocardiogram (to check one’s heart rhythm). Once medical causes have been excluded or identified and treated, persisting anxiety symptoms would warrant a psychiatric consultation.

A prescription of anti-depressants such as Selective Serotonin Re-Uptake Inhibitors (SSRIs) to aid in balancing of brain neurotransmitters may be suggested. Anxiolytics such as benzodiazepines e.g. Clonazepam may be used in the initial phase of treatment, and thereafter only short courses being prescribed to reduce the risk of dependency.

Cognitive-Behavioural Therapy (CBT) involves cognitive re-structuring and anxiety symptom management. Cognitive interventions are aimed at challenging and correcting the inaccurate and maladaptive thought patterns that maintain anxiety disorders. Symptom management techniques e.g. relaxation and breathing re-training procedures help to eliminate anxiogenic bodily reactions.

Image 5 – Anxiety & The Body (Blog Article by Dr Sean David), image source: https://www.psychreg.org/anxiety-disorders-causes-treatments/

Lifestyle adjustments to one’s hectic pace of life need to be made to break the vicious cycle of stress and worry. Developing a healthy routine with regularly scheduled self-esteem raising activities, ensuring adequate rest and nutrition as well as maintaining social connections are pivotal for mental wellness.

References

  1. Massachusetts General Hospital, Handbook of General Hospital Psychiatry, seventh edition, chapter 13: Anxious Patients.
  2. Kaplan & Sadock’s Concise Textbook Of Clinical Psychiatry, fourth edition, chapter 6: Anxiety Disorders.

K-Pods in Singapore: A Growing Threat to Public Health

Singapore is facing a new and disturbing trend in substance misuse: the rise of ‘K-pods’—a street term for vape pods laced with etomidate, a drug traditionally used in hospitals for short-term anesthesia. While etomidate has a legitimate place in clinical settings, its misuse outside these contexts is extremely dangerous, posing significant health risks to users.

What is Etomidate?

Etomidate is a fast-acting anesthetic used during procedures such as intubation. It is valued in critical care due to its minimal cardiovascular effects. However, when misused—especially via inhalation in modified e-cigarette pods—etomidate becomes a serious threat to both physical and mental health.

The Hidden Dangers of K-Pods

Recent studies, including a May 2024 article in Frontiers in Endocrinology and a paper in Toxicology, have highlighted alarming findings about etomidate’s long-term effects, particularly when used recreationally:

1. Gut-Brain Disruption

Etomidate affects the gut-brain axis, impairing intestinal function and possibly contributing to central nervous system disorders. This link is especially concerning because disruptions in this axis have been associated with mood disorders, immune dysregulation, and neurodegeneration.

2. Mood and Mental Health Impacts

Etomidate use lowers levels of 5-HTP, a precursor to serotonin, increasing the risk of depression, sleep disturbances, and anxiety. It also reduces GABA levels in the brain—critical for calming neural activity—leading to heightened anxiety, poor sleep quality, concentration difficulties, and, in some cases, panic disorders.

3. Risk for Vulnerable Populations

People with a predisposition to psychosis or other mental health issues may be particularly vulnerable to etomidate’s destabilizing effects on brain chemistry. Recreational use can act as a trigger, with potentially long-term psychiatric consequences.

4. Adrenal Suppression and Toxicity

Perhaps the most dangerous effect is adrenal toxicity. Etomidate suppresses the adrenal glands, potentially leading to adrenal insufficiency. In severe cases, this can develop into adrenal crisis—a life-threatening condition with symptoms such as confusion, dehydration, low blood pressure, and fainting.

5. Electrolyte Imbalance: Hypokalemia

Hypokalemia, a drop in potassium levels, is another significant risk. Even mild potassium deficiency can cause muscle weakness, breathing difficulties, and irregular heart rhythms, which can escalate to fatal cardiac events if untreated.

Treatment and Recovery Options

Fortunately, recovery from K-pod use is possible with timely intervention. A combination of medical care, psychological support, and community involvement is key to breaking the cycle of substance abuse.

1. Medical Intervention

Users experiencing withdrawal symptoms, adrenal issues, or hypokalemia should seek immediate medical attention. Hospitalisation may be required in severe cases to stabilise vital functions, correct electrolyte imbalances, and monitor adrenal function. Ongoing medical follow-up is crucial.

2. Individual Counselling

One-on-one therapy provides a safe space to explore the underlying reasons behind substance use. Counsellors can help individuals manage anxiety, depression, and trauma—factors often exacerbated by etomidate misuse.

3. Group Therapy

Support groups, such as those offered by Promises Healthcare or peer recovery networks, provide social reinforcement and reduce feelings of isolation. Group settings encourage accountability and shared experiences, which are particularly beneficial for younger users.

4. Family Therapy and Education

Family support is critical, especially for adolescents. Educating families on the signs of substance misuse and involving them in the treatment process enhances recovery outcomes.

5. Ongoing Monitoring and Relapse Prevention

Recovery is a long-term process. Follow-up sessions, lifestyle adjustments, stress management strategies, and healthy routines are all part of a sustainable relapse-prevention plan.

If you or someone you know is using K-pods or other substances, contact a licensed addiction treatment provider or your nearest polyclinic for support.

The Urgent Need for Awareness and Action

K-pods are being marketed to youth and young adults as a trendy alternative to traditional vaping. But beneath the appealing packaging lies a highly dangerous substance with severe long-term consequences.

This trend demands immediate attention from health authorities, educators, and families. Public awareness campaigns, stricter regulation of e-cigarette ingredients, and early intervention strategies are essential to curb the spread of K-pod use before more lives are affected.

Conclusion

What might seem like a harmless recreational activity is, in reality, a ticking time bomb. The misuse of medical anesthetics like etomidate in K-pods represents a serious public health concern in Singapore. With proper awareness, access to treatment, and community engagement, we can prevent a new generation from falling into this dangerous trap.

Porn, Sex workers and Infidelity – The Crisis of Discovery and What to Disclose 

And – to that extent – they are “in the same boat” and they both have an opportunity to de-escalate the situation and resolve it together.  

But they probably need considerable help. 

 Each may be overwhelmed by powerful negative feelings – so that neither are able – or willing – to consider de-escalation.  

Indeed, their natural reaction may to make things worse – and to fuel the crisis into a prolonged trauma.  

This distressing dynamic is most obvious when the partner seeks to answer the question: “what happened – and why”? 

Partners urgently need to hear and gather an ever-increasing amount of evidence about the sexual behavior and the circumstances. While the person responsible, is just as convinced that they need to hold onto their “secrets”.   

The Dynamics of the Partner 

Partners may feel compelled to spend time, effort, emotional energy – and even finances – to gather the details.  

They may subject the person responsible to hours of questions each day – and this may last for many weeks and months.  

With the details that the partner has pieced together – and to fill in the gaps that they perceive – the partner may unwittingly create a vivid “horror movie”.   

Some partner may envisage haunting details of sights, sounds, sensory touch, smells, emotions, behaviors and motivations – creating the most distressing account of the events as possible.  

They may be insistent that the person responsible concurs – in every detail – with the partner’s account.  

The partner may also seek to impose a “picture” of how the acting out partner (e.g. a sex worker or an affair partner) experienced the sex or “romance” – and relentlessly describes that person’s thoughts, feelings and motivations. 

Many partners ruminate on whether there was an emotional bond between the responsible person and the sex workers or affair partners.  

They may focus on: the nature and quality of this bond; why the bond was so important to the person responsible; and how it compares with the couple’s bond.  

The person responsible may – in contrast – insist that the sexual relationship was only transactional, compartmentalized and objectified – or that it was simply a “fantasy relationship” – and part of usual the ritual of seeing sex workers or affair partners.    

However, the partner may firmly believe that sex must have been experienced as more than a meaningless, casual act – and that it invariably involved a connection.  

This drive to know and “picture” all the details, inevitably leads the partner to an escalation of their overwhelming feelings – and may lead to lasting trauma.  

The Dynamics of the Person Responsible  

The person responsible is likely to react viscerally and strongly to their partner’s need to know. 

That person may sincerely believe that their sole task is “damage control”.   

Inevitably their attempt “fuels” the destructive dynamic that is unwittingly overwhelming their partner.   

The person responsible is likely to seek to: conceal what happened; provide half-truths or minimal details; minimize; deflect; avoid; rationalize; intellectualize – or “gaslight”.  

“Gaslighting” is an intentional manipulation of a partner to believe they have “got it all wrong” and that it is the partner – not the person responsible – who is gravely at fault. 

The Way Out 

Is there a way out? 

The answer may well be: “yes”.  

Couples struggling with these distressing dynamics after sexual discovery who seek professional help, may be able to reverse the course of this behaviour – and address their escalating emotions. 

The Action Plan 

Professional therapists, skilled and experienced in these dynamics, will assist the couple to work on an action plan.  

This may involve:  

  1. The Safety Plan: Creating a crisis management plan, that seeks to ensure the safety of the couple, their children and others. 

The plan will provide practical safety guidelines and assist the couple to articulate safety boundaries and consequences.  

It will include suggestions on how to build a network of support and resources for each of them – and seek to establish that they do not need to face the crisis alone.  

It will also include practical suggestions on how to de-escalate distress; and will give the couple simple “tools” – to use in the moment – to regulate emotions and more effectively tolerate distress. 

The couples’ ability to commitment to a safety plan is only effective if they are able to change their priorities.  

This may be a challenge. 

It may be hard to shift their priorities away from unwittingly nurturing thoughts and behaviours that exacerbate their emotions – towards a commitment to reducing their distress; nurturing their own wellbeing; and the safety and wellbeing of their children.  

  1. Individual Therapy – Weathering the initial stages of a crisis is more effectively accomplished in individual therapy.  

Each party in the couple, working with their own therapist for individual sessions, gives them the safety and freedom to fully articulate, explore and reflect on their own experience of what happened and why. 

They will be able to articulate their learnings and establish their priorities.   

  1. The Disclosure: A structured, systematic and therapeutic disclosure process will be described and (if agreed on) undertaken in therapy.  

Both parties can give their truthful accounts in safety and with support – while seeking to avoiding any further trauma.  

Disclosure is perhaps, the most crucial work the couple can do in therapy. But it is best done only when the couples’ priorities and expectations are aligned – and when they have the emotional capacity to undertake it therapeutically.  

If you or your partner face a crisis in your relationship with the discovery of sexual betrayal – there may well be a solution.  

Porn Addiction: Impact on Relationships

Some people using porn may face the situation where their partner inadvertently discovers this.  

For many porn users, the instant reaction is to deny it – and to continue to do so, despite the evidence.  

Their partner is naturally shocked and angry – not just by the porn use but also by the blatant dishonesty and increasingly fervent denials.  

The partner’s distress is now compounded – and they may seek and find more evidence.  They may even see the porn user’s attempts to “cover their tracks”.  

As the partner’s pain, distress and frustration mounts over the succeeding days and weeks – the user may seek to minimizes their porn use. 

The user may give an account that the porn use was casual, occasional or infrequent; and that they were only looking at “romantic genres” – and only for short periods.  

The user may be reluctant to admit that they masturbated using porn – or where porn use took place.  

Whether the information provided by the user is true or not – the partner’s trust may be broken to the extent that the partner is simply unable to believe it. 

The partner may see the porn user’s account as an attempt to minimize their behavior – particularly if the partner feels that they had to extract the information under a long, persistent and angry “interrogation”.    

They might think – or even say – that porn use is prevalent among men and that: “it’s just not a big deal”.  

This will be heard by the partner as ignoring their powerful feelings of emotional pain, sexual betrayal, broken trust and confusion. 

The partner may be feeling that the user was comparing her to the porn images – and that she was judged by the user to be unattractive, unglamorous, sexually unappealing or “boring”.  

This may engender in the partner a profound sense of shame, failure and rejection.        

If the user avoids focusing on and validating the partner’s account, the partner is left to suffer in pain and isolation.  

This can result in a serious and lasting fracture in relationship.  

And this distress may be even compounded by years of neglect and inattention to the relationship by the porn user. 

Indeed, porn itself can result in sexual dysfunction and distraction from investing in committed relationships.  

Porn normalizes sex as being objectified and reduces sex to a physical urge that can be quickly and easily satisfied. 

The user’s willingness to separate the act of sex from the context of a loving, committed, and mature relationship, leads some partners to contemplate separating – or even ending the relationship.  

The partner and the user may then have to struggle with difficult decisions about parenting children, finances, and relationships with extended family members and others.  

The Way Out 

Is there a way out? 

Yes, there could well be. 

But it may require the porn user to reverse their perspectives. These new perspectives include: empathetically understanding what is happening to their partner and what their partner needs from them; and taking full accountability and responsibility for the consequences of their behavior.  

The Barriers   

There may be many emotional barriers in the way of the user changing their perspectives.  

The user may be overwhelmed by their own guilt, shame, confusion, fear, frustration and anger. 

These powerful emotions may drive the user to be emotionally “protective” of themselves. This “protectiveness” may be outside their conscious awareness.  

In this context, acting dismissively, minimizing, being dishonest and avoidant can be viewed as “protective” behaviors.  

The user may, for example, dread the consequences of taking the initiative to tell the whole truth to their partner – and this fear leads to avoidance and dishonesty.  

To support their dishonesty, the user may rationalize that it would be too painful for their partner to hear the whole truth – and that the user wants to “protect” their partner from any further distress.  

But the corollary of this rationalization is that continued dishonesty takes power away from the partner’s right to process the whole truth – and to decide what to do about it.  

For the user, being truthful hands the power back to their partner, and creates fear and alarm.  

In effect, the user feels powerless to avoid the relationship consequences of porn use.  

Fear and shame may drive the porn user to imagine dire consequences to the relationship and the family – which, in turn, drives more fear and shame.  

Dishonesty, minimization and avoidance become entrenched – and it becomes ever more difficult for the user to accept that continuing with their reactive behavior is more likely to result in desire consequences. 

Similarly, the user may automatically avoid actively listening, validating and affirming their partner’s painful narrative – as this engenders fear and shame in the user and results in the user facing the full extent of their consequences.  

The user would rather the partner minimize their emotions – and the user is convinced that their partner’s emotions will “blow over” and “normalcy” will be restored.  

So, the user may avoid encouraging their partner to express their thoughts and feelings and may not invite their partner to safely process them together as a couple. 

Their partner is likely to see that the user’s avoidance and deflection as simply another example of the user’s neglect and disrespect of their relationship. 

The truth is that working through their respective emotions and narratives as a couple makes perfect sense. They are, after all, “in the same boat” – doing their best to “weather” a “perfect storm” in their relationship. 

Those porn users who seek professional help, may be able to reverse the course of their reactive behavior – and address their overwhelming emotions. 

The Action Plan 

Porn users who seek professional therapy may be advised to work on an action plan.  

This may involve:  

  1. Understanding how to actively listen, validate and affirm their partner. This includes exploring – with kindness and compassion – their partner’s narrative and their pain.      
  1. This also means openly accepting full responsibility for the consequences to their partner and the family – and apologizing for the hurt.  
  1.  Being fully open and honest – and initiating and taking an active role in insightful discussions on their porn use – and any problems that the relationship may have faced before the discovery of porn use. 
  1. Reading, watching and listening to the material provided on the problems with porn use and the effect on partners.  
  1. Learning “tools” to manage the user’s distress. 
  1. Being screened by a therapist to rule out (or in) compulsive sexual behavior. This is a recognized mental health problem and that can be effectively addressed through a systematic program of recovery.  
  1. The partner considering individual therapy to effectively explore, express and address their distress. Therapy offers a confidential, safe and supportive space in which emotional healing can take place.     

If you or your partner face a crisis in your relationship with the discovery of porn use – there may well be a solution.  

When Tantrums Turn into Trouble: Understanding Child Anger Management

Seeing your child struggle with anger can be challenging for any parent. Tantrums, outbursts, and aggressive behaviours can disrupt family life and cause concern. But it’s important to remember that anger is a normal emotion, and children are still learning how to express it in healthy ways. This blog post will explore the roots of anger in children, offer practical strategies for managing it, and highlight when to seek professional support.

Decoding the Anger: Why Do Kids Explode?

Children experience anger for various reasons. Sometimes it’s a reaction to frustration, disappointment, or feeling overwhelmed. Developmental stages, like the terrible twos or the teenage years, can bring about hormonal shifts and increased emotional intensity. Underlying issues like anxiety, learning difficulties, or family stress can also contribute to anger problems. Understanding the root cause of your child’s anger is key to finding effective solutions.

Taming the Tantrums: Strategies for Parents

Here are some practical strategies to help your child manage their anger:

  • Teach emotional literacy: Help your child identify and label their emotions. Use simple terms like “sad,” “mad,” or “frustrated.”
  • Validate their feelings: Let your child know it’s okay to feel angry, but it’s not okay to hurt themselves or others.
  • Create a calm-down corner: Designate a safe space where your child can go to cool off when they feel overwhelmed.
  • Teach problem-solving skills: Help your child identify triggers and develop strategies for managing challenging situations.
  • Encourage physical activity: Physical activity can be a great outlet for releasing pent-up energy and frustration.
  • Set clear limits and consequences: Establish clear boundaries and consistent consequences for aggressive behaviour.

When to Seek Professional Help 

While occasional outbursts are normal, persistent anger problems may require professional intervention. Consider seeking help if:

  • Anger is frequent and intense: Outbursts happen regularly and are difficult to manage.
  • Anger is affecting their daily life: Anger is interfering with school, friendships, or family relationships.
  • You feel overwhelmed: You’re struggling to manage your child’s anger and feel like you need additional support.

What a Child Therapist Can Do:

  • Identify underlying issues: A therapist can help uncover any underlying emotional, behavioural, or developmental issues contributing to anger problems.
  • Teach coping skills: Therapists can teach children effective coping strategies, such as relaxation techniques, problem-solving skills, and communication skills.
  • Provide family support: Therapy can involve parents and siblings to improve family dynamics and create a more supportive environment.

A Supportive Environment at Promises

At Promises Healthcare, our experienced child therapists provide a safe and nurturing space for children to explore their emotions and develop healthy coping mechanisms. We offer individual therapy, family therapy, and group therapy tailored to your child’s unique needs.

Our therapists use evidence-based approaches like play therapy, art therapy, and cognitive behavioural therapy (CBT) to help children understand and manage their anger. We work collaboratively with parents to create a supportive home environment and empower children to thrive.

Is Gaming Taking Over? Spotting the Signs of Addiction in Your Teen

In Singapore’s tech-savvy landscape, gaming is a popular pastime for teenagers. While gaming can offer entertainment and social connection, excessive gaming can become problematic. It’s important for parents to understand the difference between healthy enthusiasm and addiction. This blog post will explore the warning signs of gaming addiction in teens and offer guidance on how to address this growing concern.

The Gaming Landscape in Singapore

Singapore boasts a vibrant gaming culture, with esports gaining popularity and gaming cafes becoming social hubs for teens. Easy access to online games, mobile devices, and high-speed internet makes gaming readily available. While gaming can offer benefits like improved problem-solving skills and hand-eye coordination, excessive gaming can lead to negative consequences, including social isolation, academic difficulties, and even addiction.

Spotting the Signs: Is It Just a Hobby or an Addiction?

Recognizing the signs of gaming addiction is crucial for early intervention. Here are some red flags to watch out for in your teen:

  • Preoccupation with gaming: Constantly thinking about gaming, even when not playing.
  • Loss of control: Difficulty limiting gaming time, even when it interferes with responsibilities.
  • Withdrawal symptoms: Becoming irritable, anxious, or restless when unable to game.
  • Neglecting other activities: Losing interest in hobbies, social activities, or schoolwork.
  • Lying or hiding gaming habits: Being secretive about gaming activities or downplaying the amount of time spent gaming.
  • Using gaming to escape problems: Relying on gaming to cope with stress, anxiety, or difficult emotions.
  • Physical symptoms: Experiencing sleep disturbances, headaches, eye strain, or carpal tunnel syndrome due to excessive gaming.

Addressing Gaming Addiction: What Parents Can Do

If you’re concerned about your teen’s gaming habits, here are some steps you can take:

  • Open communication: Talk to your teen about your concerns in a non-judgmental way. Listen to their perspective and try to understand their motivations for gaming.
  • Set limits and boundaries: Establish clear rules about gaming time, including weekdays and weekends. Use parental controls and monitor their online activity.
  • Encourage alternative activities: Promote healthy hobbies and interests, such as sports, music, or volunteering. Spend quality time together as a family.
  • Seek professional help: If your teen’s gaming habits are causing significant problems, consider seeking professional help from a therapist or counsellor specializing in addiction.

Why Professional Help Matters:

  • Understanding the root cause: A therapist can help identify underlying issues contributing to gaming addiction, such as anxiety, depression, or social difficulties.
  • Developing coping mechanisms: Therapy can equip your teen with healthy coping strategies to manage stress and emotions without relying on gaming.
  • Improving family dynamics: Family therapy can help improve communication and address any family issues contributing to the addiction.
  • Building a support system: Connecting with other teens facing similar challenges can provide valuable support and encouragement.

Supportive Environment at Promises

At Promises Healthcare, we understand the complexities of gaming addiction in teenagers. Our experienced therapists provide a safe and supportive environment for teens and their families to address this challenging issue. We offer individual therapy, family therapy, and group therapy tailored to your teen’s specific needs.