CNA interviewed Dr. Joseph Leong about why some people become bystanders when their loved ones abuse their maids. He highlighted a “power differential” in which the maid abuser is typically the head of the household. Read on to find out the details.
*Visions is an addictions arm of Promises and we help assist clients in Singapore to enable them to improve their lives; and our website provides the images, names, languages, qualifications, and experience of specialists who can help.
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’.
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
Stimulating the autonomic nervous system results in an array of bodily perturbations.
Several nervous system structures are involved in fear and pathologic anxiety.
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.
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 the 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 the balancing of the 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 are prescribed to reduce the risk of dependency.
Cognitive-Behavioural Therapy (CBT) involves cognitive restructuring 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.
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.
Massachusetts General Hospital, Handbook of General Hospital Psychiatry, seventh edition, chapter 13: Anxious Patients.
Positive discipline and gentle guidance are concepts which are not given enough recognition. In comparison to corporal punishments and other forms of authoritarian parenting, positive discipline aims to teach by first creating a safe relationship with children, putting connection before correction. According to recent neuroscience research, people learn best when they feel safe and connected to others, in the context of safe relationships. This helps to instil discipline with maximum efficacy in the long run.
What does positive discipline bring to the table? Apart from building trust and strengthening parent-child relationships, it teaches children responsibility, self-discipline, problem-solving skills and cooperation. By ensuring that learning isn’t fear-based – such as in the context of authoritarian parenting – it also helps children build on their self-esteem, develop their sense of significance, as well as manage their emotions effectively. However, it is key to note that gentle guidance may not always yield immediate results. Consistency plays a crucial role, and over time, parents will notice their children actively apply what they have learnt.
Positive Discipline Techniques
This technique involves diverting your child’s attention to other activities when they are acting out, or when you’re trying to guide a child’s behaviour from inappropriate to appropriate. For example, if your child is running around in the kitchen while someone is cooking, stop them and introduce another item or toy that would be of interest to them. Rather than simply saying, “Don’t run in the house,” say, “ “It is not safe to run in the house. Please go outside if you want to run.”
In addition, follow up with questions to confirm that he/she understands the boundaries (i.e what is and isn’t acceptable). Questions can include:
“Is it safe to play in the kitchen while it is in use?”
“Where else could you play instead if you feel like running?”
Such open-ended questions confirming boundaries can also initiate child-led problem-solving.
With positive discipline, it is important that you describe the behaviour you want to see without lecturing, and whenever possible, let your child know what they can do, as opposed to what they cannot do.
Emphasise the positive things your child does. If you only pay attention to negative behaviour, you will end up reinforcing that behaviour. When your child does something worthy of praise, be sure to acknowledge it and give him/her recognition for it. Positive reinforcement is not limited to words of praise for good behaviour. In fact, rewarding your child with natural rewards can be an extremely effective method for encouraging similar behaviour in the future. For instance, if a child asks politely for a cup of juice instead of throwing a full-blown tantrum, consider giving a little more juice or even a nice topping to motivate similar polite requests in the future. Remember to point out what they did right and emphasise how you appreciate their polite behaviour. This kind of praise helps your child maintain a positive self-identity that they will want to live up to as well.
Punishing your child often can turn you into the enemy, fostering an unhealthy parent-child relationship. Many parents tend to punish their children in ways that are unrelated to the offence too, and this can be confusing or simply encourage their children to act in defiance. Where possible, allow the natural consequences of their actions to unfold. For instance, if your child throws a tantrum and refuses to put on a raincoat while it is raining, the natural consequence is that they would get wet. They will be far more likely to acquiesce the next time than if you respond with a time-out when a similar situation arises.
Time-in and Time-out
You may be familiar with the time-out consequence, a common disciplinary technique when a child has done something wrong. Solitary, boring time-outs can be effective when well-executed. However, research has shown that such disciplinary methods are best when occasional time-outs are paired with time-ins. Time-ins encourage good behaviour, and are carried out by having the parent spend quality time with the child after a bout of bad behaviour. Instead of lashing out at the child and sending them away, spend time with them and help them calm down if they are emotionally agitated. Once they’ve calmed down, it would be much easier to discuss better choices for the future, and encourage them to apologise for their bad behaviour.
Paying attention to language use
Language is very important when it comes to disciplining a child. When anger strikes, it’s easy to get caught up in the heat of the moment. Be mindful not to use derogatory language or words of insult, as this can be hurtful and harm the child’s self-esteem. Moreover, try rephrasing your sentences. Instead of saying, “you messed up”, begin sentences with “I” statements. Convey how you felt about their behaviour rather than solely focusing on what the child did. This makes the approach to discussing the situation less critical, and allows the child to calm down and feel less defensive especially if their actions were unintentional.
While gentle parenting is a brilliant method as a whole, it is still important that we do what we need to do if there is danger involved. For instance, if your child is running straight for a busy road, yelling or grabbing at them is completely valid and reasonable.
All in all, remember to focus on encouragement and redirection of bad behaviour to appropriate alternatives. Positive discipline can go a long way, and it will certainly benefit both parent and child.