Written by: Dr B. Malavika, Psychological & Educational Therapist
Play is a critical part of a child’s development from birth. It boosts healthy brain development that is conducive for physical, cognitive, and emotional growth. It encourages imagination and creativity, and improves social skills and confidence. It is therefore not surprising that psychologists realised its power and tapped into it as an instrument of healing.
Challenges are a part of life. But in childhood, they can be harsher as children haven’t developed the capability to understand or deal with what they are going through. In their tender minds, loss or pain could be something as small (to an adult) as a broken favourite toy and range up to a major loss in the forms of death, separation from a loved one, hospitalization, abuse or other personal/family crises. While some children might manage to some extent by voicing their displeasure or through negative behaviours, others might just suppress their emotions. If the setbacks are beyond the coping skills of the child, the trauma can manifest as psychological or emotional disorders.
Parents often ask how they can know if their child needs counselling. Some signs could be that the child is being more angry, nervous, defiant, sad, or withdrawn than usual, or than is reasonable. The child could also be showing changes in eating and sleeping patterns, a decrease in school grades or reduced interest in previously favoured activities. When in doubt, it is better to err on the side of caution and seek help.
Play therapy is one of the prominent forms of therapy for children and is practised by a variety of mental health professionals, like counsellors, psychotherapists, clinical psychologists, psychiatrists and social workers. It is an intervention which allows children who are experiencing emotional or behavioural issues to open up their emotions in the safe space of the ‘playroom’. They are given toys to play with, and the children play as they wish, without feeling interrogated or threatened. For the children themselves, play (therapy) is familiar and fun and they are thus able to work out their undesirable experiences and resolve their emotional and behavioural difficulties. What materials the child chooses to play with and how they play all have meaning. The therapist watches their play to get an insight into their emotional or mental health problems.
Depending on the issues faced by the child and their own training, therapists conduct non-directed or directed play therapy and provide play materials accordingly. Non directed play therapy is free-play and very similar to the free association of adult psychodynamic therapy. While in the latter adult clients are allowed to talk and ventilate to gain insight and resolve their problems, free play with limited conditions and guidelines, allows the child to express their feelings just through their play. Their verbal expression might or might not be as important.
Directed play therapy includes more structure and guidance by the therapist and several techniques are used to purposefully engage the child. These could be engaging in play with the child themselves or suggesting new topics, themes for play. Parents might or might not be included in the sessions. Materials may include art and craft materials, sand and water, clay, dolls, toys, blocks, a family of dolls, miniature figures, animals, musical instruments, puppets and books. While traditionally Play therapy is considered to be beneficial for children ages 3 to 12, it has been modified and customised by researchers and therapists to help adolescents and adults also, and some mental health practitioners have started including video games as therapeutic tools. Apart from being used at counselling centres, play therapy is also being used at critical-incident settings, such as hospitals and domestic violence shelters to help children deal with deep issues.
In regular lives, parents can encourage their kids to play indoors and outdoors and especially in nature. Lawrence J. Cohen has created an approach called ‘Playful Parenting’, in which parents are encouraged to connect playfully with their children through silliness, laughter, and roughhousing to enhance relationships and general well being.
Challenges are a part of life. While the purpose of therapy is to solve problems, playing for the sake of fun can prevent them. This can be applied not only for children but for the inner child in every individual to make life happier and more meaningful. As the proverb goes – All work and no play makes Jack a dull boy.
Singaporeans spend most of their time at their workplaces, and in some sense, their workplace is their second home, and now, their workplace could be their home. How do we consider our colleagues? Are they like family to us? Are we working in a supportive environment?
Many a time, the workplace health and mental well-being of employees are compromised as business organisations focus on driving revenues and profits with little attention to safety, health and wellness of the staff. The impact of these is the negative effect on job-related attitude and job performance. In some instances, some workers may develop mental health issues such as anxiety or depression over time if they are too overwhelmed. As such, there is an increasing need for employers to acknowledge the positive correlation between having good mental health in their workers and the productivity and success of the business.
Across all workplaces, we need to step up and start considering ‘wrap-around strategies’ to counter the negative effects of excessive work on employees’ mental health, one of which includes unhealthy stress levels especially when it’s so easy to blur the boundaries of work and personal time while we work from home. Organisations usually conduct one-off mental health awareness programmes as an attempt to spread awareness among employees in the hope of reducing the occurrence of mental health issues. However, by making these awareness programmes an annual occurrence, employees tend to find it a dread, and the messages no longer get through to them as effectively. On the other hand, how many employees would attend the programme if it were to be on a voluntary basis? Many companies are aware of this but are still trying to find the right balance between promoting mental wellbeing and business sustainability.
Employers and HR practitioners have to accept that mental health issues are more often than not deep-rooted, and cannot be solved easily with such band-aid solutions (as most people would expect). This calls for wrap-around strategies, which would mean tackling mental health issues at the fundamental level and preventing problems from cropping up in the first place. It is in no one’s interests to try tackling the situation only when things get out of hand.
Having the right mindset and attitude is pivotal. We need to start thinking of our employees as our very own family members. If so, what can we do to make them happy? Do we have a framework for a healthy workplace? Are there plans in place to provide employees with the necessary support? For one, organisations can take the first step to introduce more flexibility into the workplace, with working from home being a mandatory option these days, it is the most opportune moment to reframe workflow processes for the longer term. This includes creating a flatter hierarchy, where there are fewer layers of management and less formal divisions between the higher-ups and the rest of the staff. Employees will thus be more involved in decision-making processes, creating a greater sense of ownership and accountability. The greater involvement of staff in the organisation will allow them to develop into more confident and capable workers, as well as enhance employee satisfaction. With greater employee satisfaction comes a greater sense of empowerment and motivation – factors that are crucial towards the productivity of the organisation.
Do we need to start thinking of what are the overlooked essentials of employee wellbeing? In your organisation, what is the decision-making process (in terms of policies and other forms of red tape) like? At present, most workplaces have a ‘top-down’ approach, where decisions are made by the senior management of the organisation and information is then cascaded downwards to the lower levels. In such cases, the staff are not given a voice and have no contribution to any of the decision-making processes. In contrast, when employees are given a chance to contribute their ideas, this encourages employee engagement and motivates them to put in greater efforts to overcome challenges. In turn, employees will certainly gain a sense of accomplishment and satisfaction. Hence, while it is true that not all work-related decisions can be made by the middle or lower tier of the corporate hierarchy, organisations should allow employees some level of discretion and autonomy to provide feedback or inputs to the decision-making process where possible. Organisations that succeed at providing the autonomy, social connections and support to their employees are better able to foster physical and mental well-being.
Needless to say, a flatter organisation would be counter-productive if the supervisors or senior management are unwilling to let go of micro-management and to show care for their employees. Managers and supervisors should start making an effort to check in with their subordinates and to ensure that they are coping well with their workload. Moreover, this should occur frequently, rather than being a one-off occurrence. Perhaps the head of each department could act as a “Welfare Ambassador”, and check-in with the employees within the same department. Getting to know the people in the same team better will allow them to identify any mental health symptoms, no matter how small. One way to get it started would be to allocate mini bonding sessions daily, each lasting approximately 15 minutes (even if it is just a short video call check-in). During this time, take turns to talk about your day, or about any difficulties that you may be encountering. relationships and social support with co-workers can improve emotional connections and ease any mental stress and burden. Such baby steps will help develop the camaraderie among teams and improve everyone’s overall well-being in the long-run. However, Managers do need to take note that they are not professional counsellors and would need to draw healthy boundaries for themselves so as to not be overwhelmed by the transference of emotional issues. Learn to, for your own safety of boundaries, to openly and healthily bring up the subject of steering an emotionally and/or mentally troubled employee to seek professional help. Remember, there is no shame in seeking help.
Organisational structure aside, it is also important to ensure that the workplace has a conducive environment – one that fosters overall well-being of the staff. All work and no play will eventually take a toll on the employees’ health, both mentally and physically. If space constraint is not a problem, try allocating a room for staff to take short mental breaks. In other words, have a “chill” room! Do take note that this should be a separate space from the staff pantry, where employees usually have their meals or to grab a quick drink. Mental-break rooms, on the other hand, can be used for socialising or for employees to take a short rest. Such a room can be decorated in an informal style, with more comfortable furniture. There is absolutely no harm in placing a few beanbags or some sort for employees to relax on whenever they feel overwhelmed by their hectic schedules. For those working at home, perhaps remind them to take mental health breaks. HR could schedule it into company calendars as a reminder and these small steps could foster greater trust between employees and the company. Trust that their welfare is being considered in decisions and that they are not just a tool or a means to the company’s bottom line, but a life that they now also have a responsibility to steward.
In short, mental well-being is important for a productive workforce and a healthy workplace.We need to create an environment where employees feel welcomed and safe. Workplace mental health is not – and should not be – an issue that we sweep under the rug. We need to acknowledge that providing support to the colleagues around us holds great importance and that we cannot simply cast them aside, leaving them to deal with their troubles alone. Ultimately, assisting your employees and ensuring they have the best mental health support will go a long way.
Being in the rat race can be exhausting, especially when we feel the need to constantly measure up. With the majority of us being brought up in a competitive culture, we tend to compare and be compared against others in terms of our achievements and levels of success. In some way or another, there is also a certain mindset that we should feel a certain level of shame or guilt if we are not as high performing (i.e. productive) as we should be. However, we failed to recognise that our productivity is not all there is to determine our self-worth. We cannot measure our own self- worth or self-value based on what we can or have achieved. Our unique qualities, as well as our intrinsic values, are all factors that contribute to what makes us truly ourselves. We need to focus less on external yardsticks and appreciate our inner qualities. Falling into the misguided notion of equating our state of busyness or productivity to our self-worth will lead to unnecessary stress and other health-related issues – both mentally and physically.
People who tend to beat themselves up for the various things that they were unable to complete rather than acknowledging what they have actually accomplished will experience low levels of self-worth. In fact, for these individuals, the amount of praise they give themselves is much lower than the amount of self-blame when they fail to get things done. Surely, a common measurement of productivity is the number of materialistic accomplishments. But it is also a common misunderstanding that busyness is a reflection of productivity. The misconception is that when a person is ‘too free’, he is being unproductive.
Productivity, unlike what most would expect, isn’t about getting as much done as you can and checking off every task on your to-do list. Productivity isn’t just about producing more. Instead, it is about focusing and spending time on the right things. There is a difference between spending your precious time and energy on a multitude of tasks that aren’t nearly as important, as compared to accomplishing a few things that matter the most to you. Our point is – try doing some soul-searching, and understand what you truly value or what are the things that define you. This will help you to refocus your time and energy on what you actually want to accomplish at work and in your personal time. If you treasure familial relationships more than work, then allocating more time towards family bonding will seemingly be more productive, and time well-spent. Redirecting your energy towards what you value most is what ultimately contributes to your self-worth as by doing so, we focus more on our intrinsic self.
We need to recognise that self-worth is the opinion we have about ourselves and the value we placed on ourselves. Under most circumstances, we can safely say that our productivity is not equivalent to our self-worth. Firstly, it is of utmost importance that we stop comparing ourselves to others. Although easier said than done, we need to come to terms with the fact that people are bound to walk down different paths. What is important to them may not matter even the slightest bit to you. Similarly, what they have achieved shouldn’t automatically become your personal goal just to match up to them. The more we compare ourselves to others’ achievements, the less satisfied we will be with ourselves and the lower our self-esteem becomes. Needless to say, this becomes totally self-defeating.
Perhaps you’ve heard of the common saying that we should always “focus on the process, not the outcome, and you will enjoy great success”? In light of this, the only being we should be comparing ourselves to is our past self. Are you doing better than before? Are you allocating time for self-improvement and self-appreciation?
This leads us to our next point – we need to cut down on excessive self-criticism and self-blame. Instead, embrace and accept our flaws. As humans, we are all inherently flawed. However, no one should have to believe that he or she is less worthy, inadequate or inferior due to his or her flaws. Viewing your weaknesses from such an angle will only cause your self-confidence to plummet. Instead, think about how you can change your bad habits, if these were your flaws for example, and improve on yourself. Getting yourself on the road to becoming a better version of yourself will prove to be more effective in raising your self-worth than by using productivity or the number of tasks you got done as a mode of measurement.
As mentioned, we all have our own unique qualities that distinguish us from others. It is important that we recognise and appreciate them, for they make us one of a kind. If you ever feel down in the dumps, with feelings of worthlessness or inadequacy, it helps to remind yourself that you are more than that. Grab a piece of paper and list down your positive traits and things that you appreciate about yourself. Doing some inner-search and writing down words of affirmation can definitely lift your spirits and help you regain your self-esteem.
With that being said, some may still find it tough to detach themselves from counting on productivity-based self-worth. After all, it may have become a habit, having been brought up with such a mindset. However, we need to note that this becomes a problem if it causes us to succumb to unhealthy levels of stress and anxiety, especially if we overload ourselves with too much work and aspirations in an attempt to boost our self-worth. If you find yourself overwhelmed and unable to cope, we hope you’ll seek help from professionals for the sake of your mental wellbeing in the long run. Do reach out to us whenever deemed necessary.
At its most elemental level, people avoid the risk of failure for one simple reason – it hurts. Every single person has experienced failure. If you were to interpret failure by its definition in the dictionary, “the neglect or omission of expected or required action”, wouldn’t you, as a child, have stumbled along the way to achieving those long strident steps you take when strutting along the sidewalk? Yet, nobody feels ashamed of failing to learn to walk as a toddler. Why’s that? You could say that no-one in the right mind would expect that of a human child – we aren’t deer, or gazelles that need to shake off the afterbirth and walk – or risk predation. Our success as a species which put us at the top of the food chain negates that need. Fear is a function of the amygdala, yet failure isn’t. There’s a distinction here that we need to be mindful of. If you’re a parent or have access to YouTube, you’ve probably noticed that there’s an innocence in children that can be quite uplifting to watch, as they try multiple times to succeed at a simple task. They don’t puff their cheeks out and sigh in despair, or bury their heads in their hands. At most, they demonstrate frustration.
Shame is learned behaviour that children integrate into their developing moralities, either from being taught or through observation. Studies done on athletes have shown that perceived parental pressure (or pressure from authority figures) have deleterious effects on how sportspeople experience and interpret failure. Simply put, the fear of failure is a construct of how societies function. For some people, the avoidance of shame that failure brings weighs too heavily on them, and that is the crippling fear of failure. Dr Guy Finch puts this rather more succinctly: “fear of failure is essentially a fear of shame”. How then, do we begin to become more self-aware in the face of these deeply ingrained avoidance mechanisms to start building our best selves?
Evidence-based science suggests that the most efficient way to bring oneself out of the debilitating spiral of negative self-talk – one of the most insidious culprits in perpetuating avoidance based behaviours that stymie growth – is Psychotherapy method, Cognitive Behavioural Therapy (CBT).
After all, overcoming fear of failure is all about reversing negative thought patterns, and Cognitive Behavioural Therapy (CBT) is designed to help you identify the underlying belief that causes a negative automatic thought (which in turn guides the feelings that come with it).
With the help of a qualified mental health professional, which can be anyone from a trained psychologist, psychotherapist or even psychiatrist, you can be empowered to break the circuit of the pervasive vicious cycle of negativity that prevents the unfettering of fear of failure’s heavy chains.
For instance, think of each deeply held criticism that you can’t let go of as a block in a Jenga game with your friends and the tower represents your thought life as a whole. Even though you’ve suffered through failure after failure, you can’t seem to jettison them from your psyche. Can you imagine a game of Jenga that doesn’t end in peals of laughter? It seems that some re-evaluation is needed to turn the way you handle each soul-sucking gut-punching failure from the darkness of your room. The grip of negativity steadying your trembling hand, an extension of your mind, putting each block up on autopilot because you believe you are not good enough. Instead, we suggest turning the lights on, invite someone you trust into your sanctum of despair, to play the game of Jenga with you. As you ease into their presence, you’ll begin to notice that the tower doesn’t look so intimidating anymore. It’s no longer just a congealed mess of all your shortcomings and toxic thinking, but a simpler thing that can be deconstructed. If each block represents a negative conviction you have about yourself that is too painful to touch, reach for the piece that looks more well-shorn and polished (which represents a perceived positive character trait or accomplishment that you hold dear). Put it back on top of your tower. It is yours, isn’t it? Or perhaps let your confidant handle that splintery block.
Of course, we all know that Jenga isn’t all laughter and grand gestures. There’s physical tension and the cogitation of making the right choice so the tower doesn’t crumble prematurely. Maybe you aren’t too good at Jenga. That’s fine. But if you start thinking of this special game of Jenga as a collaborative effort instead of a competitive one, you’ll start getting the picture. Who would you like to invite to collaboratively play a game of Jenga?
Sagar, S and Stoeber, J. Perfectionism, Fear of Failure, and Affective Responses to Success and Failure: The Central Role of Fear of Experiencing Shame and Embarrassment. Journal of Sport and Exercise Psychology, 2009, 31, pp 602-627.
Youths these days have a lot on their plate. Teenagers have to cope with the highly competitive education system, and the fresh graduates are worried about employment opportunities or career advancement. Coupled with the need to maintain good relationships with their friends and family, these individuals may be experiencing high levels of stress. Some people do thrive well under stress, but what happens when stress levels exceed the healthy range? For those who are unable to cope, chances are their mental wellbeing would take a toll.
With young people unable to attend school in person regularly or go into the workplace during the circuit breaker, they might have felt increasingly isolated due to the lack of face-to-face social interaction over this extended period of time. Furthermore, having to fight for their own space while at home with their family members may have caused some conflict and frustration for some. Undoubtedly, cabin fever may have also kicked in for some of them. Although circuit breaker measures have recently been eased, youths may not be able to adjust back to the norms as easily as one might expect. Reports have shown thatit is expected that more youths will be prone to developing mental health issues such as depression due to the various implemented COVID 19 pandemic coping measures.
Depression is one of the world’s leading mental health disorders, and youths have become increasingly prone to it. Studies have shown that depression affects up to 18% of Singaporean youths. People with depression may turn to self-harm or experience thoughts of suicide. These are often methods they adopt in order to cope with their difficult emotions. According to the suicide prevention agency Samaritans of Singapore (SOS), suicide remains the leading cause of death among youths aged 10 to 29 in Singapore, and as of 2018, 94 of them had succumbed to suicide. In order to curb the rise of depression cases among youths, it is important that we are able to identify the early stages of depression. Doing so will allow them to seek treatment earlier and to help them get back onto their feet. Depression, if left untreated, will severely impact people’s lives in a negative light, causing personal, educational and familial difficulties.
Here are some of the most common symptoms of depression that you should look out for (not exhaustive):
Extreme sadness and low mood
Lack of interest in activities once enjoyed
Lack of self-worth
Increased lethargy
Experiences sleep disturbances and loss of appetite
But how can we first better support troubled youths? When it comes to dealing with depression, individuals with mild depressive conditions could adopt self-help strategies such as trying to maintain a balanced diet, to pick up on relaxation techniques, embark on daily gratitude journaling exercises (e.g. 3 things I can be thankful for today) and get some exercise in, even if it’s just a stroll around the estate or exercises from ATHLEAN-X™ or Athlean-XX for Women. Try encouraging them to live a healthy lifestyle and maybe create a ‘Daily Wellness Plan’ – a list of little and big things they can accomplish on a daily basis to comfort and keep their moods up. However, it is key to take note that even though their depression may be perceived to be mild from a third person’s point of view, we should never make assumptions as to what they truly feel on the inside. We should never, under any circumstance, tell them to “snap out of it”. It is very important for us to be patient and listen to what they have to say if they do approach and confide in you. Stay empathetic and show your concern for the individual. Acknowledge and respect their feelings and worries. Listen actively by using active listening skills. Encourage them to join mental health support groups like those conducted by PSALTCare – journeying with others that are going through similar struggles can encourage social healing.
On the other hand, for those coping with moderate to severe conditions, we might need to encourage them to seek a multidisciplinary approach to recovery like psychiatric help and look to taking medications, with supporting psychotherapy or counselling sessions and support groups. They might also be afraid of the stigma attached to seeing a Psychiatrist or what would transpire in that session. Try to assure them that there is nothing to be ashamed of. In fact, it is a lot more common in Singapore now, and a trip to the Psychiatrist is as straightforward as seeing your family doctor. Alternatively, these youths can book appointments for psychotherapy first. With appropriate treatment and support, it is entirely possible for them to move on and lead a more productive and happier life. Here’s a questionnaire that is widely used by Psychiatrists to help determine depression to help you with next steps decisions: www.mdcalc.com/phq-9-patient-health-questionnaire-9
If you or anyone you know are struggling and are unable to cope with the post-lockdown blues, we strongly encourage you to get professional help. Do not hesitate to contact us when necessary.
Stress. What is stress? This word is used so casually nowadays that it has lost its impact as something that can be detrimental to health, especially during this unsettling period of the Covid-19 pandemic. We might have adapted to the restrictions put in place, like wearing a mask and practicing social distancing wherever we are, but have we truly come to terms with these regulations, or are we trying to distract ourselves from the pressing concerns of our future? Adhering to the past few months of circuit breaker regulations definitely have not been easy on everyone, be it young or old. The stress and inconveniences experienced due to a sudden change in routine habits have been unnerving for many and as we progress on to the next few phases, what does this mean for us?
By now, Singaporeans would have been working from home or have been home-based learning (HBL), adapting to these changes of environments whilst managing their hectic schedules. However, as the world economies bulldoze to get things back up and running, we cannot ignore that there might be no place for permanency again i.e. making our homes temporary workspaces then returning back to original practices or shuttling between the two.
Undoubtedly, there are pros and cons to each family being at home together, where relationships are constantly tested and stretched. Some might argue that it’s been a good time for family bonding: to better understand one another as the rat race may have left some in a time capsule ignorant of changes; while others unable to compartmentalise their thoughts, feel that it’s a disruption to their workspace and schedules, having to juggle work and personal life in the same physical space.
Moving forward, our government aims to have routines restored back to normal, this means returning back to the high demands of work and student lives, but what is normal? We wonder if it will be difficult to get back into the grind after the somewhat sedentary lifestyles some of us have been living in the past few months, giving up on flexible self-dictated work hours and or dragging our muscles to leave home and travel to work. Also, companies and schools will have to work around challenging social distancing measures, which can pose a problem considering our highly interactive nature. Whilst schools are drawing out plans for rotational return of students, trying to stagger and minimise cross contact within large groups, companies on the other hand, have to reorganise their “back-to-back” cubicle style like workspace that was easier for communication, into something less compact. These new arrangements will potentially be disruptive to students’ learning, having to conduct lessons both online and face-to-face (f2f), along with teachers who will have to adjust their teaching methods accordingly and capture the essence of each lesson, whilst engaging students. Offices will have to convert into something less compact or cut down on the number of employees on site, which may not only slow down productivity but also potentially decrease employee satisfaction and well-being. Nevertheless, this creates a lot of physical, emotional and mental stress.
At the initial stages, non-chronic stress may be beneficial to give people an adrenaline boost to encourage them to press on. However, if we are not capable of managing stress, it may become chronic. This can cause our brains, nervous systems and behaviour to affect the expression of genes in sperms or alter brain development of our offspring.
A more immediate manifestation shows that the brain activates neuropeptide-secretion systems in response to stress, leading to a cascading effect involving adrenal corticosteroid hormones. This can result in stress-related brain diseases, like depression and anxiety disorders as well as post-traumatic stress disorder (PTSD). Moreover, chronic stress can stunt memory growth and even kill brain cells, which result in learning impairments. Not forgetting, the physical aspects of stress such as headaches, muscle fatigue, changes in appetite or insomnia, all of which can be overlooked as just temporary “disturbances”, rather than a contributing factor of stress that is beginning to pose a hindrance on daily activities. This might be threatening if it’s not diagnosed and dealt with in its early stages. Prolonged periods of stress can also cause some to turn to less favourable options like alcohol, smoking or even drugs, which should be avoided at all costs.
Here are some suggested precautionary measures we could take to prevent the rise of chronic stress:
One of the possible solutions to relieve stress is exercise, although some might be deprived of going to their usual gym studios, we can opt for a nature setting outdoors to get some vitamin D too! Instead of being cooped up at home, fresh air is always welcomed.
Another way to destress is picking up new hobbies like baking or cooking. Unknowingly, you can invest loads of time into learning new recipes to convert into practical use that may come in handy in the future!
Next, meditation. Even though it might take a while to enter a full meditative state, this is definitely worth the try to keep calm and relaxed amidst this chaos, to be at peace with yourself. It also clears your head to think about self-goals and plans ahead.
Last but not least, laugh! As the saying goes, laughter is the best medicine. This is easily attainable to get your tummy hurting watching humorous videos or sharing silly jokes and the best time to share happy moments with your family!
Food For Thought: If Covid-19 is here to stay, how do we embrace it without crippling our way of life?
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