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Family Therapy 101 in the context of the pandemic.

Family Therapy 101 in the context of the pandemic.

The year 2020 saw a rise in uncertainties. Many have experienced anxiety, job loss, a strain on finances and family relationships due to the impact of the pandemic. By default, couples need to adjust to working from homes, with blurred boundaries between work and family, lesser personal space and challenges in new routines. They may not have readily communicated effectively about their roles, given the constant changes in adjusting to tightening and lifting measures.  Coupled with the labour crunch, families may find it increasingly formidable or costly to hire a helper to care for children, who are required to stay home for home-based learning or the care of elderly parents who may be weak and frail.  This may inevitably lead to unresolved conflicts between the couple due to the stress and demands of constant transition and change. In 2020, a survey for mums showed that 60% of the participants rated their stress level at a 7 out of 10. In addition, 3 out of 10 of the participants felt sad most of the time.   

Children and young people are not spared from the raging wave of anxiety. According to a survey conducted by Focus on the Family, kids are more anxious about exams than Covid 19 (The Straits Times, 18 Sep 2020). However, in an international study of 72 countries (including Singapore), only 6% of teens share their problems with their families (Impact of the Pandemic on Family Life Across Cultures 2020, Namad Bin Kalifa University). No wonder the CEO of the Institute of Mental Health says that “Gen Z faces different forms of stress, maybe more anxious, depressed than others before them (Today, updated on 1 Mar 2021).” President Halimah also urged Singapore to step up efforts to protect children’s mental health early (The Straits Times, 2 Dec 2020).    

Given the tremendous stress that kids and adults are facing, families are stretched very thinly. Therefore, they ought to rise above their concern of seeking a mental health facility to deal with their issues early, so that family members can get the professional help they need.   

It is timely for the family to consider attending family therapy to address and deal with the mental well-being issues, be it stress or anxiety collectively.   

You may have some questions about family therapy, and here are some FAQs that seek to answer your questions. 

 

Why Family Therapy? 

Having to deal with unhealthy family dynamics constantly puts a toll on one’s mental wellness. Family therapy focuses on improving family communication; it deals with family conflicts, seeks and creates better functioning and environment. It provides family members with an opportunity to talk about how they think and feel, being affected by the issue they face. It enhances skills to facilitate healing. Therefore marriage and family therapy are essential. 

Family therapy shifts the focus from blame, diagnostical lens, linear causality, and looks at circular causality in an issue. For example, a teen who exhibits school refusal may be staying home because of his worry and caregiving role to his mum, who is in chronic health and has a strained marital relationship with her spouse. It helps the family understand the issue confronting them in the family context and the larger contexts, i.e. the pandemic. 

Family Therapy is often used to help treat an individual’s problem that has dire effects on the entire family, i.e. depression, anxiety and behavioural issues. This type of psychotherapy is also helpful in addressing family-centric problems, i.e. conflicts between spouses, siblings, parents and children. 

 

What is Family Therapy? 

Family therapy is psychotherapy designed to identify family patterns that may have contributed to behavioural or mental well-being concerns. The idea is to help family members break those habits as the family therapist involves the family in discussion and problem-solving. 

 

What can I expect when my family and I attend a Family Therapy session? 

During family systems therapy, the family therapist works individually and collaboratively to resolve their issue, which directly affects one or more family members. Each family member has the space to say what they think and how they feel as the issue affects them. For example, when a teen has anxiety issues, a family member gets to talk about how this issue impacts them.  

 

How long is each session and how long is the therapy period? 

1.5 hours per session over a period of 4-8 sessions, subject to review with your family therapist. Family therapy is a specialised counselling process. No one is a miracle worker. It takes time and commitment for the family to work through their issues. 

 

Are family therapists trained? 

Yes, systemic family therapists are trained with a Masters in Family and Systemic Psychotherapy, a specialised skills competency in systemic couple and family work. It draws on systems thinking and views the family as a unit. It evaluates the parts of the system (individual) in relation to the whole (family) and examines how an issue of one or more members of the family affects the whole family. It suggests that a family member’s behaviour or issue may be embedded in the family dynamics and influenced by the family of origin issues. 

Family Therapists would have undergone at least 560 hours of academic instruction and supervised clinical practice, accompanied by years of experience. 

 

When should my family and I attend Family Therapy?

It is always helpful to seek family therapy early before the issue snowballs and becomes more difficult or complicated to manage at the later stage. 

 

Who should attend Family Therapy? 

Immediate Family members in a family nucleus should attend Family Therapy, i.e. couples, parents, children (includes teens and adult children) siblings.

 

Does my whole family need to attend? What happens if I am unable to get all my family members to attend Family Therapy? 

It will be helpful if your family can attend therapy together. However, it is okay if not all family members can turn up for therapy. The family therapist will collaborate with the members who come for therapy sessions. 

 

How do I prepare for Family Therapy? 

Discuss with your family members about attending therapy together. Think and write down what you want to discuss before each session. Then, ask your family therapist how you want to improve the communication in the family. 

 

Is there confidentiality? 

Yes, the session is confidential under the Singapore Data Protection Act 2012 (“Act”). 

 

Where can I attend Family Therapy? 

Promises Healthcare provides family therapy service, so feel free to visit our website or contact us at Tel: 6397 7309 to make an appointment. 

Winifred’s “Rules” for a Flourishing Marriage

Winifred’s “Rules” for a Flourishing Marriage

Written by: Winifred Ling, Couples Therapist and Relationship Coach

*This was first posted on her blog.

I made an analysis of the 10 Rules of Marriage that I found on the internet recently and received several requests for proactive and positive rules that couples can abide by.

Based on what I understand and practise as a relationship expert, I came up with Winifred’s 10 “rules” that I hope will encourage you to invest in your marriage or relationship. These rules are derived from the principles used in Gottman Method Couples Therapy as well as Applied Positive Psychology that I am skilled in.

While I call them “rules”, they are not cast in stone. Pick and decide with your partner on the rules that are most relevant to your current stage of relationship. Let’s dive in and look at each of them.

  1. Be a safe harbour to each other

What this means is that you will be the person that your partner will turn to for connection, support, comfort and love. There is intimacy and closeness when you can be your real and authentic self. You also prioritise each other when you make decisions. For this safe harbour to be strong, you make effort to safeguard the relationship by setting clear boundaries on rules of engagement with the opposite sex. You don’t take the marriage for granted. For couples who share the same faith, pray and grow your faith together.

  1. Adopt a growth mindset

Be willing to learn and change, recognising that there are skills that each of you can learn in order to deepen your relationship and connection. Instead of seeing your partner from your own perspective and forming your own conclusions, entertain the possibility of discovering new things about each other. Continue to work on being the best version of yourself for each other. Cultivate self-awareness so that you can continue to reveal your true self to your partner.

  1. Listen, summarise and validate

The first rule in listening to each other is that you’re not both talking at the same time! Unfortunately, I observe the contrary a lot in my couples. After a while, both persons are talking at the same time and no one is listening. Always take turns to speak. To ensure that you are truly listening, make sure that you are able to summarise and validate the point or position of your partner to his/her satisfaction. Always check to see if you’ve heard each other’s side of the story correctly. This is the foundation of good communication.

  1. Practice gratitude

Much research has shown the importance of gratitude not only in the formation of a new relationship but also in the successful maintenance of these intimate bonds. Additionally, the experience of gratitude enables you to feel closer to your partner thereby leading to a greater satisfaction in the relationship. When you are grateful for your relationship, you’re less likely to compare yourself or your partner with someone else. Learn to focus on what is good in your partner and the relationship will become stronger and deeper. Verbalise your gratitude to your partner frequently to minimise the feeling of being underappreciated.

  1. Do small things often

It is more important to show your care and love through tangible actions frequently rather than doing a grand gesture once or twice a year on special occasions. You strengthen the emotional connection between the two of you when you do small acts of service and love to your partner by sending a message to encourage him or her on a challenging day or to share in the joy of small wins. Identify your partner’s love language and show your love accordingly in a way that he or she can receive and appreciate. Thank each other regularly, affirm the virtues you admire in one another and be willing to apologise first to repair any regrettable incidence.

  1. Build a healthy love bank

A “love bank” is a collection of what makes you feel connected, cared for and valued by your partner. The concept is similar to a normal bank account where there are deposits and withdrawals. When you build more positive interactions with your partner, your emotional love bank account flourishes. You feel safe and secure. Even if you have a “withdrawal” (for example, a small argument), it doesn’t feel too threatening. You know that you have sufficient amount in that will not result in a deficit. When you notice that your partner or you are getting more annoyed and easily triggered,there is a danger that you may need an overdraft. For example, things that don’t usually bother you about your partner’s behaviour, irritate you now. Pay attention to it and put in effort to increase the emotional connection. Ways to increase your love bank include understanding your partner’s inner world, showing fondness and admiration, and turning towards his or her bids for connection. Repeat #3, #4 and #5. Be mindful not to turn this into a game of reciprocity where comparisons are made on who’s done more.

  1. Approach conflict with curiosity

The ability to regulate conflicts is critical to the success of a relationship. When you address your differences adequately, they are less likely to snowball into a massive conflict. When you find yourself in a different position from that of your partner, be curious and ask questions about his or her position so that you can deepen your understanding of your partner. What happens more often than not is an assumption is made that your partner is  making your life difficult by being oppositional or disagreeable. This perception is detrimental as you begin to assume the worst in each other. Those who are conflict-avoidant often find it challenging to regulate their own emotions and the emotions of their partner during conflicts. It’s important for them to learn the skill to call for a break so that they can self-soothe before continuing with the emotionally-charged conversation. When you are curious and re-frame your conflict as an opportunity to deepen your understanding of each other, the differences become less daunting.

  1. Be playful and laugh a lot

Recall the time when you first got together: there were easy conversations, plenty of laughter and fun. As you progress to different stages of the relationship, responsibilities and burdens will increase. As such, it is easy to slip into a routine and forget about having fun together. Cultivate and utilise your sense of humour as it is a good way to connect with your partner and to lift the mood when the going gets tough. Watch comedies, share jokes and funny stories so that you can laugh together. If you have kids, laugh with them too. Life is hard and it will be harder when we take everything too seriously.

  1. Support each other’s dreams

Couples who decide to be committed and marry each other usually have dreams in mind. When you are not intentional in having such an important conversation with your partner about their dreams, it is easy to be consumed by day-to-day tasks and activities that you forget the big picture. Take time to find out and revisit your partner’s dreams regularly. Initiate such conversations when you’d like to take a new direction in your life. You can enhance your relationship by creating shared meaning and dreams. Common ones include building a family and home together, finding a cause that’s meaningful for you to support, creating impact through the work that you do either professionally or in the community you serve. Discussion of such dreams is important as it will affect the decisions that you make as a couple and family.

  1. Accept influence and compromise

It is impossible to always find agreement between two individuals. Therefore being able to accept influence and compromise is key to the success of the relationship. Accepting influence is about developing your ability to find a point of agreement in your partner’s position. It is not about insisting that you’re right or finding evidence that your partner is wrong all the time. In accepting influence, it doesn’t mean that you need to change into someone you are not. You need to have a good sense of who you are at your core, and be sure to protect it so that you are not coerced into becoming someone else. If you make the decision to be the person that your partner needs you to be, accept your responsibility for that decision rather than blaming it on your partner. The challenge in accepting influence is really about relinquishing your control and preferences some of the time to prioritise the needs of your partner.

 

I’d really love to hear what you think of these “rules” and which might be the ones that you will focus on cultivating and practicing. Feel free to email me your thoughts and questions.

If you find this blog post helpful, you have my permission to share it with your friends and family.

Relationship Fortifying Versus Relationship Recovery

Relationship Fortifying Versus Relationship Recovery

Written by: Winifred Ling, Couples Therapist & Relationship Coach

As a couple therapist, the question I sometimes get is, ”Is my problem serious enough to warrant a therapist?” 

I like to address this question in this article. 

There are 3 key reasons why you’d want to see a couples therapist/relationship coach

  1. When you have issues in the relationship that you’ve tried to solve but you’re unable to.
  2. When you want to do a health check for your relationship
  3. When you’d like to enhance your relationship 

Prevention is better than cure and this applies to relationship as well. If you’re in a committed relationship and not married yet, nothing should stop you from finding ways to strengthen your romantic competence. 

The majority of couples that I see now in my clinic are those with troubled marriage or also known as ‘relationship recovery’. Increasingly, I have more couples who decided to seek help and they are in under category 2 and 3. It’s highly encouraging for me to see this trend as younger couples are less affected by the stigma of seeking help.

In enhancing your relationship, what you can expect is the identification of possible conflict areas, assessment of your communication and conflict management skills, emotional regulation skills as well as the strength of your relationship. The former framework of therapy is based on looking at the problems and trying to fix them. What was missing is how to focus on what is good in the relationship and magnify and fortify those strength? This is equally important and it’s also more positive. 

For ‘relationship recovery process’, the types of cases that I see include infidelity, being stuck in conflicts, poor emotional regulation which leads to avoidance of conflict and rebuilding trust and commitment. 

There is a certain transition in life where relationship coaching or therapy is highly recommended. This is as follows:

  • Pre-marital: Before you make the lifelong commitment, you want to be ensured that your chances at staying married is as high as possible. You want to know what the non-negotiables are and learn skills that make the process of integrating your life smoother.
  • Transitioning to parenthood: While bringing a baby into a family is a happy occasion, it brings about a lot of stresses to the marriage. 2/3 or 67% of couples who transition to parenthood suffer a decline in their satisfaction of marriage. Help and support is available for  you to learn how you can mediate this and continue to keep the spark in the marriage alive. 
  • Couples who have suffered child lost or have unsuccessful attempts at assisted reproduction. 
  • Couples who are planning to adopt: You will want to know what are the expectations that you have of each other and what sort of rituals of connection you can establish so that you don’t lose sight of your own relationship.
  • When you have a child with special needs either physical, intellectual or mental: This additional stress could make or break the marriage and often times, couples place so much focus on the child that he/she ends up neglecting the partner. What you want to cultivate is the mindset “we against the world” rather than “I am alone in this marriage”. 
  • Empty nest: There is an increase in marital break-ups at this stage because they have waited for their young children to grow up. The many years of emotional disconnection and busyness of life in caring for the children may have caused neglect to the marriage but it is possible to breathe a new lease of life to the marriage so that you can enjoy your golden years meaningfully. 

Ultimately, relationship is hard work. You will need to consistently invest in it just like how you would a plant. You will need to Create an environment that’s conducive for the relationship to thrive; learn the skills that can help you connect better with your significant other and be intentional in what you want in the relationship. 

Healing from being with a person with Narcissistic Personality Disorder

Healing from being with a person with Narcissistic Personality Disorder

Written by: Winifred Ling, Couples Therapist & Relationship Coach

Happily-ever-after is an ideal that many believe and pursue and numerous studies have suggested that the key to happiness lies in a thriving marriage. I am also convinced that when couples come together and decide to get married, they do not have the thought of a divorce on the horizon.  

To many, marriage is not a frivolous decision but one where he or she has deliberated and decided to entrust oneself to the other legally. Imagine the horror when shortly after the wedding bells, you discover that your spouse turned out to be someone that you don’t recognise and ends up hurting you so deeply that you wonder how you even got to this point: being romanced to being discarded. This is what it is like to be in a relationship with a narcissist. 

Let’s explore the traits of a narcissist. 

The following are the 9 official criteria for Narcissistic Personality Disorder (NPD):

  • grandiose sense of self-importance
  • preoccupation with fantasies of unlimited success, power, brilliance, beauty, or ideal love
  • believes they’re special, unique and can only be understood by, or should associate with, other special or high-status people or institutions
  • need for excessive admiration
  • sense of entitlement
  • interpersonally exploitative behaviour
  • lack of empathy
  • envy of others or a belief that others are envious of them
  • demonstration of arrogant and haughty behaviours or attitudes

In essence, a narcissist has an excessive sense of self-importance over and above the needs of others. There is a sense of grandiosity and arrogance; and a lack of ability to empathise and experience reciprocity within intimate relationships. They are typically charming and charismatic. The early stages of the relationship are almost always exhilarating, romantic, powerful and intense. Love-bombing is a tactic where NPD makes you feel so special and loved that you can’t help but fall deeper in love with him or her. Most narcissists only reveal their true colours when they are in conflict. And when you no longer serve their needs, they discard you from their lives or make it a living hell for you. 

Imagine the adverse and trauma that one experiences when you wake up one day and realises that the love you’ve received is not real and permanent. 

The following are the lasting psychological and emotional impact of being in a relationship with a person with NPD: 

  1. “I don’t know what is real anymore.”
    Survivors of persons with NPD have the inability to trust their own judgment. Because gaslighting is a key feature in this toxic relationship, they lose touch with what is the reality. Gaslighting is defined as a form of manipulation, emotional and psychological abuse that results in a slow dismantling of a victim’s self-trust and judgment.
  2. “It is all my fault. Everything I do is wrong. I trigger him/her. I deserve his/her anger.”
    Because a person with NPD will never assume responsibility for anything (they believe they do no wrong), they turn it around and project their emotions on the survivor. The survivor is the one who is over-sensitive and would ask irritating questions that trigger them to react. The consequence of this is that the survivors feel powerless and start to blame themselves for not being good enough for their partner.
  3. “I am worthless and deserve nothing
    From the constant criticizing and undermining from a person with NPD, the survivors begin to accept the narrative that they are the problem and suffer from low self-esteem. They may start to withdraw from their family and friends who are concerned and question the relationship. They also hide their partner’s behaviour and lie about it.
  4. “I am going crazy”
    This is related to point #1. Because a person with NPD constantly lie and intentionally say things that make the survivors question their reality, they start to think that they are crazy for having those questions. They feel confused and lost all the time.
  5. “I don’t know. I can’t decide. It will be wrong anyway.”
    They have great difficulty in making decisions because they start to believe that they can’t do anything right. This is the message that is drummed into them persistently and this could extend into other aspects of life, such as in their work.

 

One of the common frustrations that my clients, who have survived persons with NPD, have often expressed: ‘how is it possible that they missed the warning signs’. Because of the suffering that they have been through, they have asked for the warning signs to be shared so that more can be aware and watch out for them in their relationships. 

  1. Self-centeredness
    They believe that the world revolves around them. They are not able to empathise and therefore can only see from their point of view. When things do not go their way, they get very upset and may threaten to end the relationship. Everything is on their terms. For example, my client shared that when they were dating, the partner dictated when to meet according to his schedule. Not knowing better, she accommodated. That is a red flag. Also, when they no longer have use of the partner, they have no qualms to simply discard them by being emotionally unavailable, refusing to communicate and abandoning the partner.
  2. Frequent threats and emotional blackmail
    If you feel like you are perpetually walking on eggshells not knowing when your partner will explode on you, chances are he/she has NPD. Threats and emotional blackmail are their tools to control and get you to submit to their wants. E.g., Go ahead and leave, I never needed you anyway. I’ll tell everyone what a mean person you are.”
  3. They act entitled and rules don’t apply to them.
    They believe that their needs are more important than their partner’s. There will be no reciprocal gestures unless there is an ulterior motive to get what he or she wants. Because of the self-importance and arrogance, they believe that they can do as they please as long as they don’t get caught. They deserve special treatments.
  4. Obsessive focus on the external
    This applies to how they dress and carry themselves. Typically they are attractive, have material possessions and are of certain social status. They appear to be an excellent “catch”. They will go all out to inflate their status and standing. Another client told me that her husband, a covert narcissist, was charming and social. His real self only surfaced when they were on their own and when he felt threatened by her. This creates problems as people may not believe her when she tells her challenges.
  5. They are master manipulators and schemers.
    The key emotions that you feel when you’re with a narcissist are guilt, shame and confusion. The hallmark of a person with NPD is the inability and unwillingness to take responsibility for any action and word. Consequently, they project their emotions onto the survivors and make them feel guilty and responsible. They can also be verbally abusive and are good liars. They scheme and twist the words of the survivors to their advantage. They have no issue in making their partners the bad guy and spread rumours that paint themselves as the victim. The bottom line is this: they need to make themselves feel good at the expense of everything and everyone. When they don’t get what they want, they will withdraw either physically and /or emotionally from the partner. They may give the silent treatment, be passive-aggressive, stonewall and/or ignore the partner. At the end of it, the partner will accept the blame and promise to not upset them next time.
  6. They are hot, then cold.
    When they want something, they will go all out to get it. As such, in the early stages of the relationship or when they are on a mission to keep you under their control. They will pull out all the stops to make you feel wanted, admired and loved. One moment, you could be the most important person in their lives and in the next, when you don’t agree with them on something, it could be a trivial matter, you would become a worthless person that is undeserving of his/her respect and love. The switch from hot to cold is unnerving and they will make the survivors think that the problem lies with them.

 

In spite of the detrimental impacts of being in a relationship with a narcissist, the good news is that it is possible to heal from it. I have supported and seen my clients live a meaningful and flourishing life following the breakup with a narcissist. Though the journey may not be easy, if one is willing to work with a professional to go deeper and understand the pattern of relationships in their lives, they can find healing and freedom. 

What are the steps to heal? 

  1. Educate yourself on NPD and accept that it is a disorder. Know that you are not alone and you are not the problem. Raise awareness for it. The World Narcissistic Abuse Awareness Day is on 1 June. Get involved and when you are ready, share your story. You can empower and help others by sharing your experience courageously.
  2. Get professional help as dealing with trauma can be complicated. Learn to connect the past to the present; typically, the dynamics between the person with NPD and the survivor is one that the latter is familiar with. It is not uncommon that upon the realization that the partner has NPD, the survivor can see that a family member could be one as well. Those who persist in such toxic relationships are usually accustomed to such dynamics from childhood.
  3. Practice boundaries – physical and emotional. Have zero contact or keep it to a minimum should you share the care of the children. The survivors are usually empathic and attuned to the feelings of others. Be mindful not to take on feelings that are not yours. Have clarity on what is your responsibility and discard those that are not yours.
  4. Build a strong foundation – focus on one’s strengths and resilience, in ending the relationship and working through the issues. Find meaning in it by rewriting the narrative.
  5. Forgive and work on self-love. Self-compassion is a critical component in recovering. Learn to take good care of yourself – physical, emotional, psychological, spiritual, social.
  6. Pay attention to your body as trauma is stored in your body. Practice mindfulness to bring yourself to the present moment when you’re triggered by difficult memories. The triggers will still be there, and the healing process will be imperfect and a work-in-progress.

  7. Focus on the good – that is in you; the work that you have put in to heal and maintain your well-being by learning new skills and maintaining good habits. Celebrate quick wins when you are able to enforce boundaries or not take on responsibility for how others are feeling.
  8. Embrace a healthy relationship. After being in a toxic relationship for a long time, being in a healthy relationship can feel weird and scary. You aren’t sure what to make of it. The lure to get back to what is familiar albeit negative for you is high. Be aware of it and put measures in place so that you can recalibrate when you feel threatened.

 

Let’s remember that significant relationships in our lives will impact our mental well-being. Even as we focus on the benefits of positive relationships and promote it, we also need to provide support for those who have been through traumatic and toxic relationships. The key is to remember that relationships should enhance your lives and motivate you to be a better version of yourself. When there are disempowerment and manipulation in the relationship, it is not healthy, and you can make the decision to get out of it. 

Healing comes with returning your focus to yourself, acknowledging your feelings and emotional experience and taking responsibility for yourself. Through the right help and therapy, you can learn new skills, to regulate your emotions, have better communication and understanding, and help yourself break the cycle of unhealthy patterns. Your resilience can be enhanced, and a flourishing life is once again within your reach. 


DSM-IV and DSM-5 Criteria for the Personality Disorders

 

Understanding Childhood Emotional Neglect 

Understanding Childhood Emotional Neglect 

As a child, how did adults around you react whenever you expressed your feelings? Did you grow up receiving that subtle message to wall up your emotions so they don’t get the better of you, or become anyone else’s burden? Childhood Emotional Neglect (CEN) is a topic often overlooked, and many fail to realise that it can eventually manifest into mood disorders or anxiety disorders if not dealt with appropriately. 

Childhood Emotional Neglect occurs when our caretakers or parental figures fail to respond to our affectional needs suitably during critical stages in our development. An individual who grows up experiencing emotional neglect may experience a pattern of having his or her emotions being disregarded, invalidated or downplayed by others. While many of us may wonder, “What kind of parent doesn’t pay attention to a child’s emotional needs?” In reality, some parents may not actually realise that they have been shutting their child(ren) out emotionally. In Asian societies in particular, some parents are commonly labelled as “authoritarian” or “tiger parents”. These people may in fact perceive themselves to be giving the absolute best to their child, enforcing strict discipline and ensuring that their offsprings are well-equipped with the best skills to succeed in life. However, young children and teenagers may instead be overwhelmed by such demands, and feel as if their feelings were never considered or understood. Whilst we mentioned its prevalence in Asian societies, it is key to note that it is not merely limited to these children – many worldwide experience it too, making it an exceptionally important subject. With emotional neglect being a common feature in the childhood of many, it can become an undesirable shadow that follows us throughout our lives – eventually leading to undermined happiness and the lack of an authentic sense of self.  

Delving into the matter at hand, Childhood Emotional Neglect (CEN) can come in two forms – active and passive CEN. Active CEN is when parents or caregivers actively act in a way that dismisses or denies the child’s emotions. For instance, a boy is sent to his room for crying over the death of his pet fish, and his parents complain of having an overly-dramatic son. When the child is being denied of his sadness and is receiving the message that his behaviour is unreasonable, this forces the child to grow up hiding his feelings, and at times struggling with fear and shame of his own emotions. On the other hand, passive CEN occurs when parents show a lack of care or validation regarding the child’s emotional needs. When parents fail to notice when the child is angry, upset, hurt or anxious, this gives off a subliminal message to the child that his feelings are irrelevant or not worthy of note. In any case, both forms of CEN are clearly detrimental towards one’s mental health. 

Albeit not having a test or questionnaire that can help with a diagnosis for CEN, there are certain “symptoms” of CEN that may surface, be it in the later parts of one’s teenage years or adulthood.\

For one, individuals who have experienced CEN may find it difficult to prioritise their wants and needs, even if it’s something that would bring them great joy. It is innate for us to have desires and to just be aware of what we want and need. However, for someone who grows up having his feelings invalidated and cast aside, it could become a natural thing for him to keep his desires to himself. As such, even if opportunities do come along, these people would often fall through the cracks, most probably due to their inability to request for it upfront, or by allowing others to seize it instead. 

CEN also causes one to start projecting any feelings inward, regardless of whether they are negative or positive ones. People who have experienced CEN are particularly predisposed to turning feelings of anger inwards, as they never learnt how to be comfortable with their emotions, nor how to handle them in a healthy manner. It is often said that nothing good comes from bottled-up feelings, and that is absolutely true. 

Having pent-up feelings also mean that these individuals are not likely to seek help or lean into their support systems whenever things get tough, making them feel all the more isolated and vulnerable. Even at times when they are feeling deeply challenged by certain life events, they find themselves trying to cope all on their own, leading to unhealthy stress levels and anxiety. Unsurprisingly, the constant feelings of shame and inability to get in touch with one’s emotions will eventually lead to one losing sight of his or her strengths as well. As a result, poor self-esteem is sometimes a consequence of CEN.

While many individuals, including adults, fail to recognise the impacts of childhood emotional neglect on their lives due to its subtle nature, it is important that they get themselves back on track – to regain true happiness and greater self-esteem. You might have grown up devoid of your own emotions, but you need to recognise that facing them head-on will ultimately help you to cope with life events and for you to regain your sense of self. 

Learn to start getting in touch with and embracing what you feel – both the good and bad. Identifying what you feel in certain situations will be a good step towards helping yourself cope with your environment and daily life. When challenges seem overwhelming, don’t feel afraid or ashamed of reaching out to your friends and family for help either. Even more so, if you ever feel like you’re losing control of your life and are derailing emotionally, seek professional help as soon as possible. While not everyone who grows up with emotional neglect ends up with mood disorders such as depression or anxiety disorders, there are certainly people who do. Don’t deny yourself of your emotions any longer, therapy might just be the solution to helping you learn the vital life-coping skills you never learnt as a child.  

 


References: 

https://www.straitstimes.com/singapore/how-emotional-neglect-during-childhood-affects-ones-mental-health (Accessed 07/10)

https://blogs.psychcentral.com/childhood-neglect/2018/09/the-2-types-of-childhood-emotional-neglect-active-and-passive/  (Accessed 07/10)

Photo by Isai Ramos on Unsplash

 

How Do You Find The Right Therapist For You

How Do You Find The Right Therapist For You

For many individuals, therapy is a rather intense and personal topic, and it could have taken them a lot of courage to finally seek the help that they need. Keeping this in mind, it is exceptionally crucial that one finds the right therapist, for there’s a pre-existing implicit clinical belief that the level of treatment effectiveness is greatly dependent on the therapist-client fit. Of course, every client would love to be able to – ideally – find that one therapist whom they can fully open up to from the very beginning, but in reality, that may not be the case. At times, it is necessary to assess your relationship with your therapist and evaluate if there’s the good rapport you need for your sessions to be a success. Ultimately, it boils down to whether you feel a steady, reliable and safe connection with the therapist, and whether you are making the progress you hope for. 

To give you some background, studies over the years have shown that the more similar the therapist and the client, the higher the rate of recovery. As an example, an assessment instrument entitled the “Structural Profile Inventory(SPI)”, which measures seven “independent yet interactive” variables (behaviours, affects, sensory imagery, cognition, interpersonal, drugs/biological factors or BASIC-ID), showed that client-therapist similarity on the SPI predicted a better psychotherapy outcome for the client as measured by differences pre- and post-treatment on the Brief Symptom Inventory. Moreover, the demographic similarity between therapist and client facilitates positive perceptions of the relationship in the beginning stages of treatment, enhances commitment to remaining in treatment, and at times can accelerate the amount of improvement experienced by clients. More precisely, it can be said that age, ethnicity, and gender similarity have been associated with positive client perceptions of the treatment relationship. With gender and cultural similarities appearing the most strongly preferred among clients, these domains generally enhance clients’ perceptions of their therapists’ level of understanding and empathy, and as a result, sessions are judged to be more advantageous and worthwhile. However, besides these, there are also other means to assess your “fit” with your therapist, and we’re here to discuss just that.

First and foremost, consider if you are seeking help in the right place. Does the therapist you are looking at specialise in the area you are seeking help for? Before we can even touch on the topic of interpersonal therapist-client fit, it is important for you to take the time to do some research on various therapists’ profiles – in other words, to sift through and read up on their respective areas of expertise. Typically, therapists would have their area(s) of specialisation up on their online profile directories. It would be clearly indicated if they specialise in areas such as substance abuse, family therapy, or even anger management. It goes without saying that, for example, it would be inappropriate to consult a psychologist who specialises in child psychology when you’re clearly looking for someone who can help you with your substance-use addiction. With that said, it is to no one’s benefit for you to rush into therapy blindly. 

Once you have chosen the potential therapist that you are most likely to want to have see you through your road to recovery, another essential question you should ask yourself is whether you are comfortable with their suggested mode of therapy. During consultations, you will have the opportunity to enquire about their recommended techniques or treatment methods that will be explored during your subsequent sessions. If you are uncomfortable with any particular process, giving honest feedback and exploring other methods is always an option. However, at any point, you also have the right to seek other therapists who may be able to help you in other ways that don’t put you in a tight spot. After all, therapy is all about having a safe and comfortable space for you to sort out your difficulties. 

When assessing your interpersonal connection with your therapist, make sure to trust your gut. This way, you’ll also be able to track your progress better and to seek alternative help if required. Some questions you can ask yourself are:

  1. Am I satisfied with the current balance of talking and listening with my therapist?
  2. Is my overall therapy experience safe, warm, and validating? 
  3. Am I fully assured that I’m in a non-judgemental space where I can be fully honest?
  4. How much has the therapist helped me to gain greater insight into my own behaviour and thoughts so far? 
  5. Am I becoming more capable of coping (independently) with stressful or triggering situations over time?
  6. Am I noticing more positive changes in myself, as compared to when I first started therapy?

As mentioned, a major deciding factor should also be on whether you find yourself noticing positive changes in your thought cycles and behaviour after a couple of sessions. At the end of the day, therapy should be about working towards achieving your desired outcome, and should definitely not be limited to weekly venting sessions. Although venting and letting out hard feelings can provide temporary relief, it fosters a client’s dependence on the therapist over time and further reinforces the client’s problems. Therapy should instead help you to feel more confident that you’ve developed the relevant skill sets in order to cope with whatever emotional challenges that brought you to seek therapy in the first place.

Naturally, there’s no guarantee that we will find chemistry with the first therapist we meet. The chemistry between people varies, and sometimes it’s just not possible for us to force it. Thus, it is important to remember that a lack of fit between therapist and client is no one’s fault. However, remember that the ball is in our court, and it is within our control to start looking in the right place for the sake of our own well-being.


 1 Herman, S.M. (1998). The relationship between therapist-client modality similarity and psychotherapy outcome. Journal of Psychotherapy Practice and Research, 1998 Winter; 7(1): 56-64.

2 Luborksky, L., Crits-Christoph, P., Alexander, L., Margolis, M., & Cohen, M. (1983). Two Helping alliance methods for predicting outcomes of psychotherapy: A counting signs vs. a global rating method. Journal of Nervous and Mental Disease, 171, 480-491.

3 Jones, E. E., (1978). Effects of race on psychotherapy process and outcome: An exploratory investigation. Psychotherapy: Theory, Research and Practice, 15, 226-236.

4 Blase, J. J. (1979). A study of the effects of sec of the client and sex of the therapist on clients’ satisfaction with psychotherapy. Dissertation Abstracts International, 39, 6107B-6108B.

Beutler, L.E., Clarkin, J., Crago, M. and Bergan, J., 1991. Client-therapist matching. Pergamon general psychology series, 162, pp.699-716. (Accessed 30/08/2020)

https://www.counsellingconnection.com/index.php/2019/12/03/assessing-therapist-client-fit/ (Accessed 30/08/2020)

https://www.nytimes.com/roomfordebate/2013/02/14/think-like-a-pope-knowing-when-to-quit/when-to-quit-therapy (Accessed 30/08/2020)

Photo by Cytonn Photography on Unsplash