MHA Question & Answer

QUESTIONS ON WALKING ALONGSIDE SOMEONE

Q1. Assume I comfort a friend. However, my conscience tells me that he/she is not having the right choice/mindset. How do I help while setting a boundary in my moral conscience of good and bad, right and wrong without hurting the person?

Helping and comforting a friend does not require you to change your moral stand. However, if you want the opportunity to share your moral perspective with your friend, you would need to first take perspective i.e. you need to provide your friend with a safespace to share his/her worldview without judgement AND you need to put yourself in his/her shoes to gain an understanding as to what contributed to your friend’s worldview. If you can do this to the extent that your friend feels safe sharing with you, then you are more likely to have the opportunity to share your perspective with your friend in time to come. Conveying your moral stand does not have to be the first thing you do in comforting a friend. Your friend needs “COMFORT” i.e. someone to listen and understand where they are coming from. They do not need a moral police at the time they need understanding. This is part and parcel of effective listening. When your friend is convinced that his/her point of view matters to you, he/she is more likely to hear your perspective.

Q2. What if you know of a friend facing mental health problem but he/she doesn’t want to admit? How do you approach the matter? How do you help?

Focus more on how your friend is doing. Focus less on getting them to admit they have a problem because most of the time, the person already knows but finds it hard to acknowledge that he/she needs help. Keep connecting with this friend and live life with this person and don’t make the goal of your conversation about mental health. Remember that your friend is more than just his/her struggle with mental health. When there is genuine connection and when your friend knows that your connection with him/her is not about “fixing him/her”, then you are more likely to convince this person that he/she needs to seek help.

Q3. I have a family member, who thinks that everyone despises her regardless whether she knows them or not, I don’t know how to help her. Please advise.

First, ask your family member to tell you as much as possible what makes him/her conclude that someone is despising him/her. Then differentiate “perception” (i.e. what he/she thinks is happening) from “facts” (i.e. what actually took place – evidence). Help your family member “reappraise” i.e. come up with other possibilities that might explain the behaviours of people whom your family member perceives are despising him/her.

Q4. I have a friend who does not want to meet people but prefer to Whatsapp. In my conversation with her, I realized she is living in her own world and creating false stories about herself. She is reluctant to seek help and only wants to stay in her room. It has been 2 yrs she has been living like this. How can I help her?

I think you are already doing something to help her. If she refused to seek help, there is little you can do as a friend. Keep connecting with her over the Whatsapp. When you have an opportunity, you can suggest she seeks help but I’m sure you have already done that. Keep doing this.

You can also provide some good websites for her to read regarding mental health. A good one is www.mind.org.uk You can discuss what she thinks about the information on this website.

Q5. Would you agree that young people nowadays are not resilient which is why they succumb to peer pressure? Since talking about it seems to be very effective for young people to express themselves, how can I encourage my 19 yr old introverted son to start talking about what’s going on in his heart and mind? Pls help.

Being accepted by peers and having a sense of belonging to a community of peers are part and parcel of normal adolescence. Hence, during adolescence, peers are crucial part of a young person’s social support system.

Learning how to communicate thoughts and emotions takes time and practice. It doesn’t happen on demand. It is a skill both for the young person and whoever is engaging with them. If you want to talk to your son about his emotions, you need to develop a safespace for him to share his life with you. Telling him that he is not resilient will not help him open up to you. Listening and taking his perspective without judgement is more likely to help him open up to you.

Q6. How do we deal with our young adult child (just finish study & currently looking for a job), who seems to have mood swings and depression earlier this year, now isolating himself in his room most of the time playing games online/watch YouTube. Occasionally goes out with friends for tea, or to the gym. Doesn’t want to talk to family. How do we reach out to him and deal with the situation where we think he might need help and attention? Thank you.

It’s hard to talk when there is a pressure to open up and when there is an over-emphasis on problems per se. While it is crucial that problems get addressed, it is more important to first form a connection where the person feels that he/she matters. If conversations make the person feel constantly under scrutiny or that he/she needs help or needs “to be fixed”, the person is likely to disconnect. When that happens, it is less likely that any problem get addressed. Hence, the priority is to form and sustain connection and take it from there.

Q7. I have a nephew who is always angry with his mom even when his mom was diagnosed with cancer, he didn’t feel sad or show concern. We guessed it could be because his mom shows more care and attention to his younger brother. This nephew is in his 20s now. He just refused to talk to his mom and avoided her most of the time. He tries to create problem for her eg. Coming home late, won’t inform whereabouts, won’t call his mom and even his dad would use the word “her” when refers to his mom. How can I help?

People cope with distress in different ways. The news of a loved one having cancer can be tremendously distressing and frightening. Your nephew may not be angry with his mom for the reason you mentioned. Anger can be a way of expressing distress for many people, particularly men. It could be your nephew’s expression of fear e.g. fear of losing his mom or it could be his expression of helplessness, which many cancer carers experience. In any case, guessing does not help the situation. It is best that your nephew has a listening ear, a safespace to share his fears without judgement. If you want to help, you can connect with him by providing this safespace for him to express in ways he knows how. Let him tell you what is going on in his mind and what makes him angry. Don’t make any conclusion about what he is going through using mere assumption or guessing. You may be wrong.

Q8. My son recently befriended with a non-believer girlfriend in Uni. Girl is very attention seeker. Kind and sweet. 23 yrs old. Son is stressed with:

  1. Self-control – to avoid intimacy with the gal.
  2. Son talked to mom. Knowing that he is in his curiosity in this first boy-girl relationship.
  3. Now, mom is stressed because can’t stop son from this relationship and son’s anxiety being a good Christian vs a caring boyfriend.
  4. What kind of support can son get?
  5. What can parents advise?

It’s good to know that your son shares his struggles with you. Giving him a listening ear is a significant kind of support you are already giving your son. All couples have challenges and need to learn how to work things out. Breaking up is not necessarily the best solution when addressing challenges. Perhaps you can help your son process his thoughts by soliciting the rationale or reasoning behind his decisions and choices. Often, this way of engagement can help clarify how a decision is made and whether the decision is sound. A top-down approach is often less effective and more likely to create a defensive response.

Q9. In the event of someone suffering from a mental disorder and put himself/herself into a ‘self-exile’ state – cutting all connections toward the outside world as a superset, how should I help him/her? Should a third-party person with no deep ties offer assistance to help?

Many people with a mental disorder feels stigmatized. The perceived shame can drive someone into isolation. The responsibility to get help and to engage with community are two-sided i.e. both the person with the condition and the community have responsibilities to seek and provide help respectively. If the person chooses to remain in isolation despite the numerous attempts others make to engage the person, this choice is his/her own to bear. Having said that, the community must continue to engage the person, hopefully in ways that are effective in reducing the stigma this person experiences. The community must remind/build this person as God intended him/her to be: an image of God, highly valued.

Q10. In my point of view, mental disorder are like purgatory, a jail, horrendous jail in a pocket dimension. With all due respect, I believe that people with mental illness need to be watched over quietly as there is no telling what may happen, the unpredictable becomes real. We need to be patient in these volatile cases. True?

There are many types of Mental Disorders. Not all are “volatile” and need “watching over” but EVERYONE with any mental health problems needs someone to love him/her and someone to be his/her community to walk this tough journey of life together. Patience is not the only thing we need as we walk alongside those with mental health problems. We need much more than that.

Q11a. How do you help someone who battles with intrusive thoughts of fear, wanting to perform to impress him/her bosses or colleagues?

Perhaps the person needs to reevaluate his/her purpose and identity. Fear of under-performing can either help us maximize our potential or break our spirit. How it turns out depends very much on our worldview of “who we are” and “what is our purpose”.

Q11b. Please advise on medications that causes impotency and brings devastation to a marriage?

A marriage anchored solely on physical intimacy needs recalibration. Usually, the cause of a marriage breakdown is multifactorial. Both parties contribute to the breakdown. Good to start working out the problem one by one with an honest conversation. Get someone to moderate this conversation if need be.

Q11c. How do you counsel someone who reaches out for a can of beer to calm themselves down?

Nothing wrong with drinking beer for enjoyment or even a form of relaxation from a hard day. It becomes a problem when 1) when drinking becomes a regular coping mechanism or used as a temporal measure to reduce pain and 2) when one finds himself/herself drinking more to acquire a sense of relieve i.e. developing a dependency. In such a situation, one needs to develop an alternative coping mechanism that addresses the problem rather than one that sweeps the problem under the carpet. There are many adaptive coping mechanisms one can learn. Drinking is not one of them.

QUESTIONS ON SPECIFIC MENTAL HEALTH PROBLEMS

Q12. How do I get out of the pit that is crippling social anxiety?

If you find your level of anxiety is significantly affecting your functionality from mundane activities like eating and sleeping to your work performance and relationships you have with friends and family, it is time to seek professional help. You can either seek the help of a Clinical Psychologist or a Psychiatrist.

Q13. Is drug addiction considered a disorder? If so, how do we identify it?

Technically, yes. Please visit educational websites such as www.adfam.org.uk for more information.

Q14. Is dementia a mental disorder?

Dementia is technically a brain condition i.e. neurological disorder. It does impact mental health of the one having this condition and their significant others. For more information, please visit www.who.int/news-room/fact-sheets/detail/dementia

Q15. I am a 65 yr old man. I am having lack of sleep. I can sleep only about 5 hrs plus every night, then waking up feeling tired and sleepy. Having poor memory and worrying about dementia. I feel its damaging to the brain. Any cure? I also have depression since about 16 yrs ago. Never consulted any doctors. Any help?

It would be good for you to visit a Psychiatrist to address your concerns regarding sleep, memory and mood challenges. The Psychiatrist known to manage dementia and aging-related psychological conditions is Dr Philip George at Assunta Hospital. No harm making an appointment to see him to clarify what you can do to manage your concerns and to move forward in making life more manageable for you.

Q16. For OCD condition – who should he/she to see first: Psychiatrist or Psychologist? If someone with OCD condition refuses to see specialists, what is there do?

It depends on how severe the symptoms this person is experiencing ie. how much has this condition affected his/her daily life and social interactions. If significantly affected, it would be advisable to seek a Psychiatrist first to determine if medication is necessary. If no medication is necessary, a follow up with a series of therapy with a clinical psychologist is recommended.

Q17. Really thankful for the helpful information given from the talk which has allowed me to understand my 13 yr old boy better. I have been struggling to deal with him for the past one year. However, with the info I gained today, I still have one concern. I suspect he has Tics, as he likes to do actions such as head-jerking and shoulder-shrugging and in these 2 months, constantly making loud nose sniffling sound. I also suspect he has OCD as his room is extremely tidy and no one is allowed to move his things as he will get upset. As parents, what role can we play to help him?

It would be advisable to bring your son to visit a Psychiatrist who specializes in children and adolescents to address your concerns regarding his tics and suspected OCD symptoms. An example of hospitals that has an adolescence unit is Hospital Kuala Lumpur. You can set an appointment with the Child/Adolescent psychiatrist there.

Q18. If someone cried and then at the other time create issues. Is this considered as mental health problem?

This question is difficult to address because there is very limited information to work on.

Q19. Please give advise for people who has family members who cause problems and yet does not seem to care to resolve any issues which causes unending stress.

Effective communication is needed. Also, the cause of family problems is usually multifactorial and multi-party. You are advised to speak to a counselor.

Q20. Do we label people with emotions such as emotional outburst, anger & rage, frustration, irritation, devastation and depression as a person having mental illness?

Mental illnesses are not the same as distress. The former are diagnosed medical conditions using a specific criteria, including emotional experiences. The assessment is determined by trained professionals. Everyone experiences emotions and expresses emotions in a variety of ways. Both negative and positive emotions are essential for our normal functioning. Hence, there is no “good” or “bad” emotions. Emotions alone cannot determine whether someone has a mental illness.

QUESTIONS ON SUICIDALITY (THOUGHTS AND BEHAVIOURS RELATED TO SUICIDE

For all the responses to the questions in this section, please note that suicidality (issues relating to suicide and self-harm) can be beyond what a community can do. The individuals engaging in self-harm and/or suicide-related behaviours may need professional help above what friends and family can provide. Contact Befrienders, a Psychaitrist or Clinical Psychologist.

Q21. I just want to know about suicide situation, I looked everywhere in my life…

  1. My life as a human being if like slave to my family
  2. My loved one everyday will say something bad so that everything must become bad
  3. I lost everything in life including marriage – end up divorce
  4. But I still keep on living because of the principal that given to me
  5. My question, how can I overcome harsh/dangerous words from my loved ones

I’m glad you are resilient! It’s really hurtful when someone we love says awful things to us and/or about us. We all need to be kinder with our words and see the value in each person we engage. We all need to be more affirming and less destructive with our words.

One of the best ways to manage harsh words, especially when they are false representations of who we are, is to remind ourselves of what is TRUE. Jesus said that the “ truth will set us free”. For example, the Bible says that we are more than conquerors; we are children of God; we are made in the image of God; we are dust but God is not and He enables us and sustains us on the daily basis; we are not alone even when we feel alone etc etc etc. That’s why it’s so so important to be part of a community so that we can share our struggles together and go through thick and thin in life together. Whenever you feel bad and feel like giving up on life, talk to someone in your community about it. Never isolate yourself. Keep your connections with people in your community.

Q22. My daughter talks about suicidal but said that has kept her off. When I drive recklessly, she will say things like “I don’t want to die young” (she is 27). How threatening is her thoughts about suicide?

We must take any suicidal talk seriously. The only way to find out how serious she is about taking her own life is to talk to her about her suicidal ideation (suicidal thoughts). A good website to understand more about suicide and to learn how to engage someone in a conversation about suicide is www.beyondblue.org.au/the-facts/suicide-prevention

Q23. I am academician and am surrounded by young people most of  time. I have a student who always uses ‘self-harm’ as a blackmail to get what he wants (extension of submission deadlines etc.) How do I sniff out/identify genuine cases from just a threat so that I don’t end up pushing such a person “over the cliff”?

Whenever there is self-harm, of any kind, the person engaging in this act needs help. He/she is not managing well with his/her problems, usually emotional management. Hence, rather than “sniffing out the genuine cases”, engage ALL of your students who are self-harming to talk about what made them resort to harming themselves. The focus of the conversation should be more on the triggers or reasons behind the self-harm act rather than the self-harm act itself. Helping this person to manage his/her emotions be it anger, anxiety, low mood, shame etc etc. using more adaptive coping mechanisms such as problem solving skills, time-management, exercise and articulating/expressing emotions will go a long way in reducing/preventing self-harm and self-harm related damages.

Check out: www.beyondblue.org.au/the-facts/suicide-prevention/feeling-suicidal/self-harm-and-self-injury

Q24. I have a friend who commits self-harm, and I am concerned about it. However, we can only communicate via social media. I feel that the case is serious (with pics n self-inflicted wounds) and seeing the person face to face is needed. How can I help the person properly when distance is a factor?

Check out: www.beyondblue.org.au/the-facts/suicide-prevention/feeling-suicidal/self-harm-and-self-injury

Q25. My observation of people I know personally who commits self-harm includes the following: – using physical pain to distract their mind from emotional pain which they are suffering. (physical pain is less painful than emotional pain)

  • having to deal with bleeding from self-harming distracts from the emotional pain.
  • when having a sensory overload will bang their heads against wall/floor or beat themselves (punch nose until bleeds) – How correct/true are those observations?

Somewhat true. For more information on self-harm, check out: www.beyondblue.org.au/the-facts/suicide-prevention/feeling-suicidal/self-harm-and-self-injury

QUESTIONS ON MENTAL HEALTH PROFESSIONALS

Q26. What is the fastest way to look for a psychologist?

Q27. When do we see a psychologist and when do we see a psychiatrist?

QUESTIONS ON THEODICY (THE QUESTION ON WHY GOD ALLOWS EVIL)

Q28. Why would a good God allow such pain and confusion in a believer’s life?

Pain and confusion are messages of danger or things not going as it should. In other words, they drive us to check and do something about the situation we’re in. They focus our attention and help us survive dangers. For example, people with leprosy are not able to experience pain. Consequently, they are highly susceptible to accidents, some of which can be fatal. In other words, pain and confusion are not necessarily always “bad”. Neither are they opposite to the concept of “good”.

Indeed, the biblical text is filled with words synonymous with pain: Jesus, a man of sorrow, the cross, perseverance, suffering, etc etc etc. While God may not have intended for pain to exist in the world He initially created, pain is part and parcel of our fallen nature. The “good God” did not merely conquer pain from a distance. Instead, He came into this pain and experience the full brunt of it and therefore by His stripe, we are healed (Isaiah 53). Healed of the consequences of sin, which pain is one and loss is another and I would say they are two sides of the same coin. Accurate Christian Theology does not render pain as “bad”. The narrative of pain is far more complex than a binary description of “good” or “bad”. Hence, it would make sense that a “Good God” can use pain for the good of those who loves Him and are called for His purpose (Rom 8:28).

Through Christ’ pain on the cross, we are liberated forever. However, we are not yet freed of our mortal embodiment as it stands today. Our body remains a physical body that is decaying by the day and hence, we are still subjected to diseases and yes, physical death. Until Christ comes again, we live in a fallen world where pain is a daily reality but now, with Christ work completed at the cross, merely temporal. Truly, nothing and no one can take away this liberation from pain that Christ has given to us all. (Romans 8:31-39).

The above does little justice to such a huge field of Theodicy. I would recommend you read the following book that helped me understand this complex topic a little bit more: Walking with God through Pain and Suffering by Timothy Keller

Q29. Dr Hera: Every person has stress, most normal person (emotionally balanced) can handle stress well as such they don’t get depressed or deteriorate into depression. Question: What about the group of people who inherited sickness genetically (hereditary disease)? No amount of medical intervention or treatment can cure this sickness, also no amount of counselling can cure this sickness. No guarantee everyone seeking God for healing gets healed because the Lord choses whom He wants to heal. (Even pastors end up in suicide). Please comment.

I hear you. Many things don’t make sense. There are endless meaningless sufferings in humanity. Like Job, who wrestled hard with God to make sense of his senseless suffering, we probably will not get all our questions answered in this life. Despite God not answering any of Job’s questions, God was able to provide Job with the insight regarding Who He is and who Job was in Him. That insight was sufficient to pacify and calm the raging storm within Job who finally relented that there are “things too wonderful for me, which I did not know…” Job 42:3.

As humans, there are many things that are beyond our finite minds to comprehend. I am certainly not proposing that we stop asking questions nor that we stop learning. God forbid! We MUST ask away and keep learning throughout life. While we do that, we must also be open to God’s timing with the insight He will provide us in time for the things we are trying to make sense of. Jeremiah 33:3 “Call to me and I will answer you, and will tell you great and hidden things that you have not known.”

In my opinion, we live in a fallen world and experience all the consequences of the fallen nature (including being subjected to diseases or circumstances beyond our comprehension). But I also know in my spirit, as the Bible tells us, that this life is not the only reality of our existence. We are body, mind and spirit and while our body and mind decay through time, our spirit awaits the coming of our King Jesus and the new world where there is no longer a need to make sense of senseless sufferings.

QUESTIONS ON “NEW GENERATION”

Q30. Have you ever heard about this generation being called a “strawberry generation” i.e. more sensitive, easily bruised, offended, affected etc?

  • Do you think this is true and if so, why do you think this has happened?
  • What can we do as a society/church/parents etc to help build more resilient individuals?

QUESTIONS ON RELATIONSHIP ISSUES

Q31. How can a person with minor mental illness condition divorce her husband who spent most of his time and effort with words to destroy his wife? There is not much real care from him except giving monthly allowance for food. How does a mental illness patient cope with a very harsh caregiver? His motto – hope deferred makes the heart sick which he uses to make my heart sick. I really hope he will divorce me. I just want to remain calibate. God will help me to take care of myself and my daily living. My son will help also.

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