Tuesday, November 29, 2016

"Dear Ellen, life's perfect so why am I in tears at the least little thing?"

Dear Ellen,

I've got a new job that I love, a new apartment that's just beautiful and I've finally met someone I think is The One. So why am I in tears at the least little thing? I feel like I'm on the edge of a cliff, about to fall off. I should be happy. 

Am I insane?

#PossiblyCrazy


Dear So Not Crazy,

Moving house is considered one of the most stressful life events. There's all the hassle of packing and moving, which is physically demanding, plus there's the symbolic burden of ending one life and starting another.

On top of that, you have a new job.  Again, while this is wildly exciting, it means new routines, new and possibly unknown expectations, working with new people, and possibly some extra hours while you're trying to orient yourself.

Plus, in your private life you have found love.  Possibly The Love. While that's wonderful, it's also scary. There's all the pressure of wondering if it's really the partner you want to spend the rest of your life with, and all the other changes that will inspire, balanced against the fear of whether you're going to be disappointed again.

Stress is not about bad things happening to you, it's simply a reaction to change.  That means that positive change is stressful. And my dear you're piling up change as if it's going out of fashion!  It's not at all surprising that you're uptight.

From what you say, the tears and that cliff feeling are probably just an effect of your life changes.  However, to be safe, do pop into your family doctor and ask for a quick checkup.

When you're declared perfectly healthy, pay attention to your stress. Make sure you eat properly, get your full 7 to 8 hours sleep, and keep your body moving so that it stays exercised. 

In addition, note your stress, know where it comes from, and spend some time relaxing.  A massage, a trip to the hairdresser, or a nice long movie marathon curled up with that lovely new partner - whatever makes you happily tranquil.

This letter is part of the November 2016 free agony aunt column service. As it's the last day of the month, it's the last issue.   

Thursday, November 24, 2016

What is cognitive behavioural therapy (CBT) and does it help manage depression?

CBT theory says there's a relationship between thoughts and behaviour.  For example, let's say you scream and run every time you see a wasp. You run so wildly, that you've banged into walls.

Suppose that you want the change the behaviour?  Suppose you want to stop screaming and running every time you see a wasp?

With CBT you would see how your thinking links to your behaviour. You'd sit with a therapist and look at the last few times you saw a wasp. You'd figure out exactly what you were thinking and feeling.

Suppose this leads you the discovery that you think all wasps sting.  With the help of your therapist, you would focus on changing your thinking. Instead of seeing the wasp as a wild beast that's gunning for you, you might change that thinking to acknowledging that wasps are nature's most effective insecticides.

Yup, wasps eat aphids and blackfly, the insects that eat crops, fruit, flowers and other plants. If you have a few wasps around, you don't need nasty chemicals to control garden pests.

You work then work out a plan with your therapist to identify your trigger points and to change your thinking patterns. Over time, you will learn to look at a wasp and instead of screaming and running off, you'll say, "Hello, beautiful wasp! Please eat up all my aphids!"

So, what does that have to do with depression? 

If your depression is a reaction to your personal fears and stressors, then CBT can be a real help.  For example, many of us suffer from all kinds of doom and gloom thoughts that we know aren't necessarily true but that suck all the joy out of our real life successes. 

Like the man who just got a good annual review and a bonus but who can't enjoy it because he secretly thinks his boss hates him, that he will be fired, and that he will end up unemployed because he's a failure. 

Or the woman who gets As in her continuous assessments while doing her degree but worries herself into a depression by convincing herself that she will fail the exam, fail the course, and end up working as a part time street sweeper.

If your depression comes from that kind of 'faulty thinking' then a few sessions with a therapist and some CBT can be very effective.

The thing about depression is that we tend to talk about it as if it's a problem that can be clearly defined and that has clearly visible causes.  But that's not true.

Depression manifests in different forms. Some people feel sad, some feel blank, and some cycle between the two. You have people who sleep a lot when they're depressed and others who can't sleep. For some it's something that hits hard and vanishes just as quickly. For others it creeps up like a fog, lingers, and then slowly vanishes.  (There are other symptoms too, but this is a blog post so we'll keep it short.)

Also, it appears that depression can come from all kinds of situations. Some reasons include having a faulty thyroid, or that it is an effect of medicine taken for various conditions. For that reason, you should read this first: Feeling depressed? What you should do before seeing a therapist...and a tip on avoiding crooks
Target, my cat, who always makes me happy

As for others causes of depression, well, we're fairly certain that sometimes it is a reaction to an emotional shock. Some scientists think some depression may be a result of issues with brain chemicals not working as they should while others suggest it's a consequence of the immune system not working as it should when fighting inflammation.

So the bottom line is that when you are looking at all the different ways there are to manage depression, you have to start by figuring out what the root cause of it is. Once you know why you're depressed, you can see what treatment options are available.

Me, I work with perfectly normal people who are under a lot of stress and who need a bit of mental plumbing.  I like CBT and I tend to mix it up with positive psychology because I think the two work well together.

If you're suffering a lot, and you want a little extra help from an antidepressant, then you should also see a psychiatrist. You can read about that here: "I'm depressed. Should I pop a pill, go for therapy, or both?"

I think the real problem isn't with whether CBT works or not but at the way people tend to look for help when they're depressed. If you're depressed, don't start off by looking at solutions, like "I want CBT" or "I won't take pills".  Instead, identify root causes and then see what's on the table in terms of treatments. Because if the root cause is your thyroid, then CBT isn't going to work.

Sunday, November 20, 2016

"Dear Ellen, I'm sick and tired of my boss yelling at me..."

Dear Ellen,

I've got a problem with my boss. He comes in at 1030am, has a long lunch, comes back at 4pm and at 5 he's telling me what he wants me to do. And he wants everything done the same day. Last week I worked until 9 twice! I got home after 10 when my kids were in bed. I'm staff so I don't get overttime. I get in at 8am. Also, he's yelling at me. If he can't find something, it's my fault. If a client is upset, it's my fault. Everything is my fault! I'm sick and tired of him and I want to quit. But jobs aren't easy to get. Also, I have a degree but not more. What should I do?

Question: Who do you work for and what's your job title? What are your office hours? How long have you been working there? Do you have a list of KPIs? How are you doing on those? What did your last performance review say? Is this boss new or have you worked together a while?

Answers:
(Redacted) Medium sized local company, accounts management
9-5 Mon-Fri
8 years working there
Yes, I have KPIs. Last year got a bonus. This year on track.
Same boss 4 years.

PS has the job changed in the last year?
No

PPS Is your company laying people off?
No


Dear Sick and Tired,

Okay, my first thought was that your boss might have been yelling because he's hoping you'll leave and he won't have to pay compensation. Clearly that's not the case.

Sometimes bosses yell because their staff are lazy or don't do their jobs. So let's look at you.

As you have been there for a significant time, you've been doing a good job for some years now. If you hadn't, the company would have replaced you. Also, you got a bonus last year, so you were definitely doing something right back then!  The job hasn't changed, so it seems logical that you're still hitting the spot.

At present,
1. You are in on time and he is not.
2. He's too disorganised to give you a proper period of time to get things done.
3. This means you have to work unreasonably long hours, and
4. He behaves unprofessionally, shouting at you

First things first. You don't need to put up with a disorganised man who yells. I'm going to make a few suggestions, just to list your broad options.

Your company is medium sized, so you might look to transfer internally. Speak to human resources about this, or scout positions among your peers. 

You can also try to fix this situation. Standard advice is to log everything and then approach human resources to talk to your manager and resolve this. The idea here is that they are a neutral third party who can settle this according to company protocol.

It may work. It may also backfire if your boss is the kind who thinks that talking to HR is sneaking or tattling. You know your company culture, so you can tell if this is a good approach.

If you go that route and it doesn't work, you have two options: explore a hostile work environment claim, and/or leave.

You can simply quit. Yes, the job market is lousy but all you need is one job, right? So you can write up your CV and start talking to headhunters. Believe me, companies are always out looking for someone who has experience!

What I've said so far is all standard safe advice. I would add this: you seem to have liked your boss in the past.  So, if you want to give this man one more chance, you can take the straightforward route and talk to him.

Note: this only works if he's a reasonable human being. If he's not, then it's probably not worth it.  You know him, so you decide.

If you do talk to him in an open manner, you need to do some prep.

First, put yourself into your boss' space.  As the economy sucks, my bet is that the company is having cash flow trouble. I'm guessing your boss's boss is hammering at him. So your boss then turns around and yells at you. It's unprofessional but very common.

I also bet that your boss doesn't even realise that he's pushing you too far. You've been taking it without protest, and now his bad manners have become a habit. To fix this you have to let him know he has to change his ways, but you should be circumspect and remind him that you're part of his team, and that he can lean on you - without the shouting!

For your prep, write down your work tasks for the last month, and tick off what you've done. If you've done extra work, make a note of that.

On a separate piece of paper, write down the last three times he yelled at you.  Don't be too long about it, just note the day, time and a single sentence about the occasion.

Now you need to go and talk to him. Pick a time when he's calm, and when you can reasonably go straight home or out afterwards. So just before lunch or just before the end of the day.

Take the note of the work you've done, but leave the note about the shouting on your desk.

I'm a straightforward person so I'd get straight to the point with something like this:

"Boss, I've been working for you for four years now. It's been interesting and fulfilling but recently I've been feeling unhappy. I looked at my KPIs and my work sheet, and I think I'm doing my job but I feel I can't do anything right anymore."

If it opens a dialogue, as it should, show him your work sheet.  Ask, "Is there anything else I can do?  I know jobs aren't static so if there's something different I should be doing, please tell me." Then negotiate what he wants you to do.

He should know that he's been a prat for asking you to work late, but you should remind him that you start at 8AM and a 12 hour working day is unreasonable. 

State the problem. "Boss, I work for you Monday to Friday from X till Y.  I do have a private life and a family.  I had to work X extra hours on Wednesday and Thursday last week, which meant I didn't see my kids."

State the solution. "I finish work at 6PM so it would be helpful if you give me my tasks at 5PM the day before.  That way I can think and plan, and be more efficient. Also, it means I can see my kids."

You also need to address the yelling, "You know how on Monday when X and then you Y?" Keep it brief and impersonal. If he says it was a one off, add, "Well, boss, there was also..."

Practice saying, "If I make a mistake, then tell me. But please don't shout at me. It makes me uncomfortable."  If he tries to blow it off, just insist, "It makes me uncomfortable."  He should then get the message.

Clearly the three issues can come up in any order. You should rehearse it to yourself thoroughly first. Imagine what he might say, and what you might say.

Stay calm and professional!

Also, about the degree. Speak to HR on ways you can upgrade your CV. It may simply be a matter of taking on certain tasks, or taking up various bits of in-house training. You might go back to school but frankly it's a lot of extra time and money, which you may not see back, so think very carefully before you go that route.

Good luck and tell me how it goes!

This letter is part of the free agony aunt service I'm offering November 2016. If you have a question, contact me!

Friday, November 18, 2016

"Dear Ellen, my bf just got engaged to someone else..."

Dear Ellen,

I'm in college, and I've been dating my classmate A for six months. We can't tell his family, because they want him to marry B. They think we're just friends.

Last weekend they told me they've set a wedding date for next year. They invited me to the engagement party!

I'm crushed. A says he loves me but B is from a rich family they do business with so he can't say no. What do I do? 



Dear Crushed,

I read this and thought, oh my gosh what have you gotten yourself in to?

Good men value and respect women. A hides you as if you're a dirty little secret.

A also plans to exploit another young woman for her family connections and money. The term for that is gold digger.

Good people are honest with the world. A shows one face to the world and another to you. From your letter he's pretending that this is all happening out of his control. What rubbish! He has known he is going to commit to this other girl for some time now. Do you have any idea how many lies he must have told to his family and to that poor girl and her family for them to agree to the engagement?

Forget A. He's not worth your time. Exit now.

You're a talented young woman, about to get a degree and embark on a successful career. You have a lot to be proud of. You should be with a man who is proud of you, too. One who is excited to be with you and who sees your happiness as important as his own. Someone honest and decent.

I'm concerned about the reasons you fell into this relationship. There are loads of good men who'd thank their lucky stars to be with you, so why did you go for a horror like A?

I'm going to make a stab in the dark and suggest you suffer from low self esteem. If so, you need to find out what caused this and work to correct it. Your college counsellor will help you with this. Invest in six to eight sessions working out what went wrong, and set about making sure you don't fall in the same trap again. Therapy in college is free, so take advantage.

Also, I suggest that you spend your final months at college studying hard and playing hard. Go on lots of different dates but don't go steady with anyone. You're too vulnerable at present and I'm worried you'll fall for another A.

Finally, if you have an open relationship with your parents, you might also talk to your mum and dad about this. Your parents will have seen lots of people making this and other mistakes and leaning on them for support might be helpful. If you're not sure how they'd take it, talk it through with the counsellor.

Good luck, and I hope to hear very soon that you've graduated and are happy again.

This is part of the free agony aunt service for November 2016. Do write in!

Tuesday, November 15, 2016

"How long does therapy take? Do I have to spend months and years at it?"


Updated 5th July 2017
With the free agony aunt service this November, it’s become clear that lots of people don’t really know what going to a therapist involves. So I thought I’d explain exactly how I work, and hope it sheds some light on what goes on with the virtual couch.

So, in the films Tony Soprano went once a week for all 7 seasons and Monk went twice a week for 8 seasons.  They just chatted about life, with Jennifer Melfi and Neven Bell contributing insight and support.

Is that how it works?  You can sign up for that kind of therapy if you want to but I don't work that way.

The people in the films are about delving into the deep inner you and trying to analyse Life, The Universe and Everything. I'm into seeing how you work in specific situations and helping you make changes so that you’re happier. They're big picture philosophical and I'm more mind mechanic.

Also, that bit in the films when the therapist says, “Our time is up” is something I don’t do.  I charge by the session and not by the minute as is standard practice. I do this because I think it’s vital for getting good results. If you have to stop because your hour is up, or you are worried about having to pay extra if you talk too much, then we may miss something.

So, how long do we talk? I did some number crunching and found that the number of sessions depends directly on the kind of issues we’re dealing with. 

Here’s a rough breakdown:
   
The 1 session gig
This is what one of my clients called, "Mental plumbing." It's where people are faced with a problem and they want someone to help talk them through it. This is like being an agony aunt, really, helping people talk through whether they should give up their job, move to another country, take a particular course of study...
 
Usually they've already thought things through and they want an intelligent wall to help them make sure they've considered all the angles. We talk through practicalities as well as the potential emotional impact (will you be happy, will you be stressed, what happens if...).
     
What it typically takes and costs:note, due to the financial crisis, I have reduced my fees for 2017

Pay via Paypal
Direct bank deposit
Initial conversation to discuss needs and goals
15 minutes
Free
Free
Paid session where we discuss the issue
2 hours
$30
RM100
Review session
15 minutes
Free
Free
Total
2.5 hours
$30
RM100
     
The 3 session system
This is usually a very specific issue that the client needs resolving in a very structured way. For example, they may have a problem communicating with a specific person, are facing a very challenging project proposal or contract negotiation, or perhaps they're defending their PhD thesis and so on.
 
Usually they have an idea what they might do but they want to work out a strategy, test it out, analyse results, and then go through it again.
 
What it typically takes and costs:

Pay via Paypal
Direct bank deposit
Initial conversation to discuss needs and goals
15 minutes
Free
Free
First session where we establish your needs, goals and the approach
1 hour
$30
RM100
Second paid therapy session1 hour$30 RM100




Third paid therapy session
1 hour
$30
RM100
Review session
15 minutes
Free
Free
Total
3.5 hours
$120
RM300
     
The 6 sessions
This is usually for people who want to learn coping techniques for recurring or longterm issues. For example, they may have periods of mild to moderate depression, recurring episodes of high stress or anxiety, or perhaps they've moved to a new country and they're having trouble adapting.
 
Usually the early sessions are long, like 90 minutes, because that's when we're examining exactly what's going on. But after that, the sessions are shorter, like 50 minutes, because the client has learned the techniques and is reporting back on how they're working so we can assess effectiveness and perhaps make adjustments on how we're working it.
 
What it typically takes and costs:
   
Pay via Paypal
Direct bank deposit
Initial conversation to discuss needs and goals
30 minutes
Free
Free
First session where we establish your needs, goals and the approach
2 hours
$30
RM100
Creation of treatment plan which is sent to you
2 hours
Free
Free
Paid therapy session
1 hour
$30
RM100
Paid therapy session
1 hour
$30
RM100
Paid therapy session
1 hour
$30
RM100
Paid therapy session
1 hour
$30
RM100
Final therapy session
1 hour
$30
RM100
Review session
30 minutes
Free
Free
Total
10 hours
$180
RM600
   

Multiple long-term sessions
Sometimes the people who think they have one issue that may take 6 sessions discover they actually have a second issue that needs coping with.  Sometimes we can fit that in, and sometimes it takes an extra session or so. That’s something we work out as we go along.

However, there are issues that require 6 months or more of regular sessions. Such clients are usually coping with long term serious issues such as the impact of rape, cancer diagnosis and other life altering events.

I would love to say that you can contact me for that kind of support however I am concerned that online therapy isn’t appropriate. You see, crisis psychology and support involves so much stress that I think they are best handled with face to face sessions, at least at the very beginning. 

I had these clients in the past when I was working in clinics. However, I am now self employed and I work from home. As most of my clients are expats in South East Asia (and too far away to ever drop in) I have no plans to set up a clinic. The day I do, I will expand my services.

Having said that: if you’re not in Malaysia, and you are in a place where you don’t speak the language, then do contact me. I’m not promising to take you on as a client but I’d rather you reach out to someone than cope alone.

If you are in Malaysia, and you need help in a crisis, then you can always reach out to AWAM and WAO.  They have clinics and they can put you in touch with someone in your state who can see you, too.

Hope that helps, and do keep those agony aunt questions coming!

Sunday, November 13, 2016

"Dear Ellen, what do I do about workplace bullying?"


Want to ask your opinion on office politics. HR not very keen to take action towards the players which create very negative energy. Where the staff can ridiculous fellow colleagues publicly & without any punishment. If you are in my position, what would you do?

Thanks for writing in!  Let’s deal with this in two parts: first, what is bullying and where does it come from and second, why your company isn’t dealing with it.
From Rebeccadevitt0 at Pixabat

Bullying takes many forms but classic systems include these behaviours:
·        Spreading nasty rumours about someone
·        Laughing, jeering and humiliating someone
·        Nasty name calling
·        Yelling at someone, especially in public
·        Not inviting someone to a meeting they should be at
·        Not sharing pertinent information with someone so that they can’t do their jobs properly

Bullying is often a learned behaviour. Kids who go to a school where teachers allow bullies to run wild, will become bullies themselves. Some do so after being victims while others take to it without being victims.

Offices are exactly the same. I’ve seen happy workplaces turn into hells because of one new senior manager coming in and establishing a bully climate. It’s as if bullying is somehow infectious.

Hierarchies are involved too. Studies show that places with a strong top-down hierarchy are more likely to have a bully climate than places that are egalitarian. Let’s face it: the more power a boss has over staff, the more likely abuse is going to take place.

Note: you may want to look at Hofstede’s work here and examine the Power Distance scores for different communities. Power Distance is a form of measuring how top down a hierarchy is. Malaysia scores 100 compared to India at 77, Iceland at 30 and New Zealand at 22.  So in Malaysia, bosses have lots of power over staff, and this is why we have so many little Napoleons.

I don’t know what you do or what your position is in your company, so I’m going to talk about what can be done and who might be taking the action. Please read it and decide where you fit in.

So, how do you make changes?

Suppose you’re dealing with someone who has only recently started bullying. To affect change, you need to make a list of bullying behaviours, call the bully up on them and explain what the proper behaviour should be.

For example, “Jane, on Wednesday at the weekly meeting, you interrupted Sue. This is not acceptable. We don’t interrupt others. You then laughed at her. This is not acceptable. We do not laugh at others. You then made a nasty remark about her work. This is not acceptable. We promote constructive criticism.”

Then you need to set boundaries and a timeline for improvement. In my experience, a bully can’t be fixed with a single chat or sending them off to a workshop. They will simply give you the nod, and then go straight back to their usual behaviour.

Why is this? Here’s a list:
·        They may not know how to change
·        They may not know exactly what behaviour is okay and what is not
·        They may find bullying rewarding in terms of achieving goals, and they don’t want to give it up
·        They may enjoy bullying because it gives them a sense of power, and they don’t want to give it up
·        They may think that they can defy you

Bullies also often run in packs, so they have plenty of peer support to keep up their unwanted behaviour.

If you want change, you need to provide re-training, supervision that assesses the change, and a timeframe.  Clearly, if the change is not made within the timeframe, you have to let that person go. In other words, the person who demands the change must also have the power of sanctions.

Who does the training?

If the bullying is a consequence of learning, and simply bad communication and/or leadership style, then you can work with someone with common sense who is a good teacher and mentor.

You must have a proper plan in place, though, that includes pinpointing problem behaviour, outlining goal behaviour, describing how you will affect the change, and a timeline for making the changes.

However, if the bullying is a lifelong habit, then you may have a problem.  You see, children from dysfunctional and abusive families are often bullies. If this is the case with your people, then you need to address the underlying issues. In such families, cruelty, violence and abuse are commonplace. As you might think, this is serious business and you need a qualified therapist to tackle that.

If you are a multinational, you should have properly qualified people on call who can help. If not, you need to find someone and it will require a budget. I’m going to suggest that you don’t do it in-house. People need to be able to talk freely about very personal, very painful things in their past. They can’t do so if that person is someone they have to work with or see in the office.

Now the second part of the question: why isn’t your company doing something about the bullying?

When bullies invade the workplace, people who are good at their job simply leave and go and work elsewhere. Those who stay become less effective because of the poisonous atmosphere. In other words: bullies are very bad for business.

So why do companies allow bullies to flourish?

Some do so because they’re not interested in people. If the bullies contribute to the bottom line, the company doesn’t care how they do it. They don’t care about high employee turnover, either. If this is your company, I suggest you leave and find nicer people to work with.

Some won’t confront bullies because they’re afraid. Bullies work by intimidating people (remember the list of how they work?) and sometimes even senior people are too scared to stand up to them. That’s a problem.

If you think the place is worth saving, and you have some standing in the company, you need to create a team atmosphere. Build a core of good people who support one another. Then work to deal with bullying by documenting and reporting.

Some don’t tackle it because they’re not good at their jobs. Senior managers are human, and they’re not all in their jobs because they’re capable. If this is the case in your company, you need to document and report.

How do you document? Document incidents together with times, dates and witnesses. Tip: you might use the list of bullying behaviours at the top of this response. Put it all together in a report and go and see the manager responsible (or HR depending on how your company works).

When you report, do not take the bully with you!  Do not take victims with you!  As bullies intimidate victims, and victims are often horribly humiliated by the whole situation, you need to talk quietly, openly and rationally about the situation with someone who has the power and authority to address the issue.

Good luck and let me know what happens.

Have a question?  During November 2016 I'm offering a free agony aunt service. Email me!  

Friday, November 11, 2016

"Dear Ellen, My friend doesn't make sense..."


Courtesy of Geralt on Pixabay
Note: this is a transcript of a private Facebook discussion that I'm putting here with permission of the person I was talking to. I removed all the information that might identify the people involved. 

Hi Ellen



I need to ask your opinion on this issue I have with a friend. I'm just clueless on how to help her. I'm not close to her but her recent live videos on fb has been disturbing. So my other 2 friends and I feel like helping. Her family doesn't know what to do. So your advice, I'll pass it on to her mom n dad.



The videos don't make sense. It disturbs everyone who cares I guess. And for some it's like a live drama. At first we saw as funny n we kinda laughed about it coz it doesn't make sense.



She got dumped so at first we thought all this was her own way of getting attention.



But recently it's weirder. Just a few days ago a company was circulating her ic and statement about her wandering around. Carrying luggage n keep waiting for someone n she doesn't carry money.



She posted a video where a restaurant didn't allow her to eat if she didn't pay first. And security was there. Also she was at a shopping mall and security didn't allow her in. She is running around saying that a man has been caught under black magic and went off with an Indonesian girl that looks like her.



So we aren't sure what's going on as her family have no idea how to get her back. That's the complicated part. Her parents ask my friends and I to help bring her back. As we have never dealt with such a thing before... not sure how to approach her.



I believe she needs counseling or therapy.

I’m so sorry to hear this. If your friend is irrational, meaning she's not living in the real world, she needs to see a psychiatrist, a medical doctor who specialises in mental health problems.

There are a range of conditions that can cause this kind of behaviour, and very often it needs some kind of medical treatment to get someone back on track again. Counselling or therapy is something that will come later.

Hopefully you can get her to listen to you. If so, you need to go to a public hospital, in KL the University Hospital is excellent, as an emergency patient. They will assess her and make suggestions about treatment.

Do be careful.  Delusions are very frightening, and your friend is likely going to be scared. Be gentle talking her into going for assessment.

If she won't go, there's a problem because we can't just force adults to do things. If she isn't seeing she needs care, then her family might consult a lawyer to see what the proper procedure is.

Alternatively, and this would be my first move, I would go to your local police station.  Speak to whoever is in charge and ask what normally happens.

The reason I suggest the police is because I once had neighbours who had a son who was mentally ill. He went off his meds, and got into trouble.  The police came round to pick him up and take him to hospital, to the psychiatric unit.

The police were super nice, very gentle, and awfully good about the whole procedure. The university hospital was excellent too. They kept him in a few days, until the meds kicked in, and then released him.

Also, let me make a few discrete calls to find out what others recommend. (I made some phone calls here)

Good news!  Apparently University Malaya Hospital might be able to help too.  Your friend’s parents need to call the direct line, explain what's going on and take it from there.

Do let me know what happens, please. I hope she's safe and gets proper treatment.

Have a question?  During November 2016 I'm offering a free agony aunt service. Email me! 

Monday, November 7, 2016

"Dear Ellen, I caught my son with his hands down his pants..."

"I caught my son with his hands down his pants. He's 5 yo. How do I stop him? I feel so guilty that he's doing this."

Kids aren't my field but I'm going to answer this on the basis of developmental psychology.

First of all, what do you remember from when you're five? My bet is not very much.

When we are little, we're more about doing than thinking. Kids explore and do what they enjoy. It's why they clamour for ice-cream, back scratches or a million other things. Your little boy discovered that touching his willy is pleasurable, so he does so.

You say you feel guilty and at a guess, I'm thinking you're attributing all kinds of labels that apply to adults who have mental health problems like exhibitionism. The thing is, your little son is not an adult. He's five years old, innocent and he has no idea about our taboos and shibboleths.

Most little boys and girls do play with themselves, bouncing on bicycles, rubbing up against things. Typical ages for this run from 2 to 6 years old. Ask other mums and you'll hear plenty of stories. Normally it's just a phase and they grow out of it.

Note: in some cases, the phase turns into an obsession. It's unusual and it can be rooted in boredom as well as anxiety and depression. If this happens, you should have a chat with someone who specialises in child psychology. Again, it's not a sign of moral depravity but rather a comfort seeking response because of something else going on. So it's nothing to be ashamed about but you might seek some help.

From your note I have the impression your boy isn't obsessed. However, when this is part of normal development, it's a good opportunity to explain about privacy. "Sweetie, that part of you is private. Like you go to the bathroom for pee-pee, touching that part of you is not for everyone to see."

That will help him learn about limits in a safe and natural way, and it will help you talk him out of touching himself when you've a house full of visitors.

In the meantime, try not to stress or shout from frustration. Little kids aren't complex thinkers but they are ace at emotion. So he'll see you're upset and not really understand why. He'll also feel bad about himself and for a little one that's a heartbreaking experience.

Also, avoid well-meaning others butting in with frightening tales like, "Your hands will fall off!" Scare tactics are damaging and must be avoided. 

Now, about you. You say you feel guilty and that worries me.

Mums are under tremendous pressure. From what I see, you're supposed to sing while hypnobirthing, breastfeed for umpteen years, and then raise a clean-eating kid who gets straight As from pre-kindy onwards. And in your spare time you're to be a sexy, nurturing kitchen and bedroom goddess.

Please take a moment to stand back and recognise this is a load of bollocks. You're a loving mum and you're raising a boy while holding down a job. That's not easy. Take a break and realise what impossible standards are about. Be kind to yourself and enjoy watching your little boy grow up.

Have a question?  During November 2016 I'm offering a free agony aunt service. Email me!


Saturday, November 5, 2016

"Dear Ellen, if he wants kids and I don't, should we marry?"

Photo courtesy of Frank Beckerde on Pixabay
Hi Ellen, Saw your post. Question: if he wants kids and I don't, should we marry?

Man, that's a good one! Since the development of reliable birth control in the 1950s, some people have opted out of having children. I’m very grateful we have such choices. However, when couples are on opposite sides of this question, it’s a problem.

Women are often told that we have a mothering instinct that will somehow kick in when we need it. This leads people to say, "Just get married and you'll change your mind." You're Malaysian, so my bet is that this will be very familiar!

However, from what I see, parents don't always love their kids. There are plenty of women who have them because of social pressures and who then discover that they don't actually like them. Men find themselves in exactly the same position!

Parents who are less than enthusiastic about their offspring often do the decent thing and do their best to give their kids a good start in life. They might build good relationships too as the kids grow older. But some mums and dads walk away, which is why our orphanages shelter kids who have one or two living parents. That is a disaster for the kids.

You're thinking ahead so kudos for that! The bottom line is that the question of kids is a deal breaker. If one partner wants them and the other not, you both risk lifelong regret. 

Should you go off and search for someone who more closely shares your needs? I'd say that depends.

You say you don't want kids, and I think you should explore what exactly you mean by this.

If you don't like babies or children, and the idea of spending years living with them is just horrendous, then you're probably not going to be a good mum or much fun to be around if you cave and have them. I’ve seen people in this situation, and it’s unhappy to say the least.  Some of these situations have ended with the mums leaving the relationship and the fathers becoming single dads.

But if you actually quite like babies and kids, and you don't want them because you’d rather have a career, then you can do a deal with your man. It means you carrying the child and having it, and then it will be you earning the salary and working long hours while he takes a career break and rushes around with dirty nappies, cooking dinner, organising school busses and so on. I know of several families who have done this, and it’s worked out happily.

I suggest you have several long talks with your man and see where you both stand. Think it through from all perspectives, perhaps starting off with these basic viewpoints:

1. What happens if you have kids and you maintain the common social roles where you’re the primary caregiver? How do you feel? What will life be like for you individually and together?

2. What happens if you don't have kids? How do you feel? What will life be like for you individually and together?

3. What if you have them but he is the primary caregiver? How do you feel? What will life be like for you individually and together?

Once you have your needs worked out, you can both make an informed decision.

Thanks for writing in and hope this helps.

Have a question?  During November 2016 I'm offering a free agony aunt service. Email me!

Thursday, November 3, 2016

Free agony aunt service for November 2016

This image courtesy of Gerd Altmann on pixabay
Over November 2016, I'd like to offer a free agony aunt service. You can email me, and I'll post your letter and my reply on this blog.  I'll give you a pseudonym so nobody will know who you are!

My strengths are stress, depression and relocation, but if you have an issue with a different focus, I will do my best to answer.

Have a wonderful weekend!

Ellen
happy AT lepak.com

Tuesday, November 1, 2016

Feeling depressed? What you should do before seeing a therapist...and a tip on avoiding crooks


If you call me up, one of the first things I’ll ask you is if you’ve had a medical checkup recently.  If you haven’t, I’ll suggest you see your family doctor. Why?  Because depression can be a side effect of a medical issue.

Almost everyone I know is feeling stressed these days. The economy is bad, money is tight and most people are trying to fit a job, a family, and a personal life into too few hours.

It makes sense therefore to put down any feelings of depression to stress, anxiety and other problems.  However, depression can have its roots in medical issues.  Take a look at this list:

#1 Depression can be a side-effect of taking medicines used to treat acne, asthma, high blood pressure, HIV and other conditions. Even some birth control systems are linked to depression now. 

#2 Depression can be the result of pain, even low-level pain. Exactly how this works is unclear, but if you have had an accident, have back pain, arthritis or some other condition that hurts, be aware that it can have a mental health effect too.

#3 When your thyroid, a gland in your neck, isn’t working properly, you may feel tired and depressed. Other symptoms can include constipation, rough hair and skin, muscle pain, problems with your weight and feeling the cold. It’s easily diagnosed and treated by your doctor.

#4 Although the links are uncertain, there is some evidence that diabetes, heart disease, arthritis, kidney disease, HIV/AIDS, lupus, and multiple sclerosis (MS) may put you at greater risk of depression. 

#5 If you’re on a diet, or you have diarrhea, you may be missing nutrients and this can lead to depression. Chugging supplements may not be the best solution, either.

Supposing you do go and see your doctor and you discover a medical issue, does that mean you don’t need to see a therapist?  As usual, the answer is maybe.

Take the thyroid problem, which is quite common. For some people, taking the meds to fix their thyroid means their depression about their micromanaging boss, their hassles with Great Aunt Judy and their angst ridden teenage son suddenly become manageable.

They did have stresses in their lives, but they find the thyroid malfunction has been sapping their usual bounce and confidence.  Once that’s fixed, they’re good to go.

Others find that when the thyroid is fixed, they still need help to cope with the boss, the aunt and the teenager. So they need the meds and a therapist to help them make effective changes.

The bottom line is this: every person is different, every case is different so the idea is that you get as much information as you can so that you can make an informed decision and take the action that works out best for you.

Now, about avoiding those crooks.

If you go and see a psychiatrist, she is also a medical doctor, so she can do tests to check for medical issues. Therapists tend not to be doctors, so we suggest you go and see your regular doctor. There’s no need to be fancy - just go and see someone sensible, tell them you’re depressed and ask them to check if there’s maybe a medical cause.

Crooks will demand you do in-house pee tests (and some really cheeky beggars hire nurses to do blood tests!) and while they’re gleefully adding charges to your bill, they talk grandiosely about your results. Super nasty ones then sell you supplements too, promising amazing results.

In short, seeing your family doctor before you see a therapist is sensible and if you see a psychiatrist, you’re in safe hands too. But if a non-medical doctor wants to do medical tests, my advice is don’t walk - RUN!