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Homecna_insider singaporeMore pain than happiness during therapy, but I hung on, says one...

More pain than happiness during therapy, but I hung on, says one youth. Here’s why you should too

SINGAPORE: Mental health stigma is still a major barrier to seeking help, although more youths and other survivors are bravely sharing their stories to break the silence.

It’s why I documented my experiences and treatment for complex post-traumatic stress disorder (C-PTSD) at the Institute of Mental Health on TikTok (@elephantsandmango). It was for the same reason that I agreed to be interviewed for CNA Insider’s deep dive into youth mental health. 

I have chosen to remain anonymous because I want to protect my family’s privacy whilst being able to speak openly about the issues surrounding mental health. I find that it is difficult to do one without the other.

Seeking help – be it confiding in a trusted adult, tapping a service like the Institute of Mental Health’s Community Health Assessment Team, or approaching your nearest polyclinic – is a huge first step. But what next?

The “seek help” narrative can sometimes paint a picture in which all your troubles go away when you start therapy. It can oversimplify what entering the mental healthcare system truly entails – a lot of hard work.

Now that more people are beginning to seek help, we need to empower them with realistic expectations and practical information.

Here are three tips that helped me get the most out of treatment.

1. Find a psychologist you can connect with

When I met my first psychologist, I found her to be a kind lady who made me feel validated. However, I could not understand her because – through no fault of her own – she was not a native English speaker.

After the first session, I shyly shared with her my reservations. We decided to try for another session.

After the second session a week later, I realised it would be difficult to make it work. I was paying for therapy out of my own pocket at that time – each session cost S$57 after subsidies – and did not have the luxury of money to try and build a connection.

She explained the mechanics behind exposure therapy – that complex PTSD is fuelled by avoidance of traumatic memories, which causes them to surface intrusively through flashbacks and nightmares. Imaginal exposure – intentionally reliving the memory in a safe space with the psychologist – breaks this avoidance pattern.

After I understood the mechanics, I found myself motivated to go for sessions. I no longer felt like I was wasting time, money and emotions. I saw purpose in the initial discomfort. True enough, the intrusive memories subsided, and I was better able to cope with the trauma.

After a year of imaginal exposure therapy, however, I found myself getting bored. We had gone through most of the traumatic memories and I no longer felt as much distress.

Yet, I knew that I had so much more to unpack. Perhaps, I had had sufficient exposure to past traumatic incidents and needed a change in methods?

I broached this with my psychologist and we spoke about whether my boredom was an unconscious act of avoidance, or if I truly needed a change. Once she was certain it was the latter, she obtained my consent to raise this with her psychologist and psychiatrist colleagues at IMH’s trauma department.

To my relief, the first instinct of the team was not, “sigh, more work”. Rather, they rejoiced  that I was advocating for myself. This is because complex PTSD patients have typically experienced prolonged domestic violence – thrashings by my mother were a feature of my childhood – and often have difficulty knowing and advocating for their needs.

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