Quit Smoking Using Hypnotherapy

by Joyce Hue, Consultant Clinical Hypnotherapist


Why is smoking so addictive?

There are many reasons why people, especially young teens who start smoking. It may be curiosity. Or peer pressure. Some teenagers simply enjoy the thrill of breaking rules and rebelling against parents or teachers.

Whatever their reasons, it only takes ten seconds for the nicotine to be absorbed into the bloodstream, causing the brain to release adrenaline, and create a buzz of pleasure and energy. The pleasure and energy fades quickly, leaving a feeling of tiredness and down. Since the body can build up a high tolerance to nicotine, more nicotine is needed to maintain that euphoric feel. This is why smoking can be so addictive.

Nicotine cravings can be very strong, making it difficult to quit. Research suggest that nicotine can be as addictive as heroin.

How can I quit?

There are many ways to quit smoking. The ‘cold turkey’ method calls for sudden cessation without any outside help. This only has a 4-7% success rate.

Nicotine replacement therapy (think vapes or patches) are another way of helping a person quit smoking cigarettes. However, you may simply be replacing one addiction with another.

Hypnotherapy is a safe, non-invasive way to quit smoking without the use of any drugs. There are also no adverse side-effects.

Hypnotherapy is a natural way of tapping into your subconscious mind to help you achieve behavioral changes that you want. It’s important to note that hypnotherapy cannot make you do something that you do not want to do. So if you do not want to quit smoking, a hypnotherapist cannot make you quit without your consent.

How does hypnotherapy help me quit smoking?

Smoking, just like all habits, is a reaction that is controlled by the subconscious part of the mind. Although we may consciously know that smoking is bad for us, our subconscious mind – which manages our feelings and beliefs – may think otherwise.

Hypnosis allows us to access our subconscious minds, allowing us to be more open to new ideas and suggestions. During the sessions, I bring my clients into the rapid eye movement state, which a natural healing and processing state – to help give their subconscious mind suggestions such as: ‘you don't have to try not to smoke; the habit will just start to go away.’

How effective is hypnotherapy?

Reports show that it’s very effective.

The New Scientist Magazine found that "hypnotherapy enjoys a greater success rate than any other method in helping people stop smoking."

Celebrities like Ellen De Generes, Drew Barrymore and Matt Damon credit hypnotherapy for helping them to kick their addiction.

What can you expect?

Quitting smoking is as easy as 1, 2…


The sessions will help you to identify your underlying reasons for smoking and resolve your smoking triggers and compulsions. By accessing and reprogramming your subconscious mind, I can help you to immediately stop your cravings.

Joyce Hue is a Clinical Hypnotherapist at The Mind Faculty. She specialises in issues related to stress, anxiety and depression. She runs programs such as Smoking Cessation and Hypno-Banf for weight  loss to empower clients and help improve their lives.

Treating Addiction

by Dr Rasyid, Psychiatrist and Addiction Specialist

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Common Misconceptions

There are any misconceptions surrounding those with substance abuse problems: an addict is a criminal; someone who steals, robs or even kills – anything to get their next fix; they can stop using drugs whenever they want to and the failure to do so is viewed as selfish or weak.

This issue is compounded by the media. Drug dependents are often portrayed as an unwanted social class. This creates a stigma surrounding drugs. If you are suffering from drug dependence, you may find it difficult to receive the proper health and support – even from your family and friends.

It’s important to remember that you are not weak or a bad person. Substance abuse is an illness that requires immediate medical and psychological treatment. It changes the physical make up of our body, requiring as much care and attention as someone with diabetes or hypertension. Recent studies have looked at substance abuse from a medical perspective, demonstrating that this is not simply a behavioural problem. Therefore, if it is a medical problem then it requires a medical solution.

Treating Addiction

Every treatment plan is tailored to a specific client. The first thing we look is the type of substance being abused. Are you using heroine, amphetamines, methamphetamine, alcohol or nicotine? We treat every substance differently. There are several factors taken into account: duration, route and frequency of use, the reason why the substance intake started, and the reason why the substance abuse continues.

Our treatment approach is usually based on the biopsychosocial model:

"Bio" consists of medications.
The availability of anti-craving medication for substances like alcohol, amphetamines/methamphetamines and heroine help the client maintain the duration of abstinence much longer. This makes the treatment more successful.

"Psycho" refers to psychotherapy and counseling aspect. 
Motivational interviewing is a particularly effective method. It prepares the client to make a positive change. The psychotherapy aspects provides the client with support and guidance, helping them to redefine themselves – not as an addict but someone who can successful cross the hurdle of cravings and withdrawals.

"Social" means treating the patient’s social stressors.
We will work with the client to restore health to their relationships with their family and loved ones.

If you or a loved one suffer from drug dependency, please get in touch with us: enquiries@themindfaculty.com

Learning Disabilities

by Dr Noor Aishah, Consultant Psychologist

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What are Learning Disabilities? 

Learning disabilities can be expressed in children and adolescents in different forms and cause significant impairment to the individual’s academic performance as well as impact social functioning and self-esteem.

This a neurological processing problem that can interfere with their learning basic skills such as reading, writing and math. It can also interfere with higher-level skills such as organization, time planning, abstract reasoning, long or short-term memory and attention. It is important to realize that learning disabilities can affect an individual’s life beyond academics and can impact relationships with family, friends and in the workplace.

Most psychologists found that people with learning disabilities are of average or above average intelligence. There often appears to be a gap between the individual’s potential and actual achievement. This is why learning disabilities are referred to as ‘hidden disabilities’. The person looks perfectly ‘normal’ and seems to be a very bright and intelligent person, yet may be unable to demonstrate the skill level expected from someone of a similar age.

A learning disability cannot be cured or fixed; it is a lifelong challenge. However, with appropriate support and intervention, people with learning disabilities can achieve success in school, at work, in relationships, and in the community.

Common signs that a person may have learning disabilities:

  • Difficulty with reading and/or writing
  • Problems with math skills
  • Difficulty remembering
  • Problems paying attention
  • Trouble following directions
  • Poor coordination
  • Difficulty with concepts related to time
  • Problems staying organized

The Five Most Common Learning Disabilities

Dyslexia - It is a learning disorder that impedes the child’s ability to read and comprehend text. There are a variety of ways in which this disability can be manifested. Some people struggle with phonemic awareness, which means they fail to recognize the way words break down according to sound. Similar problems can occur with phonological processing, wherein the child cannot distinguish between similar word sounds. Other issues relate generally to fluency, spelling, comprehension and more. The child may experience one reading issue or multiple issues when struggling with dyslexia.

ADHD - Child who has ADHD has difficulty paying attention and staying on task. He/she can be easily distracted and often have difficulty in traditional school settings.

Dyscalculia - Math is another major area of concern when it comes to learning disabilities. While difficulty with reading can affect a child’s ability in math, some children also suffer from dyscalculia, which is a disorder that specifically affects one’s math capabilities. Dyscalculia can range from an inability to order numbers correctly and extend to limited strategies for problem-solving. Children with math disorders may have trouble performing basic math calculations, or they may have difficulty with concepts like time, measurement or estimation.

Dysgraphia - While reading disabilities receive the most attention, writing disabilities can be equally difficult to overcome. These disabilities are known as dysgraphia. Dysgraphia can be related to the physical act of writing. These children often cannot hold a pencil correctly, and their posture may be tense while trying to write. This leads them to tire easily, causing discouragement that further inhibits progress. Dysgraphia can also refer to difficulty with written expression. With this type of disability, children have trouble organizing their thoughts coherently. Their writing may be redundant or have obvious omissions that affect the quality and readability of the text. Dysgraphia may also cause children to struggle with basic sentence structure and grammatical awareness.

Processing Deficits - Learning disabilities are also connected to processing deficits. When children have a processing deficit, they have trouble making sense of sensory data. This makes it hard for children to perform in a traditional classroom without instructional supports. These deficits are most often auditory or visual, and they can make it hard for students to distinguish and remember important information that is needed to succeed.

Testing for Learning Disabilities

Learning Disability (LD) tests focus on the types of ability-deficits that may prohibit learning. The use of intelligence tests to demonstrate deficits or developmental imbalances in psychological processing is very important in order to evaluate the cognitive performance of the child.

There are different types of LD tests. 

Currently, the most commonly used assessment for measuring intelligence in children with learning disabilities is the Wechsler Intelligence Scale for Children, Fifth Edition (WISC-V). Other commonly used tests include the cognitive section of the Woodcock-Johnson Tests of Cognitive Abilities, the Stanford-Binet Intelligence Scale, and the Kaufman Assessment Battery for Children. The use of intelligence tests to document any deficit in cognitive performance of the child. The developmental imbalance may best be understood as an uneven pattern of development, such the child may function on grade level in math but significantly below grade level in reading. Thus, an imbalance will be shown when his or her academic scores in these areas are compared.

The Dyslexia Screening Test – Secondary and The Dyslexia Screening Test – Junior may provide a profile of strengths and weaknesses which can be used to guide the development of in-school support for the child. The DST-J is designed for early identification of children who are at risk of reading failure so that they can be given extra support at school

Visual-Perceptual and Visual-Motor Tests. The most common visual-perceptual and visual-motor tests used today are the Bender Visual Motor Gestalt Test and the Developmental Tests of Visual Motor Integration. Although most intelligence tests include some subtests that are basically visual in nature, IQ tests are not included in this general domain of tests because IQ tests also assess things other than visual perception and motor performance. The test items generally involve copying various geometric designs in order to demonstrate an ability to adequately perceive and reproduce information, though there may also be figure-ground discrimination problems and reversals.

Auditory and Language Processes Assessments. Among the common tests to measure the auditory and language ability are the Illinois Test of Psycho-Linguistic Ability, the Peabody Picture Vocabulary Test, and the Wepman Auditory Discrimination Test. The test items generally involve a set of pictures and the child will be asked to point to the mentioned picture.

It is recommended to the parents to visit the child psychologist if you notice your child is having difficulties in his/her studies. The earlier intervention is better to avoid any serious issues in the child’s life later on.   


A Mindful Approach to New Years Resolutions

by Mr Ko Teik Yen

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As we bid farewell to 2017 and get set to roll forward onto a brand new year, many of us will be making a few promises to ourselves: Lose five kilos! Exercise more, eat less! Save more money! Be happier! Stress less! Get organised!  

Come February or another festive season, when we’re sitting on the couch surrounded by junk food and laughing with our friends about how rarely we’ve used that new gym membership, it’s easy to wonder why we haven’t lost those kilos or saved any money. Everything looks like it’s back to square one.

If this sounds like you, you’re not alone. Research indicates that only 8% of people actually achieve their New Year’s resolutions! Most fitness resolutions last on average around 8 days. Are we going about this whole resolution thing the wrong way?

New Year’s resolutions are no ordinary goals. They have a far more powerful effect on our psyche because the end of one year and the start of another signify new beginnings, a new chapter, and another chance and hope to achieve the things we’ve always dreamt of. (Or perhaps get rid of a few unhealthy habits.)

Have you ever looked at your list and realized it’s pretty much the same every year? We all yearn for better health, more happiness and improved wellbeing. If only I lost a few kilos, if only I exercised more, if only I give myself more time … then I would be happy. That's does not sound too complicated, right?

No sooner have we set resolutions and announced them on social media platforms, we start finding ourselves looking for reasons to give them up: after a hard day at work, the last thing we want to do is go home and go the the gym; and after a trying week, we  revert to our usual eating habits. We start to postpone our New Year plan…

Where did it go wrong?

Putting pressure on ourselves to achieve our New Years resolutions is counterintuitive. Stress triggers automatic habitual behaviour we have established over years. These behaviours become familiar and feel 'safe'. We retreat into our comfort zone in times of stress and we rarely even notice we are doing it. That's where mindfulness comes in.

How does mindfulness helps?

Mindfulness helps us to develop an awareness of our internal state and the feelings that are driving our behaviour. It allows us the space and time to sit with difficult feelings and make deliberate choices toward more helpful behaviour. Mindfulness trains us to focus on what's really matter and coming back on track every time we slip.

As we seek personal transformation in the year ahead, I offer you a Mindful Approach to New Year’s Resolutions:

1. Consider Your Intentions

The most common resolutions are to lose weight, exercise more, eat less and spend less money. Those are all important and healthy practices. But why are they your intentions? Do you want to feel more calm and peaceful? Save for retirement? Honouring the personal meaning behind an action helps us maintain our resolve.

Ask yourself; so what if I lose that few kilos? So what if I have more money? What exactly that means to you? What does that brings out in you? What you really want? Those are the questions that help you gain a deeper understanding of your intentions.

The acronym SMART for goals setting (Specific, Measureable, Achievable, Realistic, Time-bound) although is widely used, rarely sustainable. It is because it only engages the logical brain and ignoring the human as a whole. I would propose SMARTER, with an additional E for Emotionally Engaging and R for Relevant to your Values. Hence, are your resolutions excite you? And how those resolutions align to your personal values and principles?

2. Focus on Process, Not Results

Resolutions like “lose weight” and “save more money” are completely focused on a result, with no identification of a process for how to get there.

Studies show that when workers — from sales executives to Formula One pit crews — focus on process instead of sales numbers and speed, they actually perform better. Paradoxically, focusing on results makes us less likely to achieve them.

Perhaps resolutions are hard and rigid because those words — determination, firmness — are hard. We are determined to act in a certain way and we need to act 'tough' or else we may be perceived as 'weak'. We have fixed expectations of specific outcomes. But we forget that we are human living in a frantic world, exposed to elements beyond our control and prone to slip-ups and mistakes. We live in a constantly changing and unpredictable environment, which can derail even the most determined and strongest-willed among us.

Hence, the problem with resolutions is that they put us firmly in a rigid and perceived ‘hard effort’ mode: one that is obsessed with outcomes and notions of success and failure. While resolutions are fixed and hard, intentions are flexible. They’re about being mindful of where we place our focus and direct our attention.

If we focus on going for walks or eating healthy meals for lunch, we will probably lose some weight in the process. And we’ll probably enjoy the journey a lot more. If we focus on switching off lights or reducing our energy consumption, we can save more money.

The purpose of a resolution should be the process — the infinite present moments in which transformation will occur — rather than waiting for the single instance of its attainment. With intentions, there's no failure, only temporary set-backs and opportunities to learn and grow.

3. Start taking Action with Baby Steps

If we wait for the conditions to be right – the right frame of mind, the right mood, the right amount of energy and confidence – that day would be very far away.

Our action has to start NOW: with one baby step at the time and as we gained momentum, we will start noticing our mood, our mindset, even our energy levels and confidence will increase over time. It is through our behaviour and action that we EARN this positiveness and confidence, not the other way round.

For example, if I want to lose weight, I would need to exercise more and eat less. It may starts with going for a morning jog: I would start by raising from the bed, brush my teeth, clean my face, make my bed, have a warm drink or light meal, put on the running gear, do some warming up exercise, and taking that first step. And another and another… Every single baby step in this present moment NOW is crucial to kick starts the day.  Actions first. Moods and thoughts will follow. It all starts with one baby step now.

4. Be Gentle to Yourself

No matter what intentions we set for ourselves, there will be days and weeks when we don’t live up to our expectations. Through practicing mindfulness, a fundamental lesson we learn is that we are constantly beginning again — each day, each breath. When we sit down to meditate, we experience a brief moment of awareness. Then our mind starts chattering, planning dinner and worrying about the kids, our works and the next thing on our to-do list. And then with a deep breath, awareness re-emerges.

When the mind wanders, we gently bring our attention back to the breath, without judging or berating ourselves. The moment we notice our mind has wandered is the moment of insight — noticing the action of the mind is the practice itself.

The same goes for resolutions. When we fall short, we can gently and non-judgmentally bring our awareness back to our intention. That’s really the purpose of setting resolutions — bringing a kind awareness to our behaviour, recognizing when we’ve wandered, and beginning again. And again…

5. Consider Resolution Alternatives

If the pressure of New Year’s Resolutions is too much, consider a few alternative ways to set your intentions for the upcoming year:

Make a Visual Board: A visual board compiles images that represent what you want for yourself in the upcoming year. It’s a great way to have a visual reminder of your intentions (I have mine hanging in my office). The images of heart-shaped fruits, running on hillside and glowing candles gently remind me to eat healthy food, move my body, and make time for stillness.

Choose a Word of the Year. Many people have embraced the trend of choosing a word for the year — like breathe, pause, trust, dance, go — that encapsulates the feelings, attitudes, and behaviours they desire in the year ahead. Ior yourself, you can use this word can guide your choices. For example, you can ask if a particular behaviour aligns with your word and your intentions.

In Summary

The reality is thing happens. Things beyond our control can get in the way and despite our biggest efforts, we may not be able to fulfil all our commitment. This does not make us failures — it makes us normal. Research shows it takes up to four months to change a behaviour. So are we really failures and beating ourselves up if we miss the odd gym session or eat the occasional cookie? Mindfulness teaches us acceptance and move on.

Ultimately, New Year’s Resolutions are about growth and improvement. They are about bringing health and joy and ease into our lives. With mindfulness we can bring awareness to our habits and hold ourselves with compassion and kindness as we seek meaningful transformation.

Finally, it's important to recognize that your realization of your New Year's resolutions likely will not happen in an instant. It's not as if you suddenly will lose 10 kilos or instantly land a dream job. Rather, it will take a series of successive moments through every baby steps NOW as you work towards the change that you seek.

Written by:

Ko Teik Yen is a father, author, therapist, teacher, and enthusiast runner. At The Mind Faculty, he teaches Mindfulness for Stress, Anxiety and Well Being as well as for patients with chronic depression. He is the Founding Director and Clinical Hypnotherapist at LCCH Pantai Therapy Centre at Pantai Hospital Kuala Lumpur. He is a fully accredited Mindfulness Teacher with UK Breathworks. When not working, he enjoys running, travelling, reading, and practicing mindfulness meditation with fellow practitioners.

Sharan Shares: Social Media Do's and Don'ts

by Sharan Kaur

 via Pexels. 

via Pexels. 

Social media is inescapable. It has changed the way we interact with each other and the world. While there are many advantages (think #onlinedating and #relationshipgoals), it can also cause difficulties in a relationship. The two main concerns that I often encounter are: time spent and online affairs. 

Time Spent on Social Media

On regular workdays, it can be difficult to find time to yourself let alone your family or your partner. But even in these precious moments, your phone will be close by.

It can be hard to ignore the ‘ping’ of a notification, a like or a re-tweet. And yes, it only takes a few seconds to look at it but to your partner, this gesture could mean a whole lot more. They could view it as:  “I am prioritizing my phone over you”. This can be hurtful and ultimately, have a detrimental effect on your relationship. Especially if they see you smiling at a picture or a comment.

For the sake of your relationship, put your gadget away for at least thirty minutes. Use the time to really connect with your partner (and we don’t mean on LinkedIn). Talk to them about their day, tell them your thoughts and discuss your plans and ideas. Perhaps even share a romantic moment or two.

This problem is not exclusive to those in the workforce. This also applies to homemakers. Everybody recognizes that there is a problem but nobody understands how significant it can be. As this worsens, it can lead to our second issue:

Online Affairs

With Facebook, it is becoming easier to stay connected: to your mother, best friend, your ex. Many people attend therapy because their partner has connected to an old fling or a childhood sweetheart. In many cases, the first party only finds out when this online friendship turns intimate. Social media makes it very easy for an unsatisfied partner to find someone else.

Here is a worrying statistic: 30% of Tinder users are married. One in three affairs start as online affairs. You may question: is an online affair the same as a physical affair? The short answer is YES. Emotional infidelity is just as hurtful and damaging .

Many partners who have been accused simply claim that it was nothing. They were just talking. But the determinant is simple: was it done in secret?

If you were hiding your behaviour from your partner, you know that it’s something you should not be doing. If you lied about it to your partner, you know that it is problematic and you felt guilty. Remember: there are no double standards in a relationship. If you expect something from your partner, you better be prepared to meet those expectations yourself.

A Social Media Pre-nup

Create a social media pre-nup. Set out clear guidelines for acceptable behavior regarding Facebook, Instagram, Twitter or whichever platform you use to stay connected. 

This can include the duration that you and your partner spend on the social media: be flexible but set clear parameters. For example, you have thirty phone-free minutes to spend with each other in a day.

Think of the do’s and don’ts. You may be comfortable with your partner ‘liking’ their ex’s photos of breakfasts but not their selfies. Think of the possible scenarios and discuss them.

Finally, like a healthy relationship, keep your social media practices open and accountable. You should have no problem with your partner looking over your shoulder.  Do not let curiosity become suspicion.

Sharan Kaur is a relationship counselor (marriage, same-sex and family) at The Mind Faculty. 

Hypno-Band: Losing Weight and Emotional Baggage

by Joyce Hue

 via Pexels

via Pexels

Malaysia is the most obese nation in Southeast Asia. Take a look around you. Fast food chains, fried food vendors and junk food stalls are everywhere. It’s no wonder that so many people are becoming ‘conveniently’ obese.

Obesity may not be a new phenomena in the world but it is certainly the most urgent pandemic around the globe, so much so that there is a term “globesity” that can be found in dictionaries. Obesity, simply put is when you have so much excess body fat in your system that it poses a health threat to you. It has been linked to several serious medical conditions including: diabetes; cancer; gout; gallbladder disease; gallstones; osteoarthritis; high blood pressure; heart disease and stroke; and breathing problems such as sleep apnea and asthma.

It is not only a question of aesthetics but of well-being. So, how do we achieve this?

What is Hypno-Band Therapy?

Hypno-Band is a procedure that originated from the United Kingdom. It is the world-renowned treatment that has been practiced successfully in UK, USA and Australia. It presents a safer and healthier alternative to a gastric bypass surgery. Hyno-Band was introduced in Malaysia in the last few years, and is available at The Mind Faculty.

This approach concentrates on the most important fat-loss organ: our brain. Too often we focus on our body – burning fats and achieving muscle tone. However, conditioning your mind for change is an important step to dropping off all that weight.

How does it work?

The Hypno-Band System is a combination of Cognitive Behavioural Therapy (CBT) and hypnotherapy techniques that help you explore, analyse and change your eating habits as well as your lifestyle. Then, using the mind/body connection, a "virtual gastric band" is fitted over your stomach. This makes you eat less and feel full faster. This behaviour changing method is non-invasive: there is no surgery involved. (And there are less jumping jacks involved as well!)

In fact, many clients say Hypno-Band is a relaxing procedure. It is safe and there are no negative side effects associated with this procedure. The only downside is that you will have to invest in a new wardrobe because you’ll be dropping a few dress sizes.

The Hypno-Band procedure uses hypnosis as the primary tool to train your mind to lose weight and embrace your new body image. During the sessions, I will help to condition your subconscious mind to live healthy, eat healthy and maintain the body image that is healthy. It works on a strong mind- body relationship. I am sure that you have heard of people going back to their normal obese self after losing weight because they are not ready to acknowledge the change or are still emotionally disturbed. Believe it or not, the most important aspect of losing weight is to think that you can lose weight!

Through this process, not only will you lose body weight but it can also help you shed emotional baggage. You will be able to accept and celebrate a healthier, fitter and happier you!

Is Hypno-Band suitable for me? 

Hypno-Band is suitable for those who want to lose weight and are committed to achieving their goals. No weight loss system will work unless you are committed to losing weight. As with most thing, the key to success lies in your own hands. The only exception would be if there is a psychological reason for your weight problems or if you are taking certain medications.

Whatever weight-loss method that you decide on, please ensure that your hypnotherapist, beautician or personal trainer is fully-qualified to help you achieve your goals. You will not only invest time and money into your weight-loss journey, but your health and your future. If you have an questions, please do not hesitate to contact me (enquiries@themindfaculty.com)

Joyce Hue is a certified hypnotherapist and a licenced Hypno- Band practitioner.


Sharan Shares: How to Fight Better

by Sharan Kaur

As a relationship counselor, I would like to share some simple yet cogent observations that I have made over the years. The purpose of these fortnightly short articles is for the reader to pick up some of the common issues that arise within all relationship and hopefully obtain a tip or two.

 via Pexel

via Pexel

The most common declaration that couples make in a counseling session is: ‘We have a communication problem/breakdown/difficulty.’ However, many couples do not fully understand what this statement means. It’s easy to attribute all arguments, annoyance and differences to a communication breakdown. Couples also find it difficult to identify at which point of their relationship when communication is working and when it does not.

Poor communication is also something that we have learnt, and has probably become a habit. But fear not, if communication is a skill then it means it can be re-learnt. Here are three tips you and your partner can use to fight better, and achieve a more positive outcome:

Tip 1: In the next conversation you have with your partner, be vigilant about these three things: the tone used; the words chosen; and most importantly, the tension in your jaw/face/brow. Consider changing some or all of these and you may realize the process getting easier.

The first element that throws off any communication is when you start to raise your voice. Ironically, the louder one becomes, the faster they become unheard. Saying the same thing in a louder voice is only relevant if physical proximity is the issue. Otherwise, if you repeat yourself in a louder tone, chances are you still will not be understood.

Tip 2: As soon as you hear your voice getting louder, tell yourself : ‘I need to use different words.’ Yelling out the same words is futile. So quickly think of different words to use or manner to give that same message.

If you have a strange feeling of dejavu during a disagreement, it means the same issues keep arising. In this situation, both parties need to take a step back and look at the matter in a whole different light. Don’t bother with continuing that conversation. Instead, start a new discussion about why you have been unable to resolve the issue. For example, if you notice that every conversation about money becomes a heated one, stop talking about the money issue. Ask yourselves: what is it about money that hits a raw spot and is making me uncomfortable? Answer this question first and share these feelings with your partner.

Tip 3: Sometimes in the middle of an argument, just STOP. Put aside the issue temporarily, look at your partner in the eyes and say: ‘what is it that is holding us back from ever reaching any clear resolution?’ Hopefully, that will prompt the underlying issue and help you to shift your focus on what is really the issue.

It takes some practice to change old marriage communication mistakes. However, one small change can make a difference. It’s amazing how the energy between spouses can change with these little amendments. When you understand how it all fits together, you can make real progress in your relationship right away.

Sharan Kaur is a relationship counsellor with The Mind Faculty. She offers individual counselling and couples counselling sessions. To make an appointment with her, please get in touch: enquiries@themindfaculty.com

Family Constellation

by The Mind Faculty


Family constellation is an effective form of therapy that can help you uncover the underlying dynamics in which you are involved in. It is an alternative therapeutic method that has a systemic approach to restore balance and peace in the family system through acknowledgement and acceptance. It can also be used within a corporate context.  It helps you to look into the possible blockages with your different relationships to release them and help you reach your full potential.

Using representatives, the therapy enables us to ‘see’ the dynamics in a particular issue. In an individual session, these representatives are in the form of tokens or dolls.

The type of token the client chooses, and the way in which the client arranges the token in relation to themselves and the other tokens offers insight into the systemic relationships present in their life. In group therapy, the representative will be the other participants in the group.

We talk to Dyani Thiruchelvam, our speech therapist and Family Constellation counsellor about this groundbreaking new therapy:

Family Constellation is based on the concept ‘Seeing is Freeing’. Would you be able to clarify what that means?
Quite often, we can be faced with problems that we do not want to face. We may not be able to see the truth because we are blinded by distractions or what we think is normal based on societal norms.

When the client sets up a constellation, they can ‘see’ the relationships between the parties involved or the issues faced. By acknowledging what is and allowing oneself to ‘see’ the situation as it is, the path to resolution begins.  

What is your favourite part about Family Constellation?
My favourite part would be the final step in the constellation when everything has been resolved. I love seeing my client feels the ‘peace’, ‘lightness’ and ‘relief’ from working through the issue.

One of the best things about the constellation is that it enables us to express what we need to without actually having to ‘say’ things to the other people involved. That is why the use of tokens and representatives is such a crucial part of the process. It is also another reason why family constellation is so versatile and be used in almost any setting.

How would the family constellation work in a business setting?
In a business setting, people may want to look at the organisational structure to see what the relationships are like and if there are any blockages within the team that may be affecting the business’ success. For example, if there are financial / cash flow problems, the constellation allows us to look into the relationships surrounding this issue – whether there are conflicts within the team or if the division of labour is not working. There are many aspects that we could look into.

Business constellations are set up similar to family constellations. We need to identify the issue and things connected to the issue. Then, I facilitate the process for the client to set up the constellation and we examine this together to identify any potential breakdowns in order to find a resolution.

Does Family Constellation work well in conjunction with other therapies?
FC can work well with many modalities. However, if you have done a constellation with one issue, you would not work on that same issue again with another modality.

Upon saying that, if the constellation brought to light some other issues that may require further release, other modalities such as (but not restricted to) EMDR and EFT could work.

It is also important for the client to allow themselves time to process what they have experienced after the constellation and to not do too many constellations all at once. I would say that clients prefer to do one constellation a month. In between, they may work on other issues using different modalities.

Does the client have to have a particular issue in mind or can the constellation reveal blockages that they were not aware of?
It is always best to work on a particular issue. However, it is also very possible to just look at oneself in a constellation to see if everything is in balance.

Featured Practitioner: Reena Clare, Art Therapy

by The Mind Faculty

Complex emotions require a complex response. For those of you not in the know, art psychotherapy combines talk therapy with art. This mode of therapy adopts a doing-thinking-feeling approach. It gives you a different medium to explore your thoughts and feelings. In an art therapy session, our art psychotherapist, Reena Clare, will help you explore different issues such as grief, dementia, anger and children with special needs.

This is particularly useful for those who find it hard to articulate their feelings.

We sit down with the fabulous Ms Reena to talk about our favourite creative expression therapy:

What inspired you to choose art therapy? Were you artistic as a child or was there an ‘aha!’ moment?
I found it a unique way of communicating and was very interested in the way in unveilsthinking and feeling from a unique angle

What is your favourite medium to work with and why?
I enjoy using batik dye. The results always surprise me and it is delightful.

 You are a certified practitioner in Children’s Accelerated Trauma Treatment (CATT). How can art help us to heal from trauma?
Art help gives a special language to trauma that may not be easy to talk about: it may be challenging to describe or that we may not yet understand. For some, using art  can make talking about this trauma feel safe. CATT uses a arts-based method that is a adaptation of the ‘rewind technique’ – which is used to assist the recovery of PTSD (post-traumatic stress disorder) that has symptoms such as flashbacks, nightmares and anxiety.

Are there any simple ways that we can introduce art therapy into our lives? 
I recommend an art journal. Anyone can start this on their own. Get a sketch book with no lines just plain good empty paper. It can be big or small enough to carry around. Date your entries and avoid tearing any page, even the ones you are not happy with – at most, cross the page. In this you can doodle, draw, paste images, write, scribble – do anything – no rules – you can say anything – no restrictions. Make use of symbols for thing your feel are too personal to explicitly put down. Take away the pressure of filling up a whole page or making things look ‘nice’ – just let it flow.

What has been the response to creative arts therapy in Malaysia? Where do you see it in five years? 
Clients have responded to it very well. Initially people are not sure if is only meant for children or those who can draw, however once they experience a session, they will realise that age and art ability are definitely not barriers to benefiting from art therapy.

I expect there will be more and more awareness of what art therapy is and what it can do. I hope to see art therapy exhibitions more frequently held as it will and empowering form of sharing. Now I can see some pioneering cooperate companies, health organizations and educational institutions engage art therapy, and in 5 years this will increase as it reaches the masses.

Ms. Reena Clare has a Masters in Art Psychotherapy from the University of Hertfordshire. She is a qualified Art Psychotherapist and a certified practitioner in CATT. She has worked in London with various clients including those living with mental health diagnosis, special needs, bereavement, dementia, addiction and physical health conditions in the NHS, Westminster Arts, Kids Company and The European Reminiscence Network. She has sound experience working with children and adolescent on various art-fronted projects. 

Drug Addiction and Rehabilitation in Malaysia

by The Mind Faculty

Drug addiction is a serious public health problem, and is a growing concern in Malaysia. From 2011 to 2015, there are more than twenty thousand people undergoing treatment and rehabilitation in Malaysia. It has a serious impact on the individual, their loved ones as well as the community. Contrary to popular belief, drug addiction is not a choice or a sign of weakness. It is a chronic disease because the drug use has changed the structure and the function of the brain.

Addiction is a complex but treatable disease. Our drug treatment programs work closely with the individual to curb their compulsive drug seeking and use, with a focus on relapse prevention. We work closely with Solace Sabah, a clinical rehabilitation centre in East Malaysia, to help our clients re-integrate with their lives and their loved ones. There is a full expectation of recovery.

We chat with Mithun Kumar, the head of marketing at Solace, about the different resources available to us here in Malaysia.

It is a common misconception that drug abuse is a ‘weakness’ or a ‘choice’. Would you be able to clarify this? 

Around the world, this notion of drug abuse or addiction being a weakness or lack of willpower has been very common; people simply don’t understand why someone can have such a compulsive drive to use drugs even when it causes them harm. Today, science has shown us that addiction causes this weakened state of impulse control. Addiction is a brain disease, and there is research available to support it. When people are in ‘active addiction’, it is no longer a choice because their brain’s reward-mechanism has been hijacked. It should be treated as any other disease.

When drug use gets out of hand, it is not only the individuals but also their friends and family who suffers. Are there any warning signs that we can look out for to prevent this? 

Absolutely. Addiction has tremendous social bearings. The friends see it first, the family realizes later, and eventually medical and police personnel from the community come in when it really gets out of hand. Usually when a family or friend discovers addiction, it is already too late. Then they go into a cycle of “I can solve the problem” by reasoning, arguing, fighting and taking steps on their own to stop the addiction. The key here is not prevention but “intervention”. Being aware of the addiction and seeking professional help for their loved one. There are many ways you can identify someone with addictive traits.  You can read a detailed article on our site here.

The first step of recovery is admitting that you have a problem. During the ‘intervention’, the friends and family of the individual persuades them to enter treatment. Could you explain the importance of an intervention? How would you stage an effective intervention?

The importance here is, to whom are you admitting to? This is not to the family, police or medical personnel, but to oneself. Most addicts are in a state of denial: they feel they don’t have a problem. This is where an intervention plays a very important role. Using techniques of Motivational Interviewing and past experiences, we can help the person achieve this self-realization and decide that they need help after they accept the addiction. You can read more about how Solace Sabah conducts intervention here.

After undergoing rehabilitation, what are high-risk triggers for relapse? Are there any ways to minimize and prevent this?

Triggers are the stimuli that make an addict want to use again. They originate from the addict’s memory in active addiction. Triggers can be any sensation: sights, sounds, smells and touch. At an emotional level, triggers could be: anger, sadness, depression, anxiety and fear to name a few. The most common triggers would be social settings such as friends or places where they abused before. Early recovery is a very vulnerable time for triggers. This is the reason why recovering addicts need to rely on professionals and their program of recovery to overcome these hurdles.

If you or someone you love is experiencing substance abuse problems, please get in touch with us or Solace Sabah. 

Mindfulness for Stress, Anxiety and Wellbeing

by The Mind Faculty

Have you suffered from restlessness, erratic sleep, weight problems, a weak immune system, finding it difficult to stay focus or feeling as if you have lost control?

Our popular Mindfulness workshop helps us to cope with problems that are all too common in our modern life. Stress, depression and anxiety are symptomatic of this frantic and chaotic world. Clinical studies have show that a mindfulness-based training program alleviates stress, improves overall health, and helps manage pain and chronic illness.

What is Mindfulness?

Mindfulness is a skill that enables us to pay attention to what is happening in the present moment with increased awareness of our thoughts, feelings and body sensation with open curiosity.

Our Workshop

Our mindfulness program combines the clinically proven Mindfulness-based Stress Reduction (MBSR) and Mindfulness-based Cognitive Therapy (MBCT) for the prevention of depression relapse. It also incorporates skills training in mindfulness, stress physiology and cognitive awareness. It trains participants to develop and draw on their inner resource to bring about focus, balance, coping strategies, stability and wellbeing.

This five-week intensive is held over eight weeks. It includes:

- 6 guided Mindfulness meditation audios
- Mindfulness training manual by UK Breathworks
- Complimentary follow-up evening sessions at The Mind Faculty (subject to availability)
- Support via Whatsapp Chat group and other online media

A certification of completion will be awarded upon completion of the course. This meets the requirement equivalent to the basic eight-week modern Mindfulness training as a foundation training to attend Mindfulness Teacher’s Training at UK Breathworks.

What to expect

Each session consists of experiential leaning through guided mindfulness and meditation exercises.

Session 1: Breaking Anchor
Anchoring Ourselves in this Frantic and Unpredictable World

Session 2: Mindfulness of Body and Stress
Coming to Our Senses

Session 3: Mindfulness of Emotions
When Your Buttons are Pressed

Session 4: Mindfulness of Thought Patterns
The Pleasure of Small Things

Session 5: Mindfulness of Self Compassion
Put Your Own Mask On First

Session 6: Mindfulness for Others
The Tender Gravity of Kindness

Session 7: Mindfulness for Interactions
Dancing in the Rain

Session 8: Mindfulness for Life Worth Living

One-day Intensive: Putting it All Together
Making it Matter to You


"Mindfulness training by Mr. TY Ko has completely turned my life around."

"TY Ko deeply embodies a well understood, insightful and highly developed mindfulness practice tailored to the needs of stress and vulnerabilities. The beauty and efficacy of his teaching lies in the masterful balance of simplicity, clarity and gentleness combined with skillful care for the needs of his participants. I have been richly fed by this training and my health and sense of wellbeing has vastly improved.”

It will be facilitated by

Mr. Ko Teik Yen is a fully accredited Mindfulness teacher to run the UK Breathworks Mindfulness for Health, and Mindfulness for Stress courses. He is also founding director of Asia Mindfulness and the LCCH Therapy Center at Pantai Hospital KL. He is also the author of the book Parenting 2.0. He has treated clients with anxiety, depression, chronic pain, panic disorders, phobias and other chronic illnesses

Are you interested?

 We will be running our popular Mindfulness workshop throughout the year. Email us <enquiries@themindfaculty> to find out our availability. Upon registration, our facilitator will get in touch with you. This is an opportunity for you to ask any questions you may have about the program or to voice any specific needs you may have about joining the course. Each intake is small to ensure that you have one-on-one time with the facilitator.

GoodKids @ The Mind Faculty

by The Mind Faculty

We are excited to welcome GoodKids to The Mind Faculty. GoodKids is a social enterprise that helps youth at risk using performing arts.

Our youth is often unmotivated by non-conducive learning environments, which focus on academic excellence and not on developing interpersonal skills. It’s hard to pay attention when learning is based on routine not interaction. 

GoodKids provides an alternative and interactive learning environment using a combination of Performing Arts and Counselling. Using a variety of creative techniques, GoodKids will help your kid learn in a fun and interactive way.

The learning approach combines several different techniques:

Introduction to Music helps to improve attention span and promote creativity.
Percussion and Body Percussion will improve coordination and team participation.
Emoting and Acting builds confidence and addresses anxiety.

Throughout the program, you will: 

- Develop creativity
- Discover strength and weaknesses that help character building
- Learn various coping mechanisms
- Demonstrate teamwork and leadership
- Develop good communication and interpersonal skills

GoodKids is geared towards individuals who are below 21 years of age. Aside from providing a new learning experience, it is especially suitable for: 

- Have a high level of anxiety
- Are hyperactive
- Are seeking treatment for bipolar disorder, schizophrenia and OCD
- Are seeking treatment for substance abuse
- Are seeking treatment for depression
- Want to improve their coping mechanisms
- Have problems working in a team or tolerating others

Spaces are limited. We want to keep each group small so that our facilitators can spend quality time with each individual and every voice can be heard. To register interest, please contact us: +603  6203 0359 / enquiries@themindfaculty.com 

What is Eye Movement Desensitisation Reprocessing?

by The Mind Faculty

 Image via  Pinterest

Image via Pinterest

What is Eye Movement Desensitization Reprocessing (EMDR)?

This breakthrough psychotherapy was designed to help patients overcome the devastating effects of post-traumatic stress disorder (PTSD). This can occur after experiences such as physical or emotional abuse, rape, car accidents or military combat. It has been proven to help people experience the benefits of therapy that use to take years.

Using eye movements, it helps the brain to re-process a traumatic situation.

How we experience physical trauma is similar to how we experience physical trauma. For example, if you have a cut, the body works to close the wound. If there is a foreign object in the cut, or there are repeated injuries, the wound remains open, and continues to cause pain. This is similar to mental trauma. When we experience a disturbing event, it can cause blockages or imbalances in the system. Therefore, we are forced to re-experience the trauma. Using EMDR, the practitioner can help the patient to remove the black, and let the healing begin.

How does it work?

The goal of the therapy is to process problematic experiences, and reframe them in a positive light. It is an eight-phase protocol that will you resolve any negative emotions, feelings and behaviors caused by these experiences and leave you with emotions, understanding and perspectives that will lead to healthy and useful behaviors.

The therapy uses eye movements to help re-process the information. This is connected to the biological mechanisms involved in Rapid Eye Movement Sleep. It was discovered by Dr. Francine Shapiro, who found that emotional and behavioral symptoms resulting from disturbing experiences tend to resolve naturally when a person allows his or herself to recall various elements of a memory while engaging in lateral eye movements. Therefore, this can help the patient to process a trauamtic memory and disturbing feelings, and change the meaning of the painful event on an emotional level.

For example, a rape victim can shift from feelings of horror and blame to “I survived, and I am strong.”

It uses a three-pronged protocol, involving to the patient’s past, present and future. It pays attention of traumatic memories, and past related events. It also focuses on current distressing situations, in order to develop the skills and behaviors required for positive future action.

Who does it work for?

It has been proven to be effect for PTSD. It has also been successful in treating the following conditions:

  • Panic attacks
  • Complicated grief
  • Dissociative disorders
  • Disturbing memories
  • Phobias
  • Pain disorders
  • Performance anxiety
  • Stress reduction
  • Addiction
  • Sexual or physical abuse
  • Body dysmorphic disorders
  • Personality disorders

Via EMDR International Association, EMDR Institute, EMDR Humanitarian Assistance Program

Mindfulness - What It Is & What It Is Not

by Mr. Ko Teik Yen, Clinical Hypnotherapist & Mindfulness-based Psychotherapist

 Image via  Bahman Farzad

Image via Bahman Farzad

What is Mindfulness?

Mindfulness, as defined by Jon Kabat-Zinn who introduced Mindfulness Based Stress Reduction (MBSR) 30 years ago, is “paying attention in a particular way: on purpose, in the present moment, and nonjudgmentally.”  Mindfulness is a learnable skill that enables us to pay attention to what is happening in the present moment with increased awareness of our thoughts, feelings and body sensations with open curiosity.

Thousands of peer-reviewed scientific journals prove that mindfulness reduces pain, anxiety, enhances mental and physical wellbeing and helps people deal with the stresses and strains of daily life. Many healthcare centres in US and Europe now prescribe mindfulness meditation to help patients cope with the suffering arising from a wide range of diseases such as cancer pain, heart disease, diabetes and arthritis. It is also commonly used for back problems, migraine, fibromyalgia and a range of auto-immune diseases such as lupus and multiple sclerosis, as well as being effective for long-term conditions as chronic fatigue syndrome and Irritable Bowel Syndrome. Clinical trials also demonstrated that mindfulness significantly reduces the anxiety, stress, symptoms of depression, irritability and insomnia that can arise from chronic pain and illness. 

Hence, more and more people worldwide are attracted to learning how to relate to their experience with mindfulness.

Due to my own personal experience as well as my work with over 500 students and clients, I have encountered some common misconceptions surrounding what Mindfulness is. I will clarify this in hopes that it will help you to stay at ease and be clear when you practice.

Mindfulness is not about being calm or attaining any special state of mind.

We often expect mindfulness will bring us peace or calm and relaxation.  This highlights our human tendency to want pleasant experiences and to push away what as unpleasant or average. We want something, we don't get it and then we're unhappy. We think it’s not working or we’re doing it wrong.  

We start to judge our experience and ourselves.

Although it’s true that you can experience a sense of peace, calm, or relaxation while practicing mindfulness, these are not guaranteed outcomes. Mindfulness is simply about noticing whatever experience we're having now, including all the thoughts, feelings or physical sensations that are a part of it.

Mindfulness can significantly reduce stress but it’s not about stress removal

Rather than remove stress, mindfulness helps us to learn to relate to stress differently. It may seem implausible that something as simple as listening to sounds or paying attention to our breathingcan help us learn to respond to experiences in a healthy way, but it’s what science is showing and what people are saying (and it’s certainly my experience and many others).

There is now over 30 years of research with adults showing that mindfulness helps with stress by changing our relationship to it.

Mindfulness is not the absence of thought

Instead of aiming for an empty or blank mind where no thoughts exist, we learn the skill of becoming aware of our thoughts, without necessarily doing anything with them. By just noticing thoughts, we learn how to unhook ourselves from our identification with them. This is different from pushing thoughts away. It’s how we related to our thoughts, not the absence of them.

Mindfulness is not about being complacent

Acceptance does not mean agreement or complacency. It means acknowledging whatever’s going on, which is a good idea because it’s already happening. We take action to change situations when appropriate – for our well-being and the well-being of others – but we do so out of compassion and understanding versus reaction and frustration.

Mindfulness is not just about the mind

Although mindfulness has the word ‘mind’ in it; it is not only about the mind and thoughts. It is about being aware of our emotions, feelings and bodily sensations and ability to remain open to it (emotionally, mentally and physically) even in difficult moments. Hence, mindfulness includes also open-heartedness or some described as, ‘heartfulness’.

Mindfulness is not a form of spiritual escapism

The practice of mindfulness enables us to stay fully present in the moment, right here right now; be it during pleasant and unpleasant moments. Mindfulness is the exact opposite of spiritual escapism. It is through the practice of mindfulness that we learn to trust ourselves, our body and our life to unfold itself in situations that are beyond our control.

Mindfulness is not the same as meditation

Mindfulness is a state of being in the present moment with open curiosity and kindness. Meditation is the practice that enables us to be more mindful in the present moment.

Hence, mindfulness meditation is a formal practice to be mindful especially when we are busy in our daily routine. It is about bringing mindfulness to our daily life and not the end in itself. As such, mindfulness meditation is the vehicle not the destination. There are also other informal mindfulness practice e.g. mindful walking, mindful eating, and mindful drinking.

Mindfulness is not religious

Mindfulness practices are useful for all people, regardless of their spiritual or religious backgrounds or beliefs. It’s a human experience that utilizes awareness, kindness and compassion that is within us all.

Mindfulness is not a silver bullet

When we’re under stress or going through a difficult time we might look for ‘techniques’ to help us cope better. Mindfulness works, but it is important to approach it with the right attitude. Based on many years of research, it is well established that in order to fully benefit from mindfulness training, the best approach is to practice consistently.  

What are the differences and similarity between the modern, secular mindfulness training compare to traditional meditation?

In general, the principles are similar; keeping in mind that the modern, secular mindfulness training has its roots from the traditional meditation practice with thousands of years of wisdom. The major differences perhaps are the approaches that the modern, secular mindfulness training adopted; flexible, non-hierarchical, less ritualistic, encourages self-exploration, linking the practices to brain science as well as human psychology and physiology; making it so much approachable and accessible to the general public. 

Hypnosis Can Improve Sporting Performance

by Joyce Hue, Clinical Hypnotherapist

Athletes spend hours strengthening their muscles, building upon their stamina and refining their technique for the big game. The fitter and healthier they are, the better their performance.

Mental strength is just as important as physical strength in sport. Like a muscle, the mind can be conditioned and strengthened for optimal performance. Hypnosis for sports performance is an excellent way for mental training and it can help you become an athlete who shines above the rest. 

Simply put, hypnosis helps an athlete to focus better and visualize success. This process of programming the mind allows one to make a better connection between the body and the mind. In fact, these two entities are dependent on one another. If you are mentally tired, your immune system weakens and you will fall physically sick. Thus in this situation, if we can make your mind sharper and more focused, your body would become more efficient. 

Athletes like Tiger Woods, Kevin McBride and the Swiss Ski team are said to be users of hypnosis for sports. Even the USA Navy SEALs uses visualization techniques.

Hypnosis is a powerful tool that can change the way you think. If you think you are not good enough, then you won't be good enough. This negative thought could stem from a childhood experience. For example: “I am too fat to run”. This thought is reinforced, as you get older until it eventually becomes a belief. This affects your performance. By using hypnosis, we will reframe your thoughts to make healthier more positive ones. You can program yourself to be more motivated, to enjoy working out or to see yourself succeed. 

Hypnosis can help you to improve the actual skill itself. By visualizing and imagery processes, the therapist would guide you to see the target more accurately, feel the muscles working in your body or hear the sound of the applause as you score that goal. As Napolean Hill once mentioned, "Whatever the mind can conceive and believe, the mind can achieve."

Consequently, hypnosis is a perfect tool to help you improve your sports performance. You could be a professional athlete striving to perfect your skills, or an active person who wants to maximize your body's potential. The key lies in learning how to manage your mind. This modality may work immediately for some; others will find that their levels of performance gradually improving after a few sessions. If you are playing an individual sport, hypnosis helps you to focus and concentrate better on your own athletic abilities. In a team sport, hypnosis can be a group activity that allows team members to be more energetic and unified for success.

 Overall, hypnosis & visualization can help you to:

  • Improve confidence and self- belief
  • Induce deep relaxation and calmness
  • Increase motivation and dedication
  • Guide one through visualization and focus to imagine success
  • Remove negative thoughts or beliefs
  • Maintain composure and overcome distractions
  • Boost energy levels and stamina
  • Assist in recovery and pain management
  • Helps healing process through visualization

Postpartum Depression

by Professor Philip George, Consultant Psychiatrist

 Image via Kristy G Photography

Image via Kristy G Photography

What is Postpartum Depression?

The baby is here. You should feel happy and relieved. Now that there is another little one in your life, your life as a family is complete. You feel fulfilled as a woman now that you have experienced pregnancy and childbirth. There will be joy, excitement and new adventures as you watch your baby grow.

However, all you feel is sadness, anxiety and self-doubt. You worry about whether you are being a good mother and feel intimidated when other mothers give advice on baby care. Deep down, you wonder if there’s something wrong with you because you somehow don’t feel the happiness, fulfilment or excitement other new mothers do.

The good news is that you are not alone. Depressive symptoms after childbirth, commonly known as postpartum depression, are extremely common. In 700 B.C., Hippocrates described the symptoms in great detail.  

Although childbirth is considered a natural process, it is nevertheless a serious physiological and psychological event for mothers. A woman’s mind, body and spirit have just been through 9 months of pregnancy, culminating in the birth. Hence, some women may need more recovery time than others.

After childbirth, the new mother’s body will be all haywire because of the dramatic changes in circulating hormones. She may still be in pain for several weeks but she will also be exhausted, caring for the new baby and breastfeeding. There is so much to do now with a new addition to the family, and she has little time to care for herself.

On top of the physical recovery, a new mother also struggles with changes in her perception of herself, relationship with others and her new role. There are also social changes – income levels, societal status and a loss of freedom. All these snowball into a huge burden which some women find overwhelming, leading to depression.

There are three categories of Postpartum Disorders: Maternity Blues, Postpartum Depression and Psychotic Depression. The first is the mildest category, and most women overcome it successfully soon after childbirth. The latter two warrants more attention. 

Maternity Blues

This is a common condition affecting 50-80% of all new mothers. It usually begins right after birth and can last for up to 14 days. Common symptoms include mood changes, tearfulness, anxiety, irritability and feeling tense.

Maternity blues can be caused by hormonal changes, anxiety about childcare and problems with breastfeeding.  Usually no medication is required; all the mother needs is a lot of reassurance and family support. Practical advice, such as how to bathe baby, breastfeed, change diapers, swaddle or baby massage helps make the new mother feel empowered and confident.

Postpartum Depression

This affects up to 20% of new mothers. This manifests in feelings of sadness, hopelessness, helplessness and worthlessness. New mothers may lose interest in normal passions and feel unable to cope with their new responsibilities due to low energy, low drive, poor attention and concentration.  

Some mothers may feel guilty, inferior or even, suicidal. The feelings are usually worse in the mornings. They may experience a loss of appetite and sleep disturbances. Some present instead with physical symptoms such as bringing their healthy babies to the clinic repeatedly.

Postpartum depression can stem from:

  • Hormonal changes
    There is a sharp drop in oestrogenand progesterone that are normally increased 10x during pregnancy. There are changes also in plasma cortisol, the stress hormone occurring at this time.

  • Psychosocial factors
    This can include feelings of inadequacy regarding childbearing

  • Ambivalence towards pregnancy
  • Low self-esteem
  • Interpersonal issues
    This can include marital relationships or mother-daughter problems

  • Financial problems
    This can arise from additional expenses

  • Obstetric complications

Interestingly, many women with postpartum depression do not recognize they have an illness, thinking that they are just having the blues. Many associate depression with false notions, such as that it is untreatable and there is a stigma associated with treatment.

If left untreated, postpartum depression can lead to :

  • Disturbed mother-infant relationship
  • Marital tension
  • Psychiatric morbidity in children that manifests at a later stage
  • Vulnerability to future depression
  • Suicide and/or infanticide (killing of baby) 

Treating Postpartum Depression

In managing postpartum depression, the psychiatrist will first investigate social factors and mobilise support. In mild cases, this is often sufficient. The new mother will also be connected to self-help networks and groups for material, emotional and physical help.  Mothers who have had the same experience can share their experiences. 

In more severe cases, antidepressant medication, psychotherapy and/or Electroconvulsive treatment may be recommended, whether independently or in combination. A combination of drug treatments with psycho-social interventions is known to have the best results.

Antidepressants need to be taken for at least 3-4 weeks before any improvement can be seen. Once they feel better, the medication needs to be continued for at least 6- months to prevent a relapse. Mothers who are breastfeeding will need to discuss with the doctor about the safety of the medication.  

Psychotic Depression

Psychotic depression is similar to postpartum depression, but in addition mothers will have delusions (false beliefs) and hallucinations (false perceptions). This includes the feeling that ‘someone’ or ‘something’ is watching or disturbing them. Patients may also show gross abnormalities of speech and behaviour.

Psychotic depression is considered a Psychiatric Emergency and needs inpatient treatment. It is a severe and life-threatening condition, and the patient must be closely monitored for suicide and/or infanticide. Fortunately it is not very common, affecting only 0.2% of new mothers.

Factors that lead to psychotic depression include:

  • ormonal changes
  • Out of wedlock baby
  • First child
  • Caesarean birth
  • Perinatal death (stillbirth or neonatal death)
  • Psychiatric history
  • Family history of psychiatric illness

Treating Psychotic Depression

It is treated with Electroconvulsive Therapy, or a combination of antipsychotics & antidepressants. Most patients often recover but will need further monitoring as they may cause problems to the family.

Some women may blame the child for their condition, and anger from the family could be projected to the child. On the opposite end of the spectrum, some women become overprotective of the child. Counselling is necessary to handle the topic of future pregnancies.