THE RIGHT FRAME OF MIND - IMH

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THE RIGHT FRAME OF MIND - IMH
F E B R UA RY- M AY 2 0 2 1

                              A   M A G A Z I N E   O N   M E N T A L         H E A L T H

                                                             BODY
                                                          DYSMORPHIC
                                                           DISORDER
                                                           When a distorted
                                                            self-image has
                                                             debilitating
                                                                effects

                                              THE RIGHT
                                                 FRAME
                                                OF MIND
                                                 Strategies you can
                                                   adopt to maintain
                                              positive mental health
                                                   in the year ahead
THE RIGHT FRAME OF MIND - IMH
8

                                                                                                        04
                                                                                                   Live Well
                                                                                                      How pets are
                                                                                                   helping people cope
                                                                                                    with the isolating
                                                                                                   impact of COVID-19
                                                                                                       lockdowns.

         CONTENTS
              FEATURES                                                                         F   E    B    R   U       A     R   Y       -      M   A   Y       2    0     2    1

                                                                 REGULARS

IFC-Ad
         8    FOCUS
              Back-to-basics strategies
              for maintaining positive                     4     LIVE WELL
              mental health in the                               What’s new in mental health
              year ahead.                                        research, and tips on maintaining
                                                                 your mental well-being.                                     12
         14 Body dysmorphic disorder is
              a mental health condition that                16   MY S AY
              goes far beyond insecurities and                   *9(ƺÖ³À­ŒÀšœŒ–ጃËȜی?탌À
              self-obsession.                                    Professor Chua Hong Choon looks
                                                                 back on changes in Singapore’s
                                                                 mental healthcare landscape
              PROFILES                                           over the years.

         3    I SERVE                                      18    ASK THE EXPERTS
              What she lacked in formal music                    IMH clinicians answer
              training, Ms Yong Fong Ling made up                your questions.
              for in passion — all so she could share
              the joy of music with IMH patients.          19    IMH SCENE
                                                                 A round-up of news and events
         12   A L I FE I N MY D AY                               centred on mental healthcare.
              Depression might have interrupted
              his life, but Mr Ivan Lim took the
                                                                                                                         ‡łĩőőĂäàĆƅäŅäĢÚä
              pause in positive stride to rebuild
                                                                 L A S T PAGE                                            ANSWER: The 5 differences below

              a better life.                               20    BEAUTIFUL MIND
                                                                 Be aware of the ill-effects
                                                                 of the over-consumption of
                                                                 news, especially bad news.

                                       “People with body dysmorphic disorder
                                       tend to over-focus on details, but are
                                       unable to process visual information in a
                                       holistic manner or see the big picture.”
                                       DR JACKKI YIM
                                       Senior Clinical Psychologist, Department of
                                       Psychology, IMH                                                                                 Turn to Live Well, page 7, for the puzzle.
                                                                                                                                       Tu

                                                                                                                             INSTITUTE OF MENTAL HEALTH   ..   FEB - MAY /   01
THE RIGHT FRAME OF MIND - IMH
volunteer .             I SERVE
                                                                                                                                                                                                                                                        HITTING THE
         EDITORIAL
            MESSAGE
                                                                                                                                                                                                                                                        Right
                     C H A RT I N G YO U R OW N
                                                                                                                                                                                                                                          :             Note
                                                                                                                                                                                                                                                        What she lacked in formal music
                                                                                                                                                                                                                                                                                                                                                                   MS YO N G
                                                                                                                                                                                                                                                                                                                                                                  FO N G L I N G
                                                                                                                                                                                                                                                        training, Ms Yong Fong Ling
                                                                                                                                         F E B R UA RY- M AY 2 0 2 1

                     CO U R S E TO W E L L N ESS                                                                                                                       A   M A G A Z I N E   O N   M E N T A L         H E A L T H

                                                                                                                                                                                                                                                        made up for in passion — all so
                                                                                                                                                                                                                                                                                                                                                                      Volunteer,
                                                                                                                                                                                                                                                                                                                                                                     IMH Ringers

                                   e know it is important to look after our mental health, but                                                                                                        BODY
                                                                                                                                                                                                   DYSMORPHIC
                                                                                                                                                                                                    DISORDER
                                                                                                                                                                                                                                                        she could share the joy of music

                        W                                                                                                                                                                                                                               with IMH patients.
                                                                                                                                                                                                    When a distorted
                                                                                                                                                                                                     self-image has

                                   what exactly constitutes mental wellness? People often
                                                                                                                                                                                                      debilitating
                                                                                                                                                                                                         effects

                                   equate this with the absence of a diagnosed mental                                                                                                                                                                   Interview KEENAN PEREIRA
                                                                                                                                                                                       THE RIGHT                                                        M a i n p h o t o K E LV I N C H I A
                                   health condition, but in reality, it incorporates broader                                                                                              FRAME
                                                                                                                                                                                         OF MIND
                                                                                                                                                                                          Strategies you can

                    attributes such as having a positive mindset, a strong support                                                                                                          adopt to maintain
                                                                                                                                                                                       positive mental health
                                                                                                                                                                                            in the year ahead

                                                                                                                                                                                                                                     Imagine clinched   >> IF YOU WERE TO VISIT IMH
                    network and coping skills to handle the stresses of daily life. With this                                                                                                                                          the ÜvÀˆ³–

                    in mind, our cover story (pages 8-11) presents a ’roadmap’ for mental
                                                                                                                                                                                                                                       Excellence at
                                                                                                                                                                                                                                        APEX 2020
                                                                                                                                                                                                                                                        ON A SATURDAY MORNING, you
                    ܌¨¨®ŒÃÃƛ(ŒÀŒƜâ³Ëܜ¨¨ﮈȜ½Ã–³ÀvƒšœŒÛœ®—‚v¨v®ƒŒƜ‚Ëœ¨ˆœ®—                                                                                                                                                                  might hear the sound of simple but
                    resilience and maintaining a healthy outlook in the year ahead.                                                  Editorial                                                                                                          melodic tinkling resonating from one of
                        The importance of looking on the bright side cannot be                                                       Lalitha Naidu                                                                                                      the rooms. The source of this music is a
                    understated. There are those who may suffer from depression or                                                   Ting Mei See                                                                                                       resonator bar, a percussion instrument
                    anxiety disorder for instance, but still have positive mental health                                             Pameline Kang
                                                                                                                                                                                                                                                        that relies on teamwork and coordination
                    attributes which enable them to cope well. An example would be                                                   Contributors                                                                                                       between its players, who — in this case
                    ³ËÀ4œ–Œ*®9âvâ½À³ï¨ŒƜ9À*Ûv®4œ­Ɯܚ³švíŒÈšœÃƒ³®ˆœÈœ³®                                             Ronald Rajan,                                                                                                      — are long-stay patients of IMH. Meet
                    head on, and seeks out happiness wherever he can. His story                                                      Dennis Yin, Denyse Yeo,                                                                                                                                                                                              Striking A Chord With Patients
                                                                                                                                                                                                                                                        the IMH Ringers, the hospital’s resident
                    (pages 12-13) also outlines the importance of early intervention.                                                Koh Yuen Lin, Keenan                                                                                                                                                                                                 IMH runs music-based programmes
                                                                                                                                     Pereira, Kelvin Chia                                                                                               resonator bar group. The IMH Ringers is
                        In this issue, we also shed light on body dysmorphic disorder                                                                                                                                                                                                                                                                     to help patients enjoy the therapeutic
                    (pages 14-15). Far from being a case of vanity, this lesser-known                                                                                                                                                                   the brainchild of Ms Yong Fong Ling, a                                                            ‚Œ®ŒïÈó–ȚŒvÀÈÃƛSšŒÃŒœ®ƒ¨ËˆŒƝ
                                                                                                                                     C i r c u l a t i o n C o o rd i n a t o r                                                                         data analyst who has been volunteering at
                    condition can lead to social isolation and even self-harm. Often,                                                Chris Ngiam
                    those who grapple with it may not be aware that they have a                                                                                                                                                                         the hospital since 2013.                       simple was also an advantage for me,” she          DÀË­œÀƒ¨Œ Long-stay
                    medical issue that warrants proper attention.                                                                                                                                                                                            Ms Yong’s journey began when she          recalls with a laugh.                              patients learn to play
                        ÜvÀŒ®ŒÃÃœÃv®œ­½³ÀÈv®ÈïÀÃÈÃȌ½ƛŒÈȌÀ­Œ®Èv¨šŒv¨Èš¨œÈŒÀvƒâ                                                                                   A publication by                                                          noticed how much her younger brother                 Eventually, Ms Yong settled on the           hand-drums and percussion
                    will not only help dispel the prevailing negative attitudes and beliefs,                                                                                                                                                            enjoyed his weekly volunteering sessions       resonator bar, which is ideal for a musical        instruments under
                    ‚ËÈv¨Ã³Œ®ƒ³ËÀv—ŒȚ³ÃŒv––ŒƒÈŒˆȳƒ³­Œ–³ÀÜvÀˆv®ˆ‚Œ®ŒïÈ–À³­                                                                                                                                                                  at the hospital. This led her to join him      ensemble. Each member is given a bar that          the guidance of a trainer.
                    early intervention. This is something that Professor Chua Hong Choon                                                                                                                                                                in organising various activities for the       ½¨vâÃvýŒƒœïƒ®³ÈŒƛSšŒâ½¨vâȚŒœÀ®³ÈŒܚŒ®
                    emphasises in a special interview (pages 16-17) to mark the end of his                                                                                                                                                              patients, including arts and crafts, festive   it is their turn, and the notes come together to
                    decade-long tenure as IMH CEO. Here, Prof Chua talks about the work                                                                                                                                                                                                                                                                                      Very Special Outstanding
                                                                                                                                                                       Editorial consultant                                                             celebrations, outings and sports. “We          form a tune. “The initial sessions were tough,
                    he and his team have done in building community partnerships to                                                                                                                                                                                                                                                                                          IŒÀ–³À­ŒÀÃƪ_O?Iƫš³œÀ
                                                                                                                                                                                                                                                        wanted to have a range of programmes           because everybody was so excited and would
                    improve support for those with mental health conditions, as well                                                                                                                                                                                                                                                                                         Run by IMH’s Occupational
                    as how patients themselves have been empowered to play a                                                                                                                                                                            to cater to the patients’ varying needs        just play when it wasn’t their turn,” she says.
                                                                                                                                                                                                                                                        and interests,” she explains. “There           But Ms Yong persevered and taught patients                            Therapy department.
                                          greater role in their well-being.
                                                 So as the Year of the Ox rolls in, we applaud                                                                                                                                                          wasn’t a music-focused activity and            simple musical concepts like rhythm and                               Patients are professionally
                                                                                                                                                Copyright © is held by the
                                                   Ț³ÃŒ̌§œ®—ȳÀŒˆŒï®ŒȚŒ­Œ®Èv¨                                                       publishers. All rights reserved.                                                                          I thought it would be fun for them.”           pace. To shore up her own skills, she read up                         coached in singing and
                                                                                                                                             Reproduction in whole or in part
                                                       health landscape, as well as everyday                                                 without permission is prohibited.                                                                          Music, she felt, could also teach patients     extensively on music theory. These efforts                            performing skills, and often
                                                       Singaporeans who are proactively                                                        Printed in Singapore by KHL
                                                                                                                                                                                                                                                        skills like teamwork, self-expression          paid off and the IMH Ringers are now regular                          hold public performances.
                                                                                                                                              Printing,www.khlprint.com.sg.
                                                          taking charge of their wellness. May                                                      MCI (P) 111/08/2020                                                                                 and communication.                             performers at hospital events. “Performing
                                                             you be surrounded by positive                                                                                                                                                                                                             for an audience was another challenge to
                                                                  vibes for the rest of 2021,                                         Every care has been taken in the                                                                                                                                                                                    Hearts in
                                                                                                                                      production of this magazine, but IMH the                                                                          A JOURNEY OF DISCOVERY                         overcome,” says Ms Yong. “The players would        Harmony
                                                                  and beyond!                                                         publisher, and its employees assume no
                                                                                                                                      responsibility for any errors, inaccuracies                                                                       In 2017, Ms Yong raised the idea of starting   be distracted by the crowds and noise, so I had    A volunteer-run
                                                                                                                                      or omission arising thereof. Opinions                                                                             the musical group and was met with             to remind them beforehand to just look at me
                                                                                                                                      expressed by contributors are not                                                                                                                                                                                   choir for long-
                                                                                                                                      necessarily those of IMH or the editorial                                                                         enthusiastic support from IMH’s volunteer      and play as they do during rehearsals.”            stay patients.
                                                                                Happy reading.                                        consultant, Mediacorp. The information
                                                                                                                                                                                                                                                        manager. The next thing to do was to pick            The experience of forming an interest
                                                                                                                                      produced is for reference and educational
                                                                                                                                      purposes only. As each person’s medical                                                                           an instrument. Ms Yong wanted the group        group has strengthened Ms Yong’s connection
                                                                              the editorial                                           condition is unique, you should not rely
                                                                                                                                      on the information contained in this                                                                              to be as inclusive as possible. “Some may      with some of the long-stay patients. “They

                                                                                  team                                                magazine as a substitute for personal
                                                                                                                                      medical attention, diagnosis or hands-on
                                                                                                                                      treatment. If you are concerned about any
                                                                                                                                      health matter, please consult your family
                                                                                                                                                                                                                                                        be more musically-inclined than others,
                                                                                                                                                                                                                                                        but I didn’t want to turn away those who
                                                                                                                                                                                                                                                        are interested but less musical,” says
                                                                                                                                                                                                                                                                                                       remember my name and are always excited to
                                                                                                                                                                                                                                                                                                       see me,” she says. “The COVID-19 pandemic
                                                                                                                                                                                                                                                                                                       and its resulting restrictions forced us to put
                                                                                                                                                                                                                                                                                                                                                           HHA AWARD Ms Yong was a recipient of the
                                                                                                                                                                                                                                                                                                                                                           2020 Healthcare Humanity Award (Volunteer
                                                                                                                                      physician or healthcare professional.                                                                                                                                                                                vȌ—³Àâƫ–³ÀšŒĄ̀ðŒÃÈŒˆœƒvȜ³®v®ˆŒ––³ÀÈÃ
                                                                                                                                                                                                                                                        Ms Yong, who admits to having no serious       the IMH Ringers on hold but I’m itching             to improve the lives of IMH’s long-stay patients
                                                                                                                                                                                                                                                        musical background apart from “dabbling”       to go back and see my friends at the hospital       through activities such as IMH Ringers.
FO R M O R E I N FO R M AT I O N / / V I S I T W W W. I M H .C O M . S G O R W R I T E TO U S AT E N Q U I RY @ I M H .C O M . S G
                                                                                                                                                                                                                                                        in the guitar and drums. “Keeping things       again. It is my second home now.”
02 / IMAGINE    ..     IMAGES BY GETTY IMAGES                                                                                                                                                                                                                                                                                                             INSTITUTE OF MENTAL HEALTH   ..   FEB - MAY /   03
THE RIGHT FRAME OF MIND - IMH
STAYING ON TOP, MENTALLY

                                                                WELL!
                                                                                                                                                                                                  Researchers from the University of        completing a series of tasks. Before the
                                                                                                                                     THE ROOTS OF

           L I VE
                                                                                                                                                                                                  California, Davis, did just that and      session ended, they were told they could
                                                                                                                                     Kindness                                                      found that mothers have a big role
                                                                                                                                                                                                  to play. Examining the behaviours
                                                                                                                                                                                                                                            donate their tokens to other children in
                                                                                                                                                                                                                                            need. At the same time, mothers answered
                                                                                                                                     With the year-end                                             of 54 mother-child pairs, the            ¿ËŒÃȜ³®ÃÀŒ—vÀˆœ®—ȚŒœÀۜŒÜ󮌭½vȚâƜ
                                                                                                                                                                                                                                            compassion and love.
                                                                                                                                                                                                    researchers found that children
                                                                                                                                     festivities and                                                 who had experienced more               SšŒﮈœ®—Ãڳ܌ˆvƒ³ÀÀŒ¨vȜ³®
                                                                                                                                     traditional season                                             compassion, love and empathy            between children’s generosity and their
                                                                                                                                                                                                    from their mothers were more            socialisation experiences. "Compassionate
                                                                                                                                     of giving behind us,                                        willing to be generous to others.          mothers develop emotionally close
                                                                                                                                                                                                    The children involved in the            relationships with their children while
                                                                                                                                     it might be worthwhile to                             ÃÈˈâ܌ÀŒïÀÃÈȌÃȌˆvÈȚŒv—Œ³–            providing an early example of prosocial
                                                                                                                                     consider the origins of our                       four and invited back two years later. At both       orientation toward the needs of others,"
                                                                                                                                     generosity. >                                     stages, the children were given 20 tokens for        researchers said.

                                                                                                                                           The perfect gift                                                                               Experience Singapore
                                                                                                                                                                                                                                          You don’t need to travel overseas to
                                                                                                                                           The mystery of the perfect gift may        derive more happiness from                          have an unforgettable time — start right
                                                                                                                                           have been solved — at least for children   their experiences.                                  here in Singapore with these activities:
                                                                                                                                           aged 12 and above. New research by               Lead researcher Associate
                                                                                                             PET                           the University of Illinois at Chicago
                                                                                                                                           suggests that giving them something
                                                                                                                                                                                      Professor Lan Nguyen Chaplin believes
                                                                                                                                                                                      it has to do with the memory capacity
                                                                                                                                                                                                                                         > HYDRODASH Test your ninja
                                                                                                                                                                                                                                           warrior skills at Singapore’s
                                                                                                        PURSUITS
                                                                                                         The number of
                                                                                                                                           they can experience actually makes
                                                                                                                                           them happier than receiving a material
                                                                                                                                                                                      of younger children. “Young children
                                                                                                                                                                                      do love experiences ... However, for
                                                                                                                                                                                                                                           ïÀÃÈưŒÛŒÀð³vȜ®—v¿Ëv½vÀ§ƛ
                                                                                                                                                                                                                                           https://www.sentosa.com.sg/en/
                                                                                                        pets in Singapore                  object. Published in the International     experiences to provide enduring                      things-to-do/attractions/hydrodash/
                                                                                                        in 2019 (including
                                                                                                        non-registered and                 Journal of Research in Marketing,          happiness, children must be able to
                                                                                                         a
                                                                                                         adopted animals):                 the research compared the level            recall details of the event long after             > FLIGHT EXPERIENCE’S BOEING 737
                                                                                                                                           of happiness children derived from         it is over,” she said.                               Take to the skies with Flight
                                                                                                                                           material goods versus that from                 Sšv®§–˨¨âƜȚŒÀŒœÃv¿Ëœƒ§v®ˆ               Experience’s Boeing 737 simulator,
                                                                                                                                           experiences. The results showed that       ŒvÃâïáȳ¦³—ȚŒœÀ­Œ­³ÀœŒÃƛƿSv§Œ                which is used by actual pilots as well!
                                                                                                               > DOGS:                     how old a child was had an effect on       pictures or videos of family walks,                  šÈȽÃƝƨƨÜ®—v½³ÀŒƛ𜗚ȌὌÀœŒ®ƒŒƛƒ³­ƛ×ƨ
                                                                                                           111,500                         how they viewed certain gifts. Children
                                                                                                                                           between the ages of three and 12
                                                                                                                                                                                      playing in the snow, and birthday
                                                                                                                                                                                      parties," she added. "Children are likely
                                                                                                                                                                                                                                           ½v—ŒÃƨųůųưܭ˨vȳÀư𜗚ÈÃ

                                                                                                                                           derive more happiness from material        to appreciate those experiences more               > HEADROCK VR Enter the world of
                                                                                                                                           things, whereas older children             if there is something to remind them of              virtual reality at HeadRock VR,
                                                                                                                                                                                      the event.”                                          an escape from the everyday.
                                                                                                                > CATS:                                                                                                                    https://www.headrockvr.sg/
                                                                                                            85,100

                                             Furry
                                                                                                                                                                                                                                         > SNOW CITY SINGAPORE
                                                                                                                                                                                                                                           Zip up your parkas and chill out
                                                                                                                                                                                                                                           at Snow City Singapore.
                                                                                                         > SMALL MAMMALS:                                                                                                                  http://www.snowcity.com.sg/
                                                                                                            (hamsters, guinea
                                                                                                              pigs, rabbits)                                                                                                             > WILDLIFE RESERVES

                                              Heroes                                                       92,300                                                                                                                          SINGAPORE
                                                                                                                                                                                                                                           Get close to
                                                                                                        Source: The Business Times
                                                                                                                                                                                                                                           nature at
                                                                                                                                                                                                                                           Wildlife
                                                                                                                                                                                                                                           Reserves
                                                                                                                                                                                                                                           Singapore’s
                                                                                                                                                                                                                                           four nature
                                                                                                                                                                                                                                           parks.
       >> The secret to coping during the COVID-19 crisis?      Dr Young. From interviews with 32 people, she found                                                                                                                        https://www.
        A furry friend. The isolating impact of the pandemic    that more than 90 per cent of respondents said that                                                                                                                        wrs.com.sg
       has led many to seek the comfort of a pet at home.       touching their pets both comforted and relaxed them.

                                                                                                                                                                                                                                                                                                  Photo courtesy of www.wrs.com.sg
       Dr Janette Young of the University of South Australia    Many also noticed that their pets seem to know when
       observed that there has been a global surge in pet       their owners could use a cuddle. This wasn’t limited
       adoptions and purchases during lockdowns. She            to dogs and cats, added Dr Young. Birds, sheep,
       q©yu‡³­³†‡­³¦y¦’yq©e¿‡˜ƒ³†ypy˜y˳­³†e³e¦y³   horses and even reptiles provided similar comfort.
       brings at a time when human touch is discouraged.        "In the era of COVID-19, social distancing, sudden
       "Pets seem to be particularly important when people
       are socially isolated or excluded, providing comfort,
                                                                lockdowns and societal upheaval, our pets may be the
                                                                only living beings that many people are able to touch
                                                                                                                                                                                                                                          >   All attractions listed above can be redeemed with
                                                                                                                                                                                                                                              SingapoRediscover Vouchers.

       companionship and a sense of self-worth," said           and draw comfort from,” she said.

04 / IMAGINE   ..   IMAGES BY GETTY IMAGES                                                                                                                                                                                               INSTITUTE OF MENTAL HEALTH   ..   FEB - MAY /   05
THE RIGHT FRAME OF MIND - IMH
L      I   V E        WELL!

        TIPPING the SCALES                                                                                                                                        REDISCOVER RESILIENCE
                                                                                                                                                                  An online survey of some 3,500
        The full extent of the COVID-19 pandemic’s impact                                                                                                         individuals by Ohio State University and
        on our wellness may prove a mystery for years                                                                                                             online health portal Everyday Health
        to come. But early research suggests that it has                                                                                                          has unearthed some interesting trends
        done more harm than good, with a global survey                                                                                                            about the state of resilience.
        q˜Ë©—‡˜ƒ³†e³‡³†e­¦©—¦³yu—e˜Â³q·³peq                                                                                                          For instance, researchers have found that
        on physical activity and eat more junk food.                                                                                                              a passive “it is what it is” mindset is more
                                                                                                                                                                  prevalent in less resilient people. They also
        Carried out by researchers at the Pennington                                                                                                              tend to overthink or overanalyse issues.
        Biomedical Research Center in Louisiana, US,                                                                                                              Meanwhile, those who are more resilient are
        the study surveyed almost 8,000 adults                                                                                                                    less resigned to their situations and are able to
        across the world.                                                                                                                                         keep their problems in perspective. The survey
             Researchers observed that the general                                                                                                                v¨Ã³–³Ë®ˆȚvȳیÀv¿ËvÀȌÀ³–ÀŒÃ½³®ˆŒ®ÈÃ
        decline in healthy behaviour during the                                                                                                                   had over-estimated their levels of mental and
                                                                                                                                                                  emotional resilience.
        lockdown was fairly common regardless of
                                                                                                                                                                       With a growing canon of research
        geography. More people led more sedentary
                                                                                                                                                                  highlighting that higher levels of resilience are
        lives, as the stay-home directives sharply                                                                                                                directly related to better outcomes when living
        reduced daily commuting needs. But even                                                                                                                   through a crisis and improving emotional and
        when people did exercise, it was often at a                                                                                                               physical health, it is more important than ever
        lower intensity than before the pandemic. Giving
        in to cravings was also a common theme, with the
        consumption of sugary drinks and snack foods
                                                                                                                EXERCISE (WITH) CAUTION
                                                                                                                                                                  to focus on building up our resilience reserves.
                                                                                                                                                                       Fortunately, resilience can be built through
                                                                                                                                                                  constant practice. Start with these tips from
                                                                                                                                                                                                                      The #HYGGE way of life
        —³œ®—˽ƛSšŒÃŒÈÀŒ®ˆÃ­œ—šÈŒá½¨vœ®ȚŒÀŒÃŒvÀƒšŒÀÃƺ³ÈšŒÀﮈœ®—Ɯ                                                                                      the Health Promotion Board:                         The hygge hashtag on Instagram has led to nearly seven
        which showed that about 27 per cent of respondents gained weight                                        150 minutes of physical activity                                                                      million posts — proof of the growing global obsession with
        œ®ȚŒŒvÀ¨â­³®ÈšÃ³–ȚŒ½v®ˆŒ­œƒƛSšœÃï—ËÀŒÜvÌی®šœ—šŒÀ                                        a week is all you need to lead a                  > BE OPTIMISTIC
        among obese respondents.                                                                                healthier lifestyle, according                      When dealing with setbacks, focus on
                                                                                                                                                                                                                      this centrepiece of Danish culture that has been linked to
             But there were some bright spots as well: about 17 per cent of respondents                         to the Health Promotion Board.                      the positives instead of dwelling on the          a reduction of stress and increase in overall well-being.
        said that they had lost weight, pointing to the fact that the lockdowns led them                                                                            negatives. Being optimistic can also improve
                                                                                                                As the nation gradually lifts
        to discover new ingredients and look for ways to cook healthier meals at home.                                                                              your problem-solving skills, as it helps you      If the term (pronounced hoo-guh)           relaxing than harsh and cold
             The results of the study were published in Obesity.                                                COVID-19 restrictions, team-based                   focus on the possibilities instead of             ÀvœÃŒÃ­³ÀŒ¿ËŒÃȜ³®ÃȚv®v®Ã܌ÀÃƜ       white light. Find comforting
                                                                                                                sports such as basketball, football,                the problem.                                      šŒÀŒƺÃv¿Ëœƒ§œ®ÈÀ³ˆËƒÈœ³®ƝœÈÀŒ–ŒÀà    fabrics and choose casual
                                                                                                                and dragonboating can be safely                                                                       to the art of getting comfy and cosy       wear whenever you can.
Dealing with                                                                                                    resumed.                                          > ADD OBJECTIVITY                                   Ƴv®ˆȚœÃ¨³³ÃŒˆŒï®œÈœ³®­Œv®Ã
                                                                                                                                                                                                                                                                > WITH GOOD COMPANY
                                                                                                                                                                    When faced with a setback, it's normal to         that everyone sees hygge differently.
body shaming                        > REACH OUT:                      strong, capable and resilient,               Those who prefer working
                                                                                                                                                                    think that the situation is worse than it         Ultimately, hygge is about who you         Nurture relationships that allow
                                      When comments about your        regardless of size.                       out alone can continue to use
Being on the receiving                                                                                                                                              actually is. Objectivity allows you to see        choose to surround yourself with           you to feel supported and heard.
                                      body become too personal,
end of offhand                        turn to trusted friends       > PRIORITISE YOUR HEALTH:                   public stadiums, dance studios,                     things in perspective and prevents you            and what you choose to spend your          Enjoy precious bonding time by
comments about your                   and family members for          Take steps to improve your                gyms, indoor sport halls and                        from making a mountain out of a molehill.         time doing. Here are some common           hanging out with a small circle
changed body can                      emotional support.              physical and emotional                                                                                                                                                                     of close friends or loved ones.
                                                                                                                swimming complexes; just                                                                              elements that can help you get
make you feel less-                                                   well-being. Take time off
                                                                                                                                                                  > TAKE A BREAK                                      started on your hygge journey:            > GET COOKING
                                    > EMBRACE POSITIVE                social media if it is triggering          remember to book a slot before
than-secure. Here                     AFFIRMATIONS: Remind            negative thoughts about
                                                                                                                                                                    Giving your body and mind a chance to                                                        Freshly-baked foods have
                                                                                                                heading down and follow safe                                                                          > AT HOME
are tips to take                      yourself that you are           your body.                                                                                    ÀŒƒšvÀ—Œƒv®Œ¿Ëœ½â³ËܜȚȚŒŒ®ŒÀ—â                                                      been shown to be some of the
                                                                                                                distancing guidelines.                                                                                  Dim the lights and light some
it in stride:                                                                                                                                                       needed to face your problem head-on.                                                         warmest, most hygge-inducing
                                                                                                                                                                                                                        candles in the evening. Research
                                                                                                                                                                                                                        has shown that warm yellow               scents around, so warm up the
                                                                                                                                                                                                                        light is often perceived as more         oven and get baking!

 THIS IS WHAT                       The effects of loneliness — such as the increased             internally-directed thoughts such as                                                                                   ‡łĩőőĂäàĆƅäŅäĢÚä͢
 LONELINESS                         risk of cognitive decline and dementia — are widely           reminiscing or imagining social experiences,”
                                                                                                                                                                                                                         Can you
 LOOKS LIKE                         known. But exactly how loneliness presents in the             said the study’s lead
                                                                                                                                                                                                                                     A                                         B
                                    brain is less clear…until now. Scientists from McGill         author Dr Nathan                                                                                                       spot 5
                                    University in Canada have found that people who
                                    are struggling with loneliness have brains that are
                                                                                                  Spreng. “This heightened
                                                                                                  focus on self-reflection,
                                                                                                                                    #KNOW                                                                                differences
                                    distinct from the general population. According to            and possibly imagined             THIS                                                                                 between
                                    their research, the brains of lonely people featured          social experiences, would      Loneliness kills; literally.                                                            these two
                                                                                                                                 According to the 2015
                                    a higher volume of grey matter in the default                 naturally engage the                                                                                                   pizzas?
                                                                                                                                 Singapore Longitudinal
                                    network, which is the part of the brain responsible           memory-based functions         Ageing Studies headed by
                                    for processes like reminiscing, future planning,              of the default network.”       the National University of
                                                                                                                                                                                                                         REFER TO THE
                                    imagining and thinking about others.                          The results of their study     Singapore, seniors who live                                                             C O N T E N T S PA G E
                                         "In the absence of desired social experiences,           were published in Nature       alone are 1.7 times more                                                                FOR PUZZLE
                                                                                                                                 likely to die prematurely than                                                          ANSWER
                                    lonely individuals may be biased towards                      Communications.
                                                                                                                                    seniors living with others.

     06 / IMAGINE   ..   IMAGES BY GETTY IMAGES                                                                                                                                                                                                                 INSTITUTE OF MENTAL HEALTH   ..   FEB - MAY /   07
THE RIGHT FRAME OF MIND - IMH
Going back                                                                                                                                                             01       Embrace Challenges
                                                                                                                                                                               2020 offered a stark reminder that each passing year brings its own set of
                                                                                                                                                                                                                                                                         cover story . FOCUS

                       to
                                                                                                                                                                               unique challenges that can upend our lives. Predicting or avoiding change isn’t
                                                                                                                                                                               always possible, so Ms Wang suggests shifting our mindset instead. “Learn to
                                                                                                                                                                               groom a growth mindset,” she advises. “Tell yourself that you can choose to
                                                                                                                                                                               œ®ÈŒÀ½ÀŒÈȚŒ³‚ÃÈvƒ¨ŒÃ³ÀˆœíƒË¨ÈœŒÃȚvȨœŒvšŒvˆ³–â³ËvÃv®³½½³ÀÈË®œÈâȳ
                                                                                                                                                                               thrive — instead of just survive — and any failures that you face will be lessons to
                                                                                                                                                                               learn from to do things differently.”
           We’re well into 2021, and our resolutions                                                                                                                                                                                          Practise mindfulness to stay in the present. “We cannot
                                                                                                                                                                               NOTE THESE TIPS TO HELP YOU NAVIGATE NEW
          to live better may have taken a backseat as                                                                                                                          CIRCUMSTANCES AND SITUATIONS:                                  change the past nor have we arrived at the future, so the
        the stresses of daily life seep in again. Make it a                                                                                                                    Visualise your thinking patterns to understand how you
                                                                                                                                                                                                                                              present is what we should focus on,” says Ms Wang. This
        point to return to the fundamentals of wellness                                                                                                                        approach problems. One way to do this is by journalling
                                                                                                                                                                                                                                              means shifting mental gears to get out of our old ways of
                                                                                                                                                                                                                                              thinking, feeling and acting, and focusing on what is here
             and prioritise positive mental health.                                                                                                                            regularly: writing down the ideas swimming in our
                                                                                                                                                                                                                                              right now.
                                                                                                                                                                               head allows us to get a grasp on them and identify
                          Te x t K E E N A N P E R E I R A i n c o n s u l t a t i o n w i t h M S J E M I E W A N G ,
                                C l i n i c a l P s y c h o l o g i s t , D e p a r t m e n t o f P s y c h o l o g y, I M H
                                                                                                                                                                               unhealthy thinking patterns that lead to rigidity and          Practise self-compassion, especially in a time of rapid
                                                                                                                                                                               pessimism. “We can then set an intention to focus on           change. Realise that adapting to change isn’t easy and
                                                                                                                                                                               gratitude, personal strengths, or the positive aspects         acknowledge that you did the best you could. “Ignore the
                      ake your mind back to the start of the                                                       Department of Psychology, Institute of Mental Health        of our circumstances. This can assist us in proactively        overly critical voice of self-judgment and be as kind to
                                                                                                                                                                               modifying the way we view and handle challenges,” says         yourself as you are to your loved ones,” advises Ms Wang.

          T
                      year: did you make a resolution to lead                                                      (IMH), shares, you can make a conscious effort to
                      a better, healthier life? If you did, you                                                    develop and maintain positive mental health at any time     Ms Wang. This is a journey and you’ll get better over          “We deserve kindness, warmth and care — the same
                      are not alone — changes to improve our                                                       of the year.                                                time. The key is to start at some point.                       qualities we offer to others we care for.” >>
                      health and quality of life are among the                                                         Achieving positive mental health needn’t be an
     most common resolutions made at the dawn of a new                                                             uphill or gruelling task, as Ms Wang explains. It starts
     year. But in the weeks that have passed, we may have                                                          with going back to the basics of ourselves: how we deal
     already neglected to prioritise our mental well-being,                                                        with change, how we care for ourselves and how we
     which is central to living better. Don’t be disheartened                                                      build healthy relationships with those we love. Here,
     though — as Ms Jemie Wang, Clinical Psychologist,                                                             Imagine looks at ways to get started:

A Positive Spin
Remember that positive mental health encompasses more than just the absence of mental disorders.
It is possible for a person with a diagnosis of mental illness to have a high level of positive mental health.
Conversely, people who are not diagnosed with a mental illness may fail to prioritise their mental well-being.
For instance, an individual who regularly works long hours, feels overwhelmed by commitments and neglects
self-care may not have the best mental health.                                                                                                                                                                                                                                 FIND THE
     In 2012, IMH developed a Positive Mental Health (PMH) instrument — an assessment tool to measure PMH                                                                                                                                                                     RIGHT PACE
in the local population — as part of the Singapore Mental Health Study. It comprises six components that                                                                                                                                                                 Overwhelmed by the tasks at
influence our well-being and contribute to positive mental health. Read on to find out more about them:                                                                                                                                                                   home or work? Breaking up
                                                                                                                                                                                                                                                                          your workload into smaller
     General coping: (³Ü܌ÀŒvƒÈȳvÃÈÀŒÃÖ˨³ÀˆœíƒË¨È                                                    Personal growth: OŒÈȜ®——³v¨ÃÀŒðŒƒÈà                                                                                                                   mental buckets is a way to
     situation matters. “Tough times don’t last, tough people                                                   ³®Œƺó®ïˆŒ®ƒŒƜ–ÀŒŒˆ³­v®ˆv‚œ¨œÈâ                                                                                                                    avoid feeling burned out; the
     do” may be a cliché, but it’s rooted in truth. When facing                                                 to take control of situations. Being                                                                                                                            buckets can be:
     a challenge, we might feel stretched for a period, but                                                     open to new experiences will help us
     like a rubber band, resilience allows us to bounce                                                         learn new things about ourselves. If
     back. To build resilience, think positively and engage in                                                  things don’t go as planned, don’t be                                                                                                                          An urgent pile
     pleasurable and relaxing activities.                                                                       discouraged. Failure is a part of life —
                                                                                                                what is more important is to learn from
     Interpersonal skills: Strong bonds and good                                                                our mistakes instead of dwelling
     relationships will help see us through life’s ups and                                                      on them.                                                                                                                                                 A not-so-urgent pile
     downs. Building such bonds requires skills like empathy
     and communication. Put these to good use by making                                                         Global affect: Positive moods are indicative of emotional
     time for family and friends.                                                                               stability and vitality. But positive moods, like all others,
                                                                                                                are transient. “We need to understand that our brains
                                                                                                                                                                                                                                                                        A pile you can take on
     Emotional support: It can be natural to withdraw                                                                                                                                                                                                                      later in the week
     from others when facing a tough time. But the emotional                                                    švیvǼ®Œ—vȜۜÈâ‚œvÃƺƜv®ˆȌ®ˆȳïávȌ³®‚vˆȚœ®—Ãƛ
     support that family and friends provide can give us the                                                    Thus, we need to develop the ability to focus on what                                                                                                   Think about your tasks before you dive
     assurance of feeling loved and wanted, and lighten                                                         is pleasurable or meaningful,” says Ms Wang. “Look for                                                                                                into them, so you can plan and prioritise
     our load.                                                                                                  ³½½³ÀÈË®œÈœŒÃȳè³Üˆ³Ü®v®ˆÃvÛ³ËÀv‚Œ®Œïƒœv¨                                                                                                                   them better.
                                                                                                                experience. Stay with the experience for a breath or
     Spirituality: Spiritual and religious practices and beliefs can
     ÌÀیvÃvƒ³½œ®—­Œƒšv®œÃ­v®ˆœ®ðˌ®ƒŒ³ËÀ‚Œšvۜ³ËÀƛ
                                                                                                                longer, fully sensing it in your body, and focusing on what
                                                                                                                feels good about it."
                                                                                                                                                                                                                                                               INSTITUTE OF MENTAL HEALTH   ..   FEB - MAY /   9
THE RIGHT FRAME OF MIND - IMH
FOCUS     . cover story
                                                                                                                                        03      Declutter Your Life                                                      Humans are hardwired
                                                                                                                                                                                                                         for connections and we
                                                                                                                                                “Out with the old, in with the new” is often heard
                                                                                                                                                around the start of a new year, as people begin                     py˜y˳‚©—‚©—‡˜ƒ­q‡e’
                                                                                                                                                decluttering their physical spaces. This is a
                                                                                                                                                positive move, as several studies have shown that                   ©y’e³‡˜­†‡¦­³­·©¿‡¿yŪ‚©
                                                                                                                                                physical clutter can increase levels of stress, sap             ¦³‡—e’‚·˜q³‡˜‡˜ƒe˜u‚©·©
                                                                                                                                                energy, lower productivity and have an overall
                                                                                                                                                negative impact on our well-being.                                 ¦y©­˜e’Ày’’Ƈpy‡˜ƒůC·e’‡³Â
                                                                                                                                                                                                               ­q‡e’©y’e³‡˜­†‡¦­³†e³e©y’¿‡˜ƒŪe‚Ë©—‡˜ƒ
   02          Set Aside Time                                                                                                                   Clutter, however, can take many shapes and forms.
                                                                                                                                                More than just following those Marie Kondo-inspired
                                                                                                                                                                                                                        e˜u˜·©³·©‡˜ƒƒe’˜ƒÀe³Àe©u­
               for Self-care                                                                                                                    home organisation tips, Ms Wang recommends                                ¦©—³‡˜ƒ¦­‡³‡¿y—y˜³e’†ye’³†ůƑ
                                                                                                                                                going a few steps further to remove digital clutter                    MS JEMIE WANG, Clinical Psychologist, Department of Psychology, IMH
 We know self-care is important,                                                                                                                and unhelpful relationships from your life as well.
 but what exactly is it? For parents
 juggling domestic and professional
 responsibilities, self-care can be
 something as simple as splitting
 chores with their family members                                                                                                                                                                                     The Social Network
 so they can carve out some time for
 themselves, while teenagers may
                                               HERE ARE SOME                                                                                 A Digital Detox                                                          Prioritising positive mental health also
 ﮈšv®—œ®—³ËÈܜȚ–ÀœŒ®ˆÃȳ‚Œv
                                               ACTIVITIES YOU                                                                                                                                                         entails taking a closer look at our social life.
                                               CAN START WITH:                                                                               It is not unusual to be bombarded by
 boost. Those who are more visual may                                               RELAX, TAKE IT EASY                                      ®³ÈœïƒvȜ³®Ã³®³ËÀívÀȽš³®ŒÃ                                         Some relationships, like those with loved ones who support,
 enjoy the soothing nature of art and be       •   Reading
 stressed by the thought of a Sudoku                                                BREATH FOCUS IS A                                        throughout the day.                                                      inspire and uplift, should be given more attention, says
                                               •   Listening to music               HIGHLY EFFECTIVE WAY                                                                                                              Ms Wang. Conversely, there are relationships that cause
 puzzle, while the opposite may be true                                                                                                      While some of these — like text messages from loved ones — are
 for the numerate among us.                    •   Gardening                        OF COMBATTING STRESS.                                                                                                             unnecessary stress and seem to be rooted in negativity — for
                                               •   Meeting friends for coffee/tea   TRY IT BY TAKING LONG                                    ŁŠƐŭƓƧðŢƧ̶ƧļŭƛěƓ슣ŢēŁŢĴƯƛŭijǡðƛļƛðŗěƛðŢēƛŭČŁðŗŠěēŁð͢ŗŁŔěƛͣ
                                                                                                                                                                                                                      instance, hyper-critical people in our lives who create a sense
                                               •   Watching movies/TV               AND SLOW BREATHS.                                        add little to our lives. “These interfere with our cognitive processes
                                                                                    WITH EACH BREATH,                                                                                                                 of inadequacy or even defectiveness in us. Ms Wang’s advice for
 The underlying principle of self-care         •   Meditation                                               H I GH                           by reducing our attention and focus, and can also adversely affect
                                                                                    GENTLY DISENGAGE        ST R E SS,
                                                                                                                                                                                                                      dealing with these? Actively speak up for your own well-being.
 is to identify and meet our personal          •   Sports                                                                                    our psychological well-being and stress levels,” says Ms Wang, who
                                                                                    YOUR MIND FROM          H I GH C O ST                                                                                             “Be discerning of what has been said to you. Then take charge
 needs, be it for rest, connection, or self-   •   Walking                                                                                   recommends a “digital detox”. The term might frighten some, as
                                                                                    DISTRACTING THOUGHTS                                                                                                              of the situation by expressing yourself in an assertive manner
 expression. These needs can be broadly                                             AND SENSATIONS. JUST    Singapore spends                 it conjures up images of an entirely disconnected world. In reality,
                                                                                                                                                                                                                      and drawing your boundaries with them.” But steer clear of the
 categorised into ones that are physical,                                           A MINUTE OR TWO CAN     $3.1 billion on                  Ms Wang shares that a digital detox can be as simple as setting
 psychological and social in nature.                                                HELP YOU FEEL LESS      stress-related                                                                                            temptation to become a recluse and avoid people altogether, as
                                                                                                            illnesses annually.              boundaries and limits, rather than giving up our smartphones entirely.
 “Each person’s needs differ greatly and                                            OVERWHELMED AND                                                                                                                   this may make us feel lonelier and sadder. Instead, reach out to
                                                                                    STRESSED.               Source: The Straits Times                                                                                 positive sources of social support when you need it. Accept
 ȚŒÀŒƺî³³®ŒưÜçŒưïÈÃưv¨¨̨–ưƒvÀŒ                                                                                                      SET BOUNDARIES > It may be useful to designate spaces
 solution,” says Ms Wang. “We should try                                                                                                                                                                              the help they give — needing or accepting help is not a sign
                                                                                                                                             such as the dining table and bed as “no smartphone” areas, so
 to engage in at least one activity that                                                                                                                                                                              of weakness.
                                                                                                                                             you can practise mindfulness while eating and resting.
 is pleasurable or relaxing to us every
 day. This will help us better handle              Taking long, slow                                                                         IMPOSE TIME LIMITS > Most apps, including Instagram
                                                   breaths can help
 life’s stressors and manage our mental,                                                                                                     and Facebook, now come with daily reminders that can help you
                                                   to disengage
 emotional and physical health.”                   your mind from                                                                            control the time spent on them. “These apps can give you curated
                                                   distracting thoughts.                                                                     and false depictions of other people’s lives, which can affect our
                                                                                                                                             self-esteem and self-worth,” explains Ms Wang.

     ACCORDING TO
     A 2019 SURVEY,
                                                                                                                                                                                        BEEP BEEP
                                                                                                                                                                                            The average

  3 10
                                                                                                                                                                                         smartphone user gets

                                                                                                                                                                                          46
           IN

    SINGAPOREANS polled
    said they did not know
         how to relax.                                                                                                                                                                        PUSH
                                                                                                                                                                                          NOTIFICATIONS
   Source: Todayonline                                                                                                                                                                     EVERY DAY.
                                                                                                                                                                                        Source: Business of Apps

10 / IMAGINE   ..   IMAGES BY GETTY IMAGES
THE RIGHT FRAME OF MIND - IMH
A LIFE IN MY DAY        . interview
                                                                                                                                                                               seek help, I was in the least glamorous    Music has always been a                   felt they couldn’t speak to anybody
                                                                                                                                                                               state ever, and the incongruity of it      part of my life. It allows me to          about their condition due to the
                                                                                                                                                                               made me chuckle. However, my friend        express my emotions and makes             stigma that surrounds it. But there
                                                                                                                                                                               was trying to lighten things up, as        me feel comfortable with my own           are many ways you can get help. If
                                                                                                                                                                               the topic was probably too serious         feelings, be they positive or negative.   you’re not comfortable talking to
                                                                                                                                                                               for him to take. This was in 2001, and     Even before my diagnosis, I always        someone about your feelings, try
                                                                                                                                                                               though there was some level of mental      listened to Sergei Rachmaninoff’s         apps like Wysa* on mindline.sg. It’s
                                                                                                                                                                               health awareness among the general         Piano Concerto No. 2 in C minor           a chatbot that takes the form of a
                                                                                                                                                                               public at that point, most people were     whenever I was feeling down. It           friendly little penguin and helps you
                                                                                                                                                                               still not entirely comfortable talking     starts off grandly and then goes          process your feelings. I tried it and
                                                                                                                                                                               about it, especially if it struck too      into a very heart-wrenching second        thought it would be useful to someone
                                                                                                                                                                               close to home. Having an incomplete        movement, before ending with a            who is a bit shy or embarrassed to
                                                                                                                                                                               knowledge of mental health issues          triumphant third movement —               talk to another person about his or
                                                                                                                                                                               makes it an uncertainty that is            I always feel like I am going through     her mental health condition. Help is
                                                                                                                                                                               frightening — like ghosts! So some         all the emotions that I need to           available and accessible — and you are
                                                                                                                                                                               of my friends stopped hanging out          express while I am listening to it.       never alone, even if you think you are.

                     Downside
                                                                                                                                                                               with me out of this fear of the            Incidentally, he wrote the piece after
                                                                                                                                                                               unknown. They might have thought:          he came out of clinical depression
                                                                                                                                                                               “Oh this person has mental health          and dedicated it to the physician
                                                                                                                                                                               œÃÃˌÃƜšŒ­œ—šÈ𜽳®­Œv®ˆ—³         who helped him get back on his feet.
                                                                                                                                                                                                                                                                     *Wysa: An emotionally intelligent

                                              Up
                                                                                                                                                                               completely crazy.”                         I don’t know if he wrote the piece to
                                                                                                                                                                                                                                                                     AI chatbot that individuals can chat
                                                                             Depression might have interrupted                                                                                                            help people with depression, but it
                                                                                                                                                                                                                                                                     with and use to access a wide range
                                                                                                                                                                               “Wah, you actually went                    certainly speaks to me.
                                                                             his life, but Mr Ivan Lim took the                                                                                                                                                      of self-management and cognitive
                                                                                                                                                                               (to get diagnosed)? It’s
                                                                             pause in positive stride to rebuild                                                                                                                                                     behavioural therapy exercises. Wysa can
                                                                                                                                                                               going to be on your records                Surrounding myself with
                                                                             a better life. I n t e r v i e w K O H Y U E N L I N P h o t o s K E LV I N C H I A               permanently!” some said. But while         people who have a positive
                                                                                                                                                                                                                                                                     be found on mindline.sg, a Singapore-
                                                                                                                                                                                                                                                                     developed stress management and
                                                                                                                                                                               seeking psychiatric help seemed like       effect on me – mentors, friends,           coping website that consolidates
                                                                                                                                                                               ­âïÀÃÈÀŒƒ³ËÀÌƜœÈÜvÃv¨Ã³­â¨vÃÈ     family — is important. Conversations
                                                                                                                                                                                                                                                                     access to many carefully-selected
                                                                                                                                                                               resort. It was something I had to do,      with my wife and just sharing a laugh
                                                                                                                                                                                                                                                                     local resources, including a clinically
                                                                                                                                                                               and I cannot imagine what might have       with her, talking to friends who know
                                                                                                                                                                                                                                                                     validated self-assessment tool for
                                                                                                                                                                               become of me otherwise. My mother          what I am going through and can
                                                                                                                                                                                                                                                                     emotional well-being.
                                                                                                                                                                               — an educator who is quite in tune         sense if I am not in a good state of
                                                                                                                                                                               with mental health issues and now a        mind, or even just receiving a text
                                                                                                                                                                               very progressive grandmother to my         message from a friend asking how
                                                                                                                                     M R I VA N LI M                           ó®ƳšŒ¨½Œˆ­ŒﮈȚŒÀœ—šÈšŒ¨½ƛ       I am… all these help to keep my state
                                                                                                                                                                               And the diagnosis was a realisation of     of well-being in check. When you
                                                                                                                                         54, Author                            what was happening. I accepted it for      have a big enough support network,
                                                                                                                                        and musician
                                                                                                                                                                               what it was, processed it, and did what    they will look out for you. You don’t
                                                                                                                                                                               was necessary to get better — I took my    have to be ashamed about needing
                                                                                                                                                                               medicine daily, managed my feelings        this network either, for you are part
                         bout 20 years ago, I had        my mother found me alone in the                      visiting bars and clubs — which was what                         and quit my job to avoid clubs and bars.   of somebody else’s network too,

               A         a great career as an
                         entertainment journalist and
                         was becoming increasingly
                                                         study, in a stupor. I was so deep in the
                                                         situation that I didn’t recognise what
                                                         was happening to me, but she saw the
                                                                                                              I needed to do for my work at that point.
                                                                                                              The psychiatrist said to me point-blank:
                                                                                                              “Then maybe you should change your
                                                                                                                                                                                                                          and can serve as a pillar of strength
                                                                                                                                                                                                                          as well.

          well-known as a writer. On the personal        signs and made arrangements for me                   job.” So I did that. It prevented me from
                                                                                                                                                                               When you have a big                        My advice to those going
          front, I was doing well too. I was living in   to see a psychiatrist the next day. The              going down the road of alcohol abuse,                 enough support network, they                          through depression is to
          a three-storey home, owned a car, and          psychiatrist had a long chat with me.                and it made it easier for me to recover                                                                     know that it’s okay to not
          was in a happy marriage. Yet there was         He later diagnosed me with depression                from depression.
                                                                                                                                                                    will look out for you. You don’t                      be okay. I have lost a number
                                                                                                                                                                                                                                                                          Ivan is now re-married and runs an
                                                                                                                                                                                                                                                                          independent art and editorial business
          an emptiness within me and I was getting       and put me on medication.                                                                                       have to be ashamed about                         of friends through suicide as a                 with his wife, with whom he has a
                                                                                                                                                                                                                                                                          teenage son. He is also a classical
          increasingly unhappy and reckless.                                                                  I told one of my closest friends
          I was drinking heavily, and even got into      Through the discussions with                         about my diagnosis. His response
                                                                                                                                                                   needing this network either, for                       result of depression, and every
                                                                                                                                                                                                                          incident came as such a shock.
                                                                                                                                                                                                                                                                          guitarist, and performs with 3am Music
                                                                                                                                                                                                                                                                          Collective, a local music group that
          a car crash while in a drunken state.          my psychiatrist, I came to realise                   was: “Wow, you are so Hollywood!” as                 you are part of somebody else’s                        I have met exuberant personalities              writes and produces songs to raise
                                                                                                                                                                                                                                                                          awareness and promote acceptance
          Things spiralled to the point where my         that alcohol actually made me feel lousy.
          wife and I decided to get a divorce. One       I had to remove myself from situations
                                                                                                              though depression was something
                                                                                                              trendy and something only celebrities
                                                                                                                                                                   network too, and can serve as a                        with so much to look forward to and
                                                                                                                                                                                                                          live for, yet they ended up killing
                                                                                                                                                                                                                                                                          of mental health issues.
          day, in the wee hours of the morning,          that required me to drink, including                 would have. In reality, when I went to                      pillar of strength as well. Ɯ                   themselves — perhaps because they

12 / IMAGINE   ..   IMAGES BY SHUTTERSTOCK                                                                                                                                                                                                                          INSTITUTE OF MENTAL HEALTH   ..   FEB - MAY /   13
THE RIGHT FRAME OF MIND - IMH
focus . BODY DYSMORPHIC DISORDER

More                                                                                                                                                             On the other hand, men are often more
                                                                                                                                                                                                                                              It impacts the individual’s
than just
                                                                                                                                                  Interview
                                                                                                                                             DENYSE YEO
                                                                                                                                                                 preoccupied with their build or muscle
                                                                                                                                    in consultation with
                                                                                                                                      D R B H A N U G U P TA ,
                                                                                                                                                                 tone, and tend to engage in excessive                                      everyday life, and that is the
                                                                                                                                      Senior Consultant,
                                                                                                                                                                 training at the gym, overuse protein
                                                                                                                                                                                                                                           difference between BDD and

vanity
                                                                                                                                    Department of Mood           supplements and even abuse steroids.
                                                                                                                                  and Anxiety, IMH; and
                                                                                                                                 DR JACKKI YIM,Senior
                                                                                                                                                                       Between the sexes, common                                                    merely being vain.”
                                                                                                                                  Clinical Psychologist,         symptoms include an extreme
                                                                                                                                                                                                                                                              DR JACKKI YIM, Senior Clinical Psychologist,
                                                                                                                                          Department of          ½ÀŒ³ƒƒË½vȜ³®ܜȚ½ŒÀƒŒœÛŒˆðvÜÃœ®                                                                   Department of Psychology, IMH
                                                                                                                                     Psychology, IMH //
                                                                                                                                                                 their appearance. Says Dr Yim, “They          in treating other conditions such as
                                                                                                                                  Photos GETTYIMAGES
Body dysmorphic                                                                                                                                                  have a strong conviction of a defect          depression and anxiety.                             Recovering patients are more in
disorder is a debilitating                                                                                                                                       in their appearance and that they look             Cognitive-behavioural therapy aims        touch with reality, and do not avoid
                                                                                                                                                                 ugly. They believe other people judge         to educate individuals with BDD on their       óƒœv¨ÜÈËvȜ³®Ã³Àƒv­³Ëðv—ŒȚŒœÀ
mental health condition                                                                                                                SEEK HELP
                                                                                                                                    The condition can            them in a negative way. And they often        condition and challenge them to reframe        appearance. They are more aware and
that goes far beyond                                                                                                              improve with correct           engage in repetitive behaviours — such        their unrealistic negative thoughts about      comfortable with going out to meet
insecurities and                                                                                                                     treatment and
                                                                                                                                                                                                               their appearance. It also teaches them         people, says Dr Yim. And it is critical
                                                                                                                                        support.                 vÃÈÀ✮—ȳïá³ÀšœˆŒȚŒ½ŒÀƒŒœÛŒˆ
self-obsession.                                                                                                                                                  ðvÜƳܚœƒšvÀŒیÀ∜íƒË¨Èȳƒ³®ÈÀ³¨ƛƸ    to refrain from repetitive, compulsive         that once patients learn to manage
                                                                                                                                                                 Other signs include comparing their           behaviours and encourages them to face         their condition, they continue to use
                                                                                                                                                                 appearance with others. Those who have        their fears, says Dr Yim. For instance, she    these tools to keep their condition
                                                                                                                                                                 BDD tend to underestimate their physical      recalls telling one patient who worried        in check.
  >> APPEARANCE IS                                                                                                                                               attractiveness and overestimate other         excessively about acne not to apply any             Dr Yim advises those who suspect
  EVERYTHING, or so the cliché                                                                                                                                   people’s attractiveness, which is why they    makeup, then have lunch with her friends       that they are suffering from BDD
  goes. For most of us, our concern                                                                                                                              feel anxious or distressed, says Dr Yim.      and see whether they judged her or             symptoms — or know of someone
  ³ÛŒÀȚŒÜvâ܌¨³³§œÃðŒŒÈœ®—ƛ`Œ                                                                                                                           They often avoid social situations. And       Ãvœˆv®âȚœ®—ƛ:³Èšœ®—šv½½Œ®ŒˆƳšŒÀ         who is — to seek help. “Don’t let
  forget our physical imperfections                                                                                                                              they tend to seek cosmetic procedures,        friends had not noticed, and their lunch       unfounded fears about treatment get
  once we turn away from the mirror.                                                                                                                             although it is important to note that not     took place without incident. Dr Yim says,      in the way of reducing your suffering
  And worrying about our blemishes,                                                                                                                              everyone who does this suffers from BDD.      “The purpose is to help them reach a           v®ˆœ­½À³Ûœ®—â³ËÀ¨œ–Œƛ%œÛŒÈÀŒvÈ­Œ®È
  features or weight does not disrupt                                                                                                                                  Although the exact cause of BDD         conclusion that what they interpret or         a try. You have nothing to lose and
  our daily activities. But for people                                                                                                                           is still debatable, studies suggest           Țœ®§­œ—šÈ®³È‚ŒvƒƒËÀvȌƛƸ                 ŒÛŒÀâȚœ®—ȳ—vœ®ƜƸڌÃvâÃƛ
  with body dysmorphic disorder (BDD),                                                                                                                           a combination of different factors,
  ȚŒïávȜ³®ܜȚȚŒœÀv½½ŒvÀv®ƒŒ             has not been studied at full scale, but        co-morbid depression, more than 60 per
                                                                                                                                                                 including environmental and biological
  takes over their lives completely. They        v½ÀŒ¨œ­œ®vÀâÃÈˈâ‚âȚŒ:vȜ³®v¨           cent reported having suicidal thoughts,
                                                                                                                                                                 reasons. “The condition seems to
                                                 University of Singapore suggests a             and around 24 to 28 per cent attempted
  often shun social interactions and, in                                                                                                                         develop in people with extreme self-          ZOOM CALLS AND BDD:                             The key is to moderate the use
                                                 similar prevalence here, says Dr Bhanu         suicide. “As it’s unlikely that BDD goes away                                                                                                                  of video conferencing tools. Here
  extreme cases, do not step out of the                                                                                                                          consciousness and self-focused                The good, the bad and the ugly
                                                 %˽ÈvƜOŒ®œ³À³®Ã˨Èv®ÈƜŒ½vÀÈ­Œ®È          by itself, it’s vital to seek treatment as early                                                                                                               are some additional tips to manage
  house — sometimes for years — to avoid                                                                                                                         attention, and who may have been teased                                                       one’s mental health and well-being
  being seen or potentially ‘judged’ on          of Mood and Anxiety, IMH. “At our tertiary     vý³Ã܂¨Œ–³À‚ŒÈȌÀ³Ëȃ³­ŒÃƜƸڌÃvâÃƛ                                                                    These days, video conferencing tools            from the UK-based Body Dysmorphic
                                                                                                                                                                 or bullied in their childhood or adolescent
  ȚŒœÀ½ŒÀƒŒœÛŒˆðvÜÃƜܚœƒšvÀŒ³–ÈŒ®         centre, we see very few cases, which is                                                                                                                       like Zoom play a key role in connecting         Disorder Foundation.
                                                                                                                                                                 years and do not seem to have overcome
                                                 probably due to sufferers not seeking          SPOTTING THE SYMPTOMS                                                                                          with the outside world. Yet, video
  unnoticeable to others. If they have to                                                                                                                        œÈƜƸÃvâÃÀ%˽Èvƛ:ŒËÀ³ÃƒœŒ®Èœïƒ           calls can have a negative impact on           • Follow a daily routine including meals,
  go outside, they do so at night when           help or not recognising it as a psychiatric    Typically, the onset of the disorder starts                                                                                                                    exercise and self-care activities.
                                                                                                                                                                 research also points to differences in        people with BDD. In the US and Europe,
  others are asleep. “BDD is not about           ƒ³®ˆœÈœ³®ƜƸÀ%˽Èv®³ÈŒÃƛ                   at adolescence, before the age of 18. BDD                                                                      many are reporting that video calls,          • Speak to someone among your social
                                                                                                                                                                 brain function related to the processing
                                                      BDD is, however, a serious issue.         can affect both men and women, although                                                                        where participants see a thumbnail of           connections and support networks.
  Ûv®œÈâƜƸƒ¨vÀœïŒÃÀ2vƒ§§œfœ­ƜOŒ®œ³À                                                                                                                       of visual and perceptual information.         themselves, aggravate their condition
  Clinical Psychologist, Department of           If left untreated, it can result in            about 40 per cent of BDD sufferers are men                                                                                                                   • Keep your mind and hands occupied
                                                                                                                                                                 Says Dr Yim, “People with BDD tend to         and worsen their already-poor body
                                                 complications including depression or,         and 60 per cent are women. Women tend to                                                                       image perceptions. “While using video           with your hobbies.
  Psychology, Institute of Mental Health                                                                                                                         over-focus on details, but are unable to
  (IMH). “It’s a mental health disorder,         worse, suicide. According to Dr Yim,           report more severe symptoms, and usually                                                                       calls could be triggering for people          • Continue to follow your
                                                                                                                                                                 process visual information in a holistic                 with BDD, spending less
                                                 global studies have found that 70 per          have more areas of concern, such as skin                                                                                                                       treatment plan if you
  which has a substantial impairment on                                                                                                                          ­v®®ŒÀ³À̌ȚŒ‚œ—½œƒÈËÀŒƛƸ                                  time interacting with        have one.
  the day-to-day functioning of those            cent of people with BDD suffer from            imperfections, facial features and hair.                                                                                           their loved ones and
                                                                                                                                                                                                                                                             • Engage in sorting
  vȌˆƛ*Èœ­½vƒÈÃȚŒœ®ˆœÛœˆËv¨ƺà                                                                                                                                                                                            friends and more
                                                                                                                                                                 COPING WITH THE                                                   time on social media
                                                                                                                                                                                                                                                               activities that relax the
  everyday life, and that is the difference           At our tertiary centre, we see very                                                                        DISORDER                                                           due to COVID-19
                                                                                                                                                                                                                                                               brain, such as organising
                                                                                                                                                                                                                                                               your cupboards.
  ‚ŒÈ܌Œ®v®ˆ­ŒÀŒ¨â‚Œœ®—Ûvœ®ƛƸ                                                                                                                                                                                              restrictions may
                                                       few cases, which is probably due                                                                          The condition can improve
                                                                                                                                                                 with correct treatment and                                         also intensify           • Use an internet tracker to be aware of
                                                                                                                                                                                                                                      these unhealthy          your screen time.
  DEBUNKING THE MYTHS                               to sufferers not seeking help or not                                                                         support. This often involves                                          thoughts,” says       • Consider unfollowing any unhelpful
  Often underreported, BDD affects                                                                                                                                                                                                       Dr Yim.
  about two per cent of people
                                              recognising it as a psychiatric condition.”                                                                        a combination of medication
                                                                                                                                                                 and cognitive-behavioural
                                                                                                                                                                                                                                                               œ®ðˌ®ƒŒÃ³®óƒœv¨­Œˆœvƛ

  worldwide. In Singapore, the disorder                                     DR BHANU GUPTA, Senior Consultant, Department of Mood and Anxiety, IMH               therapy, which is also used

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THE RIGHT FRAME OF MIND - IMH
MY SAY     . interview
                                                                                                                                                                                                                                                                         From my early
                A J OU R NEY                                                                                                                                                                                                                                         days of leadership,
       Change,  OF                                                                                                                                                                                                                                                   I have emphasised
                                                                                                                                                                                                                                                                  the need to empower

     Collaboration                                                                                                                                                                                                                                                 our patients, so they
                                                                                                                                                                                                                                                                  can be more involved
                                                                                                                                                                                                                                                                 in their treatment and
                and hope
      As he moves into a new role, IMH’s former Chief Executive
                                                                                                                                  P ROFESSOR
                                                                                                                                  C H UA HON G
                                                                                                                                     CHOON
                                                                                                                                                                                                                                                                      take ownership of
                                                                                                                                                                                                                                                                    their mental health
                                                                                                                                                                                                                                                                         and recovery.”
         ~IJǶČĚƑProfessor Chua Hong Choon looks back on                                                                            Former Chief
      changes in Singapore’s mental healthcare landscape over                                                                    1njěČƯƧŁdžě€ijǠČěƓ̶                                                                                                              concerns as well as raise awareness of
                                                                                                                                  IMH (2011-2021)                                                                                                                mental health issues. “VOE is a triangle: the
              the years. I n t e r v i e w K O H Y U E N L I N P h o t o C O U R T E S Y O F I M H
                                                                                                                                                                                                                                                                 voice of the patient, the caregiver, and that
                                                                                                                                                                                                                                                                 of the medical professional. Only when these
                 he posting to the Institute of       designing a doctor’s rest room, where many
                                                                                                                                                                                                                                                                 voices are equal can we get a more balanced

     T           Mental Health (IMH) in 1993
                 was something Professor
                 Chua Hong Choon had eagerly
                                                      logistical and scheduling discussions were
                                                      held,” shares Prof Chua. “As a young doctor,
                                                      I had the opportunity to participate and be
                                                                                                                                                                                                                                                                 view of what is going on,” says Prof Chua.
                                                                                                                                                                                                                                                                      IMH also started employing persons in
                                                                                                                                                                                                                                                                 recovery as peer support specialists to work
  anticipated. “After medical school, I did my        involved in making these decisions. I like
                                                                                                                                                                                                                                                                 alongside psychiatrists, nurses and allied
  housemanship followed by medical rotations          to think that it helped me to see early in my
                                                                                                                                                                                                                                                                 health professionals in various departments
  in the Neurosurgery and Neonatology                 career that change is a constant, and it can
                                                                                                                                                                                                                                                                 and programmes. They use their lived
  departments. The Neurosurgery posting got           be harnessed for betterment.”
                                                                                                                                                                                                                                                                 experiences to give hope and inspire others
  me interested in psychiatry and I really wanted          As someone with a naturally positive
                                                                                                                                                                                                                                                                 who are in a similar situation to overcome
  to go to IMH to learn more,” recalls Prof Chua.     attitude, Prof Chua always sees the silver
                                                                                                                                                                                                                                                                 ȚŒœÀ­Œ®Èv¨šŒv¨Èšƒ³®ˆœÈœ³®ÃƛƷ*ﮈ½Œ³½¨Œ
  However, while he looked forward to joining         lining in challenging situations. Take for
                                                                                                                                                                                                                                                                 dealing with mental illness amazing,” says
  IMH, some friends and acquaintances displayed       example the quarantining of all of IMH’s         to transition Singapore’s mental healthcare       (iPACE) programme. “With community-based          patients as weak and helpless,” he says.
                                                                                                                                                                                                                                                                 Prof Chua. “They go through a tough time
  general disappointment. “They said things like      patients and staff after a false alarm during    from an institution-based care model to one       ƒvÀŒƜ³ËÀ½vȜŒ®ÈÃvÀŒ®³¨³®—ŒÀƒ³®ï®Œˆ         “From my early days of leadership, I have
                                                                                                                                                                                                                                                                 because their emotions and thinking are
  ‘What a shame — you have such potential for         the 2003 SARS outbreak. “It was a major          focusing on the community, recovery and           within our hospital. This calls for a system of   emphasised the need to empower our
                                                                                                                                                                                                                                                                 affected in a way that you and I may not
  v—³³ˆƒvÀŒŒÀƺƜƸšŒÃvâÃƛƷ*ÈÜvÃvÀŒðŒƒÈœ³®      incident but it led to positive outcomes,” he    integration. Then one of the deputy leaders       communicating with the different parties in       patients, so they can be more involved in
                                                                                                                                                                                                                                                                 be able to fully comprehend, yet they
  of the prevalent stigma surrounding mental          says. “As a result of that episode, there was    in IMH, Prof Chua was part of a team tasked       our network so that patients’ needs are taken     their treatment and take ownership of their
                                                                                                                                                                                                                                                                 strive to recover and go on with their lives.
  illness at that time. There were a lot of           a heightened awareness of the vast number        to research and draft the blueprint, which        care of,” he shares.                              mental health and recovery. Just as we put
                                                                                                                                                                                                                                                                 They want the same things as any of us:
  misconceptions then, too, not just about            of vulnerable patients and staff at IMH, and     introduced several programmes that tapped             Under this programme, case managers           our community partners on an equal footing,
                                                                                                                                                                                                                                                                 meaning, purpose, relationships, to be
  people with mental health issues but also the       a greater emphasis on infection control and      on ground resources like schools, general         in IMH serve as a bridge between patients,        we also needed to rebalance our relationship
                                                                                                                                                                                                                                                                 part of the community. They are no different
  healthcare professionals who treated them.          the physical health of the patients here.” He    practitioners and community services to           community partners and the healthcare team.       with our patients.”
                                                                                                                                                                                                                                                                 and these desires are not diminished. There
  For instance, people used to think that the         also shares that in-house medical services       promote the prevention and early detection        They keep in close contact with discharged            The Voices of Experience (VOE)
                                                                                                                                                                                                                                                                 is much that we can learn from them. I’ve
  behaviour of mental health patients would rub       and facilities were set up within the hospital   of mental health issues as well as enable         patients and outpatients, monitor their           programme, launched in 2014, is a step in
                                                                                                                                                                                                                                                                 learnt a lot from my patients.”
  off on psychiatrists and healthcare workers.”       in the wake of the incident to handle any        continuity of care for discharged patients.       condition, and connect them to the various        this direction. It gives patients, caregivers
                                                      similar situations in the future. “Sometimes,          “We had the resolve to do this, but         social services and resources available           and other advocates a platform to share their
  Seeking Change                                      unexpected things happen, and you need to        realised that we didn’t have that many            to them. This has been instrumental in
  Despite the discouraging response from those        grasp the opportunity to make the best out       ƹ–ÀœŒ®ˆÃƺ‚Œâ³®ˆȚŒƒ³®ï®ŒÃ³–ȚŒš³Ã½œÈv¨ƜƸ   improving continuity of care for patients
  around him, 1993 proved to be an exciting year      of it.”                                          he recalls. “So we set out to build a network     with severe mental illness — the iPACE
  for Prof Chua — and one that would shape his
  approach to how IMH provides care. “It was          Building a Community
                                                                                                       of community partners, and actively helped
                                                                                                       them become stronger in terms of mental
                                                                                                                                                         programme has resulted in more than 90
                                                                                                                                                         per cent of such patients returning for follow-
                                                                                                                                                                                                               THE BEST OF TIMES
                                                                                                                                                                                                                After 10 years as CEO of IMH, Prof Chua has
  a time of change. The hospital, then known          In Prof Chua’s view, a holistic and multi-       health awareness and capability to be able to     up treatment after their discharge and staying         taken on the role of CEO at Khoo Teck Puat
  as Woodbridge Hospital, was going through           agency approach is needed to promote             do more to support individuals with mental        well in the community.                                 Hospital and Yishun Health from 1 February
  a big move to our new premises in Buangkok          mental wellness and manage mental                health issues.”                                                                                          2021. He looks back fondly at his time in
  Green Medical Park. In this state of transition,    health issues in the population.                      To support the expanded reach and the        To Inspire and Empower                                 IMH. “My relationship with my colleagues
                                                                                                                                                         ®³ÈšŒÀܗ®œïƒv®ÈË®ˆŒÀÈv§œ®—–³ÀIÀ³–šËv          in IMH has shaped who I am today. I treasure
  there were a lot of opportunities to improve or          The National Mental Health Blueprint,       different agencies involved — from partners
                                                                                                                                                                                                                the friendships forged and the lessons learnt.
  even come up with new ways of doing things          launched by the Ministry of Health in 2007,      to patients — Prof Chua spearheaded the           was giving patients a voice, which he sees as          It has been a great privilege to work with
  — from procedures for seeing new patients to        was a landmark development in this respect.      development of the Integrated Patient             a vital component in the ecosystem at IMH.             so many passionate individuals to improve
  services we provided and even small things like     *È–³À­ŒˆȚŒ‚vƒ§‚³®Œ³–vïیưâŒvÀ½¨v®       Assessment & Continuous Engagement                “Mental healthcare is not about treating our           mental healthcare and awareness
                                                                                                                                                                                                                in Singapore,” he says.
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