Niccolo Tiangco, RPsy, MSc

Tag: mental health

  • FAQs Update: CBT vs. Thinking Positively

    I have added a new question to the FAQs page of my site. I’ll also post it here for vision:

    I tried CBT before and it felt like my therapist was gaslighting me. How is CBT different from just telling someone to think positively?

    It is true that thinking positively is one skill or component of CBT; however, the effectiveness of CBT also depends on the skill of the therapist and the relationship between yourself (client) and the therapist. A skilled CBT therapist can help you to challenge negative thinking without directly confronting the negative thoughts you experience and without necessarily debating yourself in a negative thinking spiral or rumination. Instead, your therapist can help you trace the origin of your negative thinking, connect it to your everyday thoughts, and help you to externalise and question your thinking patterns through constructive dialogue and everyday experiments designed to test your negative thinking.

  • Breadwinners, Expectations in Filipino Culture

    DISCLAIMER: This blog entry is meant for general education and discussion and should NOT be considered a substitute for the professional, tailor-fit opinion of your doctor or therapist–although people have common experiences, individual stories are unique.

    Anyone looking for examples of controversial beliefs Filipino culture need look no further than https://www.reddit.com/r/panganaysupportgroup.

    The belief is that certain children, usually the eldest ones a.k.a. panganays, are eventually responsible to provide financially for the rest of the family, including the parents.

    If the chosen breadwinners refuse or are unable to provide for the family, then the parents may guilt trip or accuse them of selfishness and ingratitude. Sometimes, posters in the subreddit find it difficult to set financial boundaries and cope with the guilt tripping, hence they ask the subreddit for advice or similar experiences.

    Should a client consult with me regarding a similar problem, I usually discuss with the client their options, solutions, and the respective consequences. Sometimes, if the client is unable to provide for their parents, then the parents’ disappointment may induce feelings of distress, rejection, or being unloved; on the other hand, if the client reluctantly provides for their families, then the client may feel overburdened or resentful. The client and I may explore compromises and workarounds, but I encourage the client to make the ultimate decision because it is they, not I, who have to live with the consequences.

    How about you, what do you think of parents assigning their children as breadwinners of the family?

  • Self-talk & Self-care

    DISCLAIMER: This blog entry is meant for general education and discussion and should NOT be considered a substitute for the professional, tailor-fit opinion of your doctor or therapist–although people have common experiences, individual stories are unique.

    For those who cannot afford a therapist, self-talk and self-care are two great starting points to improve mental health.

    Self-talk is the inner-monologue we have with ourselves. Self-care comprises the activities through which we take care of ourselves.

    It sounds simple enough, yet many are unable or unwilling to improve these aspects of their lifestyle—even though it can profoundly improve your well-being.

    Self-talk. Admittedly, self-talk is difficult to improve because it relies heavily on being aware of one’s inner-monologue. For example, what if you message your friend or acquaintance online and get seen-zoned, how would that make you feel? Some people would feel rejected, maybe offended. The self-talk might be, “My acquaintance ignored me; therefore, I must have done something wrong, or there must be something wrong with me.” This is an example of self-talk that is so automatic that it takes an extra awareness for the individual to catch it. Without catching it, the thought can lead to negative emotions such as anxiety, insecurity, or self-consciousness.

    What should we do about negative self-talk? The first step is awareness. The more aware we are of our thoughts, the less power they have over us. Meditation is a great way to become more aware of our self-talk. Journaling is another.

    Self-care. Self-care is basically how we take care of ourselves. This concept includes lifestyle aspects such as diet, exercise, sleep hygiene, and other ways we take care of our body. If you find yourself down in the dumps and you haven’t been practicing self-care, then the most rudimentary way to improve your mental health is to start taking better care of yourself. For example, some people prefer to skip breakfast but then complain about lacking energy during the day–the best way to gain energy for the day is to stop skipping breakfast. Another example, some people complain about being tired the whole day but only sleep five hours a night and drink lots of coffee–the best way to improve your energy level would be to get at least seven hours of good sleep a night. Make sure to also practice good sleep hygiene such as by cooling down from gadget or computer use before bed time.

    For deeper mental health concerns, a therapist or counselor may be necessary. But mental health also depends on our habits at home, and improving self-talk and self-care is often a great place to start.

    REFERENCES

    Latinjak, A. T., Hernando-Gimeno, C., Lorido-Méndez, L., & Hardy, J. (2019). Endorsement and Constructive Criticism of an Innovative Online Reflexive Self-Talk Intervention.Frontiers in psychology, 10, 1819.

    Tello, Monique. (2017). Self-care: 4 ways to nourish body and soul. Retrieved from https://www.health.harvard.edu/blog/self-care-4-ways-nourish-body-soul-2017111612736.

    Unknown. (n.d.). How positive self-talk can make you feel better and be more productive: Research from schools of psychology points to the benefits of positivity. Retrieved from https://www.waldenu.edu/online-bachelors-programs/bs-in-psychology/resource/how-positive-self-talk-can-make-you-feel-better-and-be-more-productive?v=amp.

  • Online Counseling Philippines: Warnings and Recommendations

    This COVID pandemic has likely increased the number of individuals seeking online counseling in the Philippines.

    Mental health professionals have a responsibility to remember that it is possible to miscommunicate or misconstrue messages online.

    For example, sometimes if a client has a fear of developing severe mental illness, they may misunderstand something said by a therapist. Check the fictional transcript below:

    CLIENT: “This quarantine is driving me crazy! I haven’t been sleeping properly. My fears of having bipolar disorder have gotten worse, especially because my aunt had bipolar disorder and went missing five years ago.”

    THERAPIST: “Hello Client, I can understand your concern. This quarantine has really given us a different temporary lifestyle, and some people experience heightened anxiety because of it. It could be possible that you have bipolar disorder but it is difficult to say for sure. Could you tell me a little bit more about your relative who went missing?”

    CLIENT: “Oh my god! Please don’t tell me I have bipolar disorder. That is my worst fear and you are just making it worse by saying that I could have it.”

    Whereas the therapist suggested that the client refrain from jumping to the worst case scenario, the client selected the passage that seemed most alarming to her. No doubt the possibility of misinterpretation is one of the drawbacks of online messaging psychotherapy.

    I therefore recommend that mental health professionals be selective and discerning in providing online messaging therapy. It may be helpful for clients with milder distresses, but the severity of the distress can also increase the likelihood of a misunderstanding between client & therapist.

    I suggest that any online counseling in the Philippines informed consent form contain a clear explanation of its possible drawbacks. Therapists may instruct the clients to read every message with a positive, nurturing, and helpful tone. Meanwhile, clients may be reminded to assume positive intent behind the messages of the therapist, even if their inner voice sometimes gets the better of them.

  • Suicide and Safety Planning

    There are a lot of myths and misconceptions about suicide that can prevent anyone from providing assistance to a person in need.

    The myths are available all around the Internet–just be responsible and make sure to check your sources and think critically instead of believing just anything you read.

    Here are some general rules in providing safety assistance for anyone who might be suicidal:

    If you hear someone mention that she has suicidal ideations, always take them seriously. Listen to them empathically and do your best to withhold any judgments. We must also generally refrain from giving advice unless they ask for it. What’s important is that we make sure we listen to them and try to assure them that it’s okay to feel exactly how they are feeling. Do not take it personally if they reject your affection.

    Another thing you can do is help them create a safety plan. That is, help the person identify their triggers or events that may make them feel worse-than-usual and therefore suicidal. Helping them identify their triggers can help them prepare for the negative, suicidal feelings instead of being ambushed by them.

    Part of the safety plan is setting aside things that they can use to harm themselves, and gently identifying if there are any distractions or things that can help them to reduce the negative feelings when they are most vulnerable.

    Lastly, we must help them by providing emergency contacts or contact details of people they can call if their triggers are difficult to handle by themselves.

    These are only rules of thumb, and every case is contextual. If you are unsure of what to do, seek professional assistance or call your nearest hospital right away.