Niccolo Tiangco, RPsy, MSc

Tag: Philippines

  • 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?

  • 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.