Finding A Way Forward

Clinical Psychologist and certified supervisor, Saima Salman talks about the psychological problems children and young adults face today and how parents can address them to ensure their mental well-being

10/11/2018 11:54:22 PM
written By : A Staff Reporter Print

India Se: What are some of the common psychological issues that expat children in Singapore face, especially those belonging to the South Asian community?

Saima Salman: A variety of terms are used to describe mental health challenges in children, youth and young adults. Psychological health challenge is a broader term including both mental disorders and symptoms of mental disorders that may not be severe enough to warrant the diagnosis of a mental disorder. Although, psychological issues can begin in early childhood, mental disorders often manifest themselves in adolescence or early adulthood. This is why it is extremely important for parents, teachers and others who work with children to detect psychological struggles early and to ensure the person gets the right support and help. Some of the most common psychological issues I see in South Asian expat children are low self acceptance, anxiety disorders, depression paired with body shame issues, eating disorders and self mutilation (mostly in girls), performance anxiety (‘I am not good enough’ syndrome when they are trying too hard to fit into the non Asian groups of children), social media addiction, unhealthy obsession with others on social media and constantly looking for validation over these virtual platforms. 

India Se: How do parents identify these issues? What are some of the early signs to look out for?

Saima Salman: Parents as well as teachers, youth worker, sports coach, caregiver, or anyone else who knows the youngster well enough to notice that his/her behaviour has changed. Signs and symptoms vary depending on what the child is struggling with. For example, in depression, at home the young person may 

• Complain of tiredness, even if they are sleeping more than usual

• Have difficulty doing chores

• Withdrawal from family, spending more time in their bedroom

• Snap at family members, behave irritably or pick fights with parents and siblings.

• Avoid discussing important events, such as decisions about future education

In school, young people may

• Show a decline in school grades

• Fail to engage in classroom discussions or struggle to participate

• Snap at or start fights with other students

• Struggle to work effectively in the mornings

Psychological signs and symptoms of anxiety include excessive fear and worry about past or future events, racing thoughts, decreased concentration, irritability, impatience, anger, and feeling on edge, nervousness. Behavioural signs include: avoidance of situations, obsessive behaviours, distress in social situations, worry in general, but particularly worry about what others think of them and anxiety about past imperfections. The child might also complain of headaches at home and other physical problems, be tearful, express unnecessary concerns that their school work is not good enough, demand constant reassurance and be touchy and irritable in family interactions.

India Se: How important is counselling or therapy for tackling these problems?

Saima Salman: Everyone feels worried, self conscious, unhealthy, down or sad at times, but it is important to be able to recognise that professional help is warranted when the signs and symptoms continue to affect your child’s functioning in daily life. As mentioned earlier, it is always helpful to catch these psychological issues early on and tackle them with the right intervention rather than letting them grow into full-blown disorders or illnesses. Timely intervention is crucial when it comes to prevention. The biggest challenge for Asian families is the acceptance that there is something sad or bad going on with the child and it is not something they continue to tackle on their own. Children generally do not have access to mental health care and families sometimes feel ashamed to reach out for help because of the stigma or fear of judgement. Asian parents need to learn to let go of any shame they feel around seeking psychological help if they really want to safeguard their children’s mental health. The first step is to get rid of the irrational beliefs around mental illness by remembering that we are living in a world where a huge number of people will suffer from some form of mental disorder at some point in their life! Normalising mental health struggles and understanding that just the way they don’t’ feel any shame taking their children to a dermatologist for skin problems or a GP for cold and flu, it is absolutely normal to take your child to a psychologist if they are struggling emotionally or mentally. A qualified clinician/ psychologist will be the right person to help your child build the emotional muscle and equip them with the right mental skills to deal with life with the much needed resilience.

India Se: While we as parents strive to keep our children materially comfortable, how can we support them emotionally so that they do not suffer?

Saima Salman: The best support parents can give is open honest communication with their children. Culturally speaking, it is harder for Asian parents to listen objectively without judgement and help guide children without a reaction under challenging circumstances. Punishments, consequences, scolding and lecturing are only some of the many ways we can help our children. The key idea is the to help them feel safe enough to reach out to us when they are at their worst rather than shut us out of fear of not being understood or accepted. Adopting an attitude of unconditional acceptance means respecting and accepting your child’s feelings and experiences as valid, even if they are different from your own or you disagree with them. Try not to judge, trivialise or criticise what your child says or feels because you have a different point of view or understanding. Empathising is another key factor in giving support to your young ones. Rather than telling them it’s not a big deal and you must be strong when they open up with you; it is more helpful to empathise by telling your child that it must feel hard and difficult. A few more tips that can truly help your child during rough times:

• Ask questions that show you genuinely care and want to understand rather than fix things

• Check your understanding be restating what the young person has said and summarise facts and feelings

• Learn to respect your youth’s culture, even if you disagree with what your child is sharing with you.  This might mean hearing stuff you never wanted to hear (e.g. my 15-year-old daughter has been sexually active and been on birth control or my son has been drinking while he is only 14!) 

• Be patient if the your child is struggling to communicate

• Try not to be critical or express frustration towards your child or their symptoms.

• Avoid giving unhelpful advice such as “pull yourself up”, “get a grip” or “stop overreacting to something so small”. These are examples of invalidation and would make the child shut down even more. 

• Do not bring your own experiences or opinions of how you dealt with a similar situation or struggle yourself when you were younger. Such interruptions or comparisons might backfire in that situation. 

• Treat them with respect and dignity 

• Do not use blame or harsh tone even if you feel triggered

• Have realistic expectations 

• Do not belittle or dismiss your child’s feeling by attempting to say something positive, such as “You seem to be doing okay to me”

India Se: Anything else that you would like to add.  

Saima Salman: Before you hand your children or any loved one over to any counsellor or psychologist, make sure you check their area of expertise and number of years spent in formal training and education. Take an appointment and go ask all the questions you need to about the psychologist’s background and training. Ask them about their success rate and if they have seen similar issues in other kids and what was their approach. I have come across a number of psychologists and counsellors with only bachelors or masters degrees with a long list of “certifications” next to their titles. Check if a professional has done some formal postmasters hands-on training in a certain form of therapy or has received formal therapy training under a licensed clinician. I always encourage everyone who reaches out to me to ask me as many questions as they can regarding my education, background and number of years in training. Also, it is very important to know if a counsellor or psychologist uses evidence-based techniques. Cognitive Behaviour Therapy (CBT) is one of the most widely used forms of therapies in the world and it heavily relies on techniques and tools that are scientifically proven to help with specific conditions.

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