I have been on more or less consistent psychiatric care for the last 7 years. But I have never really engaged in psychotherapy.
In Singapore (and I’m guessing elsewhere also), the function of meds and therapy tend to be separated for cost-effectiveness. The psychiatrist is the person who gives you the meds and may or may not talk to you. The therapist doesn’t give you meds, or answers. And because of our rapidly changing culture and ‘Asian values’, it can be hard to find a therapist you click with.
I had a free therapist at my very first consult at Raffles Hospital. It felt very much like a bargain deal, albeit at a fancier supermarket. Like Jasons. Raffles is one of the most expensive, private institutions we have and I felt terribly guilty that my parents were spending money on me to be preached at by a doctor who’s catchphrase was, “You gotta feel the burn.” My parents were under the impression that if I went to a private hospital, it would be harder for people to trace my medical history. I now know this isn’t so. My GP in my neighbourhood clinic is able to check on my history thanks to a collated national database and dispense short-gap psychiatric medication when needed.
I think this collation of personal material is… eventual. And on some level, I really don’t care for anyone in the ministries who would discriminate me for having my condition.
Anyway, my first therapist: She recommended I do things for myself. Like paint my nails. I wasn’t femme per say at that point. But I gave it a shot. 300 bottles of nail polish later, in my undergrad years, I sought the free treatment that came with being a student at National University of Singapore. The psychiatrist there was one of the ‘old guard’, that group of pioneer generation men that all seem to know each other. It took him awhile to admit he was uncomfortable seeing me because unbeknownst to me, he knew my father from those early pre-Independence days. It is this generation in Singapore that is perhaps the most suspicious of healthcare in general, mental health in particular. I don’t blame them. This was still the period of electro shocks and moralist correcting of personality.
(A writer named Loh Kah Seng has just released an academic paper titled “Mental Health and Psychiatry in Singapore: From Asylum to Community Care” which I have not read but very much wish to, to see if my observations are correct.)
The third time I got a therapist, I was warded in National University Hospital for exhaustion. We all got to talk to someone once a day. But I think it was really talking to each other that helped us to heal. Really what put me in NUH, aside from a suicide attempt, was that I could not find counselling for people who had contracted STDs from their partner (which I had at the time). The only groups available at the time came with the caveat that you had to be a married woman. The relationship I had been in was not casual, but I suppose that didn’t matter under the state’s aims, which were then IMHO about moralising sexuality (more on that some other time). Feeling that I wasn’t deserving of help was one of the many reasons I was suicidal.
At the current hospital I seek treatment at, I once had therapy with a middle-aged woman, T, who emphasised breathing exercises. I wanted to be polite, so I did not book a second appointment. I can’t take someone who recommends meditation and breathing to a depressive seriously.
My problem is meditating on my thoughts (or my non-thoughts) for such long periods, they paralyze me.
But my psychiatrist decided it was time for the talking cure after two years of just straight-up medicating and living from episode to episode. I said as much to the therapist he assigned me and who I met for the first time yesterday.
S is closer in age to me. She is pretty. Articulate. Knows how to validate me.
The problem with my condition is being very aware of this and constantly questioning intent.
We plotted my emotional cycles for the last ten years. She thanked me for my frankness. Including telling her I couldn’t take her predecessor seriously and to please not give me one of those stress ball brains.
I already have a collection.