Who do you look for to get help?

by Nathan Chua

One frequent inquiry I get is about which psychologist or counselor one should look for, when faced with emotional or psychological problems. I think there is enough confusion around, that compels a discussion about the different specializations available in such a broad field like psychology.

For this post, I will focus on three distinct, but nonetheless related fields in psychology, which are frequently the subject of inquiry. These are clinical psychology, psychiatry and counseling psychology. There are many more areas of learning in psychology that I just don’t have the space to discuss in one short blog. Please note that I am talking from the perspective of someone who works and lives in the Philippines. Some of my descriptions about the way these three are practiced, may be unique to the country.

Counseling Psychology

This is a field where social workers and counselors with master’s degrees would specialize in the Philippines. Some counselors are not just involved in talk therapy or counseling, but they can also give psychological tests as well. They can work in various organizations. A typical example would be a school’s guidance counselor. Others would be involved in hospitals, clinics, rehab centers, religious charities or any organization that is involved in social work. They are not trained to prescribe medication.

Clinical Psychology

Most practitioners in this field are involved in counseling and psychometrics. They are able to do most, if not all, of what counselors and social workers can offer. Of course, this still depends on what the clinical psychologist chooses to specialize in. In the Philippines, clinical psychologists are normally the people who couples approach when they are in the process of annulment.

Psychiatry

This field would have the widest scope. Psychiatrists are trained to do counseling or talk therapy and give tests as well. They are considered medical doctors or MD’s, and are therefore licensed to write prescriptions. Take note again that whether a psychiatrist chooses to engage in other activities like counseling or psychotherapy and psychological testing, is entirely up to him or her. In the Philippines, most psychiatrist specialize in giving prescriptions.

For those who are engaged in talk therapy, psychotherapy or counseling, they would normally have areas of specialization, depending on the segment of the population they feel most competent to work with, and in the theory that guides their practice. There are different perspectives that can be used in talk therapy. Some of them are behavioral, psychodynamic, cognitive and existential. There are quite a few who choose to be eclectic in their approach. This means they use different theories that they feel can be helpful to their clients or patients, who present different concerns to them.

Two Things that are Essential to Any Couple’s Relationship

by Nathan Chua

I am not one to say that I have easy answers to all of life’s problems. I hope the title does not mislead you into thinking that there are only two things that you need, to have a better relationship. Please note these are essential, but not the sole needs of every couple, who would each have their own set of unique circumstances affecting them. At times, their struggles concern other matters such as responsibility, physical intimacy, child-rearing, money management or trust. For this blog post however, I will focus on two deficits that I find common among couples that I meet. Let’s call them the Two C’s of Loving Relationships.

First C is for Connection.

In a blaming and shaming culture, it is easy to fall into adopting a false stance, or a false self. We essentially try to hide who we are, in the face of the shame that we experienced, most often early in life. To minimize emotional pain, we dig deep into our comfort zones, where the need to express some of our more vulnerable emotions, is held in abeyance. We therefore lose that inherent ability to show our emotions as they truly are.

This inability to show authentic emotions is connected to how couples feel toward each other. Couples only see the angry side of each other. I often wonder how a weeping and distressed individual that I see in my office, could be treated so harshly by the other. It is rather simply because this helpless and vulnerable state, is not what is normally displayed at home. Home has become unsafe. The relationship is no longer as real as it had been when it was just beginning. The result is each partner just expecting the worse out of the other, as they only see their angry and resentful selves, with no reason to believe that change can come anytime soon. Connection is lost and will be hard to come by if vulnerable emotions are kept hidden.

Second C is for Compassion.

This should not be confused with guilt or pity. Compassion is a genuine concern for the welfare of the other. Caring enough for your partner, that the last thing you’d like to see, is witnessing him or her in deep pain and sorrow. Guilt on the other hand, is a focus on the self and not on the other, while pity is too distant, and denigrates the dignity of the other. Without compassion for the offended person, it will be hard to connect and heal the inevitable emotional wounds, that are bound to be inflicted in all close relationships. Compassion is the fuel that feeds forgiveness, and the glue that connects our souls.

How shame and blame affects us – Video

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The Role of Shame and Blame in Families

by Nathan Chua

It was in the 1980s when a game show called Family Feud caught my attention. It was a game of guessing the top answers that a survey of 100 people revealed. I think what added to the excitement was pitting one family against the other. I remember how this show became something of a cultural exposure for me. I was amazed at how patient and loving the contestants were with each other, even when their family member would give the wrong answer. Of course, there is no telling if the contestants were coached into how they should behave when such misfortunes occur. There are times when the family is split about which answer they think should be given.

I was amazed at how positive everyone was toward each other, even when a member of the family stubbornly went against the wishes of the others. I thought to myself, I find this hard to imagine if my family was playing this game.

I have met many who have shrunk from themselves, and made major life decisions based on the fear of being shamed or blamed by others, especially by family members. This can be even more difficult when decisions involve careers and marriage. It probably is quite common to know that someone makes important decisions, not based on what they want, but on what ought, or what was expected from them.

All this can be traced to the fear of responsibility. This is most evident in people who come to the counseling room with the same questions in mind, “What should I do?” “You are the expert, just tell me what your opinion is and everything will be fine,” are ways to escape responsibility.

In my experience though, this manner of seeking counsel for life’s issues, hardly offers any easy answers, to that thing that they most want to get from a counselor or therapist. In the end, people end up staying with the same issues of indecisiveness and lost lives, or lost selves. People have lost themselves in pursuit of what was expected of them. In exchange for seeking what ought, over what it is that they want, people lose their sense of meaning and purpose in life.

In Kierkegaard’s words,

“The greatest hazard of all, losing one’s self, can occur very quietly in the world, as if it were nothing at all. No other loss can occur so quietly; any other loss – an arm, a leg, five dollars, a wife, etc. – is sure to be noticed.”