Monday 3 December 2012

Dislocated Minds

Have you ever wondered how the mind works? Stuff like how it makes decisions or let you dream the things you do?

Well, these questions kept me up as a kid. (No, I kid you not!)

Not that I got curious after seeing a psychiatrist. It's just that my dad liked to read a particular magazine called Book of Life which had many articles about Social Science, Psychology and Biological Life. It's one of those collectible editions where a new issue would come out every month and you were given a giant folder at the start to keep all the issues in. Same as the Tank Warfare ones now being sold at newsstands and neighbourhood "mama" or "mamak" stores.

In our case, we did not have to wait. My dad simply went and bought back issues from Sungei Road Thieves Market. They were a few years old and going for a song!

On the back cover of each issue of this BOL was a running series of 'A-Z' science terms, some illustrated with pictures of insects. At the time, our family was into collecting and preserving these creatures and so the magazine (even though second-hand) was rather timely and educational.

My first paperback book about the mind had to do with dreams and their meanings. The next one focused on phobias (published at a time when self-help books were popular). I recall a discussion on two cases: 1) A woman afraid of spiders; and 2) A man afraid of riding the elevator. The experts were split on giving shock treatment (getting acquainted with the spiders quickly) versus incremental gains (a breakdown familiarisation with things hairy, spindly, multi-eyed, etc.) I thought the latter approach was much better as it saw the problem in a more complex light. Not everything could be cured quickly or the proverbial "club to the head" or "shock to the system".

Of course, as regards to books on the fractured mind, I can only recommend Oliver Sacks. Remember the movie Awakenings starring Robin Williams? -That's the doctor. He also wrote a very illuminating book called The Man Who Mistook His Wife For A Hat. Yes, a man actually did do that. It had to do with something called facial aphasia, a kind of mind cock-eye illness.

Other books I read as a kid were the handwriting, palm and face analysis ones. I wonder if you remember all these being fashionable at the time, how curious folks were about their character and fate being discernible by features on paper, hands and on the face!

Even the HR people got into the act by requesting job applicants to write sample essays in their own handwriting. I don't think it says much about a person. All of us are trained to write in a certain way. And with the common use of keyboards, much of our handwriting has become atrocious!

There was also fortune-telling by Tarot card. My interests in this were piqued by books I saw at MPH and also my mom's own experience with a very good fortune teller in Toa Payoh. That lady was eerily accurate about details of our family. She used only normal playing cards though.

Later in school, my reading interests graduated to Helping Troubled Children (by Michael Rutter), Games People Play (by Eric Berne), A Layman Guide to Psychology (select editors, Penguin publishers), The Psychology of Thinking (also from Penguin), and Six Thinking Hats (by Edward de Bono, the first famous Bono before that Irish rock singer)

More than just knowledge (trying to figure out my role as middle child, for example), I think I actually liked the way these books were written, i.e. the language and vocab. Little wonder I also enjoyed Technical Writing later.

So, long story short, I've have had an interest in Psychology and Psychiatry for quite a while.

The thing that troubled me later was not doing something with what I knew. So sometime in the early 90s, after I got a certificate in Suicide Counselling, I decided to volunteer my time with SAMH's Recreational Club for ex-Woodbridge patients. SAMH stood for Singapore Association for Mental Health. It was located at Blk 69 in Lorong 4, not at all near where I was living then, which was in Singapore's north.

Truth be told I was actually introduced to the club by a friend who was a counsellor there. She had studied in Canada and majored in Psychology. I once asked her why she had chosen that field. Her reason was one of laziness. "My dad spent a lot of money to send me there to study, so I had to return with a degree. Psychology seemed the easiest program then."

She also later confided that her father had sent her off to Canada because her mom had died and he didn't know how to handle her. I thought what a terrible excuse that was, especially when the daughter was obviously still grieving. I don't like to judge people but sometimes, you just wonder about the decisions they make.

In any case, this counsellor (Doreen) went to high school and university there. So, in a way, she was, by the time she graduated from there, more Canadian than Singaporean. It is a wonder that she returned to Singapore at all. Doreen's explanation surprised me. "Singapore was more dynamic. Back then, there was a recession in Canada and unless you want to brain-rot over there, it was better to come back."

But the best part was that Doreen's personality was actually very suited to counselling work. She was very patient, caring, sweet and rarely in a temper. Some people might perceive her as slow to react, but she was actually very intelligent and analytical. I think she just had snail blood in her that's all.

But even though she was trained in the matters of the mind, she too had her own quirks. One of them was eating a lot of something that she liked all at one go. On one occasion, she polished of a whole basket of longans at one sitting! At another time, it was M&Ms. She just couldn't stop or say "I'll keep some for later."

I had thought at the time that her actions were rather compensatory of the affection she did not get when she needed it most as a teen. Obviously, she and her dad still had quite a bit of unresolved issues to deal with.

As a volunteer at the Rec Club of SAMH, my duties were simple. All I had to do was join their activities and be a partner, player, etc. For example, since I played badminton well, I could do that with the members on Badminton nights. During outings, I was the extra pair of hands, eyes to the counsellors. At the most basic, I was simply there to chat and be social with the members. It'd make them feel normal interacting with an Everyday Joe like me.

By now, you must be wondering what these ex-Woodbridge patients are like. Well, the public at the time had this impression that the mentally-ill were crazy people. Crazy folk who frothed at the mouth and wielded meat cleavers. Not helped by constant portrayals of such stereotypes in HK '80s movies or TV serials.

At the time, I also didn't know how an ex-Woodbridge patient would behave. But since I had some coloured belt in Karate-do, I felt prepared. Also, growing up, I lived with a crazy aunt. She was pretty unhinged. I mean we all wished she would run around with a meat cleaver so we could commit her. But no. She would rather go around waving her sanitary napkin instead. Not a new one mind you, but one that's still in use!!!

"Why is it red like this?" she would ask, expressing her soiled napkin like some unwrapped bak chang (dumpling).

My mom would go "Choi choi! Nei mo hai ngo g kan fan!!!" (Cantonese for "Damn damn! Can't you see that I am cooking here!!!")

What's worse was that our neighbour manufactured chee cheong fun, which was a slang word for sanitary napkin. For a while, we couldn't bring home any to eat, dripping with sauce or not.

(Note: Another Cantonese slang word for sanitary napkin is ma (horse). When a woman is having a period, she is said to be "riding a horse" or "care ma". Btw, chee cheong fun is a breakfast food steamed from rice water and turned into white roll resembling a Kotex pad without the wings).

As regards to the SAMH members, if you can imagine a bunch of drugged and spaced out penguins waddling aimlessly about, that's them on a bad day. On a good day, they either made small talk or were quiet by themselves. Many were simply subdued by the drugs they take. You see, quite a few of them suffered from Schizophrenia. Without drugs, they would hear voices, feel persecuted, manifest self-importance, etc.

Take Tan, for example. By appearance he looked a harmless chap who could be a Line Supervisor at some factory. Without his meds, he would call up companies (usually MNCs, go figure) and inform them that there's a bomb on their premises. One time, he barged into the office of a friend and told him to get out as there was a bomb nearby.

Another fella was Chan, a rolly-polly chap with a large face who was once an ex-New Nation newspaper reporter. Once off his meds, he would become very erudite, boisterous and argumentative all at the same time. He would also get aggressive. When I first met him, he was all normal and friendly-like, sounding confident in that deep voice of his. You wouldn't know that he was an ex-Woodbridge patient.

The women were more docile. Perhaps it was just this batch of ex-patients... I don't know. To me, they were more of a worry especially since they could easily be taken advantaged of (sexually), especially in their drugged state. When like that, a few couldn't even handle their own appearance let alone more private matters like their menstrual periods.

As far as I could tell, the meds these unhinged folks took were necessary. But they were a double-edged sword. Many suffered from side effects like dry mouth (where the tongue would go all white and rough), missing teeth (from exacerbated tooth decay), skin rashes (eczema-like), falling hair (resulting in bald patches), etc.

So, for these people struggling to arrest mental illness, it was a choice between 1) Acting crazy and not have a life; 2) Have a life but look progressively broken.

Hanging about them then can be rather depressing. But if one wants to volunteer into such circumstances, one has to acknowledge their medical condition and hope better medicines get made. That's how I overcame it and tried to offer what I could to make them comfortable. It is hard for someone to have a friend and keep a friend when his mental state swings from two extremes. Even more difficult when he cannot fully control what happens to his appearance. If a person has bad breath, body odour, scraggly hair, etc., would you stick around much? I guess not.

As you can guess I had nothing but full praise for the counsellors who were doing their jobs then at SAMH. Besides Doreen, there was another counsellor called Magdalene, who was a local grad and staunch Christian. Both were nice folks committed to their charges. But I did sense a tension between the both of them. I think it  boiled down to being educated in different ways. Doreen's approach was more fundamental and liked to tackle problems as they were. Magdalene saw them as more systemic, which made her impatient sometimes. I think the local education system focused too much on Social Science. There could also be too much knowledge cramming leaving her little room to question.

For example, if the drugs were making their patients ill, might not the drug companies and authorities be informed and alternative medication pursued? Magdalene would respond in a defeated way whereas Doreen would make noise.

I thought then that a Western education produced graduates with a mindset for change. The local one was more so to oversee change. (I could be oversimplying everything, but it was just an observation at the time.)

At the personal level, working with the counsellors, I learned the distinction between Psychological Disorders and Behaviourial Disorders. One concerns the disruption of thought, the other the disruption of relationships. There were also the classic mental illnesses and new personality disorders. Some more serious, others less so.

If you are so inclined, you can find over 400 different types of mental disorders in the Diagnostic and Statistical Manual of Mental Disorders (DSM) of the American Psychiatric Asssociation. It is the bible from which  counsellors and psychiatrists take reference. If you think you have a disorder and it is published in there, you can get an MC from a doctor provided he certifies you first.

You know, these days, many people feel the need to always check their Facebook page. Is that a disorder then? It could be Facebookie Mania or something else. After all, psychiatrists do recognise excessive online game-playing as a form of addiction (in China, addiction is defined as four hours or more spent online). The same with online shopping and porn.

At SAMH RC, we did go out on a couple of excursions. They were to East Coast Park and a boat trip to Kusu Island. At East Coast Park, we all played ball, frisbee and group games. It was fun and 'normal'. The SAMH RC members even joked about boy-girl relations seeing how that park was then known for that sort of thing.

At Kusu Island, everything went smoothly as planned even though the counsellors were at first worried about taking them all on a boat trip. But the members cooperated and took their meds, so there were no major incidents except for a few school bus-type arguments in the ferry. Someone was playfully hiding someone else's purse.

My final contribution to SAMH was to work with artist friend, Man Loon, to make a giant styrofoam sculpture that rotated on its own axis. He designed the artwork, I designed the electronics. The sculpture was for a national exhibition on Mental Illness, one of the last events at the old World Trade Centre Expo Hall.

I welcomed such an exhibition. The public at the time needed to learn what mental illness was all about and not be frightened by misinformation and taboo. The brain and mind do misfire and people need to recognise that, not victims of evil spirits or black magic.

The sculpture my friend and I eventually turned out was a giant head with a brain exposed. It had arrow signs pointing to it, signs that read 'Depression', 'Schizophrenia', 'Insomnia', 'Stress', 'Erectile Dysfunction', etc.

Wait, erectile dysfunction as a mental disorder? Yup, think about it. Or don't.

The next story: I Cried A Tear

Unhinged (see pix below) is a confessional book by a top psychiatrist why the drugs we take may not be in our best interest. Hard pushing by pharmaceutical companies play a large part, as well as doctors beholden to their handouts. - TC

SAMH Rec Club - trip to Kusu Island
Some of the books I used to read as a teenager.

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