Counselling in Singapore

“Sometimes all a person wants is an empathetic ear; all he or she needs is to talk it out. Just offering a listening ear and an understanding heart for his or her suffering can be a big comfort.” – Roy T. Bennett, author

Many stroke survivors and caregivers feel lost, sad, and frustrated as they struggle to cope with the physical and emotional effects after a stroke. It is a tough journey, and many suppress their feelings. There are various reasons why stroke survivors and caregivers are overwhelmed by their emotions:

• Role adjustments: Stroke survivors and caregivers face changes in the roles they play in their family and community. For example, caregivers may have to take over childcare responsibilities or find a job as their loved ones cannot work. 
• Stroke survivors may not be able to communicate well due to their language and speech impairments.
• They do not want to trouble nor impose on others.
• They may be overwhelmed by their functional needs and caregiving duties and become unaware of their own feelings.
• They feel uncomfortable to talk to an outsider.

“It is very challenging to accept the changes that happen after a stroke. This can easily lead to experiencing episodes of anxiety and sadness. The changes in their mood can further affect their daily functioning and their interactions with their loved ones,” S3’s social worker highlighted her observation. As stroke survivors and caregivers are distracted by their negative emotions and thoughts, they lose focus on their rehabilitation.

Many people do not understand the experiences of stroke survivors and caregivers and are too quick to give advice. “Busy with caregiving? Just hire a helper then,” they would say. It is not about giving suggestions or solutions, but to put ourselves in their shoes and to understand them. There are many reasons why stroke survivors and caregivers express behaviours which do not fit societal norms and expectations.

Therefore, it is important to hear the feelings and thoughts of stroke survivors and caregivers with an open mind. S3’s social work team employ active listening to understand the concerns of stroke survivors and caregivers.

“Stroke patients and caregivers may not be aware of the triggers that affect their emotions or behaviours. When their emotions or behaviours are affected, they can shape their own beliefs and those of others as well.  Without understanding the interactions between their beliefs and emotions/behaviours, this may become a vicious cycle and worsen the situation,” S3’s social worker highlighted. S3’s social workers provide counselling services for stroke survivors and caregivers, helping to address their problems in a positive way. During the sessions, our social workers will clarify issues, explore options, and develop strategies together with our beneficiaries. These approaches enhance their self-awareness.

Mr John Lim (not his real name), is a stroke survivor who currently attends therapy sessions in S3. A few months ago, his family hired a new domestic helper. Mr Lim is affected by this change and faced adjustment issues. He became more agitated and could not control his mood. He would lash his frustrations on his family, which affected his relationships with his loved ones. When he attended therapy sessions, he continued to throw tantrums and did not want to obey the instructions from his therapists.

S3’s social worker helped Mr Lim to explore his source of frustration through reflection during his counselling sessions. “When I asked Mr Lim about his goals, he mentioned that he wanted to be a good person. We reflected if his current behaviours are positive impressions of his goals. I also explored with him on how he could achieve his goal.” S3’s social worker underlined her approaches to help Mr Lim.

Our social worker also explained to Mr Lim about how his non-compliance had affected his progress and his relationships with the therapists. She also worked together with Mr Lim to identify other potential trigger points of his frustration. Given their close relationship, Mrs Lim did not know how to communicate with her husband, especially during his emotional outbursts. She had to seek external assistance. Our social worker explained to Mrs Lim the reasons for her husband’s anger.

Through counselling support, Mr Lim became more aware of his situation and strove to improve how he expresses his feelings. Now, Mr Lim enjoys better interactions with the people around him. For more information about S3's care services, visit http://www.s3.org.sg/caregivers-programme.