​SINGAPORE - How would you react when someone shares his or her problems with you? Do you feel awkward because you do not know how to react?

It is important for us to show care, and watch out for one another, especially when someone seeks comfort from you.

A case which I remembered from my work as a medical social worker was that of a young female patient who struggled with self-esteem issues and self-harm behaviour.

Claire (not her real name) was a tertiary student who was living with her parents and younger sister. During our first session, I was surprised at how open she was about sharing her deepest secrets. She mentioned that she could not resist the urge to self-harm, even though she had seen many psychiatrists and psychologists in the past. Claire rolled up her sleeves to show me the scars on her forearms as we spoke. Some of the scars were still fresh.

Her self-harm behaviour started years ago in her secondary school years, after some of her best friends turned their backs on her for unknown reasons. She had never felt so helpless and lonely before. Not knowing how to deal with the pain, Claire saw another schoolmate cutting herself and did the same. The pain on her forearm and the sight of the blood brought relief to the emotional pain she felt after losing her friendships.

Claire performed self-harm whenever there were painful episodes in her life.

When she had her first break-up, she cut herself. When her friends avoided eye contact with her or did not reply to her messages, she would do the same too. Whenever she felt lonely and depressed, she would self-harm. Her cut wounds would heal, but new ones would appear as she struggled with her condition over the years.

She has tried a variety of medications, but they did not help as they only made her drowsy and idle. This helplessness echoed throughout our first session.

Claire had a few dysfunctional beliefs. One of them was that nobody wanted to be her friend and she was unlikeable. However, the reality was far from it. After exploring her social support system, I found that her schoolmates would spend hours chatting with her whenever she needed company. Her parents have never scolded or blamed her for cutting herself, but instead looked for psychiatrists to help her. Claire’s sister was also always available whenever she needed comfort or a hug.

Unfortunately, Claire was not able to accept these sources of support around her.

Another dysfunctional belief she had was related to her low self-esteem, and how incompetent she felt. Looking at her strengths, I  found that Claire was far from “useless”. She had a grade A average  in school, was able to sight-read for piano, and excelled in swimming and badminton.

Despite the evidence suggesting otherwise, Claire was not convinced that her beliefs were irrational, and it felt like we were not going anywhere with the session.

The breakthrough came when I did a role-reversal, where we switched roles and restarted our conversation.

“No one wants to be my friend, nobody likes me,” I said, mimicking Claire’s tone.
“You told me that your schoolmates always spend time chatting with you, right? Your parents never scold you for cutting yourself and your younger sister always...,” Claire said, impersonating me.

“But I am useless, I don’t deserve to be happy,” I refuted her immediately.

“But you were able to get grade A in school, play the piano, swim and play badminton very well,” Claire said, trying her best to convince me.

“No, I’m not as good as you think,” I said in a deflated tone.

“My gosh! Now I know how you feel,” said Claire.

The session went well as Claire became less resistant and more receptive to alternative perspectives.

My journey with Claire continued for a few more sessions after that day, and she began to develop a greater sense of self-compassion and confidence.

Recently, I had the opportunity to speak to Claire after she completed an internship. She shared with excitement that she had received positive feedback from her supervisor. Although she continued to struggle with some stressors, she had stopped resorting to self-harm.

In Claire’s case, her loved ones took the matter seriously. They did not belittle her problems, or criticise her for her behaviour. Instead, they saw it as a cry for help and encouraged her to seek professional help. Claire was also brave in coming forward, and was willing to make small changes to help herself.

It is important for us to understand the approach to take when someone shares their problems with us. Below are eight tips on how we may respond if we encounter such a situation.

1. Take it seriously
It takes a lot of courage to share one’s personal problems. If someone approaches you to share his or her problem, do take it seriously and thank them for trusting you.

2. Listen, more than talk
Sometimes, people just want to be heard. They may not need advice from you, and you do not have to feel obliged to give advice. Instead, you can just listen attentively, and ask questions to clarify if you are unsure that you understood them correctly. This would encourage them to share more.

3. Do not belittle their problems
Avoid saying “Just get over it”, “Don’t worry, it’s just a small matter”, “Just do this or just stop doing that.”

People’s problems are often more complicated than you think. Problems that may seem trivial to you may mean the world to others. You should never trivialise their problems by offering quick solutions, or start telling them your own problems that you believe are much more difficult.

4. Do not criticise or blame them
Never suggest or imply that they are the problem, or blame them for it. You may disagree with what they tell you, but you should not rub salt into their wounds. For example, you should avoid comments such as “Why are you doing this? Why didn’t you do that?”, or “If you haven’t done that, then this wouldn’t have happened”.

5. Be encouraging
Words of encouragement go a long way. Say simple phrases  like “Thank you for telling me this”  or “I’m here for you, talk to me again when you want to”, to show that you care.  You may also share encouraging comments such as “Things will not stay the same, it will get better” to instill hope.

6. Offer practical help
Actions speak louder than words. You may not be able to fix their problems, but you can offer practical support that may make their life easier, and show them you care. Do ask them if there is anything you can do for them. Practical help can come in simple acts such as buying them a drink, or tidying up their desk for them.

7. Encourage them to seek professional help
If the person still remains troubled despite your offers of support, encourage them to seek professional help, be it from a social worker, psychologist, marital counsellor, or family therapist. Accompany them  so  they feel empowered to take the first step.

Other helplines available:
- Samaritans of Singapore: 1800-221-4444
- National Care Hotline: 1800-202-6868
- Institute of Mental Health’s Mental Health Helpline: 6389-2222
- Silver Ribbon Singapore: 6385-3714
- Singapore Association for Mental Health: 1800-283-7019
- Tinkle Friend: 1800-274-4788

8. Self-care is important
Do not over-stretch yourself to help others at the expense of your own well-being. Know your limits and set aside time for yourself. Engage in activities that bring pleasure and relaxation in your daily living.

SOURCE: ​​​The Straits Times, Singapore Press Holdings Limited. Reproduced with permission.