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From digging dirt to a degree-how education preserves mental health

From digging dirt to a degree- how education preserves mental health

By : Jason Smith

 

A milestone

Recently, I received the wonderful news that I’ve been awarded a First-class Honours for my Bachelors degree. Now 27 years old, it’s been a long road, having dropped out of university in 2014. In the intervening years, I faced many setbacks. While my mindset has remained the same, the difference between then and now is the practical experience I’ve gained in putting it to the test.  I’ve had my moments: head in hands at 2 in the morning trying to figure it all out. But my attitude has proven to be a resilient bulwark against the threat of losing my mental health; a threat I’ve been conscious of- being part of a generation of the infamous ‘quarter life crisis’. In the past, my friends have often commented on how surprisingly upbeat I’ve been during the darker moments. I’d like to share a few pillars of that mindset in the context of my life.

My lowest point

From barista, to waiter, to bartender, to zoo guide, to manual labourer, to delivery driver, to plant operator. The list goes on and on. I’ve bounced from job to job, living day to day. Financial struggles have been an ever-present reality. I naively took out more credit than needed for a man my age. The consequences , combined with bad luck and a stubborn refusal to return home reached a climax: The summer of 2018 saw me reluctantly living in my car and cheap hotels when I could afford it. I have a vivid memory of waking up in the morning of my 25th birthday alone. I was laying back in the driver’s seat tucked inside my sleeping bag, peering through the window. For a moment, I laid there contemplating the reality of my situation.

Embrace the struggle

Suffering is an inescapable part of life.  Rather than seeking to avoid it at every turn, I embrace the personal growth it can stimulate. As a result, I resisted the temptation to give up and take refuge in the comfort of my family home four hours away. I was not yet curled up in a cardboard box on the high street. I would just keep calm and carry on with patient persistence. Today I’m a stronger person for doing so.

Patient persistence

While some temporary situations might end up being more temporary than I’d like, an almost Zen- like persistence allows me to prevail in the end.  As it did with the car/hotel situation which lasted 5 months- far longer than I’d originally hoped. The following summer, I slept on an airbed, for what ended up being an entire year, until I could finally afford to buy a proper bed. I woke up on hard ground in the middle of the night due to yet another puncture more times than I care to remember. When I returned to university, I signed on for the 2017/2018 academic year. But it wasn’t until the 2019/2020 year when my financial difficulties  subsided, that I could  sit the year without any major distractions.

Feed the fire

There were many daunting moments, but they couldn’t crush my spirits. Beneath it all (sometimes buried deep!), I had a feeling of almost smug confidence, knowing these times would pass and a bright future lay ahead. I knew it because I still had that fire inside of me. This fuels my optimism and drives me on. The fire that inspires awe and wonder at the great possibilities of life. And that ‘the world is my oyster!’. I always hold on tightly to a positive vision of the future and feed the fire if it starts to flicker, literally in the mirror if necessary – I know that I must always be my biggest cheerleader.

Life can be unfair

Sure, there may well be an unusually large number of factors getting in the way, and things might be horribly unfair.  Life can get tough – working out the most efficient way to spend my last 87p to maximise my caloric intake before going hungry again wasn’t fun. But ultimately, there’s only one question in a given situation that one wants to improve; ‘what am I going to do about it?’. The external factors are a given. I can either wallow in self-pity, frozen in these conditions, or take action, step by step to improve my circumstances.

I’m in control

I was raised by hardworking, entrepreneurial parents who sacrificed a great deal for their children. From running restaurants to selling wine, I witnessed many different businesses growing up. Seeing the world through an entrepreneurial lens, the underlying message was one of self-reliance and independence.  Most importantly, the optimistic idea that the world is a place to be seized upon through one’s  initiative and effort. I carry that spirit close to my heart. When I look forward I don’t think ‘what’s going to happen to me?’, I think: ‘what am I going to make happen?’.

Not a victim

The biggest threat to that optimistic view of the ‘self’ as an autonomous individual with great power over the direction of their life is the opposite idea that we’re all just victims of forces beyond our control. This is a general idea which circulates throughout society. When there seems to be an unlimited supply of obstacles getting in the way, it can be easy to slip into such a paralysing view of the world. Paralysing because we lose the belief in our ability to take life on. We’re a goal-orientated species. Setting and achieving goals is vital to our mental well-being and as such we must always reinforce that strong sense of the autonomous self.

An intellectual journey

In a six-year period in which I’ve lived in 10 different apartments. The only constant has been an enriching intellectual journey which inspired me to return to academia. It’s important for your mental health to develop some skill or interest during difficult times because it provides that vital sense of positive momentum to drive you forward. For me it was my intellectual pursuits. I may have been materially broke, but my mind grew richer as I delved deeper into my intellectual interests. I knew that I was investing in my mind and that one day it would pay dividends.

What next?

When I decided to return to academia, I knew I wanted to study at the very best institution. I inevitably turned my sights toward Oxbridge. Gaining my undergraduate degree is a stepping-stone toward that goal. Now my focus is on preparing my Master’s application. I yearn for the honour of walking through the ancient halls of Oxbridge. If that time comes, those gruelling 12 hour night shifts covered in dirt, lugging bricks for minimum wage as a university dropout, will become all but a faded memory, if not so scarcely believable that it must have been a distant dream from another life. Whatever happens, the fire will keep burning stronger than ever.

Parting thoughts

In hindsight, our problems are often much smaller than they might have seemed at the time. Approaching future obstacles with this in mind makes them more manageable and protects our mental wellbeing. I’m almost embarrassed to say I’ve suffered in any real way – my hurdles are dwarfed by so many others not only in this generation but certainly for generations past. But that thought helps me to stay grounded. Sometimes it’s useful to take a moment to remind ourselves of everything we have to be grateful for. Instead of focusing too much on the negatives, we should start from a place of gratitude and then build on the positives to be the best version of ourselves that we can be.

By Jason Smith

About the author

Jason Smith achieved his Bachelor’s degree as a mature student in 2020. A strong advocate of an interdisciplinary approach to learning, he combined Economics, History, Philosophy and Politics to complete his degree. After completing his Master’s degree, he will embark on a long academic career where he hopes to make a positive and lasting difference to academia and society at large.

 

Obsessions, Compulsions, Depression and the Muslim Community

Obsessions, Compulsions, Depression and the Muslim Community: Reflections from the Singapore Mental Health Study 2016

By Sufian Hanafi

Introduction

Mental illness and Muslims interface in unique circumstances. In the Singapore Mental Health Study (SMHS 2016) completed in 2018, researchers from the Institute of Mental Health (IMH)  found that those of Malay ethnicity have higher odds of OCD (Obsessive Compulsive Disorder). (For the convenience of this article, Malay ethnicity has been taken as representative of the local Muslim community.)

The SMHS went on to state the “higher odds of OCD are difficult to explain and needs further research to elucidate the underlying cause(s)”.

Those familiar with OCD would know that this mental health condition consists of two components – obsessions and compulsions. Persons with OCD may have varying obsessions and compulsions.

According to Dr Elna Yadin, an authority from the International OCD Foundation who visits Singapore occasionally for consults, the  main anxious obsession  of a person with OCD is the desire not to become “a bad person”. As for compulsions, some of its more typical forms involve maintaining cleanliness and acts of washing.

When these dots are connected, it becomes understandable if one tries to hypothesise how OCD interfaces with Muslims.

OCD: An obsession with piety?

Given the  emphasis of Islamic teachings on cleanliness as an indicator of one’s faith , members of the Muslim community may run the risk of turning cleanliness into an unhealthy obsession.

It is indeed important for the Muslim to perform acts of ritual purification such as taking ablution and compulsory baths properly, in order to perfect his acts of worship. However, over-zealousness masked by attempts to attain absolute perfection during such acts of ritual washing may land such a Muslim in a psychological trap and throw him into a spiral of compulsive behaviours.

Such persons then become preoccupied with washing and keep repeating their ablution, sometimes to the point of missing their prayers entirely.

Unfortunately, this is sometimes compounded by extreme fear-mongering about the perils of not taking proper ablution, by unwitting yet well-meaning religious teachers and elders. Anecdotally, it is not uncommon in religious settings to hear about the ‘punishments’ to be suffered by one who is lackadaisical in washing after himself after using the restroom to pass bodily waste.

It is then drilled into the psyche that one’s ritual worship will be invalidated, and that he would be tortured in the grave due to a lack of proper hygiene when using the toilet.

While such teachings are essential, there may be a greater need to mediate such messages when they are delivered on public platforms.

It is true that maintaining cleanliness is part of a Muslim’s faith, and this article does not seek to deny this religious injunction. However, when it is internalised by an unwitting layman without nurturance and guidance, it may become problematic. In striving to perfect one’s faith, such a Muslim may end up obsessing irrationally about cleanliness and miss the higher objectives of the religion instead.

The Need to Prevent OCD in Religious Practice

The SMHS found that OCD has the highest 12-month prevalence among mental disorders at 2.9%. Statistically, this means that for every 50 persons in the street, at least one person would have had a diagnosis of OCD within the past  2 months. In fact, the data for Muslims may be even more startling as Malays have a 12-month prevalence of OCD of 4.3°/o. For data visualisation’s sake, this could mean that at least one out of every 2 5 Malays may be experiencing clinical OCD. Imagine how many persons in any given mosque at a Friday congregation actually suffers from OCD?

Leaders in the community must be concerned about this 25th person, for if he has an existing schema that renders him psychologically more  vulnerable, this person may tum innocent intentions into obsessions, and innocent rituals into compulsions, at the expense of his mental health. It becomes more worrying when one considers that persons with OCD have been shown to delay seeking professional help the longest (II years). Are members of the Muslim community then able to distinguish the difference between ‘piety’ and OCD in their religious practices? Does this indicate that more psycho-education for OCD is needed in the Muslim community?

While these questions fester in our minds, we should also call for a more nuanced delivery of Islamic teachings with regard to ritualistic practices, especially as religious rituals inevitably become associated with the accumulation of ‘merits’ and ‘demerits’ – a significant phenomenon because of its attributed role in determining where one ends up in the afterlife.

Solutions can be found within the vast Islamic scholarship on this matter. Therefore, adopting a moderate approach in Islamic teachings cannot be over emphasised here, accompanied by critical thinking skills to help individual Muslims contextualise and accommodate or adapt their daily rituals accordingly without jeopardising their mental health.

Depression

Not far behind OCD in terms of prevalence, is depression. While Malays (again by extension, Muslims) had  the lowest lifetime prevalence of Major Depressive Disorder at 4.9°/o, Malays were still second highest for r 2-month prevalence at 2.9°/o. It must be noted that while not every person who feels depressed receives a diagnosis of major depressive disorder, there are many variants of depressive symptoms which are equally disruptive to daily functioning.

Even without manifesting as a full blown episode of clinical depression, it is possible for one to experience acute stress, adjustment difficulties, grief and complicated grief, or simply one of the many symptoms of depression such as loss of appetite, poor sleep, irritability, low mood, suicidality and so forth. These presentations could eventually lead to depression, or may possibly exist in isolation without ever meeting the clinical criteria for depression.

Although  the rates of prevalence for mental illness for Malays were not flagged in the SMHS, there are still potential risk areas which may be of interest to helping professionals, and the community at large. Specifically, these risk areas pertain to relationship difficulties.

The Relational Dimension of Depression

The causes of depression are multidimensional and the onset of depression may be caused by biological factors, environmental factors, or both. Extrapolating from some of the evidence­ based psychotherapy treatments for depression, we will find that such ‘environmental factors’ which contribute to depression may have developed out of difficult couple and interpersonal relationships.

This poses some questions for the Muslim community because anecdotally, the community is more communal, connected and family-oriented (read: interpersonal relationships) and where the prevalence of marriage and divorce (read: couple relationships) is relatively higher. Certainly, it will be a huge leap to suggest that members of the Muslim community are therefore at higher risk of developing depression. There is simply no data to support such a correlation. Furthermore, despite ranking second highest for 12-month prevalence, Malays still ranked lowest in terms of lifetime prevalence for depression.

One hypothesis is that perhaps somewhere after an acute 12-month period, Malays (and Muslims) find a way to overcome depressive symptoms, or simply ‘manage to get by’. Possibly, this could either be due to the communal and social support that the tight-knit community lends to its members, or in spite of this tight-knit community. The latter might suggest that the Muslim community is resilient and can buttress against chronic depression.

Yet, given the literature on ‘disability days’ due to depression, paired with its

‘economic burden’, it still behooves helping professionals, and the wider community, to be able to detect signs and symptoms of this illness. The social impact of depression is such that one person with depression in the community remains one too many.

Depression, Marriage & Divorce

Another question then lingers: If we cannot definitively conclude that difficult interpersonal relationships lead to depression, can we say the reverse instead? That it is depression that leads to difficult interpersonal relationships? Could this then finally explain the pervasive marital difficulties in the Muslim community, and even in society at large?

These questions run the risk of oversimplifying both depression and couple conflict, yet it seems intuitive to do so. Adopting a systemic mental model, depression may possibly correlate with numerous other contributing factors to couple conflict such as unemployment, financial difficulties, marital/parenting role adjustment, addiction, sexual dysfunction and more.

Systemically, this implies that marriage preparation programmes and divorce counselling programmes in the community may need to include some form of awareness with regard to the impact of mental health on marriage, and  marriage on mental health.

 A not-so-final word

These reflections are a cumulation of the author’s professional practice experiences in the social and mental health sectors, and have been crystallised by the ethnic breakdown of data in the SMHS 2016. The role of mental health cannot be neglected in social and community development.  This can only be achieved with relentless advocacy. Dots of social problems, health problems and their respective solutions keep interconnecting, even as more dots continue to appear in our highly developed society. The impact on the Malay, and Muslim, community is significant. While some of the ideas that have been suggested in this article remain moot for now, it is hoped that they may spark ideas for research and uncover new social and mental health solutions for the future. ⬛

 

About the Author:

Sufian Hanafi is a  senior  social worker and counsellor who has been providing counselling , psychotherapy and psychoeducation for individuals, couples , families and groups for more than a decade. He has worked in both the health and social services sectors, specifically in outpatient children and adolescent mental health. inpatient and community adult mental health, specialised services and mandatory pre-divorce counselling programmes for inter-ethnic and blended families. He currently runs a private practice, Just Guidance Counselling & Psychotherapy.

 

Acknowledgement:

This article was first published in “Karyawan” a publication from AMP Singapore in 2019