Psychologist’s Guide to Good Mental Health in Modern Myanmar

6 October 2018

With World Mental Health Day falling on October 10, The Irrawaddy spoke to Dr. Hannah Kyaw Thaung, an Irish-Burmese clinical psychologist, for her advice on maintaining good mental health in modern Myanmar. Hannah gained her doctorate in clinical psychology in the UK where she worked for a number of years before coming to Myanmar in 2013 to establish a private psychology clinic, Marble Psychological Services. Now Marble is an expanding team of four psychology professionals who offer therapy to early childhood, adolescent and adult clients. She also volunteers with Myanmar Clinical Psychology Consortium in their year-long psychology diploma program which will have its first graduates, a group of eight mental health counselors, next week.

What areas do you specialize in? Which psychology services are most in demand in Yangon these days?

I work with adolescents and adults and do couples’ therapy. The service as a whole is in great demand and there’s a need for more mental health services here. For adults’ services, people mainly present symptoms of anxiety or depression. Some of the younger children have learning difficulties and disabilities and that involves more ongoing support.

What is the perception of mental health and psychology clinics in Myanmar today?

When Marble first opened we had more expat clients and now that has switched over to more locals. I think what happens is there is a lot of stigma here around mental health, as in every country. When people hear one person speak about their mental health or how they got help, that encourages more people [to seek a psychologist’s advice] and causes a spreading effect.

In terms of mental health in Myanmar, the approach is more of a medical model so people are usually treated with medicine. While it’s not always bad to treat mental health issues with medication, it shouldn’t be the first line of approach.

How do you define a mental health issue? When is it time to seek professional help?

That’s a great question because taking anxiety as an example, we can all experience anxiety at different times of our day and different periods of our life. It’s a continuum that we should watch out for. When you notice symptoms that are preventing you from doing the things that you normally do, or your work, or interacting with friends and family in the way that you normally do, that’s when it becomes a problem, and that’s when it’s time to get support. Otherwise, it can move further down continuum and get worse.

Specifically, what does a session or set of sessions with a psychologist involve?

It will vary upon the therapeutic approach but the initial consultation is a meeting with your therapist discussing some key issues around confidentiality. This is one of the most important elements of the sessions because it gives you the sense of safety and security that what you’re sharing is not going to get around. That person mostly guides the session, sharing what they feel comfortable with. We then discuss a therapy plan and that’s where it can start to differ. For example, someone who’s having trouble with life transitions, their therapy plan will be very different to someone who is presenting severe depression or fears.

What should we look you for in children and teenagers? How about elderly people in our care?

For early childhood, if there are any changes in their play, sleep or eating, or their interactions with peers or siblings, those are helpful to look out for.  Their ability to communicate their own internal world is much more limited than adults so they express that through the basics of their world. Teenagers are more difficult because they’re not telling you something’s wrong. Teachers are quite well placed to share what’s going on with a teenager because the friends around them will express their concern to the teacher. Within the elderly population, it’s much harder to say a particular behavior is a cause for concern because there are so many aspects of behavior that change in later life. For example, depression is quite common in older ages but not often recognized because sometimes the signs are attributed to the older person losing their words and it’s harder for them to communicate.

How does a psychologist help someone who has had a traumatic experience? What kind of traumas do people commonly experience these days?

Often it’s younger people that would present symptoms of trauma and adults, recognizing that, bring them to therapy. Trauma happens in so many different manners—road traffic accidents, abuse, witnessing death, experiencing someone else’s death— it’s so diverse that it’s hard to say one specific trauma is more common than another. Sometimes we help them through behavioral approaches. For example, if they are experiencing flashbacks, we speak with them about ways to manage that moment, how to reduce the effects of the flashback and be able to get back to normal.

Today, there are more trends and influences that negatively impact our mental health than perhaps ever before. What advice would you give readers for taking care of their own mental health on a day-to-day basis?

Sleep is key. A healthy sleep routine has huge benefits on your mental health. You know when you have a bad night’s sleep, it’s harder to deal with bad situations the next day. Routine is also important—ensure that you have a routine involving your sleep, regularly eating and exercise. The third this is connecting to other people, being open with difficult emotions. For a lot of people, particularly in Myanmar, there’s quite a tight-knit fabric of society so people are close with one another but not always necessarily good at talking about more difficult emotions and the hard things that come up for us. If you’re connecting to other people and speaking openly about these things, then it can be really helpful to your mental health.

Dr. Hannah is speaking at the TEDxYangon event this weekend with her talk entitled “Opening the Doors to Emotion.”