Twenty-seven-year-old Jeremiah was known to us only after his mother was referred to O’Joy for counselling. Mdm Lee, a 64-yr-old homemaker, was diagnosed with major depressive disorder after her poor health reduced her ability to function at home. She blamed herself and was concerned with her increasing medical expenses. Most of all, she was very worried for her only son Jeremiah.
Although academically brilliant when young, Jeremiah had been unemployed since completing his National Service. Mdm Lee’s 68-year-old husband had been the sole breadwinner for the family, and he could not retire or there would be no income for his family. He blamed Mdm Lee for spoiling their son, resulting in his “laziness” in seeking employment.
Jeremiah was observed to be reclusive, staying at home most of the time and keeping to himself. He did not seem to have any friends. He would spend hours in the bathroom and was very particular about the way his laundry should be washed and his food cooked. There were stacks of neatly arranged newspapers and magazines in his bedroom and the living room. If his mother moved his things without his permission, he would get upset and verbally abuse his mother. He had not been on speaking terms with his father for many years. Jeremiah slept during the day and was awake at night. He also rummaged for plastic materials that people threw away at void-deck, bringing them back home to wash and dry for recycling intention. When asked to see a psychiatrist about his condition, Jeremiah flew into rage and threw things at Mdm Lee.
O’Joy’s interventions to help Mdm Lee included:
helping her understand depression,
reduce self-blame and
be medication compliant,
processing her grief over lost dreams she had for Jeremiah,
life review and reminiscence work to enhance her internal and external resources,
finding meaning and purpose in life as she aged, and
lessening her financial worries by applying for Financial and Medifund Assistance.
From a systemic perspective, as her son’s behaviours were daily and constant stressors to her and there was increasing risk of physical, psychological and financial abuse, O’Joy counsellor found it necessary to help Jeremiah get assessed and treated for his condition.
We were privileged to be able to work closely with the Community Rehabilitation Support & Service (CRSS) of Singapore Anglican Community Services. After several home visits and counselling by CRSS counsellors, Jeremiah eventually agreed to see a psychiatrist. He was diagnosed with Obsessive Compulsive Disorder (OCD) and began treatment with a psychologist from Institute of Mental Health (IMH) on his employment issues and OCD behaviours, including hoarding.
O’Joy counsellor provided psychoeducation on OCD for Mdm Lee and her husband, including how not to trigger their son’s negative reactions, thus reducing the risk of violence towards them. It was a long road to recovery for Jeremiah, including employment training at a psychiatric sheltered home. His hoarding was managed by learning how to organise his things and also by redirecting his attention and energy to work. As Mdm Lee learnt to let go of self-blame and work with professionals helping Jeremiah, she felt less lonely and helpless, and her depression lifted.
(All names are not real, and details have been changed to protect the identity of these families)
Written by Chew Yat Peng, principal counsellor at O'Joy
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