Stuff You May Not Like To Hear: Middle Child Syndrome Isn’t A Thing

 

How it started: Alfred Adler (1870-1937) was an Austrian medical doctor and psychotherapist who was interested in human development.  Studying his clients, he noticed that older kids in families often turned out a bit differently than middle and younger kids. He thought that these differences were due to birth order.

Alfred Adler

Why it’s wrong: Scientific studies show that birth order doesn’t affect our development. There’s no such thing as “all first borns are x” or “or middle kids are Y.”

What is going on: We’ve come a long way since Adler, especially in hard science. Today we think that our development is a complex mix of genetics, personality, health, how people treat us, our thoughts, our socio-economic status, and our life experiences.

This bio-psycho-social model acknowledges that our early years are important, and a big part of this focusses on how our parents treat us. To a child, a parent is a god. We need them to love us and our world revolves around them.

Parents are also human and constantly evolving. Therefore, the eldest child may have strict parents who hover a lot but by the time there are four kids, the parents may be tired, less involved and maybe kinder too. Or maybe it’s the other way around!

Also, it’s not just parents that matter: our wider family, friends, school, community also are hugely influential. Kids don’t grow up in isolation, they’re growing up in a complex and constantly changing world.

Why does this discredited birth order theory hang around? Most of us have no training in scientific principles; this means we can’t evaluate critically. So we read something, see it two or three times, and assume it’s true. We also love simple ideas. And we’re resistant to letting go of an idea that no longer works.

So when a mental health expert says Adler was wrong, there’s a lot of upset. Online bullying is HUGE!  Because of it, some of my colleagues are scared to say unpopular things. They shut up and go along with discredited ideas – or even pseudoscience.

I think it’s better to know that science is about constantly updating what we know. It’s unsettling but it’s also wonderful. And exciting. Also, it’s my job to help my clients be their best selves, and that won’t happen if they’re basing their decisions on discredited ideas or pseudoscience.

Final thought about Adler. Alfred Adler was a hugely clever man and a nice one too.  He created a theory of mental health that says family, community, and social life are important for good mental health. This is the foundation of the school of individual psychology. This school of thought has changed over the century but it’s still massively useful.

Alfred Adler was also one of the few experts who wrote in simple language, so if you want to read his papers, just google them up. It’s interesting stuff.

And if you’re looking for a therapist who’ll tell you what’s still accepted theory and what’s bunk, PM me 😊

Is Mainstream Psychology Racist? Why Western Therapy May Not Work for Southeast Asians—And How to Fix It

Have you read psychology books or papers and felt frustrated – or that the information is irrelevant?

The idea that we are all the same is popular—and in some ways, it’s true. We all have hearts, lungs, and kidneys in the same place. But psychology isn’t just about biology; it’s about how we think, feel, and live—and that varies greatly across cultures.

As much psychology was developed in Europe and North America, mainstream therapy or self-help books may not work well in other places.

I’ve lived and worked in Malaysia and Indonesia for over 30 years and now run a global practice. I adapt therapy to different cultural needs and want to share how you can find a therapist who actually works for you.

"I" vs. "We" Cultures

Western cultures emphasise individualism—people see themselves as individuals first, then as part of a family or group. This fosters independence and empowerment. The downside is that is also can lead to loneliness. When needs clash, there is open conflict.

In Southeast Asia, collectivism is the norm—people see themselves as part of a family or group first. The upside is that you’re never alone. The downside is that the demand for conformity can be frustrating. Open conflict is avoided, but social pressure or bullying to enforce group norms is common.

Family Support vs. Public Safety Nets

In the West, public social safety nets are a priority—taxes fund unemployment benefits, disability support, universal healthcare, and elder care. The US is an exception, as it lacks universal healthcare. While life is expensive, it means we have a safety cushion. We can leave our jobs and move house or city if we want to. If family are toxic, we can leave and our lives are maybe difficult but not over.

In Southeast Asia, morality centres on family responsibility. Taxes are low, and government benefits are limited. If you’re unemployed or ill, your family is expected to support you. Some countries, like Malaysia and Singapore, offer minimal government aid, but most support comes from relatives, not the state. While life is cheaper, you need to build your own safety cushion.  It can be very difficult to leave a job or move. If family are toxic, it is hard to leave as the system makes it difficult to be independent.

Different Views on Mental Health

Western psychology treats mental health as a medical issue. This reduces stigma and encourages a problem-solving approach. The downside is that we can lose sight of the person; we typically try and throw pills at problems first and engaging as humans second. Part of this attitude is fuelled by mental health care being expensive compared to pills.  

In Southeast Asia, views are changing slowly but mental health is linked traditionally to weak character, evil spirits, or past life events. This fuels shame and stigma, making people avoid seeking help. Even today, admitting to mental health issues can cost you a job or promotion. Stigma has us avoiding medication, even when needed, and also because there are few psychiatrists. Traditional healing methods like prayers and rituals can offer comfort but don’t provide lasting solutions.

Hierarchy and Communication in Therapy

Western therapy is direct—clients state their issues openly, and therapists treat them as equals. This helps therapy progress quickly and efficiently.

In Southeast Asia, discussing personal problems—especially about parents, bosses, or authority figures—is difficult. Clients may withhold or misrepresent information out of shame or discomfort. Since therapists are seen as higher in hierarchy, clients may hesitate to voice concerns if therapy isn’t working.

Race and Religion in Therapy

Both the West and Southeast Asia struggle with racism, sexism, ageism, and religious discrimination. However, these issues are often hard to discuss openly, despite their impact on mental health.

How to Find the Right Therapist for You

If you’re from Southeast Asia, look for a therapist who:
✅ Respects confidentiality to help you feel safe sharing.
✅ Uses indirect communication and storytelling to foster understanding.
✅ Provides psychoeducation, so you gain practical coping skills.
✅ Focuses on solutions, rather than endless self-exploration.
✅ Considers family and social roles, not just the individual.
✅ Discusses hierarchy and its impact on your mental health.
✅ Is open to non-harmful traditional healing practices like seven-flower baths, prayer, and mindfulness.

Final Thoughts

Therapy should be adapted to fit your cultural background—not force you into a Western model. By choosing the right approach, you can make therapy work for you without feeling disconnected from your roots.

 

Self-help vs. Professional Help: Knowing When to Call In the Mental Health Expert

You wouldn’t ignore a clogged sink forever—so why ignore persistent depression?

Many people waste hours trying to heal their depression.

They know there’s something not quite right.

They know there are tools that can help.

They spend weeks or months working hard and getting very little return.

But they hesitate to talk to a psychotherapist.

I get it. Mental health services are not cheap. And when you see all the self-help resources out there, DIY seems a reasonable option.

But is it?

I think of it this way: I’m happy to change a washer in a tap or dump a bit of Mr Muscle down a sink but when there’s a persistent blockage or the water heater goes, I call the plumber.

Mental health is the same.

There are lots of excellent how to articles, podcasts and videos created by mental health professionals.

If you are a bit low after a breakup or you’re not having a blast at work every day, checking out quality sources will give you what you need.

But if the depression is persistent or overwhelming, then you need to figure out if you’re looking at a symptom or a condition.

Confused? Let me explain.

I think of depression as spots: you may have spots because you have chickenpox, a fungal infection, or an allergy to soap.

There's no point in changing your soap if you have chickenpox.

With persistent or overwhelming depression, identifying the cause is the first step to healing because it allows you to choose an appropriate treatment method.

This is trickier than it sounds because there are various approaches.

I use cognitive behavioural therapy (CBT), behavioural activation and existential therapy–all of them have their uses but there's no one-size-fits-all.

Also, sometimes it is more efficient to treat the root cause rather than the depression itself.

For example, if your depression is the result of being bullied in the office, the best way forward may be to help you change departments or jobs, and then to focus on recovery and learning lessons so you can avoid repeating the situation.

In short, you are a special snowflake. You’re one of a kind, and for mental health services to truly help, we need to understand what makes you, you.

So, if you have a persistent mental health issue, enlisting the services of a mental plumber registered psychotherapist and counsellor is much more efficient and effective than a whole bottle of Mr Muscle.

If you’re looking for professional support, contact me.