SINGAPORE: Xiao Jia*, 12, came to us as she could no longer cope with an intense fear of the upcoming Primary School Leaving Examination (PSLE).
She had set out to score more than an aggregate of 250 and didn’t want to disappoint her parents.
A plan of getting into her choice school, excelling later at the O and A-Levels, getting into her choice university course, and eventually securing a good job all hinged on doing well in this first national exam.
Her fears are not uncommon among her peers, albeit of varying degrees.
PRESSURE TO PERFORM AT EXAMS
Children and adolescents in Singapore face pressures at school and at home. Other than relationship and family problems, a commonly cited issue that afflicts many of the students we see at the Institute of Mental Health is academic-based stress.
A study conducted by the Organisation for Economic Cooperation and Development (OECD) found that Singaporean students were significantly more anxious about tests and grades compared to their international peers.
This intensified dread over academic performance may be due to a more competitive culture in Singapore.
The astounding story of Singapore’s success has been largely attributed to its system of meritocracy, one where the best and brightest rise to the top by their own merit and hard work, and tales of leaders emerging from humble backgrounds are largely celebrated as testimonies that the system works.
Singapore’s system of meritocracy in our education system is still based on academic success, and Singapore has done well in that aspect. It is ranked first in the 2015 Programme for International Student Assessment conducted by the OECD, based on assessments of 15-year-olds on reading, mathematics and science.
However, despite the brilliant performance on global academic rankings, Singapore has produced proportionally fewer top-ranked scientists, inventors, entrepreneurs and business leaders.
When Deputy Prime Minister Tharman Shanmugaratnam was asked about this by CNN many years ago by Fareed Zakaria, he replied that Singapore was an “exam meritocracy”, compared to America which was a “talent meritocracy”.
Understandably, there is no perfect measure to gauge a multifarious concept of merit. But studies have shown academic achievement is positively correlated to later occupational performance, and remains a valid measure of merit in Singapore’s context.
Over the years, meritocracy has worked well to sieve out scholastically-inclined students, and develop them into prominent leaders and captains of industry.
This, in turn, reinforces the belief that doing well in school equates doing well in life and that conversely, doing badly comes with huge, adverse consequences.
Many students and their parents, driven by this belief, place utmost emphasis on academic achievement.
TOLL ON STUDENTS’ MENTAL HEALTH
A competitive education system has put our students scholastically ahead of others globally, with benefits to individuals.
Studies have shown moderate amounts of stress and anxiety can motivate and encourage people to work harder and attain better performance.
Stress is an inevitable part of life, and exposing students to a reasonable amount in school builds resilience that will serve them well in their adult lives.
But an overly competitive culture can be detrimental for students’ mental health. High expectations can lead to excessive stress and anxiety, especially during major examinations that have perceived consequence for one’s future, such as the PSLE, and the O-, N- and A-Level national examinations.
In psychology, stress is the body’s reaction to difficult situations, real or perceived. This “fight or flight” stress response, evolutionarily developed to enable humans to escape from physical danger, manifests as physiological symptoms such as a quicker heart rate, hyper-ventilation and muscle tension.
While there are far less opportunities to meet physical or predatory threats in the modern society of Singapore, the stress response still remains in us.
For some students who place utmost importance on academic success, performing “poorly” in examinations could represent a form of failure or threat. This could potentially trigger a stress response in some students as they try to meet their expectations.
In extreme cases, prolonged stressful situations associated with tests and examinations leads to the development of performance anxiety in some students.
Some suffer intense emotional symptoms like fear, anger, depression or helplessness, while others exhibit behavioural symptoms like avoidance or irritability or cognitive impairment that include racing thoughts, minds going blank, difficulty concentrating and negative thinking.
People also experience rapid heartbeat, shortness of breath, nausea, diarrhoea or excessive sweating. In severe cases, test anxiety can lead to a full-blown panic attack, crippling the person with a sudden onset of intense fear and uncontrollable physical symptoms.
There are no exact causes of test anxiety, but studies have found that contributory factors include low academic self-concept, fear of failure, feelings of helplessness, and parental as well as teachers’ pressure on students – that may be intensified by a hyper-competitive culture.
Worse, test anxiety as a disorder inevitably leads to poor performance, as the distressing symptoms inhibit a student’s ability to absorb, retain and recall facts and information, and can lead to other mental health disorders such as panic disorder or depression.
We tend to underestimate the effects but anxiety and mood disorders are highly prevalent in Singapore, and carry a high disease burden due to the associated decreased work productivity and significant loss of function.
In cases when test anxiety becomes so severe that it develops into a psychiatric disorder and affects the student's ability to function significantly, professional help might be needed.
Parents can help their children by moderating their own expectations, and focus on their children's efforts rather than their results. Regular and open dialogues about school and academic stress, and being empathetic towards their difficulties without making critical judgements can aid.
Ensuring that the basic health needs of our children, such as getting enough sleep, maintaining a balanced diet and exercising regularly, are met can go a long way. If necessary, a school counsellor can provide extra support.
However, it may be more useful to attenuate the development of test anxiety and other mental health disorders at a macro level.
A balanced approach where academically brilliant students are recognised and groomed, while the less academically inclined ones are supported and encouraged to pursue their interests based on their strengths, will be optimal.
We have already seen positive moves in this direction. There has been a shift in Singapore’s education system away from the narrow focus of grades and academic achievements. There were no final examinations for Primary 1 students since 2013, and the PSLE will do away with aggregate scoring from year 2021.
School rankings are no longer released to the public; and media reports have shifted from highlighting top scorers in national examinations to celebrating the achievements of students who overcame the odds and performed well.
FOCUS ON WELL-BEING
The idea that academic achievement is a necessary ingredient to obtain lifelong success has become a long-held but unhealthy belief ingrained into our culture. It is a momentous task to shift this national mindset to one that is more encompassing, more accepting and less competitive.
Yet, as Albert Einstein once wrote:
If you judge a fish by its ability to climb a tree, it will live its whole life believing that it is stupid.
There are many students who excel in other varied areas, such as arts, sports or music, and deserve to be recognised for these non-academic abilities.
At the same time, expectations should be set according to individual abilities, with appropriate cajolements to push our children to reach their maximum potential, but not to the point where it becomes corrosive to their mental well-being.
Meritocracy has driven Singapore well, scholastically, and economically. It has played a large part in contributing to our nation’s success, and will continue to do so.
However, it is also important to place emphasis on well-being and prioritise the mental health of students who are the future pillars of Singapore society.
ROAD TO RECOVERY
Xiao Jia’s case has a happy ending for now. She was able to communicate her feelings of performance anxiety and high self-expectations to her parents and the treatment team during therapy sessions.
Her parents responded well and constantly assured her that what mattered more were her efforts and not the final aggregate or whether she eventually got into her choice school.
To help her cope with her anxiety, she was taught calming techniques as well as encouraged to embrace a positive mindset that could help relieve anxiety during examinations.
That year, Xiao Jia sat for her PSLE and successfully enrolled into a secondary school of her choice.
Brian Poh is senior clinical psychologist at the Institute of Mental Heath’s Department of Developmental Psychiatry.