Dr Christopher Cheok gives oral evidence at Committee of Privileges hearing on Raeesah Khan, Dec 22

they are now called the meeting to order sergeant-at-arms please invite dr christopher chop to the witness table hi morning chris take your seat may remove your mask um for the record please state your name your occupation and the positions you hold good morning chairman and members of the community of privileges my name is dr christopher soon i'm a psychiatrist by training my the positions i hold is are that i'm the acting chief of the department of forensic psychiatry and i'm a senior consultant at the institute of mental health thank you the evidence you'll be giving today before the committee will be taken on oath if you so desire you can also take an affirmation clock please administer eraser right hand i christopher chang soon swear that the evidence that i shall give before this committee shall be the truth the whole truth and nothing but the truth so help me god thank you please be seated the committee of privileges is looking into the complaint uh made by the leader of the house ms indrani raja against former member for singkang grc miss reiser khan for breach of privilege thank you very much for attending to today's hearing and for your expert evidence before the committee and to answer the questions which members of the committee would like to put to you you have taken a solemn obligation to answer questions truthfully if you refuse to answer questions directly or attempt to mislead the committee such behavior will be an offense and in contempt of this committee i also want to place it on record that this issue of a review from the psychiatrist was raised by mr pratam singh as mr sivir lim and they also had requested for such an examination to be made on miss khan but we appreciate your spending time to evaluate the situation i'll now perhaps hand over to mr desmond lee for some questions or perhaps before the questions would you like to perhaps take us through some of your evaluations and then perhaps you'll take questions from that point on thank you mr chairman so um i have assessed niskan on two occasions uh on friday 17 december and uh monday 20th december i received a formal letter of request from the parliament on the morning of friday 17th of december and i have also received a bundle of documents from the parliament together with this request i have also interviewed her husband as as required which by our standard procedures and this is to obtain corroborative history from the next of kin i have also watched the recordings of the parliamentary sessions where ms khan spoke on august the 3rd october the 4th as well as the 1st of november 2021 and i also watch the recordings of the committee of privileges when mr khan was testifying on 2nd and 3rd of december 2021 and i also read the reports from this committee that's published on the parliamentary website you like to take us through your assessment um my assessment uh based on the brief that has been provided to me uh was that um during the times that ms khan spoke in parliament on 3rd august october the 4th as well as 1st of november 2021 as well as when she spoke at this committee of privileges on the 2nd and 3rd of december 2021 she did not suffer from any significant or material dissociation during these times i also like to say that during this period from august to november 2021 she did not suffer from any significant uh psychiatric disorder that would have impact her ability to testify or speak at such sessions as required for me to assess let's see understand any other further observations you'd like to share with us um i'll be happy to answer any questions because there are many observations but uh um if if i may i also like to state that as far as possible in your questioning i will try my utmost best to protect the privacy of miss khan and unless really required by this committee i i will endeavor to protect the privacy yes we appreciate it thank you oh mr desmond thank you very much dr chuck for your um uh your assessment that you've just provided um i thought it's important to set up the context uh i i think the parliament secretary would have given you some background and hence you went through all the material that was available in the public domain but as mr chairman had said at the start of this hearing this committee of privileges has been set up to inquire into the conduct of the former senkang mp misray sakhan when she said some things in parliament on the 3rd of august and the 4th of october which are allegedly untruthful she is admitted to those untruths and then the second thing we've been asked to do of course is to then assess her level of culpability and in that regard um the factual circumstances as well as any potential medical circumstances surrounding what she said in parliament would be relevant for our determination to then weigh uh how serious her actions were and in that regard through the course of the cop we've heard a conflicting evidence following the media reports you'll probably be familiar with what the conflicting evidence pertains to and they in just pertain to different accounts of what happened provided by miss khan and some witnesses as opposed to mr pritam singh and some other witnesses these turned upon whether [Music] if and whether she was told to tell the truth in parliament or told to in quoting her whatsapp message to take the lie to the grave so whether she was told by her superiors to confess and tell the truth in parliament and make a clean confession of it or to maintain the narrative which is false and continue the lie and in the context of that there was a request by one of the witnesses which is mr pritam singh leader of the opposition to ask the committee to assess her mental health or mental wellness and that context some terms were brought to our tensions such as dissociation or disassociation and post-traumatic stress disorder because these pertain to what she said about a sexual assault victim so so that is just a broad background to give you a sense of what this hearing is about i thought you could help us by giving us a sense of the brief that you were asked to to carry out in terms of examination um you have just told us your assessment and then maybe give us a sense of the basis for your assessment so that you know as laypersons on this panel with a better understanding okay thank you so i received this uh formal uh request from parliament on the morning of friday 17 december and in this letter they have actually given me the background as to why they have requested this assessment and they have also provided some information i do not know whether you have a copy of this brief that was given to me if not i'll give it to the club after this what they have said here uh was that miss khan had disclosed that on that a report dated third november was provided by her psychotherapist ms joanna tan and she works at adelphi psych medical clinic and that she miss khan had also disclosed some information during the workers party disappearing panel on 4th of november and they wanted us uh they also stated here that uh dr john boscoli had referred miss khan to miss joannathan for therapeutic support and these sessions commence on the 12th of october they provided a memo from miss joanna tan that stated that ms khan suffered from symptoms and i stressed again the word symptoms of post-traumatic stress disorder and from my interpretation of what's on the memo ms jonathan did not state that mizkah had post traumatic stresses or the only symptoms of and in the email between the i i presume the parliament and ms khan who had requested a memo from dr john boscoli ms khan had replied that when she approached dr lee for a memo she had mentioned that as miss joanna tan was the primary therapist it was more appropriate for miss joanna tan to provide this report so in this whole assessment i have not had any site of any um reports by dr john boston lee and in singapore context any psychiatric diagnosis is typically made by a psychiatrist so in the brief that was given to me it was required for me to assess whether ms khan was currently suffering from any significant or material dissociation whether she was a sound mind and rational mind to provide evidence to the committee and whether she was able to recount rationally and understand the events that transpired on in parliament on 3rd august 4th october as well as before the community of privileges on 2nd december and whether ms khan had at any stage between august and november 2021 suffered from any significant or material dissociation that would have had an impact on her on her actions during this period and that was what was asked of me and so maybe just to tell you that with what tiff just told us at the start of this hearing um you were asked whether she was suffering from any significant or material dissociation perhaps you share with us what dissociation is for for the benefit of all of us as layman and then if you could then repeat your assessment and tell us the basis for that thank you so this dissociation is the loss of the integrative function of the human mind so in a normal setting the human mind is able to integrate many sensations thoughts processes ideas memory muscle movement so that the person can function in a coordinated way however when a person dissociates the person may lose one or more of these functions and in the state of dissociation this phenomenon is is not caused by a medically diagnosed problem that is to say if someone dissociates and loses half the power in his body is not due to a stroke that has caused this impairment it's actually a psychological reaction that impairs the person's brain function in a particular area of functioning there are many types of dissociation some forms of dissociation can be a person may feel that he doesn't have a sense of himself he feels like he's outside his body sometimes they may feel that when they are looking at at something it looks as if that they are in a movie like watching something like in a movie two-dimensional and not like three-dimensional other forms of dissociation dissociation include a temporary loss of memory or a temporary loss of a particular power in their body and typically after minutes or hours these functions return to that person yeah dissociation can be caused by many reasons in normal people without any illness any pathology a dissociation can happen when a person is in deep prayer when they are meditating or when they are in a state of hypnosis when a person consumes illegal drugs or when they are taking legal anesthetic agents they also can go into a state of dissociation when there's a psychiatric illness such as post-traumatic stress disorder or what we call dissociative disorders the phenomenon or dissociation can also occur so what i'm trying to emphasize here is that dissociation is just a symptom it is not a medical diagnosis it can occur in normal people it can be induced by drugs or it can occur in a context of a psychiatric disorder thank you so what they're telling us is that dissociation is not a medical diagnosis it's a symptom that can result from a range of causes both clinical as well as external due to drug use and other forms of action yes um so we're trying to focus on um what happened on abc start the third of august when she told the first untruth in parliament about having accompanied a sexual assault survivor based on your assessment of miss khan and looking at all the relevant material that you've looked at what is your assessment again and what's the basis for that assessment i had viewed the recordings of her speech in parliament that day and i've also asked her about it during my interview with her she said that she was present fully present mentally and when she was giving that speech in parliament and when i viewed the videos there was no sign that she dissociated while she delivered that speech in parliament okay then on you mentioned that you looked also at the 4th of october which is the second time she came to parliament she was asked some questions by the home affairs minister about her 3rd of august anecdote about the sexual assault survivor and she responded to his questions and in essence repeated the untruth what is your assessment of khan's state of mind of physiology at that point in time okay um i opened that she actually was uh really of sound mind she did not dissociate okay and whatever she said uh she was fit uh mentally fit to say what she has said and it was out of her own will and uh she knew what she was doing thank you then we come to the first of november which is a third parliamentary uh speech in respect of this matter which is the false anecdote about the sexual assault survivor in that on that occasion she made a personal statement explaining saying that she had uh uh told untruths on the 3rd of august and the 4th of october and she then explained uh from her perspective why she had told those untruths again could you share your assessment of a man mental health state at that point in time when she delivered that speech on the 1st of november in parliament she did not dissociate during the time that she was giving that speech um i think that during that period of time from october to from after the 4th of october to the time she gave that speech i believe there was some anxiety and you know some concerns that certain actions that she take will lead to certain consequences and she had sought treatment with dr john boscoli and also with miss joanna tan but on the day specifically on first of november while delivering the speech she was of sound mind she did not dissociate and it was very clear from the video recordings that she was present mentally during the time of the speech so based on your assessment from the period of august the third all the way till first of november that is your period of assessment is it or more than that um uh yes there's a period of not all the way to actually the third of december when you okay when she appeared before the committee of privileges let's just go to the two days in which she was giving evidence before us here and we want to have a sense of whether her evidence before the cop is has in any way been impacted by dissociation or any other possible mental disorder or clinical condition when she appeared on the 2nd and third of december in your assessment uh was she suffering from any impairment from mental health conditions uh no she wasn't she wasn't maybe at this point i'd just like to emphasize the standard to which we we use so it's competency to testify in a to a community of privileges or in court typically from our standard we say that the person must be able to understand the question able to recollect the information and able to communicate to the community or to to the court and in the singapore mental capacity act it is said that a person has mental capacity when he is able to understand the information relevant to the decision to retain that information to use or weigh that information in the decision-making process and to communicate that decision this is our singapore mental capacity act by using this standard i say i open that she was fit to testify before this committee on the second and third of december yes thank you would any uh form so so in your view uh from august all the way till december which is the period of your assessment your view is that she's not suffering from any significant or material a mental health condition am i right that's what i hear from you yes i agree that uh she did from the period of august all the way to december the third she did not suffer from a psychiatric disorder so significant that it would have impact her ability to give evidence or to make her speeches when asked by this panel as to you know because one of the witnesses mr singh said that ms khan was lying before the cop and when asked why he thought she could have been lying based on his assertion he raised the possibility of dissociation or other mental health conditions that may cause her to lie or predispose her to lie as a clinician having examined the uh the subject miss khan and looked at the material uh is it possible is i mean would the would she be suffering from any mental disorder that predisposes her to telling untruths she did not suffer from any psychiatric disorder that would predispose her to saying truths in fact um i have been in practice for more than 25 years and i found uh that actually many peop people with mental psychiatric disorders do not tell untruth more than any normal human being the only time that's perhaps that they have to say untruth is that during finding a job or in social settings they may have to hide their mental illness because of social stigma but other than that they do not say untruths more frequently than any other human being okay so when she was giving evidence before the cop on the second third december what you're saying is that her testimony was um she was of sound mind she was able to decide for herself what she wanted to say or didn't want to say and not laboring under any mental disorder that would render her testimony untruthful or not of her own free will i agree with what you said is there anything else you'd like to share with this panel like to inform us um i i'm happy to take questions hi monitor good morning so i understand that suspects who commit serious crimes crimes could be put under surveillance while they are undergoing investigation so that they can't feign their mental illness and use it as a mitigating factor so i would like to seek your guidance as to how do you ensure that your interview with miss khan is robust enough and able to conclude that she's not suffering from this association in case she can in case she calibrated the replies in front of you so as to suit a particular agenda yeah so in our assessment we follow best practice in our profession and so the best practice is to interview the person on multiple occasions and in this case i have seen her two times on the 17th and 20th of december and we also independently interviewed the next of kin and usually we get someone who knows her well or has lived with her so that we can ask the person about her behavior outside the clinical setting in this particular case it was fortunate that we had video recordings of what how she behaved in parliament the things that she said and also the cop interviews were also available for me to view and because all these recordings are contemporaneous their life uh it was very it could it can easily corroborate my opinion that she did not dissociate at the times that i was required to assess her thank you good morning in your interview with uh miss khan did you answer directly for medical history of any symptoms of dissociation or post-traumatic stress syndrome yes i did what was the answer can i uh give my summary opinion actually i'm asking what was her answer to uh when you asked her directly did you for example her medical history or what she suffered whether when she suffered from dissociation or ptsd what was her direct answer to you she had some symptoms of psychological trauma she had many there are many times when she felt that she had been traumatized psychologically and the first time was after the sexual assault and there were there were times after the election as well as of course after election and because there was certain police investigations at that time she felt psychologically traumatized but being psychologically traumatized doesn't equate to having post-traumatic stress disorder so she does have symptoms but it didn't reach the severity that a psychiatrist would diagnose ptsd did you find out from um i think you have read from the notes from the uh proceedings uh the transcripts and all that which were provided i think you confirmed that you read through the evidence they've been given and you are aware uh that she had a sexual assault experience i think it's in 2008. um did you ask her what were the um did she share with you what were the traumatic effects that uh that that episode had on her over the past 10 over years yes she did could you share with the committee how would these uh ex what were these experience what were these traumatic experience with due respect mr tang i think i would like to protect the privacy of miss khan i would be happy to share with you my opinion about my findings but i respectfully ask that i don't have to disclose what she has told me so you can just provide your assessment and opinion that would do thank you my overall uh opinion is that while she did have transient symptoms of some of some symptoms of ptsd it was not enduring it was not persistent and over the course of 10 years as you have asked she did not have symptoms that persisted and it did not impair her ability to function as a wife as a mother and as a you know as a member of parliament so are you saying that she would have recovered from the trauma of being sexually assaulted uh it depends on what degree you're asking for i think when any normal human being is has gone undergone a trauma the memories would never be erased certainly some of these memories can trigger some feelings of anxiety or disappointment or sadness when we recall it but it doesn't reach that degree or that severity that impairs the person so when you say when you ask about recovery i what i'd like to specifically said that she was psychologically traumatized by the incident however she did not reach the threshold that one would diagnose post-traumatic stress disorder and she as a survivor she continues to be able to function uh in her daily life in multiple dimensions when we assess we would access the her ability to function at home as a parent as a wife and also in her occupation in your assessment do you think this trauma that she went through as a result of the sexual assault would still have some effect on her when whenever she the incident is being raised when she think about the incident such that she would it would affect her decision-making on the incident for example when she decided to lie to the parliament on 3rd of august that she accompanied a sexual assault survival to the police station when she did not in fact do so i think that when a person undergoes a traumatic experience it would be naive to think that it has left absolutely no mark on the person however uh on this speech on third august i've i've been made to believe that this this was a prepared speech it wasn't something the anecdote that she has mentioned was not set on you know impulsively in parliament the speech had been prepared already and she had known that uh that was an untruth so um i in my opinion uh she did not dissociate or there was no psychiatric disorder uh that would have influenced uh you know her judge her her ability and her soundness of mind to write that speech and to deliver that speech are you able to then offer any reason as to why she would suddenly make up a lie like this i don't think it's within the remit my remit to make such an opinion and i do not think that this is uh the role of a psychiatrist thank you exactly i'm not finished i'm sorry i'm not finished yet chairman did you even ask her why she decided to share in parliament on third august about her another of accompanying a sexual assault victim to the police station yes i did what was her answer she said she was trying to advance her uh the cause of what she believed passionately about which was women's issues so you think her own experience had no part to play in the line um what i can say is that she did not dissociate she was of sound mind she wrote the speech she delivered the speech as she had written as to her motivations and as to why she decided to lie i don't think it's within my remnant and you may recall from the evidence that she actually put in the the relevant paragraphs on this lie at a very late stage in her speech she has already prepared a speech and she put it in at a very late stage do you think that there's any reason why she would do so and has this to do with the fact of her experience uh please correct me if i'm wrong uh i have been i have tried to as much as possible to watch all the proceedings and and all that i like to qualify first that the statements that i made in the next few minutes uh may not necessarily come from a psychiatric opinion it is what i have seen okay what i made to believe through the videos was that she had prepared the speech and mr singh had asked her to substantiate it and perhaps she had written that anecdote in to try to substantiate her her speech yeah um yes you're right uh he was she was asked by mr singh to uh substantiate to be prepared to substantiate yeah but my question relates to um just before that means the fact that she had only squeezed in the anecdote uh very late in time right do you think that that has got anything to do with the trauma that she went through as a victim herself i think she feels passionately about this uh cause because of her experience it the the passion probably is communicated in the the speech and the topic she chose to speak on yeah i do not think that her experience of trauma would have directly caused her to want to write that particular anecdote as it was written here let me organize my questions i have a few more questions what tests are typically performed to diagnose dissociation or dissociative identity disorder okay uh mr tan so i uh i'd like to clarify that you are asking two separate questions one is to one test part a and b is yes what tests is for dissociation and the other one is uh dissociative identity disorder okay now uh for dissociation typically there are no tests no tests such as brain imaging that is required it is about the observations of the witnesses as well as the description by witnesses as well as the uh the the patient themselves this is sufficient if it fits the description of uh this uh dissociation for us to diagnose the symptom of dissociation dissociative identity disorder is an extremely rare disorder okay the common name for dissociative identity disorder is multiple personality and in my career i have i can't recall [Music] any seeing any patient that fits dissociative identity disorder it is that rare they may exist in singapore but certainly i've not come across one in my own practice dissociative identity disorder or the lay mental multiple personalities comes from typically is seen in a person that has gone through repeated childhood trauma and the person will switch from one identity to another identity and even speaking in different voices depending on the identity that the person assumes so this is a very rare condition and certainly miss khan does not fit this description would you say that can dissociation be triggered by any traumatic event i if you ask me this in general yes a traumatic event can precipitate dissociation many times during a sexual assault i say this in general many times during a sexual assault the victim the survivor may dissociate because the stress is so great that this is a coping mechanism for the survivor to go through that experience so yes traumatic experiences can precipitate dissociation so for someone with a trauma-induced dissociation or dissociated uh disorder is it possible for a person to exhibit symptoms whenever the subject or trauma is brought up uh certainly in general yes so what would these symptoms be it depends on the person to person as i mentioned earlier to the uh to this community there are many forms of dissociation some people lose their memory some patients lose their muscle power some people feel as if uh they are viewing their world like a movie others have out of body they feel that they are not within their bodies but they're slightly outside their body so it really depends on the individual so would something like false memory creation be a a symptom a false memory creation can possibly be a one form of dissociation yes false identity creation uh alternate identity alternate identity is paul it is possible memory lapses certainly these are general listeners in general in general right so i think it's important to note that but otherwise uh this person can still be high functioning in general uh even when the traumatic event is when the traumatic event is not mentioned certainly and even when the traumatic event is mentioned not everyone dissociates yes i mean in the literature in the literature following a traumatic event roughly about one-third of people go on to have ptsd it's not that everyone will go on to a post-traumatic stress disorder we as human beings have our own protective mechanisms through the support of family friends and the people around us many people can recover from their psychiatric disorders so it's not to say that trauma equates to having dissociation equates to having ptsd so let me put it another way can a person with trauma induce dissociation or even ptsd be high functioning in general but four prone to memory lapses or false memory creation when the subject of the trauma kicks in is that possible okay first i'd like to refer you and i can provide this to the committee after this inquiry after my testimony and this is the diagnostic and statistical manual of fifth version of psychiatric illness okay basically this manual is the criteria that we use to diagnose a mental illness okay and it's published by the american psychiatric association one of the diagnostic criteria that we are very concerned about is what we call uh criterion g okay and i criterion g g g okay and it states here the disturbance causes clinically significant distress or impairment in social occupational and other areas of functioning okay so um if a person is high functioning okay then they would not have satisfied criterion g okay such that they would not be diagnosed with ptsd disorder i acknowledge that persons undergoing trauma can persist to have some symptoms of psychological trauma but they won't reach the threshold that it will become a psychiatric disorder so you are saying in other words that in your view um okay let me put it another way so do you agree or disagree that when i say can a person when i ask can a person with trauma induce dissociation or ptsd be high functioning in general but may still fall prone to memory lapses or false memory creation when the subject of their trauma is brought up or kicks in i say in general there is a possibility but we must always contextualize to the person that we are speaking about um i don't know whether you recall in the evidence i can refer to you if you need to there was a message that ms khan sent to her two assistants after the outcome of her first meeting on the 8th august with mr singh ms lim and mr faisal where she relates let me go to the document please bear with me perhaps well miss afghanistan is uh looking for the particular uh points of a race perhaps i could build on again yeah i'll just build on this it's related to some of the points made earlier mr denson was asking questions in general about some possible responses but clearly from what you shared there's really a range of responses from individuals who may suffer from these conditions or symptoms of these conditions and would it be fair to say that one would actually really need to look at a specific subject and specific context to be able to provide a more accurate description of how an individual might or might not respond yes we really need to contextualize to that individual and how the person responded because really there is a range of responses falling trauma there's a range of dissociative experience and we cannot generalize this whole topic and just speak in general we really need to already come down to the details for a particular patient thank you dennis thank you chairman um okay uh let me rephrase um my question um just now i ask you and i think you you agree generally um that the person with trauma and due dissociation can be high functioning but for prone to memory lapses or false memory creation so let me let me let me go into a bit of detail about this false memory creation would it be possible that when the trauma kicks in a person can be prone to making in the cause of a conversation be prone to having a um false memory creation that means basically somehow certain part of her speech contains certain falsehood and this is caused by that trauma so not the entire part of the speech is um entirely untruth but in in a conversation she may relate a particular untruth uh amidst other facts which are not in dispute it is one of the many possibilities for why a person will make such a statement there are many other reasons why the statement could have been made in that way okay so can i can i refer you to um to the document tab in tab l page two this is uh the documents are under ms low paying but it's actually a whatsapp message from miz khan to miss lo and mr naden as that page two in the towards the bottom and this dated eight august are we on the same page and it says hey guys i just met with pratam sylvia and faisal and we spoke about the muslim issues and the police accusation i told them what i told you guys then they have agreed that the best thing to do is to take the information to the grave they also suggest i write a statement to send out this evening all right i think the issue at hand is that it is not in dispute that um nissan met with pritam silva and that's the first sentence second sentence they discuss about the muslim issues and the police accusation that this is not a dispute and then she go on to say i told them what i told you guys and they have agreed that the best thing to do is to take the information to grave so this statement as you may be aware is in dispute uh mr lim sorry mr pritam muslim and miss faisal do not agree that uh they had told uh they had agreed with her that that the the information that she should take the information to the gray and then she finished message by saying they also suggested i write a statement to send out this evening and you may recall this is a statement about uh where she put on a facebook uh about the muslims related issues uh of her speech which is not related to the sexual and adult uh sexual assault in the accompanying the sexual the victim of a sexual assault to the police station would you agree that this could be an example whereby a person uh suffering from a certain trauma right um while still generally high functioning he could send out a message but would selectively put in a a lie in her statement in her message so now we are speaking specifics and not in general in this specific instance in the context of ms khan and what i've assessed i disagree with your statement but you agree that in general a person who suffer trauma would be able to um speak um general um would be it would be high function high functioning so when he's putting out a statement talking to someone uh giving a message that conversation or that particular message can be can contain some falsity amidst other truths within the statement generally it is possible in general is possible but there are also many other explanations why the person may want to give a falsehood thank you um can i also uh move on to ask you about other aspects of um a when a the trauma is mentioned um is it the case that when a trauma is mentioned and a person suffering from ptsd or dissociation it can create a certain distress to this person symptoms right this could be a symptom okay um so uh so in specific uh niskan does not suffer from post-traumatic stress disorder okay but in general what you have said is um is that if you're talking about causing distress when talking about the trauma i think um it is quite understandable in our human experience that once we have undergone a traumatic experience we cannot erase that memory so because it's such a traumatic memory uh it's not no it's not strange that a person would be distressed if someone brought up this bad experience you know if someone mentions a bad experience people should certainly feel negative about that traumatic experience that's only normal in human beings um in the evidence that has been given so far um i believe miss lim and um ms lim mr faisal and mr singh has mentioned that in the various meetings they had with her she had always been emotional whenever the issue of the sexual assault comes up so for example i can just relate some of these incidents to you um so she burst into tears or she get emotional every time the incident and uh was mentioned the sexual assault incident mentioned um on the 8th of august the meeting in august all three of them mentioned it uh i think um [Music] the um the meeting on the 12th of october between with sylvia and pritam the and during the two disciplinary panel meet interviews and i believe in the cec meeting on the 29th october and the 30th november uh how would you reconcile the fact that she is constantly emotional whenever this incident is mentioned during those occasion uh how would you reconcile this with your earlier findings that she is not affected by any post-traumatic trauma or dissociation i'd like to clarify that my testimony is that she does not have post-traumatic stress disorder i did not say that she did not have some symptoms of being psychologically traumatized what i'm saying is that it did not reach the threshold of a psychiatric disorder based on the way you have framed your question i my opinion is that if she were to be emotional whenever the topic of her sexual assault was mentioned this is a very understandable very normal reaction from a survivor of a sexual assault a sexual assault is one of the most traumatic experience that someone has gone through is a violation of their person i would be very surprised if anyone can speak about their sexual assault cleanly carelessly without emotion i think that's even more abnormal than being emotional when talking about their sexual assault so would you say that she uh well i i note that you say that she is not suffering from ptsd perhaps anymore but that she would you agree that she still suff there are still symptoms of her symptoms rather than the condition is that is that your distinction some symptoms some symptoms so she continued to suffer from some symptoms of this post-traumatic post-traumatic post-traumatic uh symptoms whichever way you call it so you agree that with that uh if i may just give an analogy if i give me an analogy when a person goes for a major exam a person may have anxiety so if they have the symptom of anxiety you know it doesn't mean they have a generalized anxiety disorder or panic disorder which is a psychiatric illness yeah and each time they go they go for a high-stakes exam they may still continue to have anxiety so in in the psychiatric profession we always put in this criteria that the symptoms when present must be able to reach that intensity and that persistence that impairs the person's functioning so many people who have gone through traumatic experience be a sexual assault a road traffic accident a physical assault domestic violence they would continue to have some anxiety when they speak about a topic or even they watch a news uh story about another person's trauma this is these are all normal reactions but it doesn't mean they are mentally incapacitated by their symptoms thank you so you're saying that uh some uh some of these survivors of big traumatic events like sexual assault or serious accidents they may always suffer symptoms whenever the memory of the trauma is evoked and it can go on for many years and they may not be exactly suffering from a ptsd disorder so so to speak that that is your evidence my evidence is that they may suffer the symptoms but it may not impair them i i would i would say that is it would be uh very unusual for a person to undergo a traumatic experience and just erase it and said if the person told me uh that they went through a traumatic experience and then went on to say i forgot it all totally i would say that is highly abnormal it's just a defense mechanism trying to perhaps compartmentalize or suppress that memory but if a person talks about their traumatic experience they are able to talk about it rationally in a measured way you know displaying uh some emotion about it but of course not too emotional i think these are all very normal i mean it's normal human behavior to act in this way so specifically i think from this khan even though you know some of these upsetting memories um she may feel upset by some of these things it doesn't reach that threshold that would have impact her judgment impact her decision making capacity or her reality testing even she was of sound mind would it still be possible that when the trauma is brought up it would have affected her judgment in such a way that she is capable of uh false memory creation telling a lie it's a specific is this specific position is a specific question to uh applying to ms khan first of all she doesn't suffer from dissociation she may have said so but i think she used the term in a lay person's capacity not from a professional definition of what dissociation is okay so my my testimony is that she does not suffer from dissociation or traumatic dissociation from for that matter okay uh i do not think that even when she speaks or the topic of her sexual assault was mentioned it affected her so severely that she lost her mental capacity perhaps not losing mental capacity but lapses of judgment telling your life for example you exclude that uh indef uh definitively okay so in the handbook of the mental capacity act and it is it is said that us people can make bad judgments and making bad judgments uh doesn't mean it is due to mental illness it could just any normal human being can make bad judgments but it could be due to the trauma the judgment could be due to the trauma in specific for this particular instance i do not think so did you ask her how did she arrive at her own admission that she suffers from dissociation she if i recall correctly she said that her psychotherapist told her that she had dissociation i had asked her what did she mean by dissociation okay and her reply made me believe that she didn't fully understand what dissociation was and when she used that term she did not have a deep understanding of what the term meant can i just uh ask you a few more questions about dissociation um how many categories of dissociation are there i think there are no real um how i say um internationally agreed uh way of categorizing the different types of dissociation but certainly broadly speaking [Music] there could be psychological manifestations of dissociation such for example a loss of memory a change of identity a feeling that things are not real a feeling that a person is not within their physical body so these are the psychological manifestations of dissociation uh there are uh physical manifestations as well technically we call them a conversion i mean but this is technicalities and this is when people lose sometimes half their their body sensation half their body power yeah so these are the physical manifestations would you would you be able to share your understanding about dissociation being possibly conscious or unconscious um i don't understand that question okay um are you um [Music] are you aware that uh no let me let me rephrase this sorry about it is there a difference between a conscious and unconscious dissociation are you aware of this okay i i don't understand the context in which you are coming from but also let me answer you uh what i understand from your question okay some people can voluntarily try to put themselves into a dissociative state this can be done through deep prayer meditation hypnosis even through trance in religious ceremonies when people undergo a trance state as we see in some of our temples a chinese temple sometimes uh what they call taotang okay these these translates are all dissociative states as well so if you talk about consciousness yes they consciously enter into that statement yes some people can also unconsciously go into a dissociative state when there's extreme stress that they need to protect their mind from the stress so i i don't i don't really understand any context thanks thank you for an explanation let me let me put it in a certain context let me go back to how dissociation will affect uh manifest in the form of lying telling and untruth how would you apply uh the terms of unconscious and conscious dissociation to uh the fact that a person who suffers from it is lying again this is a general question yes it's the central question for now yeah this this is a very broad question because there's so many manifestations okay um say for example a person has say a dissociative identity disorder and here a person the person assumes an another identity so identity a the person may call themselves peter and identity b he may call themselves james yeah so so who is lying i i you know because they've assumed a different uh identity peter may say that he has gone to this particular school ex and james may say he has gone to this particular school why you know so i i i mean these are the illustrative examples that i can provide but i don't know i think we are here perhaps i mean we are being general questions let me finish i think the point here is that we're trying to evaluate and i think the doctor is here to evaluate miss khan's condition i understand where you're going with the general questions but as i explained i think that many many variables and many circumstances if it leads to where you would like to go i mean that'd be useful but i thought perhaps if we could be a bit more specific that'll be useful i think for us to assess level responsibility i think which is what the issue at hand today because i think when you go into the realms of general questioning there's so many possibilities and really depends on context so perhaps if you could narrow down the w so thank you uh when i yeah thank you chairman for that yeah i'm sorry if i didn't make myself clearer um let me try to make it a bit more helpful to you to understand um when when a person you were raising a person a certain example a person having an identity right so let's say whether it's he's assuming a false identity consciously or unconsciously there's a difference right is there a difference it really depends he knows that he's assuming uh false he's assuming a false identity or telling a lie or he is not even aware that no wonder is there a distinction as such in the case when a person dissociates in a case of dissociative identity disorder they truly believe that they are that alternate personality could it also be possible that when they are suffering from some symptom of dissociation they knew about dissociation and they make use of this knowledge as an excuse can i clarify whether if a person knows that this phenomena dissociation exists then he uses it to the person's advantage yes oh that would be malingering isn't it but that's possible right is that possible for uh this a dissociation sufferer or somebody who thinks that he's suffering from dissociation to make use of that that effect to his or her advantage i mean if if you say in general then of course it is possible but that would be malingering but these cases do exist of course people do take advantage of that certainly so you but you do not agree that our uh ms khan suffers from an unconscious or conscious or unconscious form of dissociation at all i disagree yes she does not suffer from this significant dissociation during the periods from august to december the turn the fact that she has been telling people that she suffers from dissociation including yourself could it be possible that she's made use of this fact to as an excuse for herself when she makes a lie i think that's beyond my remit uh what i can say is that when i asked her what she understood by the meaning of the word dissociation it did not fit the medical definition of what dissociation is did you answer about the emdr therapy that she has undergone and no i did not did you ask her about any treatment or therapy she has undergone recently i asked her why she had seen her therapists did you could you um did did you ask her about her treatments that she has undergone she told me she was taking some medications and undergoing psychotherapy uh have you analyzed the uh treatments or prescription that she has been given she informed me that she didn't know the name of the tablets that she had been prescribed uh have you sought to make contact with her the medical practitioners that have been assisting her uh no i have not so you have not seen the medic her medical records from the past um i think until the uh the personal data protection act i have no access to her medical records she has stated in the email to parliament the email to the parliament representative that she has attempted to get a memo from dr john boscoli and he has a from her interpretation has said that it's better for miss joanna tan to provide that memo so i have not had any sight of any medical report from her psychiatrist did you ask her whether she undergone any previous psychiatric or psychological treatment prior to august 2021 yes i did are you able to share with the committee whether she has been undergoing treatment um i respectfully declined to answer that question in respect to respect her privacy i understand um in your professional opinion um does miss khan harbour feelings or resentment towards mr saying or muslim as a result of the events of sorry not muslim mr singh as a result of the events of third august to 1st november that's beyond my remit um i'm only just asking whether in your opinion does she harbor any feelings of resentment from your interview and could these feelings have had a bearing on her testimony and committee or privileged hearings no that's beyond my remit no thank you um in the evidence they've been given um there i would just try to summarize as best as i can right from the perspective of mr singh miss lim and mr faisal certainly she first let me just set up some facts and then with the context then i'm going to ask you the question so the facts are a little bit long but but basically just to remind you that uh you know she first admitted to the lie uh to mr singh on i think 7th of august when mr singh pressed her about it there is a dispute in divisional event basically mr singh's mr singh's position to hers is that she's got to deal with it she's going to take ownership uh basically mr singh's position is just got to be prepared to go to the parliament to admit to the lie okay ms khan has a different view of this but assuming mr singh's position is correct okay so we go down to um fourth of october and the second sitting she then added another lie she continued the lie and and after that she then when she met mr singh and muslim that evening i don't really remember this she said to him that but the senate path honesty okay yet on 12th of october according to the evidence of mr singh and muslim when they were meeting at mr singh's request to prepare or to to to prepare to make an admission in parliament she was initially uh she initially refused to admit uh she was she tried to rig her out of it and um but she was then told that she had to do it and she agreed to deal with it um do you agree that her conduct has been confusing i her conduct in not wanting to even coming up to admit a lie for these number of months from august to october do you find it confusing why would she want to delay this uh coming to terms with this issue and making a decision what to do about it do you find it confusing because i don't really know what's the established facts but i would find it difficult to comment on your question all i can say is that she was not laboring under a significant dissociation and not laboring under significant psychiatric disorder so can i just ask you after you have uh assessed her right yes you you have uh you have shared with the committee about your findings i'm bearing in mind what you said about she is not suffering from ptsd or dissociation but i think it is not in dispute that i mean from what you have said that she may still be suffering from symptoms especially when the incident of the trauma of her sexual assault is raised each time what would you advise to her as possible treatments or possible measures that she can adopt to minimize any risk to minimize such incidents i can speak in general about some strategies to cope with some of these things but i'm not her treating doctor so it's not my place to um answer in specific for her because i think this is best suited to be advised from a treating doctor i'm just the assessor okay chairman i have no more questions exactly doctor thank you so much for um sharing some of your insights and assessments um in your opinion i'm just going to move to the period where you know she delayed a decision to come clean or didn't come clean so in your opinion with trauma mental state or her symptoms have affected you know her decision-making process to hold back for three months between august to october um you know whether any of these would have been a challenge or barrier to her to come clean i don't think specifically trauma in itself would have played such a big role in her decision making to to delay or not to delay i think there may have been other uh you know uh priorities or other uh reasons why she chose to take the actions that she has taken so doctor what you're saying is that actually she has perfectly sound judgment sound mind to make that call she had okay so to be clear i think she had the capacity to make decisions uh whether she made a good decision bad decision whether she chose to say a truth untruth or she was aware that she was taking such a course of action okay good i was just trying to say whether something clouded her judgment in that sense so in your opinion when if you would if you were made if it was made clear to her that she had to come clean early say in august or september period early early on um she would have been of sound mind and she could have made perfect judgment to make that call if needed if it was merely clear to her she could she had the capacity to make the decision of as to what she wanted to do what she wanted to do yeah whether the decision was right wrong good not so ideal that's a separate issue altogether i understand so um so basically i think you know when if you suggested to her that is your call so she had perfect judgment on the sense to decide what she wants to do so it's not impaired by just to confirm not impact by any of these uh i wouldn't use the word perfect i mean she had adequate capacity to make those uh decisions okay so whether she was asked to lie to delay or to make a call just to confirm again that she would not have been confused she would not be in a confused state medical definition confused um she would not have been in a medically defined confused state that would have impaired her so significantly that she didn't have the capacity to make the decisions okay thank you doctor no further questions make some observations i think uh for me to build on what mr denniston was asking uh he will be presented a set of uh facts i mean actually what we are really trying here to do is to determine what the facts are essentially there are two versions essentially you could broadly boil it down to that and that's really at dispute and that's where the cop is trying to determine whether had impact in telling the truth her recount of the instructions and directions given to her that's one version the other version is as mr danistan alluded to was suggested by mr pritam singh mr lim and mr faisa manap who disagreed with her version so that's another version we are in a process of trying to determine which is accurate which is true and i guess that's where the question has arisen as to her judgment her medical condition mental state and whether she's been able to make rational decisions as you have said general questions general responses really vary in the many reasons why people do different things all of us do many things as well but that doesn't necessarily mean that it's a mental impairment of any sorts um but in your judgment and what you've shared and if i were to understand correctly is that in your assessment uh talking to her talking to her husband and also going through the footages that have been available during the set period looking at transcripts what has been discussed in your opinion medically she doesn't suffer from some of the conditions that that have been put forward to you um basically she is of sound mind she's able she's conscious she's able to make the decisions whether they're right or wrong decisions that's a different method all of us make right wrong decisions all the time um but in your professional opinion she was aware and conscious of what she was doing would that be correct yes so i think um that really behooves a cop to determine i guess uh in our effort to determine which versions seem to make sense and that's that's within our remit um but i think we do thank you for your uh assessment and i do understand the sensitivity and i think you have done that to refrain from going to details but it may not be necessary i would just want to place it on record i mean someone who for me personally who supports a lot of the work in the mental health front uh concerns about mental health stigmatization about how perhaps we could sometimes over medicalize things which doesn't help those who actually do have the conditions uh would there be any general observations and comments that you'd like to share with us for our own understanding and perhaps also for the public understanding as to how we should approach issues like this because there is always the temptation to i guess attribute mental health conditions to individuals for various reasons but would there be any generals of comment you'd like to share with us given the context of what we've been trying to approach and trying to address today i think that um many people living in our urban society would undergo uh different stresses from work family life and society in general but just because you have certain stress and emotional symptoms doesn't mean you have a psychiatric disorder however the a good proportion of singaporeans do suffer from some form of psychiatric disorder and i think if anyone does have a psychiatric disorder i think it would be very useful for them to seek help seeking help doesn't mean going to a psychiatrist you can also go to a mental health professional in the community there are agencies out there that there are counseling services in the neighborhood available to them so i think most important is seeking help and i think there is no shame to admit that one is suffering from a psychiatric disorder or even stress from the normal stresses of of life but most important is that we are able to support each other and a good number in fact the vast majority of people with mental health conditions do recover and it's important that we give them the support so that they can make the full recovery and get on with their lives would it be also correct to say that we should be careful not to i guess over medicalize and i guess over analyze and attribute conditions to folks because we all do feel stress and concerns and would that be something that we should bear in mind because it does also stigmatize those who may actually suffer from such conditions yes i think we shouldn't use these psychiatric terms loosely and if uh if we were to use the terms i think we should have a reasonable understanding of what they mean and not to just use use it casually because i think a person who truly suffers from a significant psychiatric disorder would feel that the other person doesn't truly understand their experience and many of these people have told me that when they suffer from a major mental illness the number one thing that they feel sad about is that they feel lonely because they feel that no one else can understand their experience and they find it difficult to find someone to relate to i understand okay so with that uh there being no other questions uh thank you very much uh for the assessment and sharing of us your evaluation on miss khan and uh terms which we have put forward to you through image transcript of proceedings will be shared with you for verification do go through it if any amendments do make changes and send the transcripts back to us you have written up any short report they will make it available to us as well if there are any uh do note that the transcripts and any evidence given to committee are not to be disclosed to anyone and or published it must be kept strictly confidential until the committee has presented its report to parliament um there have been no other questions once again thank you very much for assistance uh you may withdraw and like to ask the sergeant-at-arms to accompany your witness up thank you very much thank you thank you thanks

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Id: Lmi9124_5r4

Length: 90min 12sec (5412 seconds)

Published: Wed Dec 22 2021