Day by day, the news from around the world continues to detail the far reaching impacts of COVID-19. As I listen to the rising numbers of cases both in my own country and abroad, and the rising death toll, my heart goes out to those in more dire straits then we are here in Canada. However I also recognize that we may very well find ourselves in a similar situation soon. As a mental health therapist, I have been noticing myself using many of the tools of therapy in my own life to help me stay well and balanced mentally and emotionally during this time. I thought I would share the tools I am using that have worked for me so far.
1. Gratefulness Practice
I have found myself paying closer attention to the things that I can still do day to day, and purposefully noticing them, savoring them, and feeling grateful for them. This morning heading into work for 6 am, I was feeling the privileged of still being able to work, and of having been able to find a flexible schedule that accommodates childcare needs. i savored this by walking slowly around my morning-quiet workplace, reflecting on how much I enjoy the bond I have with my team. I picked up coffee at Tim Horton’s and wondered how long we might be able to do so- then savored that coffee. I notice that my schedule currently leaves me tired, and I am also grateful for some extra time with my kids. I’ve been savoring this by catching the best moments between us and slowing down to bask in them a bit. I am most worried about my grandparents, and am grateful that I have grandparents to worry about. I savor all the good times we have had, and all the ways they have built me as a person.
2. Managing fear
-Recognizing where fear is effective, and where it is not
When I think about all of the ways the world (and MY world) may be affected -socially, economically, politically, potential resource scarcity, potential illness and death of people around us- it would be easy to be consumed by dread. But my dread would do nothing to change or prevent what is happening. The only thing my fear would do would be to rob me of the ability to see all the things I do have, and can do. Caution however, is very useful right now, so my job is to do what I can to cultivate some moderate level anxiety to keep me careful and aware, but try not to do things that might tip it up into fear.
-Accepting fear and anxiety (and other emotions) with compassion
When I feel fear visiting me, I acknowledge it with compassion and understanding. I might say to myself, “I am feeling fearful right now. We all feel that way sometimes. I’m going to bring extra kindness and understanding to myself while I am afraid”.
–connecting to a balanced perspective -examining my thoughts
However I also remind myself that while it is scary, right now in this moment, nothing bad is happening. I remind myself that today will be uncommonly warm for March in Canada, and I am going outside to enjoy it with my kids. That I am taking all precautions that I can, and that most others are too. Anxiety and fear tends to cause us to overestimate the likelihood of bad things happening, assume that the consequences of the negative event will be catastrophic, and underestimate how prepared we are to cope (Clark & Beck, 2012). In this current situation, some bad things are already happening (the economy, growing numbers of people ill, deaths from that illness) and are likely to continue. However I remind myself that there are a range of potential consequences that vary in severity. The mortality rates are estimated at 3.6-5.7%, and our efforts to contain or slow the spread will help avoid health care problems, facilitating life preserving care (Baud et. al, 2020). We do not yet know what dampening effect our actions will have on the spread, and vaccines are being researched at rapid speeds. Reminding myself of the range of possibilities helps me move away form catastrophic thinking.
– Identifying strengths to cope with challenges
I look to past experiences for clues about the skills and resources I already have to cope. I do this by calling up the memory of challenges I have overcome and ask myself “how did I do that?”. I really think about what helped me get though the hardest parts, and move through to the other side.
If I were highly fearful, I might even write myself a letter to read over summarizing my balanced perspective and strengths and resources. I could read it in moments when the fear might be overwhelming me and I might not be able to remember this perspective. Narrowing of perspective is a natural part of feeling fearful, as we filter out all information that is not threatening due to our negativity bias -see this post for more on that: 4 Lessons from Corona Virus that have the power to shape our future
Re-opening our perspective helps us shift out of the thinking pathways we have built for fear, and into new more balanced perspectives. Fear’s tendency to filter out all information that is not threatening makes it hard to shift out of that without some kind of prompt. That could be doing relaxation exercises to change your body’s reaction away from fear, and reading the letter to yourself to help the mind follow.
-Worry exposure and mentally rehearsing coping effectively
If thoughts about my worst case scenario keep breaking in, then I imagine some of the things I am afraid might happen and imagine myself using all my skills and resources to get through. If my fears are really big, like someone very close to me dying, I imagine what I would have to do to cope effectively to cause me to be moving forward in my life 5 years later, in the way that person would want me to. If I am worried about how others would cope if I succumbed to illness, I imagine all the strengths and resources I know they have- and how they could rally them to cope to the point of returning to living an altered but full life in the future. I might also imagine them keeping our connection by honoring and remembering me.
As you might imagine, this kind of ‘worry exposure’ exercise does not feel good. It often makes me feel more anxious while doing it, but if I do it daily it helps those worries come up less often-and be less fear inducing when they do. Worry exposure does this a few ways. It reminds us firstly that we can think about bad things happening, but thinking about it wont cause them to happen (Beck & Clark, 2012). We may not consciously believe this, but sometimes we have that little superstitious sense that it might and its easy for that to make us get anxious about having fearful thoughts. Secondly thinking about bad things happening is different then those things really happening. When bad things really happen, our fear response often helps us get through them as it gives us energy to respond. When we have a fear response to a thought, it is not helpful because a thought is not dangerous- there is no response required. However when we push the thought away because it makes us feel afraid, we are treating the thought like it really is dangerous, something that needs to be escaped. When we allow ourselves to have the thought and emerge at the end unharmed, our brain and body slowly start to register that the thought didn’t hurt us, and is not dangerous. After enough repetitions our fear when having the thought goes down. When the thought is less fearful, it comes up less, because we don’t perceive it as a threat that we need to do something about- we see it as a thought (Van Der Heiden & Ten Broeke, 2009).
Imagining myself coping as well as possible in the situation is also helpful. When we are stuck in anxious or fearful thinking, we usually stop at the worst possible point in the story, like a deer in the headlights. We cannot imagine how we could cope, well, because we HAVEN’T imagined how we could cope. This often leaves us feeling overwhelmed and telling ourselves “that would be horrible and I could not every handle that”. When we think this way, we feel more vulnerable because we don’t feel like stand much of a chance should bad things happen. Right now, we are in a situation where things are highly uncertain, and all evidence does suggest the situation will worsen before it gets better. Imagining myself coping well helps me feel better prepared and connects me to the values I want to embody in my life no matter what comes my way. Its also helpful in a practical sense, because whatever we imagine ourselves doing, we are more likely to actually do. This is why visualization is such an important tool in sports and performance psychology!
3. Connecting to the bigger picture
Finally, I remind myself that while this is a time of crisis for humanity, times of crisis can also become powerful sites of change. I remind myself to do what I can to contribute to helpful dialogue about what can be learned from this situation, as well as what I personally can learn and what that might mean for how I choose to live going forward. That’s part of what I am hoping to do with this blog-offering what I can to be helpful, while using the writing to put things into perspective.
I think the many cancellations occurring right now creates some quiet space in life that has been missing for so many of us. Our world has been built for high productivity, both personally and professionally. This emerged aligned with capitalist values, where higher productivity means greater profit with lower overhead cost. This has trickled down into our everyday lives, however, where the cost of our standard of living has necessitated individual turning themselves into productivity machines, managing our lives a little like a business. For the most part, to afford our standard of living, all adults in a household have to work, many full time. That leaves little time and energy to spend attending to our own basic needs (healthy food, exercise, unscheduled time, joy, social life, sleep, our relationships, our communities, our children). However at a time when we have less time and energy to spend on these things, the pressure to do them all well is very high- to parent mindfully and consciously, to care for our bodies and minds, to stay connected. We see this constantly in the ads for these things in social media, in our conversations, in apps to help us build in 5 minute mindfulness between client/meeting etc.
For folks who are not in the thick of working years, who are retired or on disability or stay at home parents, there often seems to be the opposite problem. Because so many in the population are taking up much of their time and energy working, and many social connections are associated with work, being outside of that environment can be very isolating. There has been an erosion of natural social networks, and a shift toward superficial social networks though social media. For many people in this category, loneliness, boredom and lack of meaningful roles can be a real problem.
Needless to say, there is part of me that hopes that out of the wreckage of the pandemic, we may find ourselves in a position to re-evaluate the way we live. We are proving to ourselves day by day that when something is important enough, our world can literally change overnight. I wonder if that open the possibility of rebuilding our lives and societies based on values and practices that are focused on environmental sustainability and core human needs, rather then on the needs and demands of the economic system. I realize that is a radical consideration that would require many to sacrifice much-but at this point, it is becoming increasingly evident that we need to change something to continue to thrive as a species, and that we have the power to do so. this is a moment that may allow us to reflect on our willingness to sacrifice- and on how much value those things sacrificed really have.
4. Getting behaviorally active.
Then I get out of my head and get busy doing all of the things that I have not had time to do in my usually very busy life! I’m going to catch up on some things on my to do list that have fallen by the wayside to help me gain a sense of control in my life and productivity. In my regular life, I cannot find time and energy to do many of the things that add value. The icing on the cake, so to speak. Right now, I’m also going to add more icing! I go to work (I am a social worker and therapist in a publicly funded community mental health organization) and it is a deep privilege to participate in people’s journey to personal balance and wellness. If I had the choice, I would not choose to stop working because it is through my job that I live my value of being of service to others, so while it is cake (something I have to do) it is also icing. I am going to take advantage of my shifted schedule and flexibility to spend more time with my horses, hang out with family, contact some friends and go outside mid day on weekdays with my kids. I’m going to savor the things that bring me joy, even in a moment of global crisis.
This is my summary of how I am walking my talk as a therapist- integrating therapy wisdom into my own life. How are you coping?
Baud, D., Qi,X., Nielsen-Saines, K., Musso, D., Pomar, L., Favre, G. (2020). Real Estimates of Mortality Following COVID-19 Infection. The Lancet. doi: https://doi.org/10.1016/S1473-3099(20)30195-X
Clarke and Beck (2010). Cognitive Therapy of Anxiety Disorders: Science and Practice. New York, NY: Guilford.
Clarke and Beck (2012). The Anxiety and Worry Workbook: The Cognitive Behavioral Solution. New York, NY: Guilford.
Van Der Heiden, C. & Ten Broeke, E. (2009) The When, Why and How of Worry Exposure. Cognitive Behavioural Practice,16(4): 386-393
Robichaud, M., and Dugas, M. (2015). The Generalized Anxiety Disorder Workbook: A Comprehensive CBT Guide for Coping with Uncertainty, Worry, and Fear. Oakland, CA: New Harbinger