EPISODE 4:

Episode Content:

This has been a profoundly stressful couple of weeks in the world, with COVID taking over everyone’s thinking all over the world.

It’s an especially challenging time being a helping professional. Many of us are on the front lines working with sick or vulnerable people.

In the mental health field, there’s a massive rush to learn how to practice online using telehealth – and we are a lucky field where that is possible!

I thought I’d talk to everyone today about how to take care of yourself in a crisis – getting back to basics, and also adding in some small daily habits that you can use even when you’re running around busier than ever.

When life has you extraordinarily busy, surrounded by people all the time, having to learn new skills, add new habits, adjust work routines, and all the other crazy stuff we are doing now – it’s really important to braid in time to decompress throughout your day. Call it whatever you want – relaxing, chilling out, meditating, doing self-care, whatever it is – you need to do it right now.

You may not have your usual time to meditate, exercise, or do whatever you do in the morning, but that does not mean that you are doomed. You can still find small ways to settle your body and mind.

I suggest you think of one thing that you do every day, and turn that activity into a small relaxation or mindfulness exercise. It could be something small like brushing your teeth, parking your car, turning your work computer on.

For instance, you can turn brushing your teeth into a relaxation exercise by doing it slower than usual, becoming aware of your breath, slowing it down, and extending your exhale. You could plant your feet on the floor and sway your body side to side while you do it – a lot of us find this kind of rhythmic swaying calming and soothing. You might imagine yourself growing roots into the ground with your feet to create a sense of stability or security.

We all have a lot more time to wash our hands right now, so this is another opportunity to have a calming moment. Bring your attention to the sensation of the water against your hands, feel your arms and fingers moving. You can also imagine that you are washing away the stress of the last period of time – the last client, patient, encounter, class, whatever it was – and restarting your next activity with a fresh start- and, as it happens, some very clean hands.

The next option is to create small moments of relaxation connected to tasks you are already doing. When I’ve taught this to people, what seems to work best are times of transition – for instance, finding 30 seconds to sit and rest before getting out of the car, or when sitting down at your desk at the start of the day or before-or-after lunch, or when you first lay down in bed at night.

At these times, set a timer for whatever amount of time you realistically have. If it’s only 30 seconds or a minute, so be it. You may be surprised what such a small period of time can do. If you don’t want to set a timer, you could choose to count something instead -  for instead you could count from ten to one slowly, or take three calming breaths.

The best way to use this tiny moment of time you have created for yourself is to take a breath with a nice long exhale, soften your neck/shoulders or other areas that commonly get tense for you, and say one positive coping statement to yourself. If you have a little more time, you might imagine your feet rooted to the ground and the stress draining out of you, neutralized by the earth. Or imagine a surge of energy coming into your body when you need it most. You can also visualize window wipers or a dry erase board, wiping away the thoughts and feelings related to the last hour’s task or last patient before you dive into meeting with the next. Be creative and remember that you can use your imagination to help create the experience you most need for yourself.

Another option is to give yourself the 3-5 minutes you would need to listen to one of your favorite songs, a relaxing tune, or a song that most fits the mood of the moment. What’s important is to bring your attention as fully as possible to the experience you are having.

This is also an important time to talk about our self-talk, because the voices in our head can be our greatest allies or really get in the way.

I think it’s important to acknowledge the thoughts you are having and give them some appreciation. Even if they are panicked, irrational, angry, completely confused and chaotic, let’s stop and realize that the thoughts we are having are there trying to help us. Thinking has helped our species survive for a long time, and we rely on our thoughts to help in so many ways. The problem is that thinking sometimes gets out of control, it believes the only way to resolve a problem is to keep hammering away at it, when really the best thing to do would be to take a break.

It’s useful to pay attention to the different perspectives that come up in your thinking and to recognize them almost like they are different people. A classic cognitive-behavioral strategy is to imagine your thoughts coming from different people sitting on a committee, and acceptance and commitment therapy uses the metaphor of thoughts as passengers on a bus. We don’t want the committee members, or the bus passengers, to take over. They are merely there giving their input and sharing their points of view. Another, wiser, more holistic part of you is in charge of the committee, or is driving the bus. So, for instance, when you have a panicked thought about catching coronavirus at work, you can thank that passenger for its point of view and assure it that you are doing all you can to stay safe and healthy. This starts to allow you to create some distance from your own thoughts, and be more deliberate about which ones you will choose to follow.

You can also choose to pick up new passengers on your bus, add new committee members – or encourage existing ones to have a stronger voice. Maybe right now there’s a very loud, anxious voice trying to run the show, but somewhere on the periphery there’s a quieter voice saying “I am so grateful that I can still work and my finances are stable, which is not true for everyone right now” or “thank goodness my friend Jane is so funny, she really helps me get through a hard shift” or “I have dealt with a lot of hardships in the past, and I bet I’ll get to the other side of this one as well” or maybe one of your passengers is doing something related to your faith, like quietly saying a favorite prayer.

These voices of gratitude, appreciation, and taking a bigger perspective are important to listen to right now. They are the parts of you that will help you get through a crisis, so listen for them and when they arise be sure to give them a microphone.

You can also choose what in cognitive-behavioral therapy is sometimes called PRN Thoughts- much like a “PRN” medicine which means you take it “as needed," a PRN thought is a statement you’ve prepared for yourself like medicine to be used when needed. If you know somewhere around hour four of your shift you start to get exhausted and overwhelmed, this would be a good time to have a PRN thought you can take. Maybe it is a self-compassionate statement, something to validate your experience like “it’s okay to be tired, and completely understandable right now.” Then you might add on a promise to yourself, like “I’m just going to keep doing what I can, even if I’m not at my best, and that’s okay. I’ll get some nice rest as soon as I get home.”

Also, if you are doing new things in your work life, pay attention to its new effects so you can try to mitigate them before they overwhelm you.

As much of my work goes online, I’m realizing how lucky I am that my work typically has me spend very little time on the computer. Now, I’ll be on Zoom day-in and day-out, either for psychotherapy appointments w/clients, teaching students, or going to meetings. My back and neck are already sore and confused. I have found a few stretches to help and am trying to make the time to do them between appointments. I’m also trying to figure out how I can do some of these video meetings standing so I don’t have to be sitting all day.

It can be challenging when changes are thrust upon us unwanted, but see if you can cultivate some curiosity about it. How does my body respond to these changes? What do I need to thrive – or at least get by – in these new circumstances? Maybe you need different food to fuel you, or a different kind of downtime to help relax.

With all the extra time I’m spending on the computer, I find myself wanting to be anywhere but there on my downtime. I’ve been working hard to get outside and away from screens whenever possible. Usually this isn’t a problem for me, and in fact I enjoy coming home and spending some time on my computer after a long day teaching and being with clients in my office. Now, it’s a whole new thing, and time away from the screen in the evening is feeling more essential.

This might also be a moment for one of those PRN thoughts, something like “I can adapt to these changes; I can learn new habits to carry me through this.”

Maybe you can take some time before or after your shift – maybe on your commute, or while eating breakfast- and consider “what needs to change in my routines to help me through this time? what do I sense I need to do differently in order to cope better?”

It's also important to make sure you take some time to be with friends and loved ones right now, even if it just means watching a movie "together" on Zoom, or setting up your computer at the dinner table to share a meal with distant friends.

If you are prone to anxiety or depression, if you have trauma in your background, or if there are other personal emotional challenges that you face, these tips may not be enough. Be sure to reach out to get the help you need before you get overwhelmed and start feeling worse.