COVID-19: Anxiety and Cognitive Distortions

By Kathleen Jones, PA-C

I came across an early study out of China where 1,210 people rated the psychological impact COVID-19 was having on them:

53.8% - Moderate - severe impact

28.8% - Moderate - severe anxiety

16.5% - Moderate - severe depression

Have you felt anxious in the past 2 months? I think we all have. I’m sure a study conducted within our own community would reflect similar numbers.

Our thoughts can run wild during times like these - it is important to try and catch these cognitive distortions until they spiral.

“Cognitive distortions” are thought patterns that cause us to view reality in inaccurate and usually negative ways. Left unchecked, they can worsen depression, increase anxiety and strain relationships.

Examples of cognitive distortions:

Overgeneralization:  “I heard of someone younger/healthier than me that died of COVID-19, so I will die too.”

Jumping to conclusions: “I will definitely get COVID-19 because I work in a hospital.”

Catastrophizing: “The world/economy is heading into chaos and won’t recover.”

Magnification/minimization: “This is not a big deal. The media is blowing it way out of proportion.” Or “This will lead to our ruin as a nation.”

Labeling: “I just found out I have COVID-19. When I felt sick, I didn’t practice social distancing. I am a failure.”

Emotional reasoning (belief that your emotions are the truth): “I am afraid, so we must all be in danger.”

I have definitely had some of these thoughts. So what can you do?

1 - Identify the thought.

2 - Try to reframe it (Any objective evidence? Alternate explanations? Gray areas?)

3 - Ask, is the thought helpful to you/others?

4 - Take what you learned and either dismiss the thought or grow (Could the thought be reframed to encourage change?)

Viktor Frankl was an Austrian Neurologist/Psychiatrist, and a Holocaust survivor. He wrote, “We who lived in concentration camps can remember the men who walked through the huts comforting others, giving away their last piece of bread. They may have been few in number, but they offer sufficient proof that everything can be taken from a man but one thing: the last of the human freedoms—to choose one’s attitude in any given set of circumstances, to choose one’s own way.”

We are nowhere near the atrocities of the Holocaust, but we are in a unique and trying time. What can you do to make things a little easier on yourself, and others?

Friends With Myself: How Ketamine Helped a Frontline Therapist Overcome Panic Attacks

By Greg Ferenstein

On the surface, Emily* had a blessed life: a supportive husband, a loving son, and a solid career as a frontline therapist. She had all the professional training and social support to manage her mental health, yet she was plagued by debilitating panic attacks.

Even when nothing was wrong, she couldn’t escape intrusive, catastrophic daydreaming of how she was likely to wreck her family and community. She knew the thoughts were purely imaginary, yet the uncontrollable episodes of sobbing that accompanied these ruminations took a toll on both her family and office administrators.

As an example, Emily recalls being mildly afraid that she might cheat on her husband. That same day, she went through a grocery checkout line with a male cashier and was bombarded with thoughts of cheating on her husband.

“I immediately just lost it,” she says. “I cheated on my husband because I went through this line that had a male cashier.”

She burst into her home, began crying, and apologized to a very confused partner. She remembers thinking that “I just can't, I can't live like this.”

As a working mental health professional and current master’s degree student, Emily was surrounded by treatments and strategies to help her deal with her panic attacks.

And she did on occasion find them helpful.

Yoga, for example, helped give her space to contemplate quietly. “I was able to lay there and relieve some of my self-loathing and self-hatred and difficulty in accepting myself as a human.”

Unfortunately, nothing seemed to stick, partly because Emily was terrified to let her mind wander. “I get a little skittish around trying to create images in my mind because I don't trust my brain; any moment, this self-compassion exercise could be totally taken over by myself.”

As bad as the attacks were, Emily could still function as a loving mother and run a therapy practice while going to grad school.

But COVID tipped the scale; intrusive fears became too intense. Shopping at Target was a panic-inducing experience. “What if the girl that is spraying the carts right now doesn't believe in COVID? And so she actually just put water in the spray bottle …. And now I'm going to take it home, and we're all going to die?”

The constant fear became too much. She needed new solutions.

The ketamine experience

At this point, Emily was open to anything that could help. She heard about a clinical pilot for frontline healthcare workers offered by Novamind, a mental health startup specializing in ketamine-assisted psychotherapy.

Ketamine, a dissociative anesthesia, was showing promise for a range of mental health issues, including suicidal ideation and depression.

Novamind’s clinic pioneered a method of pairing ketamine sessions with intensive psychotherapy.

Growing up in a religious community, Emily felt uncomfortable with psychedelics. But she was desperate for solutions and decided to sign up.

Emily was placed in a trial with other frontline healthcare workers exploring how ketamine-assisted therapy could help them overcome their mental health challenges.

In preparation for the treatment, they were given worksheets and instructions on how to mentally navigate the psychedelic experience. In between treatments, the group would come together for discussions and integration.

Emily recalls one particularly powerful psychedelic episode that rooted out the source of her panic attacks.

As she began to feel the effects of the ketamine, she remembers seeing a visualization of a black hole and asking the overseeing physician how she should interact with the bizarre object.

“The doctor encouraged me to go toward it and that he would be there if I needed. I asked to hold his hand.”

Images morphed, and she recalled herself a young religious missionary in South America. As an adult, she was no longer a member of her same church, and since leaving, maintained intense shame around trying to force religious beliefs on the local residents.

During the psychedelic experience, Emily felt the people of the town forgive her. They told her that her missionary work did not harm the community and that they were grateful to have known her.

Then, with that same compassion, Emily turned to speak to her childhood self, “I told her these thoughts that you have are called ‘obsessive compulsive disorder’, and you don't have to repent for them.”

Emily and her younger self openly discussed all the complex feelings around moral purity and guilt they would experience in their life. She forgave herself. And, in that moment, Emily acknowledged it as a significant source of panic attacks.

“It was a closure I didn't even know I needed.”

Better at managing attacks

Emily still experiences episodes of shame, but now, they don’t spiral out of control.

She recalls one recent example of an incident that would have triggered a panic attack prior to her ketamine treatment.

One day, she had thrown away a bunch of plastic. Normally this slight moral transgression would trigger intense feelings of guilt about how she was wrecking the planet.

“Yes, I will have the thought of like, ‘Oh my gosh, what am I doing to the earth’, but within moments, I'm able to go to a place of ‘Emily’, this is so hard for you, I'm so sorry that you struggle with this—everything's going to be okay.”

Emily estimates that before, she would have a debilitating episode about once every three weeks, and then more minor attacks in between.

Since her treatment, she has experienced just one triggering episode, but it was not as severe, and she was able to adopt new coping mechanisms.

In addition to a more stable family life, Emily believes she’s become a more empathetic and present therapist. “I'm able to be fully present in their story, instead of letting my mind wander off into my own story.”

Emily is a therapist in a community with a lot of mental health distress around religion. Her clients have become curious about her personal transformation and the role of psychedelic-assisted therapy. Emily says that she would recommend Novamind.

“Dr. Reid Robison and Dr. Stephen Thayer were really great at setting us up for success,” she exclaims. “I can't imagine doing this with any other people.”

*Emily is a pseudonym. Some quotes edited for clarity.

About the author

Greg Ferenstein is the founder of Frederick Research, a mental health innovation consulting firm. His research has been widely covered in leading publications, including the New York Times, The Brookings Institute and The Washington Post.

His field investigations in mental health have been supported by respected technology companies, from Google.org to Lyft and his public policy papers have influenced bills at the U.S. federal and state level.

Prior to founding Frederick Research, he taught statistics for journalists at the University of Texas and received a Masters in Mathematical Behavioral Sciences.

Interested in sharing your story? We'd love to talk.

Social Isolation Impatience Syndrome

By Bob Mcnutt, LCSW

The last year and a half of social isolation seems to have some unexpected impacts on our patience and distress tolerance. This seems somewhat paradoxical since we have all practiced being bored and lonely since 2020, which seems like it could increase our tolerance for discomfort. Instead, it seems that the decreased stimulus is causing many to retreat into physical and emotional caves of comfort, making it difficult to integrate back into normal life.  The following is a list of common issues caused by the changes of the COVID era and what you can do about them.

1) We all have different expectations regarding protections and connections, we want everyone to comply with our personal style of health protections in interactions.  Seeing someone near you practice alternate styles of protections in interactions can create some severe judgements towards the other.

2) Isolation in person and connection through social media seems to have further engrained people’s held biases.

3) We are not used to other people getting in our way as much. Roads were emptier, food was delivery or pickup at restaurants and stores, more online shopping, and less overall interactions with people who slow us down by being in front of us in line.

4) We have less interactions with casual teasing banter and are now more prone to offense.

5) The favorite or easiest coping/avoidant behavior has been too accessible at home and we haven’t needed to accept and push through distress as much.

6) Feedback from work has not been face to face for many of us, we become more sensitive to light criticism when we cannot see the response from the other person. We get more fearful of negative responses in person.

7) Fearmongering on all sides of media, the news cycle is not friends with contentment. When media is constantly stimulating fear and anger responses, our ability to manage small distresses lowers.

What to do about it:

1)  Focus on your own version of health protection in interactions. If you feel unsafe because of other people, how can you feel safer without completely isolating in your home. If you feel frustrated by restrictions on behaviors or protective behaviors of others, try to empathize with the fear or vulnerability that they may be experiencing. I do not recommend trying to change the behavior of a stranger.

2) Expand your in-person or online sources of interactions, reduce your impersonal sources of information. In person interactions allow for greater levels of connection, empathy and differing perspectives. Before you block someone online, ask what can be learned from this interaction first. Be cautious on quickly labeling others as trolls, try to understand perspective and intent before reacting.

3) NEVER BE IN A RUSH TO SIT ON THE COUCH. If I am impatient in traffic or at the store, what am I telling myself is so crucially important to get home to.  Live in the moment when possible. Standing in line and sitting in traffic is far from torture when we connect with the moment non-judgementally.

4) Watch for intent first and be quick to forgive unintended offenses, when in doubt- assume the best. Try laughing/playing along.

5) Listen to your body and acknowledge the physical symptoms of your emotion. With each symptom, we can enhance the discomfort of these by worrying about them or lower the discomfort by accepting them. If symptoms are isolated and examined with curiosity they can be objectively labeled to dilute the intensity (rather than saying “I am anxious”, state “I am having the following symptoms of anxiety _____”). Look into expanding your coping skills by doing some light research into popular coping mechanisms.

6) Nobody is perfect for more than 1/8th of a second at a time. You will make mistakes. You will disappoint others. You will cause disruption in others’ lives. You must accept this reality if you wish to interact with the world around you.  Separate failures from character (Unhealthy: I’m a failure! Healthy: Welp, I failed on that attempt, I’ll try again/learn from my mistake). Look for intent behind negative feedback: seldom is the intent “stop trying and leave me alone forever.”  - most intents in negative feedback are: “I noticed this issue, try to resolve it and learn from this.”

7) Ask what you actually achieve/learn/grow from social media and news outlets. Look at the intent behind the social media and news outlets (They want your money or personal information to sell).

Bonus: Desensitize yourself to minor discomforts: start or end you shower with cold water for 15 seconds; be bored without filling the space with phone tapping or TV; keep the air conditioner at 74 instead of 72; exercise. Bonus feature of this is a slightly lower energy bill each month.

Bob McNutt

About the author

Bob McNutt, LCSW specializes in substance use, behavioral issues, depression, trauma, and PTSD. In his practice, Bob addresses the social and spiritual concerns of his clients, helping them to restructure negative cyclical thoughts.

Bob McNutt earned his bachelor’s of behavioral science from Utah Valley University and his master’s of social work from the University of Utah.

Episode 38: David Treleaven on COVID Trauma

 

"To move through trauma often means going back to what was too much. Often we need to be with someone who is with us saying ‘I’m here. You’re safe. It’s okay to feel it now.’”

In this episode of the Numinus podcast, Dr. Joe speaks with David Treleaven. David is a trauma professional, mindfulness teacher, and educator. He is also the author of Trauma-Sensitive Mindfulness: Practices for Safe Healing. After struggling through symptoms of secondary trauma on a meditation retreat, he developed the Trauma-Sensitive Mindfulness (TSM) approach.TSM helps trauma survivors avoid the risks they face when practicing meditation. TSM has been taught to veterans, prisoners, healthcare professionals, first responders, and many others.

Through workshops and online courses, David teaches mindfulness providers the tools of TSM, so that they can meet the needs of people struggling with trauma. More information on his online training can be found here.

David has worked with organizations like Search Inside Yourself Leadership Institute (developed by Google) and the University of Massachusetts Medical School by bringing them the tools and techniques of TSM to their staff and programs. He is also a visiting scholar at Brown University.

He is the host of The Trauma-Sensitive Mindfulness Podcast. He has had guests on like Sharon SalzbergRick Hanson, and recently Dr. Joe Flanders!

 

In this interview Joe and David explore:

  • Challenges with the definition of the word trauma
  • Is there such a thing as COVID trauma?
  • Why some people are more resilient in the face of difficult experiences
  • Neurobiological models of Post Traumatic Stress (PTS)
  • Diagnosing PTS
  • Approaches to treating PTS
  • The implications of collective trauma from COVID-19

 

Here is more information on subjects mentioned in this episode:

 

More quotes from David from the interview:

“Post-traumatic stress can be the impact of two different impulses acting at the same time.”

 

“Sometimes I think of trauma as us living through impossibility, and then the costs of that.”

 

“The further away I get from academia, I find myself less interested if we count a hundred people and we talk about all of their stories, whether or not we’re going to qualify their experience for being traumatic or not. What I’m most interested in is what, in a very practical way, are going to be the interventions that are going to support this person to have less pain and suffering in their life.”

 

“To move through trauma often means going back to what was too much. Often we need to be with someone who is with us saying ‘I’m here. You’re safe. It’s okay to feel it now.’”

 

“In my experience with people when they’ve really moved through or integrated that trauma is that they’re on the other side of a pretty big emotion or discharge through the body, they say, ‘Oh, it’s finally over. It’s been trapped inside of me for a long time. And now I’m integrating it in a different way.'”

 

Here are some highlights from their conversation:

 

COVID might refer to a specific viral entity, but it means so many other things. And I guess there’s a diversity of experiences that people have had. And I don’t know, you tell me, do we want to talk about–what was your distinction there, like traumatic experiences people have had in the pandemic era or or just like some kind of collective trauma that we’ve all experienced living through this? 

Well, there’s so much to say here. I’ll talk about how I’ll define trauma here which would be a response to actual or threatened death, serious injury or threat to physical integrity. And I think it’s important to at least start here and see if we’re on the same page because trauma as it’s become more of a popular mainstream term has become slightly diffuse.

And I’d say the definition has been watered down and there’s been some concept creep in the humanities more generally around trauma, which yes, again, there’s a double edged sword here. Where it’s great that people are talking about trauma and unhelpful in some ways to just generalize.

So I’d like to talk about trauma as an input or a situation that is a threat to life and limb where our survival and our fundamental safety is on the line. And COVID cuts both ways here, where definitely it has been a significant threat and it has been an actual material threat to family. I mean, people, families, communities or people are literally dying or their well-being has been threatened. And then there’s been a whole range of more generalized threat that people could say has been traumatic.

But I’d actually challenge that where I think it’s actually just been more a challenge in adversity and where it got murky and it was confusing about, ‘Is my life in danger here, even though I’ve been triple vaxxed,’ for example. So there’s a whole other place where trauma has happened. And then I think there’s been a massive period of adversity collectively that we’re trying to sort out and maybe we’ll be talking about it here in the conversation.

 

Let’s come back to that very evocative story about the child that gets pulled out of the way of an oncoming car. That seems like a pretty good example of a threat to the child’s life, their safety and that child’s nervous system probably goes into some kind of fight or flight reactivity. And then if I’m extrapolating a little bit, the mother is basically communicating through her reaction, ‘shut that emotion down.’ And the child is basically saying to themselves, if I want to stay connected to mom here, which feels really important right now because I’m kind of freaked out, I have to put that emotion away, inhibit it in some way.’ That sounds to me like an example or a mechanism around how things get stuck. 

I wonder if you can say more about why would that be in evolution that certain really intense experiences get trapped? And even what the hell does that mean for something to get trapped in our nervous system? Can I know exactly what that means experientially and sort of working with clients?

The metaphor that’s worked for me I learned from Babette Rothschild, who’s a trauma writer. She wrote a book called The Body Remembers. Yeah, all the best trauma books are like, ‘The Body Keeps Score of the Body.’ But she’s great. She’s awesome. When she’s training people around trauma and is trying to capture what you’re saying, what’s the essence of it? Why does that stuckness happen? Like, what’s the stuckness?

She’ll bring a bottle of soda up on stage and she’ll start shaking it up, and she’ll basically be talking about how the stuckness is the cap. And her metaphor is saying, ‘now what would happen if we just open this soda right now?’ And of course, it would fly. It’s too much for someone. So in Babette’s work, it’s been a lot about–and in a lot of trauma work, it’s about kind of cracking that soda top and allowing some of the pressurized gas.

But let’s back that up even further, because I think it answers your question. The reason I think that metaphor works is that when it comes to trauma, like with that child, there is some kind of activation. I said factory loaded some kind of deep survival response, often referred to as fight flight. So the sympathetic nervous system and the autonomic nervous system just hit the accelerator. We have the survival response. We don’t have to think about it. It just happens automatically. Flood of adrenaline pupils dilate to try to protect us. And then that’s the moment that I think you’re pointing to. That gets very interesting.

Why the cap? There’s lots of stories about different mammals who are able to shake and discharge that activation. You know, a classic example is the deer who shakes it off. It gets really frozen and then shakes it off, moves on like nothing happened. But what’s happening for humans?

You gave the example around attachment. I’d say, ‘yes, I’m faced with the choice of either being disconnected from my caregiver, which is fundamentally threatening. So let me basically cap that energy through locking my jaw so I can stay connected.; And then in other situations, there’s a legitimate freeze, the intense parasympathetic arousal sometimes known as tonic immobility. Which will come and cap or trap that activation of fight flight in the nervous system that can’t discharge over time.

So it has deep evolutionary roots about why we had that freeze, for example, playing dead like the possum. If you’re a gazelle, you’re dragged to a cave, you might freeze. The predator thinks that you’re dead and won’t actually attack you. There are many different inherited reasons that we have that–but it can create tremendous amounts of suffering in an ongoing way for people because we can’t uncap that freeze and it gets really frustrating.

PTSD or post-traumatic stress can be the impact of two different impulses happening at the same time. So for example, the impulse to run and the impulse to freeze, they’re both happening. They’re both legitimate survival strategies. And that combination of the two creates that charge. And you could say that stuckness.

And I wanted to link it here to what’s happened to a lot of health care workers or even family members. Where I heard stories of people saying I was on one impulse was to hold the line around safety in hospitals around who could come in and out of a ward, for example. And then there’s an equal impulse to, of course, let a family member come and be with someone, that loved one or a family member. And so it creates these impossible situations.

And so sometimes I think about trauma as us living through impossibility. And then the costs of that.

 

I think that I probably learned this vocabulary from you, but maybe I can just ask you, describe it, this notion of like pendulum motion. And there’s another term that I find really useful, like titration. 

Titration?

Exactly. I think these are great tools for people to know. Can you describe those? 

Yes, it doesn’t come from me, but Peter Levine. It comes from Somatic Experiencing, which is a really popular psychotherapeutic approach to trauma or healing. And I don’t receive any money for that. I just trained in it a long time ago and the core principle–this actually gets right back to the soda bottle or the pop bottle.

So imagine that bottle of carbonated water being shaken up, and you could think of that as a traumatized system that there’s a tremendous amount of sympathetic activation fight flight in the container. So the accelerator slammed the ground. But there’s also tonic immobility. So it’s capped and that if you imagine the feeling of the accelerator and the brakes slammed down, that’s often what trauma can feel like or post-traumatic stress. It’s really painful, uncomfortable, and dysregulating.

So the idea behind pendulation and titration in this work around trauma–the idea is you’re going to pendulate your attention, so basically go back and forth between areas of where you feel more trauma and areas where you feel more resourced. And in doing so, you’re doing what’s known as titrating. Which is actually an old concept in chemistry where you’re opening the soda bottle, but only to the degree that a little bit of the carbonation is released and then you’re turning it back.

If you opened it all at once, that’s not titration. It’ll cause an explosion. Someone gets flooded. It’s too much. And we all know this. I think intuitively that we can take only so much until we need to take a break because our systems can’t tolerate it all at once. So the essence of a lot of trauma work is to go back and forth in order to titrate and not have it over, not have trauma overwhelm.

 

I wonder if you’d agree with this statement that at least this might be just one among many qualities. But this is the quality or the expertise of a trauma therapist that might be sensitive to the pace and to not go at it full speed right away because one has to work very carefully with that limit. And if you went to a therapist that doesn’t have that training, they might not know how to work with that. Is that a fair statement? 

That is the essence to me of trauma training. That is why one would train to know how to work with a combustible process. It’s because more is not going to be better when it comes to working with trauma.

Let me give an example of that. So I was trained as a somatic therapist where the main question I had was, ‘Where do you feel that in your body? It’s all I had. I was like, ‘Well, where do you feel that?’ And if you just keep driving someone towards intensity to your point, that actually can be too much for them. Now that can be confusing because when you’re working in any kind of mental health work, I think when you see emotion, you think you’re doing a good job. Someone’s crying. I’m like, ‘I must be doing something right.’ And then I’m trying to amplify it because I think we’ll go deeper. ‘That’ll be great.’ And sometimes that’s true.

But when it comes to trauma, right to your point, it’s not. It’s that you need to have a more nuanced approach and you’re learning to track someone’s mind and body in a really nuanced moment to moment way.

 

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Managing Back-to-School Stress during the COVID-19 pandemic

Back-to-school stress is a normal occurrence for most children. But this year’s coronavirus outbreak has led to increased anxiety around this already stressful time of year. Here are some tips to help your child or teen manage some of the changes they will encounter this year and the complicated emotions they will face now that they are back at school.

Promote self-care & practice relaxation activities

Self-care is an important part of wellness. Encourage your child to engage in activities that promote self-care and relaxation on a daily basis. It’s important to note that sometimes children may need to take time to discover what activities help them feel good and recharge. So, encourage them to try a variety of activities. Some self-care activity examples include; writing in a journal, colouring/drawing, taking space to listen/dance to music, meditation, watching a movie or reading a book, and keeping active. Relaxation exercises that are important to promote include; deep breathing, progressive muscle relaxation, visualization, or grounding exercises. You can find many guided relaxation activities online or through mobile applications. And don’t forget! Parents need self-care too! Make sure to also create them to engage in your own self-care activities.

Avoid second-hand anxiety

Children and teens are extremely in sync with their parents’ well-being. If you are anxious and make a lot of statements of worry, then most likely your child will pick-up on that anxiety and emulate it. It’s important that parents have a space to express their worries and vent but try as much as possible to do so behind closed doors.

Have open and age-appropriate conversations

Youth are aware that a virus exists, and it has had an impact on their life and school environment. It is important to have an honest, age appropriate discussion with your family about what is happening, procedures that the school is implementing, and how they can help and stay healthy. Not talking about it may cause more anxiety in your child. Begin by finding out what your child(ren) know about the current situation, what they understand, and what information needs to be corrected. In an age appropriate way, answer any questions they may have. It’s ok to say when you do not know something. Tell them you will do some research to find out and get back to them. Its also ok to acknowledge that the situation is stressful for both you and them.

Validate emotions

This is a difficult time for everyone. It’s important to have conversations with your child about their emotions, encourage a space for them to talk, and ask specific questions about their feelings around starting school. For example; you can ask a younger child what they miss/don’t miss about being in school? What they are worried about/excited about in going back to school? You can provide younger children with a fun activity, like colouring, to introduce the topic and keep the conversation flowing. Its also important that when your child/teen is talking about their emotions you don’t go into “problem-solving” mode right away. First step is always to validate how they are feeling. For example, “I can see that you’re feeling X, that’s normal. It’s a difficult time right now.” Help your child with labeling their emotions if you see they are having a hard time identifying how they feel. Finally, try to avoid minimizing how they are feeling (e.g., “just tough it out”), but validate that what they are experiencing is normal in the given situation (e.g., “It’s normal to feel upset when our whole routine is changed, many people are feeling the same way right now”).

Involve students in decisions

Children and teens have very little in their control when it comes to how the school is going to function. Having them involved in some decisions (especially for teens) is very important. Feeling some sense of control helps decrease high stress and difficult emotions. Letting your child choose the colour/design of their mask, having them choose their lunches, or providing choices for social activities are easy ways to provide choices and include your child in the decision-making process.

Equip students with situational knowledge

Talk to your child about the protocols currently in place at the school to keep them safe and the strategies they can take to help maintain that safety. It’s important that your child understands how to properly wash their hands (and to wash hands often), what physical distancing means, and how they can implement it at school. There are many YouTube videos that demonstrate the proper way to wash your hands and the benefits of washing hands regularly. Further, with younger children it might also be helpful to role play scenarios that they might encounter at school.

Monitor media consumption

There is a tremendous amount of information being shared on social media, television, YouTube, etc., that is not always accurate. Further, constantly watching the news and consuming COVID-19 updates and stories can significantly increase anxiety and stress. It’s not only important to monitor your child’s media consumption for accuracy, clarify any new information they receive, but also limit the amount of virus-related media they are consuming.

Keep a routine

Although school protocols and procedures may feel like they are constantly changing, it helps to gain some resemblance of normalcy by controlling the aspects one can control. A routine can help in providing this sense of normalcy and control during the pandemic. Creating transition routines for after school activities like washing their hands when the enter the house, changing their clothes, and engaging in a self-care or relaxation activity can help alleviate anxiety.

Maintain a regular sleep schedule

Sleep is essential for many reasons including managing stress, anxiety, and promoting general psychological well-being. Some simple and important sleep hygiene strategies include, keeping a consistent sleep schedule (wake-up and bedtime), schedule your “ideal” amount of sleep hours, limit napping (especially late in the afternoon), reduce electronic use at least 1-2 hours before bed, make the bed a sleep-only zone (i.e., no homework done in bed!), develop a relaxing bedtime routine that can be followed each night, and avoid substances that can interfere with sleep (e.g., caffeinated drinks and foods).

Organize time with friends

Finally, in some school’s students are being separated into classrooms or “pods” that do not change throughout the day. If your child is not in a group with their friends, it is important to organize regular and scheduled physically distant activities and social time outside of schoolSocialization and friendships are extremely important to child and adolescent development and it will help in decreasing your child’s anxiety to know that they will not be missing out on spending time with their friends.

If your child is experience very high levels of stress or anxiety you can also seek professional services which are available in both the private and public sectors.

For additional information on the Quebec back-to-school protocols currently in place visit:

https://cdn-contenu.quebec.ca/cdn-contenu/adm/min/education/publications-adm/covid-19/plan-rentree-2020-en.pdf?1598463227 – English

https://cdn-contenu.quebec.ca/cdn-contenu/adm/min/education/publications-adm/covid-19/plan-rentree-2020.pdf?1597860080 – French

Well-Being Transformation in 2020

We need to stop seeing our humans as resources for the workforce and start supporting humans with resources to reach their full potential.

With the many challenges we are facing today, especially with this on-going COVID journey that is adding fuel to the fire, workforce disengagement is high and business models are increasingly challenged. As I wrote in a recent blog, our fears and insecurities are increasingly now becoming our worse enemy in these challenging times. When our mind is threatened, it is often cognitively limited, short-sighted and self-protective.  Our shift into survival mode rather limits our ability to be strategic and innovative.

After 30 years as a strategic planner and management consultant, I redirected my career to grow Numinus, dedicated to helping organizations navigate in these difficult times, increasing resilience and overall psychological well-being.

In 2019, I was interviewed to explain how mindfulness could help transform organizations. In early 2020, I co-authored an article in which we discussed the inroads that mindfulness has made in the work place.

Many organizations such as Sodexo, IA Financial Group, Alayacare, CBC, Ubisoft and many others, are currently experimenting with or adopting mindfulness practices to help support individuals deal with suffering and unleash potential.

At Numinus, we have been delivering well-being and mindfulness introductory sessions and in-depth learning journeys to all kinds and sizes of organizations over the last decade. During these sessions we explain through neuroscience how our minds are challenged and underutilized in today’s increasingly complex environment. More importantly, we provide strategies to exercise our minds in a similar way we have been training our bodies in the past.

Such awareness training is only a beginning as individuals and organizations are currently ill equipped to deal with today’s VUCA world. We are witnessing record levels of mental health issues such as increased stress, anxiety, poor sleep, depression, burnout, social disconnection and poor quality decision making.

Developing mindfulness with early adopters is a great start.  However, to truly adapt to our new environment, we need to take these initiatives yet one step further. We now need to go beyond developing individual competencies to developing an organizational culture that promotes, supports and exemplifies self-awareness, presence, self-regulation, purpose and compassion for others, shifting from intent to actual transformation.

The time has come to develop psychological well-being as a strategic competency to deliver a competitive and sustainable advantage, and more importantly to bring human beings at the core of our organizations.

A structured approach needs to be deployed, tailored to the organization’s well-being maturity level, employee needs, existing development programs, levers and barriers linked to the desired state of well-being.

Below is a typical process we go through to shift from developing psychological well-being from an individual and discretionary strategy to transforming the corporate culture to embrace new ways of being while doing.

Embracing new ways of being while doing

To survive and flourish in this evolving world, we need to stop seeing our humans as resources for the workforce and start supporting humans with resources to reach their full potential, while considering all stakeholders with whom they interact. This requires us to rethink and reengineer our systems, practices and rituals, built over past decades when humans where only at the service of productivity and shareholders.

Today’s workforce is younger, stretched, seeking balance and purpose. We urgently need to start realigning our organizations to bring back dignity, consciousness, presence and compassion if we wish to strive and evolve to this new era, full of challenges and promise for those who will adapt.

Equanimity Practice: It’s OK

 

The coronavirus pandemic is challenging to our well-being in many ways. It has taken away physical connection with others, routine, many outlets for physical activity and entertainment, among many others. It may even take away our jobs and sense of purpose. One additional challenge is the extent to which the future has become so much more uncertain, be it with respect to our health, freedom to move around, employment, financial security, etc.

It is very natural for the mind to get busy trying solve a problem or prepare to face a threat or, at the very least, try to fill in some of the unknowns. Ultimately, it is difficult if not impossible to resolve the uncertainty at the moment. There are few answers out there. So we need to be able to tolerate the uncertainty.

To make matters worse, our minds typically have a negativity bias, which means that the narrative the mind imposes on the uncertainty is often negative or even catastrophic. ‘What if I get the virus if I go to the grocery store? There’s no way I’ll have a job on the other end of this. Will I ever see my friends in Italy again?’ These thoughts can seriously amplify our anxieties or drag our moods down.

I have been practicing and sharing a meditation that can help us tolerate uncertainty and move on from worries and ruminations. The core of it is the insight that even if the future is uncertain and the stakes are high, in THIS moment everything is ok. Things might get more complicated or difficult next week. But next week hasn’t happened yet. And if circumstances do get worse, wan can mobilize our resources to rise to that occasion. Or we may end up surprising ourselves when we realize that even THAT particular moment is ok.

This practice is an invitation to let go of the hunger to resolve uncertainty and engage with the present moment. You might also try using your senses. Look around. Listen. Touch things. Go for a walk and feel your leg muscles working for you. Breathe. If you can, give someone a hug. If you are feeling keyed up or unsettled, know that your body is doing everything it can to protect you from danger. And it’s kind of miraculous.

If any of these practices provide some engagement with the present moment, you now have some space to be intentional about what you do next. What do you need in this moment? Who or what is important to you? What is the person you want to be doing? Use the energy your body is mobilizing to propel you toward doing good in the world.

Give it a try and let me know how it feels.

How does COVID19 Affect Epilepsy?

= Authors =

Christina Muratore, Epilepsy Toronto

Geoff Bobb, Epilepsy Toronto

Mackenzie Muldoon, Epilepsy Toronto

Ivana Yau, NCT & SickKids

Evan Cole Lewis, NCT


 

Epilepsy & COVID-19

Recognizing that people had questions about how COVID19 may or may not affect epilepsy, NCT and Epilepsy Toronto teamed up to create a helpful resource.

A list of frequently asked questions were gathered together and addressed.

If you have further questions, don’t hesitate to reach out to Epilepsy Toronto or Neurology Centre of Toronto.

Stay safe everyone and remember to abide by social distancing standards as these are our best way to contain the spread of COVID19.

Mental Health Services Transition to Online Care

The coronavirus pandemic is wreaking unprecedented havoc on our healthcare system, economy and communities. The combination of high stakes, uncertainty, lack of control and limits on social connection is creating a perfect storm for psychological distress. Undoubtedly, there is a mental health crisis lurking underneath the public health and economic crises unfolding before our eyes. And this, while everyone is forced to stay home.

The one bit of good news is that psychotherapy works online. Numinus has been offering virtual sessions for many years. But in the last week, we managed to transition our entire clinic operations online. While the virtual therapy session takes some getting used to—for clients and therapists alike—the results have been positive. Clients are grateful that they continue to have access to services. Sarah, one client said “I still had a real connection with my therapist, still able to make progress on issues that I have been working on for a while, and reduction in anxiety from what’s going on today.” Therapists also report that they are having positive experiences despite the remoteness. Jessica said “I’ve been pleasantly surprised by the quality of the connection I’m making with my clients despite the distance.” Julien even found some clinical advantages to virtual sessions: “I also find that there are advantages to meeting clients in their natural environment.”

The research on virtual psychotherapy supports these experiences. A 2012 review paper by Backhaus et al. concluded that virtual therapy is “feasible, has been used in a variety of therapeutic formats and with diverse populations, is generally associated with good user satisfaction, and is found to have similar clinical outcomes to traditional face-to-face psychotherapy.” Surprisingly, according to Simpson and Reid (2014), meeting a therapist online does not seem to compromise the quality of the client-therapist relationship, which is an important ingredient in successful therapy. So good quality mental health care is available online.

This mental health crisis is affecting organizations as well, as they rely on the sustained performance of their people to adapt to sudden, tectonic shifts in the business landscape. Virtual psychotherapy may be an essential ingredient to maintain employees health and functioning at work. Many organizations try to support employee well-being by offering extensive health insurance benefits. In this post-COVID world of social isolation, the primary headwind to employee wellness are feelings of anxiety and disconnectedness that arise from suddenly being thrust into working from home in an uncertain world. Psychotherapy is typically covered under these policies, but often not sought out. Alayacare, a Montreal-based health tech company contributing to COVID-19 solutions, is encouraging employees to make use of these benefits. CEO Adrian Schauer says “we are aware that some of our people are having difficulty coping with the current circumstances, which is totally understandable. We feel like working with an organization like Numinus to give our people access to licensed mental health professionals just makes sense.”

The insurance companies providing mental health coverage are just as motivated to facilitate services. For one, like many of us, they are often looking for ways to make meaningful contributions to their communities in this crisis. They also fundamentally want their customers to get good value for their policies, or else organizations won’t renew their policies. For example, SunLife’s  indicates: “We want to ensure plan members continue to receive the health care they need. Now, we’ll cover virtual services for appointments where they do not need direct physical therapies.”

Do you work with or represent an organization looking to support its employees through this crisis? Have a look at Numinus comprehensive offering for organizations during the COVID-19 crisis.

Guided Meditation: Relating Mindfully to COVID-19 Stress

 

We are currently in moment in history of collective uncertainty. And learning how to be in wise relationship to uncertainty is more important now than ever. Most of us are invited to stay put at home and may notice we have a lot more time on our hands. This can lead to having more time to worry and be anxious. But it can also be used as an opportunity to retreat, slow down, and learn how to best be with ourselves when experiencing difficulties like fear, anxiety or grief. Learning to relate to these states wisely can help us see things more clearly, have a broader view, take more effective actions, and to be our best selves even when things are difficult.