Loneliness. Solitude. Alone.

Such words often stir feelings deep in our souls and hearts.  As humans we tend to avoid such feelings and experiences.  And yet we have had to often face all three more deeply this year than others.  What do they mean?  Are they the same?  How are they different?  Sometimes we find we want to just brush over the words and feelings that pop up and run to find someone and be busy.  Yet some philosophies, spirituality and philosophy among them, encourage solitude at times.  And in solitude we are alone.   

Depending on the definition, loneliness is either physical isolation or the feeling of sadness over not having people around.  Or, from a philosophical and psychological perspective, it is a feeling of having insufficient relationships or accessibility to others to meet the needs a person has at that time.  It may simply be a need for companionship and with Covid-19 we cannot always get together as we’d like because it competes with need to stay at home more.  

Solitude is defined as the less painful part of not having people available – being alone and enjoying that and finding comfort or relief in the silence, or as Paul Tillich defined it, “the glory of being alone”.   

Alone is simply having no one else present.  It’s a state of being, but not related to feelings.   

Introverts often relish times of solitude and use them to recharge their batteries.  I’m partially introverted, and a quiet evening alone is sheer enjoyment for me.  I am in solitude, not feeling loneliness.  However, an extrovert who recharges with others may face alone time after a busy day as painful and lonely.  That person doesn’t have the others around to recharge with and thus the felt experience of solitude is very different.   

I read a book by a philosopher and psychologist from the 1950’s, Clark Moustakas, that was entitled “Loneliness”.  It was interesting as I read reviews of it on Amazon today – readers talk about it as not being the self-help book of the 2000’s, but rather a warm, inviting book, that asks us to look at what we are experiencing in the way of solitude versus loneliness and helping us to individually tackle the existential loneliness we are feeling at times.  I truly believe the experience of loneliness is not unique to us – but rather something we all experience at times, and based on the situation of it, may feel like solitude is pleasurable or loneliness which is painful.   

I was speaking with a friend who had cancer years ago, and one of the things she mentioned to me was that while she had family and sisters who were there to support her every step, and friends who were available and caring, the essence of her experience was a very lonely one.  She had to go under the radiation with only herself.  And eventually, she had to face her own death in some lonely ways.  Yet she also had times of solitude when she experienced spiritual growth and connection.  During Covid-19 many people are feeling lonely and depressed – others feeling solitude – and both can be in times they are alone or with others.  But it is loneliness that leads to depression.   

Depression is a reaction to longer term loneliness for some, and can leave a person feeling isolated, hopeless, and abandoned.  On a rational level, we may know that we are not abandoned at all, and yet the isolation is hurtful.  I can only imagine how isolating life is for many in senior care facilities or hospitals during this time.  The time we most need connection and love and touch is the very time we are quarantining and not connecting or touching.  And if a person has a limited memory, as many elderly do in senior care facilities, then that must feel like true abandonment.  Thankfully iPads and other devices have allowed some connection for many; but, this is still not the touch and presence that can bring us out of loneliness.  And unfortunately for many living alone and for others isolated in their living without time with friends, this is leading to higher levels of depression that has led to even higher levels of suicide than the past.  This month is National Suicide Awareness month and it’s so important we remain aware that we can turn loneliness to more of an experience of solitude – for growth spiritually and otherwise that can become more positive rather than the intensely painful loneliness that underlies the suicide increases.   

So how does a person make this shift?  Here are a few ideas from multiple sources of both spiritual and psychological literature.  Moustakas would encourage us to look within for what loneliness means to us, and how solitude might help us move out to a more healthy place.  He believed that it comes through introspection and not just trying to change the environment.  So asking yourself questions – what does it mean to you to not have people around as much?  What do you believe that means about you?  How did you come to have that belief?  What are your spiritual beliefs about loneliness?  Is there a way to walk into the loneliness and see what you might learn about yourself?  How is loneliness helpful in your life right now?  What is there for you to learn from it?  Start anywhere in these questions and begin journaling about your own experiences and internal feelings.  I would encourage you to move on to see where this goes and, if you can, look for Moustakas’ book (it’s hard to find but worth it) and take the journey he offers through it.  One of the gifts of loneliness is shifting to solitude through which we find meaning or purpose in this time.  In writing through exercises such as the above I do believe you’ll make your way through the desolation of loneliness to the peace of solitude.  

If depression has you, then first deal with the depression.  If it is significant and/or you have thoughts of self-harm at all – then you need to reach out for help now.  Not later.  There is a suicide hot-line at 1-800-273-8255 that is available 24 hours a day.  If you don’t feel suicidal but the depression is strong, then reach out to your family doctor, gynecologist, therapist, or spiritual director/priest/rabbi and get some help for it.  Only after this is resolved will you be able to move into the above ideas from Moustakas.  

Don’t ignore the spiritual work you may be called to during this time that can soothe the loneliness.  Starting a new practice can be helpful at times when we feel dark around us rather than the light of solitude. At other times hunkering down in a tried and true path is more comfortable.  Regardless, consider which feels right to you and perhaps try walking a handheld or land-based labyrinth, focus on a daily reading, take a mindful walk in the park, reread a special spiritual book or passage in the Bible or your faith’s tradition and take comfort in the words.   

In addition to the personal work, I would also encourage you to consider who else might be available.  Call a friend and ask to do it face-to-face on WhatsApp or Facetime or Zoom or some other modality.  Visual connection helps over only auditory and much more so than text.  I also encourage walks – get out and move and at least see others in your neighborhood as it will give you a mild sense of connection to your community in a safe way.  Other ideas to reaffirm connection can be joining an online class or service where there are regular Zoom or other meetings and you have the opportunity to interact with everyone; planning a weekend camping with a friend or a time at a cabin with friend or family member; volunteering where you feel safe such as walking a dog at a shelter- walking outdoors and cuddling with an animal might meet two needs in one; get a pet after considering what you can handle long-term, it may not be a dog or cat but perhaps a hamster or bird to keep you company.  You get the idea.   

Loneliness is a frequent feeling experienced recently, and may underlie the fatigue many are feeling in following pandemic safety.  There are ways through it, as I’ve shared.  John O’Donohue also writes about solitude and loneliness. May his words bring you encouragement, comfort, and increased solitude over pain.   

With care and best wishes for growth and comfort to your heart,  

Dr. Beth 

Dr. Beth Sikora, PhD, LPC, NCC 

Making Decisions: A Time of Challenge but All Shall Be Well

It seems there isn’t a week that goes by that doesn’t demand we make decisions about our safety and health as well as that of our families’, elections, finances, how to better show respect for each other, and what to do about school for our children.  While that is always the case in some way, 2020 has certainly brought all of these issues to a much higher frequency and intensity than we’ve had to deal with in the past.  It’s hardly a surprise, then, that both anxiety and depression are rising at a very high speed and being predicted to be the next pandemic we’ll have to address.  In fact, the Arizona Republic today reported that a warm line that is for those struggling with those feelings has gone from an average of 850 to 1500-2000 calls a week since mid-March.  So, with an awareness of how much stress is on individuals with decisions right now and the anxiety and depression increase I’m including a Part 1 and Part 2 to this blog.  The first is on decision making, and the second on anxiety and depression. 

Part 1:  Decision Making   

Weighty decisions can be difficult to make when the options are clear or there are good arguments to be made for either side. And right now, that is proving especially true. It’s tough to know the right thing to do, isn’t it? Mask wearing. Elections. Going back to school or a workplace. How do you make decisions when there are so many unknowns, and the options are not the best? There was a clip on Good Morning America this past week from a pediatrician who was sharing her advice on making decisions. Her focus was on safety of students returning to school but my takeaway was something that could be expanded to broader decisions: there is no “right” decision.  A person just has to make the best decision for his or her family with the information available at the time  and move on. So, let’s take it back to the basics, and start with the decision-making process itself.

1. Identify the decision: Clearly define the nature of the decision you must make.

2. Gather relevant information: Collect some pertinent information from trusted sources. Some information is internal: you’ll seek it through a process of self-assessment. Other information is external: you’ll find it online, from other people, and from other sources.

3. Identify the alternatives: As you collect information, you will probably identify several possible paths of action, or alternatives. You can also use your imagination and additional information to construct new alternatives. In this step, you will list all possible and desirable alternatives.

4. Weigh the evidence: Draw on your information and emotions to imagine what it would be like if you carried out each of the alternatives to the end. As you go through this difficult internal process, you’ll begin to favor certain alternatives: those that seem to have a higher potential for reaching your goal.

5. Choose from alternatives: Once you have weighed all the evidence, you are ready to select the alternative that seems to be best one for you. You may even choose a combination of alternatives. Your choice in Step 5 may very likely be the same or similar to the alternative you placed at the top of your list at the end of Step 4.

6. Take action: You’re now ready to take some positive action by beginning to implement the alternative you chose in Step 5.

7. Review your decision & its consequences: In this final step, consider the results of your decision and evaluate whether or not it has resolved the need you identified. If the decision has not met the identified need, you may want to repeat certain steps of the process to make a new decision. For example, you might want to gather more detailed or somewhat different information or explore additional alternatives.

This process may be one you already intuitively use, but if you feel you’re more of a gut reaction person, write down the direction you want to take based on your instinct and then try using the process described above. Do you arrive at the same conclusion? Is there a way to blend both conclusions that feels like a well-informed answer for you? Remember that even in times of uncertainty, we can each only do our best. What is right for today may not be what is right for tomorrow, so take some time, consider all options, and trust yourself. We can only make the best decision for today, and with the information we have today.  Know that and try not to question the decision later.  Reassessing later is fine to see if you need to change direction, but it’s again a decision made from the information you have on that day.  The decisions you make will be the right ones for yourselves for today, and that’s the best any of us can expect.

Part 2:  Anxiety and Depression Increasing

Essentially depression is a feeling of hopelessness, sadness, and/or loss of interest in life or activities you would generally enjoy.  It may be situational, i.e.:  related to a current situation in your life; or, clinical, i.e.:  related to a biological change or malfunction from medical, hormonal, genetic, or other reasons over which you may not have control.  Anxiety is a sense of impending doom or reaction to a stressful or situations perceived as dangerous.  The symptoms of each are specific, and you can get more information on anxiety and depression on our website.

Now that you understand it – what do you think?   Are you suffering a bit from it?  I do encourage you to track it for a while to see where you are with it and how it’s trending.  So, get a piece of paper, a notepad in your device, or use a program, and rate it 1 (none at all) to 10 (you could act on suicide today).  If it is 8-10 you need to call your doctor or therapist.  Or, at the bottom are a few crisis lines if you can’t quickly reach someone for help.  Please don’t let your ego or past beliefs get in your way – depression is a high-risk illness – and potentially can be fatal in a small number of cases.  So, get the help you deserve.  How about anxiety?  I would encourage you to again track for a while – what is triggering it?  If it’s decision making – see above.  If it’s getting sick – work on focusing on what you’re already doing to take care of yourself and family.  And if it’s always stuck in your head, ask for help. 

If you are nervous about dealing with both children and work this fall, sit down and speak with your partner or a good friend and work out a plan for your day.  Sometimes using a calendar helps one in organizing the day so you know what the children need to do and where they need to be – whether at school or online for school, work hours, doctor and other appointments, shopping, etc.  And together also brainstorm all the free services or low-cost services you can call on to help save you time – Instant Cart, Door Dash, individual store shop and pick up options, and others.  Also, who can you share with and split the errands or needs?  Perhaps after reviewing your calendar together your spouse or partner can list all the errands for the week, and each agree to handle some of the work.  The same with work around the house.  Often an hour of planning can help save you hours.  And that will mean decreased anxiety and depression.    

Other anxiety and depression prompts can be larger with less tangible solutions.  Things like, will I be laid off?  How will I survive if that happens?  What will happen in the election?  Worry about a parent in an assisted care whom you cannot visit presently.  Or even a lonely feeling of not seeing friends as you have in the past, the isolation many are enduring.  Interestingly the steps are similar to decision making in that we need to first identify what is triggering the feeling.  Next, look for information about that to identify whether you are worrying or anxious about a reality or something that isn’t real at present.  An example might be a fear of being laid off as fear of the economy is in your mind.  Well, check out your company’s financial condition, see what your boss or Human Resources know about potential lay-offs.  They won’t give you concrete assurances, but often you can identify whether things have even been talked about and check the trade periodicals for the same.  Then consider how to make your position and you more valuable to the company and be sure to improve your position through upgrading skills, identifying your successes to more than just yourself, and challenging any negative thoughts that are not grounded in facts.  Even if you are affected by a lay-off by doing these last things you are upgrading your value to other companies.  Then note this on your calendar for 30 days out and reassess.  Each time you want to worry – take yourself back to the calendar and notice you have a “worry date” made for later.  That written task let’s our brain let go of this more easily.  The steps here are:  a) identify the cause of the feelings; b) get information about the reality of the situation; c) determine if there is someone else who can help you gain more information or perspective (often this is a spouse or friend); d) list options you can take to better the situation for you; e) make a date to next evaluate the situation; and f) reassess it on that date. 

Next time I’ll write about loneliness as it is impacting so very many individuals and I believe it is frequently underlying the current depression.  But for now – you have some concrete tools to deal with situational depression and anxiety and decision making.  I also have to encourage you to call on your spiritual resources, support people, creative outlets, and music.  All can improve or worsen our current functioning.  So, consider a step in each of these areas, you may be surprised how much something as simple as listening to music if you haven’t for awhile will help your mood.  Or coloring a mandala.  Or even just doing a walking meditation or online church service.  We’re not made in isolation, folks, we need others to live successfully.  So, use the creations of others (music), the connection spiritually that you have; the friends and close others in your life as well as family; and creation outdoors to bolster you at these times.  And if it is even too much for those resources, see the resources for immediate help if you can’t reach a therapist or physician.  But take care of yourself and reach a therapist or doctor for ongoing care. 

To close I’ll share a prayer that was written during a time of great difficulty 100’s of years ago: 

All shall be well.

And all shall be well.

And all manner of thing shall be well.  (Julian of Norwich)

Be well and take care of yourself,

Dr. Beth

Teen Lifeline:  (for teens) 602-248-8336 or 1-800-248-8336

Maricopa County Suicide and Crisis Hotline:  1-800-631-1314 or 602-222-9444

National Suicide Prevention Line:  1-800-273-8255 and for Spanish:  1-888-628-9454

Crisis Response Network:  602-347-1100

Decision making process excerpts taken from https://www.umassd.edu/fycm/decision-making/process/

Creativity in Life

The word “creativity” may make you think of artsy types, ready to craft a mask, whip up a painting, play an instrument, or pen a novel. And it is, in part, but it’s also about coming up with something new. In this case, let’s consider creative new ways to communicate, to stay connected, to motivate employees to stay engaged and do their best work even while working from home, and also, to entertain ourselves and find some joy in even the most trying of times. And, for those of you who would like to stretch yourself in the traditionally creative sense, keep reading, I have a few ideas for you too.

“Necessity is the mother of invention”-English proverb. We have found this to be true during trying times in our history which turned up products that changed lives. Take a look at the list of things we may never have had without tough times that caused someone to think outside the box.

  • Toll House Cookies: Ruth Graves Wakefield accidentally created the recipe while baking for her guests as the owner of the Toll House Inn. During the great depression, running out of baker’s chocolate, Wakefield settled for cutting a chocolate bar into pieces assuming the chocolate would melt. Instead, it hardened into tiny chips and became the first chocolate chip cookie. Families in the area of the Inn sent the cookies to their soldiers overseas who then shared them amongst the troops and began writing home begging for more–they became a global phenomenon. She eventually gave the recipe to Nestle, who compensated her with the only thing better than money: a lifetime supply of free chocolate.
  • Basketball: The game was invented in 1891 by Dr. James Naismith, a sports coach, but for the first three years, it was actually played with a soccer ball. Then in the midst of a recession, Naismith encouraged A.G. Spalding to create a ball specifically designed for the new game. With few changes, this is the same Spalding ball you see on the courts today.
  • M&M’s: “Melts in your mouth, not in your hand.” During the Spanish Civil War in the 1930s, Forrest Mars, Sr. (of the Mars Company) saw British soldiers eating pellets of chocolate coated in a hard candy shell. The shell kept the chocolate from melting in the soldiers’ hands. Mars patented the product and started producing M&M’s, exclusively selling to the military in World War II.
  • Pilates: Physical trainer Joseph Pilates conceived the idea of the workout known for core strengthening, flexibility, and balance while a prisoner of war in an internment camp during WWI. He honed his method of “contrology” on fellow inmates, aiding in the rehab of injured veterans. After the war, Joseph Pilates immigrated to the US and collaborated with dance and exercise experts to nail down the system we know simply as “Pilates.”
  • Meetup: New Yorker Scott Heiferman was in his apartment on September 11, 2001, when two planes crashed into the World Trade Center. In the aftermath, he found himself surrounded by neighbors he’d never even met. Following the tragedy, Heiferman observed the desire for community and that led to the creation of social networking site Meetup, where users can meet like-minded individuals in their area and make plans for face to face meetups.

And today there are already examples of crafty new products, businesses pivoting to meet new demand, and new uses of existing products. I’ve seen several ads for keychains that look similar to bottle openers but have been designed to open doors, press elevator buttons, and other tasks acting as a stand-in for fingers on high touch surfaces. In other countries there have been 3D printed handles attached to refrigeration doors in grocery stores that can be opened using a forearm rather than a hand. And businesses, even locally, that were previously in the space of building cabinetry that have now taken up crafting acrylic barriers for public spaces in an effort to meet the new demands of safety for businesses. School shop classes and computer labs have in some areas started implementing use of their equipment to create face shields. Shortly after the virus struck and stay-at-home orders were issued, restaurants were finding ways to create online bodega offerings by continuing to buy from their suppliers in bulk and then make household sized quantities of products available in a market that was difficult to find many products. And this next story I hear about our teens… While it may not be one of productivity, these kids are inspiring to me because this ingenuity is exactly what we need in our future generations. There was an article written about a year ago titled, “The Hottest Chat App for Teens Is… Google Docs” which describes that our teens are creating google docs, sharing them with friends—often as they sit in class—and due to the nature of Google Docs ability to see live updates by any of the document holders, are chatting with their friends much the way our older generations used to with passed folded notes.

Stories like these are inspiring to me, I love to watch the way people come together in support during times like these that are so difficult in so many ways. And to see that some businesses are able to find new ways to bring in revenue at a time many financial forecasts have flattened, it’s inspiring and has me hoping that others are looking for ways to do so themselves. I’ve also read that groups of co-workers who are now forced to work from home but are single, and thus, feeling very alone, have begun creating Zoom calls every morning with their colleagues so they can virtually sit side by side and do their jobs—and not feel so isolated. I’ve also read that there are nurses, who are understandably fatigued and stressed and overworked, that are finding ways to lighten spirits during their shifts. One story that stuck with me was a nurse who had two patients on a non-Covid floor who had to frequently get up to urinate, requiring help each time. The patients were apologetic, feeling they were pulling the nurse from more important duties. She reassured them, and realized they had senses of humor that would appreciate this boost—she created an “award” for them at the end of her shift for “most frequent use of the facilities”. The initial embarrassment was turned into a laugh for the patients and the nurse and lightened the mood all around.

And, now for the creatives and the creative hopefuls among us—let’s inspire you to keep going with your talent or your desire to learn a skill. Want to learn the guitar, or learn new songs? Fender has online classes found here in bite-sized pieces. How about the piano? Want to learn with Harry Connick, Jr showing you the ropes? Check this out. If writing is more your style, there’s playwriting, guidance for getting that novel written you’ve had rattling around in your brain, or a cool article from none other than Judy Blume, of tween girl fiction fame, with some tips on writing a children’s book. And if you’re looking for some visual art inspiration, I was impressed with this page Berkeley put together. There are also some great online art classes being offered by artist collectives like this—there is some free content to get you started and the classes utilize a number of different medias, from painting and sketching, to mixed media. And for the parents among us looking for outlets for the kids, take a look at Camp Creativity for some fun free content.

Let this be a time of creativity. The change in perspective by introducing a new idea lightens the spirit, helps move through darkness to hope, and may prove the path to a whole new business or product. If you are a supervisor to others, take some time to consider new ways to motivate your team—the morale boost can help not only their mental health but the fiscal health of your business. If you are a health care worker, are there ways to inject some levity in your day in even small ways? Quality patient care and provider burnout are uniquely tied together, so look for ways to help ease your daily stress, even if you simply create an “award” to bring a laugh. Are you working from home and lonely? Consider starting Zoom calls with colleagues so you can still have some office chatter while sitting in your home office. And, if you’re a parent facing burnout, look for Facebook groups for your area or for parents with children of similar age, or take a look at Meetup to find some peer support. Often, having those groups can make you feel less alone in your frustration and you find humor in commiseration. All or any of these ideas can help prevent or alleviate the depression and boredom I’m seeing so often around me.  Take a chance – take a leap – and try creatively something new in meeting a need you or others around you have.  

Wishing you creativity and hope this coming week,

Dr. Beth

Sources for past inventions and products:

https://www.interestingthings.com/gallery/20th-century-inventions-in-times-of-crisis/

An Exercise for a Time of Adversity

I’ve been working on my thoughts for the blog this weekend – one I promised on growth in adversity. And I’ve written it once, had it edited, and am issuing a fully rewritten one now. Obviously, adversity is hard to go through – and challenging in other ways. The meditation that had hit my inbox on Friday that spoke to me about growth in adversity was from Henri Nouwen in “You Are Beloved.”  And what strikes me today in it is the same and yet different after more meditating and doing a finger labyrinth meditation today.  The quote is: 

“The great conversion in our life is to recognize and believe that the many unexpected events are not just disturbing interruptions in our projects [or lives], but the way in which God molds our hearts[.]…Our great temptations are boredom and bitterness. When our good plans are interrupted by poor weather, our well-organized careers by illness or bad luck, our peace of mind by inner turmoil, our hope for peace by a new war, our desire for a stable government by a constant changing of the guards, and our desire for immortality by real death, we are tempted to give in to a paralyzing boredom or to strike back in destructive bitterness. But when we believe that patience can make our expectations grow, then fate can be converted into a vocation, wounds into a call for deeper understanding, and sadness into a birthplace of joy.” [changes mine]

What my labyrinth walk, a talk with a friend this morning, and the above from Nouwen have all pointed me toward is – – release.  Release is necessary to grow in times in adversity.  In fact, it was just in rereading the quote that I realized that the onus was on God and Spirit to mold – not me to change.  And then release of what?  From what?  To what?  Ahhh – there is the rub at times.  From even knowing that. 

What we often want so much during difficult, really adverse life events or times is to KNOW.  Know what we are to do next.  Know why something happened.  Know how to change it.  Know how to prevent it.  Know how to keep life from changing as it has been comfortable for us. And in the last weeks, months, or even days, we each have had to face down varying levels of demons or challenges in our lives.  Think about it for just a moment – what are you facing right now?  Is it illness?  Is it not understanding your partner or spouse?  Is it not knowing what to do next to help someone?  To help yourself?  Is it financial difficulty?  Go ahead, take a few moments to name the situation for yourself. Write it down if you’re open to doing so before you read on.

Now, what is it that you are trying to control in that situation?  For me, often it is outcome.  I want to be able to create a change or gain an insight in order to grow and move.  Or I want to create that space and hold it for another.  But my goal or method is not the answer; often, it is allowing the answer to unfold.  It is … release.  And yet being with someone or sharing the process with someone without knowing is to walk in darkness alongside them knowing that is enough.  As you are aware of what you are trying to control – perhaps a parent from getting Covid or dying from it alone in an ICU; maybe how you will pay the bills in 3 months when the severance runs out or tomorrow when there is no money; maybe how your employer is responding to changes in life recently; or maybe how you are managing your day-to-day life in the midst of a mild or moderate depression.  Give yourself a moment to pause, and again write down whatever outcome you are trying to control.

Next, I’d like you to find an object that reminds you of that issue.  A penny for a financial one; a rock for a stubborn issue you can’t seem to get around or influence; a Bayer Aspirin bottle for a loved one who is ill; these are some ideas to get your mind going.  If you can and choose to do so, take a few minutes to go find it in your home and return to finish reading. Pause here.

Then take the item you have chosen and hold it in your hand. Gently, as the hand is with the birds in the image above. Consider this item as fragile, even if, at first glance it isn’t. Your emotions about the issue this item symbolizes may be fragile, so treat this item with tender care. As you are meditating, look over the item you’re holding and see what feature you might not have noticed previously.  Release what you think you know, and turn it over and look at it with new eyes.  Consider what it has to show you.  I’ve had a very craggy rock Finley brought in the house that I’m using for my exercise in this.  And as I’m looking at it, I’m seeing an eruption in the top of it that is very sharp and discolored and today am aware of that as the focus – not the rock.  It is helping me to see the pain in something from not a heavy place but from the sensitive, hurting place.  What is different about the item in front of you – what hadn’t you noticed about it previously?  What is the message about the situation from that perspective?  Consider spending a few moments writing about that.  You might think about it in these terms if you get stuck on this part. 

I saw the _________________________ as representing _________________.

What I’d never noticed about the ___________ was ___________________________.

I’m aware now that it is possible that ________________________________.

As you finish the above exercise, what is the takeaway for you?  What have you learned by simply looking for the small factor you hadn’t considered or known about or been aware of as clearly?  Does that allow your view of the adversity you experiencing to shift?  And what does that mean to you about moving forward? Take some time to think about this and make some notes about it before moving on. Pause here.

Going back to Henri Nouwen’s writing – adversity, change, growth, understanding, and finally, joy are the stages of movement when moving through adversity and emerging in a new place.  What we must do is release ourselves from having to understand and know — and then, only then, we can begin moving towards the change, growth, understanding and finally joy that comes from that release.  The baby bird in the above picture wasn’t born with the ability to fly, it needed tending to and nurturing until ready to be released from the nest in flight. Only then, after time, after growth, came the release. I hope you can find your way to it through the above exercise too. 

Peace and calm be yours this week.

Take care,

Dr. Beth

Covid-19: Coping with the Changes 3 Months Later

This week has been again more stressful for many than past weeks as we see the number of Covid-19 numbers going up, hospitals filling, and requirements for masks in Maricopa County and many locations throughout the state.  In addition, this isn’t the first time around – this is into month 4 of dealing with this (although just into it) and I’m hearing tempers flaring, patience waning, and what I’ll term “Covid Fatigue” hitting.  What’s a person to do when this is happening?  And it’s now impacting our relationships, we know people with Covid-19, we’ve lost friends or family to it or they have had a serious case of it, and we haven’t been able to socialize or attend church and/or work in the same ways for quite some time.  And even the possibility of in-school education or dorm life is in flux right now for the fall.  And, to top it off, it’s been at or near 109F. (Good news, though, it may be down to 98F for part of this coming week.)  What a June!
 
Well, we are a resilient people, truly, although the level and speed of it varies by person.  Resiliency is the ability to overcome obstacles and move forward.  Resiliency leads to hope – and so we are to hang in there when things seem desperate.  There is an article I wrote a number of years ago about this and it’s on the website.   So, feel free to go there for more information.  But the essence is that to build hope, we must have people around us, spiritual practices, and be aware of possibility.  I’ve always liked Elizabeth Edwards quote:  “She stood in the storm and when the wind did not knock her down, she adjusted her sails”.   It’s time to adjust our sails a bit.  Here are a few ideas that have come to me lately, some of which I’ve shared here in the past or with clients, some are newer:
 
Realize you are just not accomplishing what you want to do – from something small to large?  Download Apalon’s Productive-Habit Tracker to your phone or tablet and choose just one or two things you want to be sure you do daily or weekly.  Build some success before you add more.  And give yourself a break – it is happening to most people as they live and work at home.
 
Concerned your spiritual life is not where you want it to be?  Commit to one thing a day – maybe a meditative walk; perhaps doing a finger labyrinth; spending some time to do a guided relaxation; say a prayer you relate to – a rosary, a personal talk with God, a psalm, or a pray with others through a compline online, keep a gratitude list, or listen to music that is meaningful to your heart or spirit (you choose!).
 
Fearful about the fall and what it will mean for you?  Teaching at school or via Internet?  Needing to teach your children again or sending them to school?  Sending your young adult to live in a dorm or live at home?  Focus on bringing yourself back to the present.  None of us know what August or September will look like.  So, we must stay in today.  Perhaps using a short affirmation for this will help: “I have only this moment”, “Relax in today”, “I find stillness when I live in the present”, or write your own. 
 
Feeling lonely or alone?  First, find a being in your home with whom you can share a hug, pet them, cuddle, or otherwise connect physically for a bit.  No one there and no pet?  Dr. Peter Levine urges us to hold ourselves.  How?  See Dr. Levine’s methods described and directions for several self-hug and holding exercises.  My favorite is to simply put your left arm across your tummy and with your right reach up and pat your left shoulder.  It will repeat what your mama did to you when she held you – and it is extremely calming.  Then reach out to a friend or family member by Facetime, Zoom, WhatsApp, or another method.  It amazed me again how much closer I felt to a friend last Saturday when we spent time talking by WhatsApp rather than only by phone.  Invite one or two friends over and socially distance in the evening while catching up.  Or do a Zoom breakfast or game night.
 
Uncertain or afraid of vacationing and feeling housebound?  Get your family together to brainstorm.  Two people have told me that they are doing camping trips and/or using RV’s to get time away with family.  Brainstorm a stay-home vacation – and here are a few ideas to get you going – https://www.realsimple.com/work-life/life-strategies/staycation?  The larger hotel chains have information out there on what they are doing, National Parks and Recreation has information on traveling to the parks and AAA has some information.   
 
My spouse is driving me nuts!  How do I cope?  We’ve heard about this on TV, in the news, and from our friends, right?  So how do we cope when we are living and working together full-time?  First, communication is essential.  And that is very hard when we’re stressed and misinterpreting the intention of others as well as struggling to find a little alone space.  Or perhaps just tired of the way they work as it’s different than ours or conflicts with our methods. CNN had a few ideas worth looking at. I’m most impressed with the couple who, in a 576 square foot apartment found ways to compromise and parent children.  What bothered you 3 months ago will now be driving you around the corner.  So, take a deep breathe, do something to relax yourself, get away from your spouse or partner, and talk to a friend before you try to talk to your partner. 
 
Feeling bored at home?  Listen to a new podcast (or two), review some of the art galleries we put on our website under Covid-19 resources awhile ago, go swimming, or put some music on and dance.  I’m very much enjoying the “Poetry Unbound” podcast each morning (under 10 minutes usually) and playing in the water with the puppy.  Both are new for me – and take me in different places that open my brain and heart. 
 
Ok, there are a few ideas.  Next Sunday I’m hoping to finish the article on growing in times of adversity.  But for now – I’m hoping these ideas help you just get through the tough moments in life.  I commit to acting on the alone and spirituality ideas above – so what is your choice?  I hope you do it even for 5 minutes. 
 
Take care and be well,
 
Dr. Beth
Beth Sikora, PhD, LPC, NCC

2020 – The Age of COVID and Protests – Part 1: Parenting

I was interviewed on a podcast recently and some of the topics we covered were things I thought may be of interest to you. We discussed how to talk to children about all of our recent heavy headline news. And, are these times fostering more PTSD?

Let’s take a look at Covid and our kids; how do we safely allow them to see friends and be kids? It’s been about six months now and this virus is still in the headlines—in Arizona and some other states we’re even seeing a greater number of both new cases daily and more hospitalizations than we did during the first of the outbreak when we were under stay at home orders. It was tough to manage when the spread was new, but now that it’s continuing for so long it feels nearly impossible to keep our children happy at home away from their friends. So, what do we do? How do we talk to them about these times? Start by ensuring you have trusted and up to date information– take a look at the websites of the CDC, your state public health department, and Johns Hopkins, as examples. Only after you have a clear picture of what the current Coronavirus status is, are you ready to talk to your children. At that point, open up the discussions!

The first consideration is realizing that the conversation varies greatly depending on their age. For children 4 and under, it’s enough to simply say people are still getting sick in our city and we have to change the way we play with friends to help keep everyone healthy. Begin by teaching children to keep their hands away from their faces. Pull their hair back so it doesn’t tickle their cheeks and noses, have tissues ready for runny noses and sneezes, and choose age appropriate, size appropriate toys to keep their hands busy. Rattles, teethers, and soft toys for babies belonging only to them and well sanitized between uses are good options. For older children, choose things that aren’t choke hazards that are good for fidgeting, Rubik’s cubes, fidget spinners and cubes, and similar—keeping in mind that a toilet paper tube is a good size to put something through to test whether it is small enough to choke on.

Another good safety lesson for your kids is to teach them their personal space area, which is really well illustrated by having your older toddler hold a hula hoop around their body. Let them hold it and walk next to someone to see what it feels like to keep that distance from someone else and play. And–what does play look like at this age? The safest course of action is to create alliances with certain friends, setting expectations that each of you will only open your bubble to one another. Along with that, you’re maintaining safety by not going out to stores without a mask, not dining in restaurants, and not seeing people, including family, from outside of your own home other than the other family or families that have created the alliance with. If you decide to see someone outside your bubble, then you wait 2 weeks until you again see your playmate friends. It takes a commitment to uphold this level of conscientiousness, a level of honesty with the other family or families in the bubble, and a good degree of trust.

The next safest way to play is to meet up at a playground. Keep in mind what we’ve learned about the virus, larger, more open-air spaces spread out the germ load making the viral transmission less than in an enclosed space with people closely in contact. Playdates in the park could include not only the playground equipment, but also scooters, bicycles, kites, jump ropes, and hula hoops. Things that promote independent side by side play rather than heads huddled close together sharing Legos as an example. And if you’re not comfortable with the playground equipment, go to a part of the park with only grassy play areas and try the other activities mentioned.

Grade school children conversations can include a bit more information. Remember you’re not trying to encourage worry with your child, so don’t use scare tactics.  Rather, you are sharing with them the reasons their play lives don’t look the same as what they did.   You can ask if they have questions about this sickness that is affecting people, ask them what they know about it. By knowing what they’re thinking it can guide you in what you need to share with them. With this age, you can explain in a bit more detail the reasons behind changes you’ve implemented in your family activities. It’s okay to tell your children there is an illness that is causing some people to get very sick and sometimes need to go to the hospital. You can tell them that using a mask can help not only keep them safe and healthy but also those around them, so it’s important to wear a mask in public. If you’re having trouble getting them to wear the mask, treat it like a dress up accessory. Find or make a children’s mouth and nose covering mask that is in a print or style of a super-hero, maybe add a cape and let them wear the whole ensemble to the store. Or, maybe a princess mask and gown. Remember, children are imaginative and the more you can incorporate the mask into their imaginative play, the more likely they are to embrace it! The information shared on playdates for the younger set applies here too.

Middle and high school children have a much higher level of understanding than the younger set, obviously, yet the premise of creating a dialog remains the same. Open up the talk by asking them what they think about Covid, what facts they know, and what questions they have. This is an age that you can be a relatively open book about how this virus has affected our world. Remember that you are not attempting to create panic or anxiety so frame your words in a way that isn’t an attempt to scare them into submission, rather a factual account of the vast numbers of people that have been affected. From how long the illness is taking to get over, to the extent of hospitalizations and deaths, there is not an area than need be kept from this age bracket. However, know your child.  If he or she is a child who will remain up at night worrying about the lives of all those who are sick, limit your details about of the illness when discussing the symptoms of the very sick.  High school teens are able to get a lot of info on their own, and likely are through friends and social media.  We all know that some of this information is not correct, so it’s especially important to begin with what they know, what worries them about Covid, and what their thoughts are about this disease. 

If you don’t recall the specifics of past pandemics, now may be a time to look at how the influenza pandemic swept through in 1918, or any of the epidemics that have gone on in our country or world’s history. Your children have learned about these times in history more recently than you have and using the examples of the past may help them realize that with time, this will be something we are able to move forward from. Enjoying time with friends for the middle-high school age group looks a bit different than it did for the younger set. This is a time in life that maybe it’s okay to ease up a bit on the restrictions of their gaming devices, recognizing this is an area many kids play games with their friends—and in this case it’s a physically safe way to have some social time. Beyond that, this is where you model the behavior you want to see in your kids. They’re watching you, and if it’s okay for you to gather with friends, go out to dinner or drinks, or go to parties, they’re going to expect to be able to do the same. If you are distancing and your pre-teens or teens want to have a social life resembling what they had prior to the outbreak, you will have to set some guidelines—and remain consistent. If your child has a close friend and you know the family of that friend is also distancing and using the cautions you are at home, maybe you’ll decide it’s okay to let the kids spend time together. If the other friends’ families aren’t distancing, or you don’t know their family expectations, maybe you’d be okay allowing the kids to get together at an outside venue—a pool, or a lake—but not let them ride together in a car to get there. This is where well thought out judgement is necessary. It is a stressful time and will likely require you have conversations with your spouse or significant other to be sure the two of you are aligned in thinking so you can’t be played against one another. Make concessions so each of you feel heard if you’re not in total agreement, and as is always the case with good parenting, consistency is key. Upholding standards so your kids know what to expect each and every time can eliminate a lot of fights.

Talking with your children about race relations, protests, and the police all follow the same guidelines. Use your child’s age to determine how deeply you delve into the topic. If your children are young, picture books can be great, dolls with different skin tones can illustrate and model play among people of all colors—remember not to buy only dolls that look like your child. If your kids are older, it’s a wonderful time to ask questions to see how they think, ask what they’d like to see change, and help them navigate how to handle racist conversations with others, including the possibility that racism is coming from somewhere in your own family. If you are a person or a family who protests, go forth in the safest way you can—and pay attention to some of the really excellent graphics circulating on social media about how to protest safely including always wearing a mask and carrying water with you. Recognize that this may be confusing to children who are told they cannot attend a birthday party, yet they then see you or all of your family surrounded by hundreds in a protest. Be prepared to explain your reasoning and your safety precautions.

Some of your older children may be taking in the messaging on de-funding the police. They may have opinions about why it is a good measure, or why they’re afraid of it. Again, be informed yourself by reading up on the topic. Understand what de-funding means, and where the funds are proposed to be allocated instead. Ask your kids questions. Get a good understanding of their level of interest in the topic, their concerns or gaps in knowledge, and if you don’t know all of the answers with this topic or any—it’s okay to tell them that. Research it with them, or on your own and come back to the conversation after you’ve done some more reading. Try not to put it off for too long, lest they think their questions aren’t important to you. Remember that a lot of learning how to critically analyze a situation comes with maturity. Help them learn how to be critical thinkers by posing questions to them that go deeper than the superficial, and really listen when they speak to you.

My theme here has been talking and creating open communication. It is a healthy start to help a person move through these news headlines that are so heavily weighted. Matters of health, social injustice, overhauling our police forces are among the most stressful and highly charged topics in life. So, is all of this exposure to so much right now fostering more PTSD? I don’t believe so in most cases. But the news can potentially trigger PTSD if watched too frequently. By proactively limiting exposure to these events and viewing of the news, social media, and talking through these matters with your children or teens who may also see the coverage, the potential can be minimized.  And, as has been highlighted in nearly every writing I’ve done on stress, take note of what media you’re consuming, both in your sources and in the amount. If you find it difficult to digest, have a hard time sleeping, have ruminating thoughts, and/or find yourself anxious, it’s time to unplug for a while. Rest. Meditate. Be in nature. Check in with friends. Talk to someone you feel really hears you.  If this is not enough, always seek professional help. People are resilient but do much better at handling difficult times using healthy tools. There was more discussion centered on PTSD, trauma, self-care, and stress in the podcase, and we’ll be issuing a part 2 to this blog within the next week or two, so stay tuned!  You can also listen to the podcast, click here.

Finally, as the numbers are increasing so very quickly of COVID in our county and state, please take care of yourself and let us know if you need any assistance.  Grief is sure to be an issue we’ll be dealing with in coming blogs, but in the meantime if you need to hear more about this topic, you can do so here or on stress and COVID here.  As always, I wish you good health–both mentally and physically, and encourage you to take care of yourself daily, moment by moment. 

Dr. Beth


Calming an Anxious Mind

Sometimes it can seem as though our minds never turns off. During these times most recently, we may find that we have ruminating thoughts about the state of our world, our nation, our state, our county, and lastly but certainly not least–our households. Trying to maintain a positive attitude at home or with others may be difficult, let alone being fully present with others.

These are concerns facing many today, and part of a larger theme of anxiety I’m hearing about routinely in my practice. Across our nation, we are seeing re-openings of businesses, and with that comes new decisions of what is truly safe to do. I’ve provided resources in past blogs (found here, here, and here) of reliable sources to look for information as well as tools to get you through this time on my website found here.

Today though, let’s talk about the anxiety itself and how to cope with it. There is a graphic circulating online which shows varying stages of acceptance, take a look below:

This is a great illustration of the process of learning to open oneself up again. In some ways, this re-opening feels a bit like the immediate post-911 world to me. There was fear of going out and resuming “normal” life directly after the attacks because we just weren’t sure it was over. Our nation faced significant losses during that time, and we will never be who we were before that event; but, as time marched on we learned to process the experience and with that, we moved forward. We will do the same with Coronavirus/Covid-19. Take a look at the graphic, see where you think you may fall in the bands radiating off of the circle of Covid–do you see that you’ve made some progress? Or are you still practicing some of the behaviors in the darkest zone, the fear zone? Do you see that some of how you are feeling or acting are examples spread across more than one zone? That is a completely reasonable reaction. Likely where most of us are.

The above graphic also reminds me of the stages of grief, in more than one way. Many of us are familiar with this model of grieving developed by Elizabeth Kubler-Ross and I find the stages apply to more than the loss of a loved one. She defined them as, 1. Denial and isolation, 2. Anger, 3. Bargaining, 4. Depression, 5. Acceptance. Some of those examples look familiar to the handling of this Covid era too, don’t they? The initial denial that this could be happening to the people of our world, our nation; the anger at others who may not be taking the news the same way we have chosen to respond; the bargaining–if only we’d done X, then…; and the isolation which can also bring on depression.

My point to all this? We’ve handled grief likely on a personal basis, but also as a nation before. We’ve been fearful of unknown forces. We have come through it, and maybe we don’t look the same as we did before the catastrophe–on a world or national scale or on an interpersonal, familial one such as after the loss of a loved one–but we humans are resilient and even after a time that feels like it could have been the end of the world, we can again find beauty in things. So, let’s talk about how to move forward.

Mindfulness. Merriam Webster defines mindfulness as: 1: the quality or state of being mindful. 2: the practice of maintaining a nonjudgmental state of heightened or complete awareness of one’s thoughts, emotions, or experiences on a moment-to-moment basis also; a state of awareness. It’s a topic I’ve covered on a recent blog found here because I feel strongly mindfulness is one of our most useful tools in healing.

  • I came across some wonderful “attitudes for anxiety” in a blog post on Positive Psychology–to read the full post, click here. The 10 attitudes to practice for anxiety are towards the bottom but there are a number of other tools to practice she highlights–it’s worth the read. The one I find most essential is to: 1. Notice what is going on in your body. What are you feeling? Where? Is it the discomfort of reflux? The heart-pounding of panic? The headache or migraine of muscle tension? 2. Just stay with that feeling and feel it for a moment. Really let yourself become aware of what is going on internally. 3. Recognize what your thoughts are that either preceded the physical issue or are still present with the physical sensation. 4. Take a slow deep soothing breath into that part of your body that is in pain, taught, or uncomfortable. Hold it. Then blow it out as fast and hard as you can. Imagine that breath out as the difficult thoughts and feelings – blow them all out of your body. Do this several times and then attend to the area of the body with some self-care, i.e.: massage the muscles, notice the heart pounding may have slowed down with the breaths, or the reflux released just a little and if not take the medication you have for it.
  • Learn to meditate. There are countless videos and apps for meditation, some found on our website here, others a mere google search away. But here’s a good one I learned from a nun at an anxiety workshop many years ago. Spend 5 minutes looking into the flame of a candle. A well done video with an introduction to this meditation and a recorded candle’s flame for this process can be found here.
  • Deal with only one day at a time – Jon Kabat-Zinn has discussed this on Oprah’s Super Soul Sunday, the clip may be found here. He proposes checking in on yourself. How do you feel this morning? Are you still upset about a fight last night, or worried about an upcoming meeting? What do you want to achieve today? Understanding how you feel before you embark on your day can help you go through your day more mindfully. “Drop in on yourself and rest for a stretch of time,” Kabat-Zinn says. “And then as you go about your daily life, check in. Once an hour, once a minute. Once a day. You decide”.
  • Another technique a trusted colleague recently reminded me of when dealing with anxiety about the future and what is okay to do now or in a week about Covid-19 is to look at your watch. What time is it? What day? This is all you can make decisions about and deal with in this situation – use your watch as your reminder. See this blog for more information.

As I’ve written about before, practice good self-care. Not only the physical in good hand washing practices or wearing masks; but also, the mental self-care. Remember to limit your media consumption, be gentle with yourself, and get outside daily. If you’re dealing with OCD, it can be a tough time to manage your symptoms. If your current techniques aren’t working or you’re becoming worse through this, here’s an article written first person by someone who is handling OCD related to our current pandemic. Take a look at her tips, and if they’re new to you consider implementing the ideas. Even if they were routine previously, it may be time to up your game on using them. There are also some basic self-care principles written about here.

The same basic ideas apply to how to best care for your children during this time, but I cannot underscore this point enough, talk to them. Ask questions about how they’re feeling in an age appropriate way. If they’re older, see if they have questions on the state of things related to the illness and the ability to go out in the world or what your emergency preparedness plans would be. Ask them how they’re really doing at this time, and if they’re isolated from their peers–and consider supporting them in some things you previously may not have been as open to such as gaming on a device. In limited doses, it may be a great way for your kids to stay connected to their friends–it’s often a group activity yet can be played from individual houses. Watch for behavior changes in them–and if you’re seeing signs that are worrisome get them help. At this time of tele-therapy, they may be more open to the idea of talking to someone from the comfort of their own space rather than having to go into an office for counseling. If your children are younger, don’t overlook playtime as moments that feelings surface. Role playing with dolls, or even putting names to favorite play cars and trucks may bring out “feelings” the toys may have–but could really be the feelings your child may be dealing with. Remember, just like it can be hard for us as adults to put a name on a feeling or be forthright when we are having a hard time, children feel that too. Play with your kids when you can make time. No moment is too small–from the bathtub to a walk around the neighborhood, remember to take moments to check in on your littler people. Here’s a quick read from Seattle Children’s hospital on helping children and teens cope with anxiety.

I hope this provides some tools to each of you to calm the anxiety you are facing. Remember that this, too, is just a season. It will pass, and even if we have some longer lasting changes to adapt to, as was said by the late great Maya Angelou, “I can be changed by what happens to me. But I refuse to be reduced by it.”

If you need some professional help, know I’m only a phone call away. Get ahold of Angie, my practice manager, and get yourself scheduled. I’m here for you, reach us by phone at 602.508.9190.

Wishing each of you an easy mind today, a restful night tonight, and a more peaceful tomorrow,

Dr. Beth

Decisions…Difficult but Important to Choose and Own

Our current times continue to present challenges in many ways for all of us.  From the smaller decisions of what to purchase at a grocery store and how to do so: online, via delivery, or in-person; whether we’ll follow the guidance to wear masks; to the no-brainers of breathing in and out each day, and to the largest decisions about when to retire and other big life changes.  We can say that some of these decisions are easy, whereas on others we will not reach agreement with everyone.  As Eleanor Roosevelt said “In the long run, we shape our lives, and we shape ourselves.  The process never ends until we die.  And the choices we make are ultimately our own responsibility”.  There are crucial decisions being made by governors and legislators right now related to COVID-19, the economy and businesses, as well as protecting individuals.  At this time, we are also called upon to make our own choices, and decision-making is often challenging and stressful.

Part of this stress is brought on by hearing multiple conflicting ideas about how to open a country back up, what is too soon, what is too long, how much individual health and lives should be considered versus the economy, and whose guidance should be followed in these areas.  I believe, as Eleanor Roosevelt and others have said, that we are responsible to determine what is in our own or our loved ones’ best interest.  Some of the decisions our leaders make we need to assess and determine what to follow and when, such as the recent ones, and ones to come, about reopening.  So, I thought it was time to review a few basics on decision making.    

First, get yourself in a quiet place, without distractions, and relax yourself.  Hard to do in a Covid-19 world, but perhaps these steps will be taken over a period of a day or two, and that’s fine.  This might be doing some meditation, prayer, deep breathing or yoga, or other ideas you might have.  It’s important to have our brain available, and when we are relaxed, we have more capacity to use our full brain without it being impacted by a fight, flight, or freeze change in brain reaction. 

Second, once you’ve done the above, write down what the decision is that you’re trying to make.  Tie it down to one decision, after all we can’t make more than one decision at a time.  Writing it down helps you to focus.

Third, do the research you need to do.  For decisions about work, going out of the house, deciding whether to go to salons or restaurants, or even just whether to grocery shop versus using pick-up services, I’ve found some sources of information and am providing those here.  These links provide various views so you can consider what the pros and cons are.  But seek out your own sources as well.

  1.  CDC suggestions/plan on how to reopen

**I’m providing several Governors’ plans as it will allow you to see what they are considering and that may help you in making your own decisions.

After reviewing the facts and areas to consider from the above or other information you have, the fourth step is to write down your pros and cons on choosing to take various steps, i.e.:  go out to dinner vs. picking up dinner or having it delivered, going to the hair or nail salon, working in these environments and offices, and the others you’ll be faced with in the next week to months.  Then if it is clear to you what you will do, be clear with yourself how you reached the decision.  We can only make the best decision we can on any one day and with the information available to us.  You’ll want to reassure yourself later why you made a decision if later you question it.  If it is not clear, consider talking it through with your spouse, a significant other, close friend, person you respect, or trusted other.  And then follow the above once your decision is made. 

The fifth step, that will seem familiar to all who have studied science – from junior high forward, is to re-evaluate and make sure the decision still makes sense as you go.  Feel free to change your mind if that makes sense to you later.  For example, as many have suggested from a lot of entities and as we’ve seen in other countries, the numbers are going to go up as we reopen, so you may choose to change your decision if they are going up very rapidly, or begin going back down.

I ran across this in looking for a poem on choice and decision-making.  And in the end, I loved the simplicity of it:

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Source credit: quotesgram.com

Having peace during these times is challenging – but remember that with following all the guidelines we already know from so many sources, continue to:

  1.  Wash your hands often, with soap and water, for at least 20 seconds.
  2.  Wear a mask in public.
  3.  Cover your nose with a Kleenex if sneezing anywhere.
  4.  Cover your mouth with a Kleenex if coughing.
  5.  Socially distance keeping 6’ between you and the other person/people.
  6.  Clean and disinfect touched surfaces regularly and throughout the day.
  7.  Do not touch your face or wash your hands after you do.

All of these get tiring to hear about at times – but they will be essential for a long time to come.   And they can provide you with peace within that you are doing all you can to protect yourself and others. 

Finally, remember to take time to relax, enjoy your family around you, reach out to friends in socially distant methods, pray, meditate, and use the tools we and others have provided. 

See our website for general resources.

We also have COVID-19 specific resources as well as blogs on ideas in managing these stressors.

You deserve to take care of yourself, and I encourage you to make your own decisions, and take care in all the ways you need to do so during these challenging days.  We’ll be back to the regular blog again on Sunday, but I wanted you to have these thoughts earlier as things are changing rapidly. 

Take care,

Dr. Beth

Covid-19 and Brain Conditions

We keep hearing the experts talk about the dangers of Coronavirus especially involving those with preexisting conditions or “comorbidities”. But does that include a brain or neurological condition? There is so much information that’s been written that it can be difficult to sift through. We’ve compiled some good resources from trusted websites just for you. In general, the answer is no, your risk is not greater due to your condition and the current CDC guidelines should be your first steps. Following that, there are a few other things we’re suggesting to take a few additional precautions. We’ve created the graphic above which can be downloaded here. Once downloaded, each of the links are clickable so you can use it as your single page go to for lots of information.

The takeaway? 

  1. MS:  Be sure to really focus on stress reduction as both a preventative of exacerbations of your condition and warding off COVID-19.  If you do get sick, treatments appear to be the same as the general public. Be sure to follow your neurologist’s recommendations and closely follow the CDC guidelines on distance, wearing a mask, and staying in due to your lowered immune system. Additionally, it’s a good idea to have 3 months of medication on hand. https://multiplesclerosisnewstoday.com/faqs/2020/03/02/faqs-about-coronavirus-and-ms
  2. Parkinson’s:  Since this patient is also usually over age 60, be careful to follow all CDC guidelines and stay in.  See the following link for a letter the Parkinson’s Foundation Association recommends keeping with you:  https://www.parkinson.org/sites/default/files/Hospitalization%20During%20COVID-19%20Letter.pdf  Take a look at some other ideas at: https://www.parkinson.org/blog/tips/Coronavirus. There is also webinar and audio content available at: https://www.michaeljfox.org/news/coronavirus-and-michael-j-fox-foundation
  3. Migraine:  Be very careful of your known triggers to prevent worsening.  Monitor and minimize your stress levels, practicing good self-care.  Have enough of your meds on hand for 3 months.
  4. Seizures:  If you have been consistently free of seizures with medication for 6 months or more, there is no current indication of a correlation.  But do have a 3 month supply and take it as prescribed.  And, as always, manage your stress and worry to the best of your ability.
  5. ABI – TBI :   Good news, there is no known higher risk for those with a brain injury. But you do need to manage all symptoms such as seizures and migraines– see above for details.  If your ABI is stroke related – keep taking the medications you were put on, following your neurologist’s advice and stay in touch especially if you are having more seizures, headaches, etc.  https://www.stroke.org/en/about-us/coronavirus-covid-19-resources  Watch diet, self-care, balance and keep up your exercises for this safely, manage stress, and have any medications on hand preferably for 3 months.  Follow all CDC guidelines for safety for COVID-19.  See https://www.biausa.org/brain-injury/community/covid-19-resources and https://news.shepherd.org/qa-coronavirus-disease-2019-covid-19/ For other information on traumatic brain injury and COVID-19. 

Links for everyone: 
To maintain this self isolating, we will all do better with managed stress, good quality and amount of sleep, and maintaining relationships with friends and loved ones using technology. For some suggestions, take a look at the links below!

  1.  Down Dog – https://www.downdogapp.com/ free until May 1st to all; free to teachers, students, and healthcare to 7/1
  2.  Music to calm and relax:  https://advancedbrain.com/shop/music-to-relax/ easy download as well.
  3. Headspace:  https://www.headspace.com/covid-19
  4. Browse our recent blogs
  5. 5 quick tips:  https://www.npr.org/sections/health-shots/2020/03/03/811656226/pandemic-panic-these-5-tips-can-help-you-regain-your-calm
  6. The resources page of our website (we try to keep this updated with news, shopping tips, and some fun!)  https://www.thewholenessinstitute.com/covid-19-resources.html

 I hope you have a safe and healthy April. Please reach out if you need additional support, this is a stressful time for most. I’m here if you need me.

Take care,    Dr. Beth

COVID-19, Control, & Compassion: Choosing Our Attitudes and Being Compassionate

We can’t control our world, our family’s lives, even our own life right now, can we?  We can’t know when or where the Coronavirus will hit.  We can’t know if we’ll get it, or our neighbor, or our best friend, or our coworker.  We can’t know if we’ll come through this time financially whole or if the financial condition of the country and world will collapse. And this is scaring many of those I see or those I read about in the news or that I hear from on Facebook or other social media accounts.  And I get it – there is much uncertainty.  This morning, though, I wondered to myself – but can we ever?  Can we truly ever have power and control over all that happens to us?  All that we experience, think, and feel?  All that we so often trudge through life trying to control.  Our boss?  Our job? Our health? Our financial condition?  Or is it possible, just possible, it’s an illusion of control?  And that the truth we are living right now – that we cannot control the spread of COVID-19 more than following the suggestions of medical professionals and mandates of our government is the reality we live each and every day? 

Dr. Viktor Frankl was a psychiatrist who was put in a prisoner camp in Germany during the time of Adolph Hitler.  A man of Jewish faith and lineage, he was in the group abhorrently victimized and often killed by those under Hitler.  And from him came some of the most profound writing in the area of existential psychology – or the psychology of meaning and experience of life.  He survived the camp, a feat beyond my imagination, and stated, “When we are no longer able to change a situation, we are challenged to change ourselves”.  Ah – here is the kernel of hope we do have, we can always change ourselves, our reactions. He went on to elaborate: “Everything can be taken from a man [person] but one thing:  the last human freedoms – to choose one’s attitude in any given set of circumstances, to choose one’s way”.  And this is how he survived the experience in Auschwitz.  And helped many others to do so – to choose their attitude to keep trying, one step, one day at a time; and to assist others by noticing them, handing them a crust of their dried bread, or a sip of the tiny bit of water they were given. 

A choice – we, too have choices.  Are we going to share with others compassion and love and a safe place to share what isolation is like?  Or what living at home 24 hours with children and/or spouse is like?  Either can be very challenging.  Are we going to be supportive of the grocery store clerks and employees – or grumble that we didn’t find what we wanted?  It’s a choice, isn’t it?  I will say I can sometimes be tired and grumble when someone doesn’t acknowledge what I’m experiencing – but how would they?  We’re each unique and experiencing this time differently.  So, I need to back up and possibly share it and ask for understanding or at least respect for my experience and apologize for the grumble. 

Kristen Neff talks about self-compassion, and Viktor Frankl about compassion towards others.  But Neff makes an excellent point – if we don’t have it and show it to ourselves first, how will we ever share it with others?  So, as we are facing days that are long, with limited control but room for personal choice in attitude, perhaps a little self-compassion would be a good first step.  Especially through this next week when many who are Jewish cannot celebrate Passover as they are accustomed to and Christians cannot celebrate Easter as they are.  We will need to choose attitude and show compassion. 

Kristen Neff discusses this from a place of self-compassion, Brene Brown from a place of shame and working to change that and let go of that, and Viktor Frankl from a place of making a choice in our experiences about our attitude.  All three, interestingly, have similarities in what to do.

  1. Notice what you’re feeling.  Be with it in the moment.  Be present and mindful so that you are aware and do not act out, hopefully, towards another.  So, for example, when I am feeling lonely facing Easter without the family and traditions we usually share, I need to sit with that.  Feel the pain, the disappointment, the loneliness. 
  2. Being kind to yourself in language is also important.  Rather than the voice that might say, “Oh grow up, it’s one holiday.  You’re fine.  At least you’re not in the hospital and dying of Covid-19”; we need to instead say, “I’m having a hard time. This is something I haven’t experienced so it feels new and lonely.  And it’s a change – I struggle with change in family tradition.  So, I need to be even kinder in planning and deciding how and what I will do Easter Sunday”. 
  3. Name the feeling and share it with some safe person in my life.  It might be in prayer.  It might be in text to my best friend.  It might be a call to a family member to connect at least that way and share and listen to what they are experiencing as we face the next 7 days.  (This is unique to Brene Brown’s idea of coming out of the shame spiral by facing it and sharing it.)
  4. Decide how with what attitude to face the next 7 days and what choices are available.  For example, reaching out to others is something Viktor Frankl recommends as we reach out in love.  Not in guilt or caretaking or shame.  But as he says, “Love is the ultimate and the highest goal to which [we] can aspire”.  This means both the love in self-compassion above, but also the love in reaching out.  Perhaps something special to do with the children over the coming weekend.  Perhaps sending cards of love to family we cannot see. Maybe planning our own special day of ritual and celebration and sharing it in love for the other(s) we might be with – even if that is ourselves.  Nurturing the sense of self-compassion, and care. 

So how will you face your own attitudes this week?  How will you remain mindful of what you are experiencing?  What change can you commit to?  What are the steps you might take to show yourself and others compassion?  I would encourage you to write them down.  Post them, put them in front of you, and lovingly remind yourself of them each day. 

Warmly and with compassion,

Dr. Beth

PS:  Want to learn more about these 3 theorists and clinicians?  I suggest the following books:

Daring Greatly:  How the Courage to be Vulnerable Transforms the Way We Live, Love, Parent, and Lead by Brene Brown

Man’s Search for Meaning by Viktor Frankl

Self-Compassion:  The Proven Power of Being Kind to Yourself by Kristen Neff