Of Goodness and Evil

The past week has brought the hope and celebration of a new year … and a showing of anger, narcissism, psychopathy, and hatred.  We have seen it in war, in racism, in other ways, but not in this country in this way.  As such it has left me a little uncertain how to write a blog for the new year and yet address the fears and anger and profound sadness with which this year has started given the events of January 6. 

I found myself rereading “People of the Lie” by M. Scott Peck.  He writes of the fact that we must be careful if we call another evil, for we also can go that way.  And, in fact, those who are evil will always call the other evil.  Think of the partner who treats their partner with blame, abuse, and a sick form of love; yet believes their lies that the partner truly is the one who is sick.  Or someone who tells an individual that they are “lazy” when they know that they have a learning disability or other “hidden” disability that may simply mean slow processing or difficulty learning or doing one’s job.  One may seem worse, i.e.:  the abusive spouse over the parent, teacher, sister, or friend who calls someone “lazy”; yet both can hurt the other party.  In “Dare to Lead” Brene Brown would call this time in America, or with family, or friends, or employees a time to be being willing to have ‘tough conversations” with a whole heart. My greater desire is to find a way to help you find hope and healing, not to cause pain or offense, or affront anyone.  As I found myself reviewing the writing of the psychology of evil by Peck I was reminded of his words, “The problem of evil, for instance, can hardly be separated from the problem of goodness.  Were there no goodness in the world, we would not even be considering the problem of evil” (p. 41).  And so, I am trying to point out the way we can each move toward the goodness in life.  We must remain aware of what is going on in the world and at home, and make choices much as those I am reviewing below for our own personal growth.   

January 1 is World Day of Peace each year.  Interestingly, I didn’t see a notice of this other than one brief one.  That may have been due to a holiday weekend and busy weeks leading up to it.  But I ran across a blog that addressed it, and the comments made by Pope Francis in it that are even more pertinent today, the 9^th. “These and other events that marked humanity’s path this past year have taught us how important it is care for one another and creation in efforts to build a more fraternal society”.  Peck agrees that love and goodness allow us to see the evil.  And that the first step is to see it and call it for what it is.  Brene would say we must live our values, be what we believe, and bravely live into trust with others and speak truth – but with empathy.  Essentially Peck says the same.  And in doing so, we must look at both the evil (or less than healthy) in ourselves and then, with compassion, speak our truth to a trusted friend or counselor, face it, and bravely work to change it. 

As an example, it’s been a very busy week and I’ve had to deal with multiple needs of others and not had time to deal with everything that was hitting my phone, email, and texts.  In trying to keep up I didn’t get a text answered that could have caused less anxiety for one person; I skimmed a few emails from a committee and likely hurt someone on that committee; and I’ve neglected Finley (ok, so he probably took the least of the toll; but I took him to daycare to play on Friday to make up for my lack of attention and he came back exhausted and is now zonked out).  But I’ve had to go back and apologize to both people with whom I could have responded better and not caused the concerns that came up.  Did I do it from a place of evil?  No, but I did need to correct and be kind to them and trust that I can apologize and move forward.  That’s what is meant by living what we believe, then speaking with compassion in seeking to change what my act of moving too fast did to others.  Those are fairly easy things to repair.  And yet they take time and thought and self-awareness.

What about the bigger concerns?  What about a person who might be hurting a loved one of ours?  It might be a boss hurting a friend, a child’s mental health hurting a parent, a minister hurting a group within a church, or even an animal killing other animals.  While we might be able to explain each situation, there is pain, and a part of evilness, and a piece of unrest we experience in these situations.  I ran into this in the first clinical situation I ever was involved in professionally.  I was at a children’s center and was told to work with a child who had already shown a great deal of disregard for others or for human life.  I remember thinking, “what in the world do I do here?  I’m not equipped!” So, I read a lot about children like him, adults like him, spoke with some experts in town, and a couple out of town.  In the end, what mattered most to me was helping his mother, in a small a way, begin to see him and recognize him for all of who he was.  My goal became, through family therapy, to give her a tiny bit of understanding and help her to find some remnant of a human child who was good but terribly hurt by others to the point he was striking out so forcefully against all.  That came from, as Brene says, brave work and tough conversations with the mom, as well as loving hard – with courage.  Did I help the child?  Frankly, I do not think I had the ability or experience or tools with which to effectively help him.  For that I believe, even today, that he needed much more than I could offer at the time; thus, my decision to focus on the family.  

What can we each do at this time?  Rather than ignoring it, or hoping all will go away, we can take a couple of steps toward getting through a difficult time. 

• Name what it is that causing you the most difficulty internally.  Simply stating it, writing it down, acknowledging it, is a step toward dealing with the difficulty we are facing.  Is it fear?  Is it confusion?  Is it just dealing with life in front of us every day while we try to get our heads and hearts around what happened Wednesday or news we received from a friend?    
• Then, take some time to be vulnerable and share with another person.  Talk with a friend, email your child’s teacher for help, talk to a mentor about what’s happening in the world and what you are feeling.  Pray about the friend going through a divorce.  Write or talk to those you fear you’ve hurt – say you’re sorry or ask for forgiveness.  If it’s about the unrest here in the USA, find someone you can talk with who will not incite more unrest, but help you put a plan in place that helps you. 
• Decide if there is something you need to do about the situation.  During one situation this week my choice was to take time to make a gift bag for a friend.  I realized what I needed was to do something, not just ruminate on the issue.  So, I took an hour to pull together what I wanted to offer her to surround herself with through the coming days and months. 
• Finally, nurture yourself.  Take some quiet time with your spouse and just settle in for time to cuddle.  Watch a movie if you’re exhausted and on empty.  Pull your puppy in for hugs and lap pets. 

The last thing I would also recommend is that you spend more time in a way to engage your spiritual self.  For one person that is prayer or a music service.  For another it is contemplative prayer.  For still another it is taking a meditative walk and really looking at what is going on around you.  One person I know reconnects with what is happening in the world and his life overall to gain perspective using levels of consciousness as a focus.  Or, for still another reading something uplifting or writing a gratitude list.  Whatever it is – I strongly urge you to open that part of your life up more widely.    

This year, 2021, will have challenges as every year does. Some of the next days may bring more difficulty, or it may ease in other ways.  And yet we can live our lives consciously and from a place of love and connection with others.  Focus more on the love than the evil, and you will find the days easier to handle.  We will make it through these days and times.  Only a day at a time.  Only a moment.  And yet, as a very good friend reminded me at one point in the last 2 weeks, “All will be well”.  I’ll end again with the prayer of St. Julian of Norwich (see https://www.youtube.com/watch?v=BT0P5aE2IBg for a beautiful song of this). 

All shall be well.

And all shall be well.

And all manner of thing shall be well.

…

For there is a Force of Love moving through the universe,

That holds us fast

And will never let us go.

~St. Julian of Norwich

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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/

2020 – The Age of COVID and Protests – 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

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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

•  CDC guidance documents on various topics relative to COVID-19. 

• WHO ideas on reopening workplaces

• Arizona Department of Health Services dashboard with statistics of what is occurring in each county in AZ.

• Arizona Department of Health Services blog by Dr. Cara Christ

• Governor Ducey’s page with the current status of things as they change. 

• Governor Andrew Cuomo’s guidelines for reopening New York**

•  Governor Newsome’s plan for reopening California**

**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:

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 1^st 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

Caring for Yourself in Times of Fear and Illness

This week has been a stressful one for many people.  The combination of the coronavirus, the stock market, the grey skies and rain, school and college closures, and the world news each day has been very hard.  But . . . in all of this, did you catch any of the good news?  It’s a bit hard to find, I learned, as I went to locate some for you to try to balance the week.  I did finally find a couple of pieces: 

            The La La Land Kindness Café in Dallas has hired 9 foster kids who aged out of the foster care system and were having trouble locating jobs.

            How about the House and the President agreeing, within just a couple of days, to relief legislation for victims of the coronavirus? 

            The Dow started a rebound today – that’s very good news for most!

            All of the fast action employers and schools/universities are taking to protect their employees and students – it seems unprecedented to me, although it may not be.  From Amazon in Washington to ASU to Ford to many others many are limiting exposure by providing employees with laptops and having them work and study virtually.  

All of these are truly ideas that are very positive news – and get covered in the anxiety so many are feeling, and the care for family that is often at the root of this.  Just tonight I learned one of my sisters-in-law may have been exposed to it, and her father likely has it.  Yet of the 16 members of my family nearby, she is the only one, which is good news thus far. (Edit 3/15/20: Good news! Her father’s test results reflected negative results.) See how we can flip it?  In psychology it’s called reframing the bad or difficult situations by looking at life a bit differently, without denying the hard does exist as well.

We sent out notices about Covid-19 procedures for our office this week.  Now it’s time to also offer some concrete help along with the above reframe tool.  The American Psychological Association and the National Association for the Mentally Ill are the two sources I’m using for the ideas that follow.  I wanted you to have some resources to print or click for the coming weeks.  What I know from 911 and other events is that when we are faced with being bombarded on social media and news media with information that is difficult, we tend to seek out more information and stay focused on the difficult situation.  This merely drives fear and anxiety up further.  We do need to know what we can do to try to protect ourselves; but once we know, i.e.:  wash hands to count of 20, do not shake hands and stay a further distance from others, and isolating someone with clear symptoms including fever, cough, and shortness of breath, we need to also look at how we care for our family and selves in a way that minimizes the fear and focuses on good things in life.  And, in the situation we have right now, we also need to know how we can cope with isolation whether from working at home, not going out for social events, not being able to travel to family or friends on trips we have had to cancel, or other reasons.  And we must have a method to deal with the uncertainty, fear, loneliness, depression, resentment, and challenges we face trying to secure things we may need.  So, here goes!

1.  Make sure you have some games to play that are age appropriate for you and your family, and especially if you have children.  If isolated, the family will need ways to entertain themselves, laugh, enjoy each other’s company, and get through the days together.  We know that closeness breeds irritation, so have some things that can break up the days and draw you together, not apart.
2. Have a plan with your doctor.  My physician sent out a text announcement to all of his patients tonight just letting us know he’s there, where to go for trustworthy medical information on the virus, and what to do if we are having symptoms.  Reach out to your pediatrician, cardiologist, pulmonologist, or primary care to know ahead what to do and how their office is managing this.
3. Use the tools that help your mental health on a regular basis.  So…do:
4. Keep up your physical activity – there are some great YouTubes on how to do yoga, walk along with you to keep your steps up (I like Leslie Sansome’s https://www.youtube.com/watch?v=m9yI2LGZRE0), and many others depending on what you prefer to do.
5. Make sure you have enough medication or supplements like Rescue Remedy, Vitamin C and B, and other things around to keep you feeling better and less anxious. 
6. Stay on a schedule.  We can get very loosey-goosey when at home too long or too much.  So make sure you keep an agenda to normalize your life and not fall into the doldrums too much.
7. Make sure you can connect with Messenger, FaceTime, and the others available.  It helps for you to actually see friends, not just text.  We’re learning that the more texting that is done, the lonelier people are becoming.  So, in this time of increased stress – reach out even more and if you can’t touch one another, at least see one another.  I know someone who was separated from a loved one for quite some time, and they would watch a favorite show while connected on Facetime.  Another dad who was away who would play checkers with his children.  Get creative in your connection!
8. I know you get tired of it – but remember to breathe when anxious.  Or start a mindfulness app during this time.  The website has a number of these on the Links page, and this is a great time to learn to do it and practice.
9. Listen to music that uplifts you – for me that might be one thing – but what is it for you?  Listen!  Music does a lot to impact our moods.
10.  Keep some numbers available if you need to reach out to a warm line, i.e.:  you’re not suicidal but you are feeling isolated and need to connect.  See SAMSHA’s line for disasters at 1-800-985-5990 or locally at 602-347-1100.  And remember AA, Al-Anon, and many other groups have online and phone meetings.  Take care of your sobriety as well! 
11.  Pay attention to your spiritual practices.  I love labyrinths and downloaded the Mount Mojo Labyrinth Journey app to my cell phone quite some time ago.  I can walk it by finger on the phone even if I have only 5 minutes and can’t get to one locally.  Or, call a friend to pray.  Watch a Joel O’Steen, Beth Moore, or even your own pastor or rabbi may have something online to watch or even just listen to. 
12. Humor, humor, humor!  You have to laugh!  I go to Bob Newhart videos, Carol Burnett, or Tim Conway as well as Friends and Frazier.  My mom loved SpongeBob Square Pants (I did not ever figure that one out!)  How about funny movies often free on Amazon Prime, Netflix, and other places you may have membership. 

All of these are tools – now you just need to use them.  As I said in my letter to current clients, I’m here and I am available.  Feel free to call and schedule an in-person or video therapy session.  The teletherapy appointment is on an encrypted service that meets HIPAA standards, we don’t use FaceTime or other things that might seem easier – but don’t offer the privacy.  So, if you can’t come – we’ll walk you through how to set it up. 

May you find these ideas helpful – and know there is a hand to reach out to.  And keep reaching out to friends as well.  Do you have other ideas?  Let us know and we can share those on our Facebook page. The disasters end.  The illnesses come to an end in such large proportions.  The blue skies come out again.  Something my mama told me growing up is that “it’s always darkest before the dawn”.  Obvious, right?  But it kind of normalizes problems and difficult times.  And reassures us – that “Joy will come in the morning!” (Psalms 30:5).  And so it will!

Take good care of yourself!

Dr. Beth