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COVID-19 Coping Strategies

There are no questions about it, these are anxious and challenging times! We can now add COVID-19, volatile markets, closed borders, mandatory social distancing, skyrocketing unemployment, and an increased risk for illness and death to the stockpile of existential threats that we collectively face daily. Unfortunately, there is a high probability for even more adversity in the coming days. The very real tragedies, hardships, and suffering can feel overwhelming at times, and they trigger feelings of hopelessness, powerlessness, uncertainty, despair and loss of control. 

We must be vigilant to the fact that these types of life adversities will increase our chances of relapse for depression and anxiety—for any mental health illness. Even the most resilient will experience increased levels of depressive, anxious, paranoid, irrational, and catastrophic thinking. It is common, and it is to be expected that old self-defeating habits and behaviors, dysfunctional and repetitive thought patterns, and instinctive fear-responses will hijack our emotions. Emotional habits such as denial, detachment and repression often are experienced on one side of the emotional equation; and, on the flip-side panic, hysteria, obsession and despair. If we are not vigilant, we can get stuck on one side of the emotional equation or feel yo-yoed between the two instinctive fear-responses. This is ALL to be expected, it is normal, it is common, and it is not to be judged, criticized, or trivialized. 

Our fear-responses must be normalized, accepted, and taken seriously—now more than ever! The awareness of our habitual thought patterns, emotional habits, and reactive behaviors can act as our compass during this turmoil; and, compassionate acceptance of our habituation can help us to be more responsive as we take preventative measures to protect our physical and mental health.

So, what can we do NOW to help us cope with this global public health crisis and the physical, psychological, economic, social, professional and spiritual fallout that we’re helplessly witnessing and experiencing?

The following tips, practices, and evidence-based psychological strategies can help us to cope during these difficult and uncertain times.

First, please take this pandemic seriously and plan, prepare, but don’t panic! Anxiety, stress and chronic worry trigger our stress-response, and cortisol and adrenaline flood the brain and over engage the sympathetic nervous system (SNS). When the SNS runs too hot for too long, our immune systems become compromised, and we put ourselves at an even greater risk for infection and mental illness. 

Turn your anxiety into action! Be vigilant and proactive about your personal and public health safety practices. Stay informed by reviewing the Centers for Disease Control and Prevention website and follow your local and state protective measures. It is as critical however, to place strong boundaries around daily news consumption. Practice healthy compartmentalization by being selective about when, where and how much news you consume. The media’s job is to inform AND sell the news. Sensationalism works well to boost ratings, sell newspapers, and increase advertising revenue, but it wreaks havoc on our minds, bodies, and spirit. I recommend choosing a time during the middle of the day to catch up on the latest headlines, news and public announcements. Starting your day and ending your day consumed by the headlines will negatively impact your level of functioning throughout the day and severely impact your sleep hygiene. If you notice chronic fatigue during the day and insomnia at night, you are likely not putting enough emotional-distance between yourself and the external world.   

Stick to your current behavioral health and wellness activities. For millions of us, we have worked diligently to create a healthy work-life balance in order to ensure that our homes remain places of refuge, and to keep work where it belongs—at the office! Millions of us now find ourselves sequestered to our homes, practicing social distancing, and placed under mandatory stay policies. Turning off work has just become that much more difficult for us, and we will find ourselves struggling again to practice the habits that support a healthy home and work-life balance. So, workaholics beware; we will need to stick to our normal work routines. Start and end your workday at the same time that you would have normally had you gone into an office. Create a separate workspace that you can close-off ideally or blockout visibly from the other rooms in your home. Take breaks and lunch at the same usual times. Workout and exercise daily. Movement is a critically important stress-reducing activity. These behavioral strategies will ensure that you keep the healthy work-life balance habits that you had previously, and they will offer you and your family the quality relationship time that everyone deserves. 

Let’s discuss some emotion-focused strategies. COVID-19 has most certainly triggered existential fears—uncertainty, loss of control, feelings of powerlessness, lack of freedom, and fears of illness and death. It is important that we do not  judge, criticize, belittle or minimize our fears, anxiety, despair, or any of our natural and instinctive emotional reactions. Judgement of ourselves or others for experiencing unnerving emotions is like pouring gasoline on an already smouldering fire—combustion will soon follow! 

The majority of us are feeling intense pressure, so now is the time to practice self-compassion and self-soothing. We must be gentle, patient and kind to ourselves and to others. Asking ourselves the following questions when self-criticism or judgement shows up will help you to NAN™ your emotions—normalize, accept and not judge them. Take time to answer these questions, and then internalize the comforting answers by practicing to comfort and soothe your emotions. 

  • How would I treat an anxious child that needed comforting during a traumatic time? 
  • What would I say to a nervous child that needed support when they felt out of control or faced uncertainty with terror? 
  • How would I protect a scared and sad child that deserved to feel safe, secure, and connected at a time when they felt unsafe, insecure, and alone? 

As destructive as having judgement of our emotional reactions, denying or repressing them will increase the likelihood of relapse into depression, anxiety, substance abuse or other mental illness. Remember, “What we resist, persists!” Depressing our emotions is counterproductive and destructive to our nervous system. Consciously connecting with our emotions for twenty minutes, once a day, will help us to “manipulate them” instead of being emotionally-hijacked by subconscious impulses, urges, and reactive feelings. Therefore, we must practice engaging the parasympathetic nervous system’s relaxation-response now more than ever. 

I have created a practice that I call the IWP Emotional-Mindfulness & Regulation tools, and it is a healthier and more productive approach to offset our instinctive stress-responses to pain, suffering, and fear. Click on this link to learn more about this practice and to learn to connect daily to the full range of your emotional experiences in non-threatening ways. The benefit of the daily exercise will be the immediate relief that you experience by intentionally connecting to your instinctive fears and to the anxiety that has been triggered by this health emergency. You will find that the exercise helps you from carrying around the weight of your subconscious fears, and eventually the outcome will be to gain better impulse control and enhanced emotional resilience. 

The final strategies that I want to offer will help with cognitive functioning and assist us to better work with our habitual thought patterns and the unproductive beliefs and narratives that get triggered during traumatic times. These tips can help you to learn to get curious in order to break habitual thought-patterns, practice self-affirmation to feel more secure, and use memory recall to connect with our strength and resilience when we need it most.      

As “breaking news” occurs and yet another troubling headline dominates our focus and attention, we will find ourselves battling not just the virus, but also a reactive brain running down familiar rabbit holes. Habitual ways of seeing life and thinking about life will resurface. If we are prone to feeling victimized by life, our thoughts will twist the narrative to support helplessness. If we are prone to denial, our thoughts will create rationalizations to support denial. So, if we are prone to anxious, catasphrophic, critical, extreme, rigid or other irrational thinking, our thoughts will continue constructing stories that reenforce those old habitual cognitive patterns. If we are unaware of our habituated patterns, we will most certainly experience the all too familiar feelings of despair, panic, helplessness, depression and anxiety. 

We must therefore be vigilant by examining our thoughts for habitual patterns, identifying them, and replacing them with other ideas, scenarios, possibilities and outcomes. When reactive thoughts or rigid beliefs present themselves, we can learn to break free from cognitive patterns by using what I call the IWP CQC™ Self-Affirming Practice—bring your curiosity, questions and a contemplative mindset to the moment. Then use self-affirmation and self-direction to replace unhelpful habitual thoughts with more responsive, neutral, rational and healthy thinking. Click here to access the IWP CQC™ Self-Affirming Practice.   

Another practice that we can use to cultivate flexible thinking and emotional strength during difficult times is called the paradoxical intervention. We can stabilize our anxiety, calm the nervous system and support our immunity by spending time reflecting on our past grief and suffering. Although so many of us are currently feeling overwhelmed and dizzied by all those worst case scenarios, struggling to think optimistically about the future, feeling helpless and bewildered about how we will get through this uncertainty, we are actually physically and psychologically resilient.  

As a psychotherapist and coach, I often prescribe my clients to revisit their past discomfort, anxiety, loss, or grief. I ask them to explore what they remembered about their initial thoughts, feelings and experiences. Together, we explore how they got through those traumatic times. What resources did they use? What did they learn about themselves, if anything? Did any thoughts or beliefs about their hardship change over time? Did they discover any opportunities? Find any meaning despite the suffering? Experience any growth? 

This counterintuitive intervention can allow us to reconnect to our emotional resilience, as we are reminded that we have an innate tolerance to these exact types of existential crises. Uncertainty, loss of control, feelings of powerlessness, and fears of illness and death aren’t actually new concepts for us.  

I can say with certainty that I’ve never experienced a global pandemic that has so abruptly changed our society, but I can recall frightening and painful experiences from my past that deeply shook me. I can remember what it took for me to survive my past adversity, challenges, heartaches, losses, and even tragedy. I can reconnect to my strength, determination, survival instincts, creativity, and adaptability. And in doing so, I can feel hopeful again and perhaps even some calmness in spite of the current circumstances… 

For additional coaching tips and more evidence-based stress-reduction strategies, please don’t hesitate to reach out to me. We are all in this together! 

Stay safe and be well, 

Ryan 

IWP CQC Self-Affirming Practice

The brain instinctively goes into “autopilot” when faced with emotional turmoil, trauma, pain, fear or anxiety. As a result, our sympathetic nervous system is activated to engage our fight-or-flight stress-response. Cortisol and adrenaline flood the brain to ensure our involuntary bodily functions kick into high gear to get us out of danger. Although this natural stress-response can save our lives when faced with immediate danger, it can also impair our health, and trigger self-defeating behaviors, repetitive thought-patterns and problematic emotional habits—if we are not facing immediate and present dangers

When we experience stressful, challenging or painful situations, and the brain and nervous system struggles to differentiate between adversity and immediate danger, our habitual ways of thinking trigger familiar emotional reactions and conditioned behaviors. Here are a few common examples of how adversity triggers the habituation cycle—cognitively, emotionally, and behaviorally. 

If we are already prone to thinking that we are the victims in life when adversity strikes, our thoughts will twist around a narrative that subconsciously supports helpless feelings followed by inaction or a lack of responsibility or control. If we are prone to denial in times of grief, our thoughts will subconsciously create rationalizations to repress our feelings supporting a naive and uncaring attitude. Moreover, catasphrophic thinking leads to anxiety and nervous behaviors; critical thinking leads to depression and paralysis or projection; and, extreme or rigid thinking leads to dramatic and cold attitudes and reactions. In other words, we often find ourselves running down familiar and frustrating rabbit holes unaware of how our habituated thinking is reinforcing the same feelings of despair, panic, helplessness, depression or hopelessness.

If we can learn to accept with non-judgment that our conditioned thought-patterns will resurface during times of adversity, we can become more aware and equipped to cope with them and the emotional and behavioral patterns that follow. Once we better understand our habitual ways of thinking, we can start to reframe or turn down the volume on our instinctive thoughts. Reframing, neutralizing and directing our thoughts becomes the key to a more rational and balanced perspective and to cultivating more equanimity in mood and behavior. And this all starts by asking questions and learning to affirm and direct ourselves. 

When reactive thoughts or rigid beliefs instinctively appear during times of difficulty, we can learn to break free from cognitive patterns by bringing our curiosity, questions and a contemplative mindset to the moment—CQC™. And, we can use self-affirmation and self-direction to replace unhelpful habitual thoughts with more responsive, neutral, rational and healthy ways of thinking, feeling and acting.

This exercise will help with cognitive functioning, mood stabilization and behavioral habits that get triggered during times of adversity. Be patient as you practice CQC.™ Habits are hard to break. The goal is to gain more awareness of habituated thoughts and to let that awareness and the practices support a more stable mood and calmer actions in times of future challenges.   

When triggered by adversity, say to yourself silently or out loud:

  • Let me pause, get curious, reflect and be open to other perspectives now. 

Question yourself:

  • Are these thoughts familiar to me? 

If yes, identify the thoughts and label them: 

  • These are my habitual thoughts and beliefs.
  • These are my critical, judgement, catastrophic, fearful thoughts, etc.    

Next, ask yourself the following questions and answer them:

  • What are the implications of my habitual thoughts?  
  • How are these thoughts helpful and useful to me now?  
  • Is it true that the worst case scenario is happening and what evidence do I have today to prove this? 
  • Are there any alternative scenarios that I can think of? 
  • What’s the best case scenario? 
  • What’s a neutral scenario? 
  • What observations am I aware of as I examine alternative thoughts? 

Next, use self-directing feedback to gain even more perspective. 

  • What else could I be focusing my thoughts on that could assist me now?  
  • What control do I have at this moment?
  • How do I feel powerful and strong today?
  • What in my life feels predictable, steady and familiar now?  
  • How is my mind and body working well today? 

Finally, use self-affirmation to cultivate calmness of mind, energy, and body. Repeat the following: 

  • I am safe.
  • I am secure.
  • I am healthy. 
  • I have close connections and strong relationships.
  • I am passionate, purposeful and principled. 
  • I have abundance in all areas of my life.   

©Ryan Lewis Counseling / Integrative Wellness PLLC 2019 

IWP Emotional-Mindfulness and Regulation Tools

  • Begin slow diaphragmatic breathing for two minutes. 
    • Count of six on the inhale (keep chest still, breath deeply into your belly, fill up the belly like a balloon). 
    • Count of eight on the exhale (slowly constrict and fully empty the belly on the exhale, imagine squeezing all water out of a sponge).  
  • Identify your immediate feelings. 
    • Ex. I’m feeling anger, scared, frustrated, annoyed, weak, fragile, hollow, nervous. 
    • Write down your feelings:
    • ___________________________________________________________________
    • ___________________________________________________________________
  • Remember that avoidance, resistance and nonacceptance fuels unhealthy emotions. NAN™ your feelings by normalizing them, accepting them, and not judging them. Spend one minute repeating the following statements silently to yourself or out loud: 
    • These feelings are normal to have.
    • I accept my feelings as they are.
    • I do not judge myself for feeling this way. 
  • Bring your curiosity, questions and a contemplative mindset to dig down deeper to the emotions below your surface feelings. 
    • Ex. I’m actually feeling a loss of control, sadness, despair, pain, helplessness, hopelessness, or fear of illness or death. 
    • Continue to identify deeper emotions and feelings:
    • ___________________________________________________________________
    • ___________________________________________________________________
  • Use Body Scan techniques to explore where the feelings and emotions exist within the body. 
    • Ex. I’m feeling these emotions in my chest, stomach, neck, and head.
    • Where else do you feel the physical symptoms of your emotions?
    • ___________________________________________________________________
    • ___________________________________________________________________
  • Use Object-Relations and visualization techniques to turn your emotions into an object, so you can externalize them and experience them being outside and separate from you.  
    • Ex. These emotions feel like a big, red, solid brick sitting heavily on my chest. Visualize lifting the brick from your chest and placing it next to you.  
    • Ex. My emotions feel and sound like a runaway freight train. Visualize a train rolling by you and disappearing from view as the sound diminishes.   
    • Describe your emotions as objects:
    • ___________________________________________________________________
    • ___________________________________________________________________
    • Spend three to five minutes visualizing the objects as being separate from you. Place the objects next to you or watch the objects move away from you. 
  • Use Self-Directing statements to connect to your strength, emotional resilience and to encourage yourself to prepare to let go.
    • Ex. I’m going to just sit with this. I’m not going to resist these feelings.  I’m letting these feelings go soon. I’m not fearful of these emotions. I know these feelings too well. I know they will pass. I’m going to imagine what it will look and feel like to let go of this critical, harmful, or fearful narrative.
    • What Self-Directing statements did you come up with?
    • ___________________________________________________________________
    • ___________________________________________________________________
  • Use Self-Affirming statements to create the emotional experience and feelings that you want, need and desire. 
    • Ex. I feel safe, secure and grounded. I can let go of control with ease. I don’t require myself to be a hero right now. I appreciate, love and respect my humanness. I am a strong, resilient, and wholesome person. I feel calmer and more relaxed now. I am a healthy person. I only treat myself and my body with compassion, kindness and patience. Letting go of my old narratives feels healthy, productive and good.   
    • What Self-Affirming statements did you come up with?
    • ___________________________________________________________________
    • ___________________________________________________________________
  • Lastly, create intentional Gratitude Statements about your overall emotional experience.   
    • Ex. I am grateful to take this time and to remind myself that it is ok to feel scared, lost, powerless or helpless at times. I am grateful to connect with all of my emotions. I am grateful that this experience reminded me that I can identify and observe my emotions without needing to run from them. I am grateful that I can visualize being separate from my emotions, and I can direct myself to calm down or to let go of any emotion. I am grateful for the opportunity to slow down, breath, and to see myself with more compassion, kindness and patience.    
    • What are you grateful for?
    • ___________________________________________________________________
    • ___________________________________________________________________
    • ___________________________________________________________________

©Ryan Lewis Counseling / Integrative Wellness PLLC 2019

The Dualities of Life and the Therapist / Client Experience

Self-disclosure moment:

Being a therapist, I witness—often hourly—the constant duality of our human experiences.  As a privileged observer into the lives of others, I see our best and most challenging traits exposed: our humility and our arrogance; our self-critic and our self-promoter; our need for attachment and our need for individuation; our cravings and desires to be validated by others versus our self-reliant, go-it-alone attitudes.

Part of the process of therapy is exploring our conditioned [often negative] ways of thinking and our habitual thought processes, and then working hard to replace them with more responsive and thoughtful new patterns—creating a more self-enhancing narrative. Often, we explore the strangeness of accepting our difficult feelings in an effort to bring them to the surface and intentionally process and express them, so that we may let them go; and yet, we also talk about the importance of detaching from so many of our instinctive emotions and reminding ourselves that “even though I feel something, it doesn’t necessarily make it true”—this is called Emotional Reasoning.  We explore our unique coping mechanisms and our ingrained behavioral strategies that have helped us to survive up to this point in our lives, and then we turn around and discuss behavioral modifications that will help us to shed our outdated defense strategies and implement new behavioral responses to boost self-esteem and to build steps toward success and self-confidence. The list of dualities can go on and on….

For me, the ultimate duality as a therapist is being privileged enough to play the role of psychotherapist, counselor, educator, life-coach, (or, my personal favorite—”Shrink”); and, in return, having my clients move me in such profound ways.  If I am open, present and mindful, I am educated daily on so many new perspectives in life; I am taught by my participants about novel and unique ways of coping and dealing with our challenges and struggles; and, I am reminded always how I too can be a more well-rounded, flexible, healthier person—both personally and professionally. How fortunate am I?

Moreover, I am consistently intrigued how I/we can be transformed through the power of our relationships. We can be accepting and welcoming of others and their opinions, and influenced by them; or, we can be closed-off to their insights and to their experiences, learning nothing new.  In my line of work, it is the unique duality of the client/therapist relationship that can be magical.  My clients have opportunities to be heard, understood, and accepted unconditionally. If they are open to me and to new ideas, they may learn new strategies and solutions. More importantly, they may learn how to see themselves with more forgiving and loving eyes, so that they can begin a personal and relational transformation to achieve their goals and to live a more relaxed, untroubled, and accepting existence. And, if I can do my job and enmesh myself into their worlds—losing myself, listening well and absorbing their perspectives, I find that I have at my disposal a treasure chest of new knowledge and reminders of how connected we all are through our universal struggles and humanness. This relationship (like all relationships) can produce feelings of heavy-heartedness and distress. It can also produce wondrous feelings of connectedness, gratitude, satisfaction and opportunities for me to step outside myself for awhile and to feel the warmth of the universal “oneness.” We are unique yet bonded through or human challenges and triumphs. This is the duality of the client/therapist partnership.

Ironically, it is the unconditional acceptance of our human duality that can be the most liberating of all, as we are reminded that we really do have the freedom to choose. We can resist change and stay stuck, or we can embrace it and challenge ourselves to be more humble, accepting, grateful and curious beings—overjoyed by our ever-changing experiences. We must understand that we have a conscious choice [once we learn to disconnect from our instinctive, habitual, reptilian brains], as to how we navigate around our human dualities.

Each day, each month, every year, we may be overwhelmed, confused, defeated and judgmental of and by our humanness and by our experiences. We will be frustrated that we have both a self-critic and self-promoter living within; annoyed that we must both connect and “feel” our difficult emotions in order to finally detach from them and to let them flow freely through us; and, exhausted that we must modify our outdated behaviors that have protected us in the past, yet now weight us down in the present. But, I encourage myself and everyone to continue to see the duality of our relationships and of our humanness not as an overwhelming task or cruel joke from the universe or a Supreme-Being, but rather as a gift. We are the only living species that has a choice between being tied to our limited bodies and conditioned brains or transcending our physical and psychological limitations. It is through our conscious, mindful and effort-filled curiosity that we will see our personal and relational responsibilities to both identify and accept our internal “stuckness” and relationally-closed habits. Once aware and accepted, we will be on the path to setting ourselves and others free through our shared connectedness and a personal commitment to evolve beyond the habitual and conditioned brain. How fortunate are we to have opportunities to navigate through such choices?

Be well~

Ryan