I personally feel like I have woken up inside a real-life version of The Walking Dead/ Contagion or some other Apocalyptic movie. I had a call with a group of clients yesterday and everyone was just staring at me like they had been stun-gunned. The reality is that some people are coping quite well and some are in contrast very upset and emotional. Alot of that depends on how much COVID19 is directly impacting their lives and livelihood right now….
People are rarely themselves during times of uncertainty
I want to call out that during times of great uncertainty, you find that people deal with things at different times and in different ways. It’s all rather normal and depends on how acutely someone is feeling the impact of this event. Someone working on the front line worried that they will infect their family is in a very different place to someone who is working at home and feeling bored of being cooped up. We must therefore have compassion for how everyone is going through this. Think of it this way:
So let’s be mindful of being kind and empathetic to the differing ways people are experiencing COVID-19.
What is going on?
I read a brilliant article in the Harvard Business Review all about the collective grief so many people feel during this crisis. In the article the writer asserted that the world is experiencing differing types of grief. The COVID-19 crisis has succeeded in changing life as we know it and although most of us know that the events we are experiencing are temporary, we realize that things will be very different when we come out of this. Life is changing and this was the point at which life changed. We all need to now adjust to this ‘new normal’ which includes the fear or economic toll, the loss of connection with others, the potential loss of those we love without even being able to say goodbye. We are not used this kind of trepidation feeling in the air. So if you find yourself feeling sad, welcome to the club. You might be feeling Anticipatory Grief, which is the feeling we get about great uncertainty coming. A storm is brewing and we have no idea how bad this is going to get but some will imagine all kinds of doom-and-gloom futures which can lead to catastrophizing and jumping to worst-case scenarios. We feel the world has changed, and it has. There’s something bad out there. With a virus, this kind of grief is so confusing for people. Our primitive mind knows something bad is happening, but you can’t see it. This breaks our sense of safety.
We’re feeling that loss of safety. I don’t think we’ve collectively lost our sense of general safety like this. Individually or as smaller groups, people have felt this. But all together, this is new. We are grieving on a micro and a macro level. We know this is temporary, but it doesn’t feel that way, and we realize things will be different. Just as going to the airport is forever different from how it was before 9/11, things will change and this is the point at which they changed. The loss of normalcy; the fear of economic toll; the loss of connection. This is hitting us and we’re grieving. Collectively. We are not used to this kind of collective grief in the air.
Let’s use this Cognitive Behavioural Therapy Model developed by Dr Rachel Morris for acute Anticipatory Grief:
Whenever there is great uncertainty, it triggers our FIGHT or FLIGHT response within our brains
The amygdala is the brain’s ‘alarm system’. It works to keep us safe by constantly being on the lookout for threat. The amygdala is very sensitive and lives by the rule ‘better safe than sorry’, so as soon as sign of danger are sensed it immediately kicks into action and prepares the body/mind to defend itself. It also records information from our senses (sight, sound, smell, touch, taste) about any dangerous situation. It all happens so quickly and automatically that sometime the amygdala has set off the alarm before we are even consciously aware of what is happening.
The uncertainty and its associated pace we are all experiencing with COVID-19 is activating many amygdalae’s out there. I would hazard a guess and say that there are not many people in the world who are sleeping soundly.
What happens when the threat system is activated?
The main purpose of the threat system is self – protection. Our survival instincts tend to make us do one of four things: fight, flight (run away), freeze, or appease (try to calm down the threat). When the threat system is activated a hormone called adrenaline is released into the bloodstream. This increases the release of cortisol which is the stress hormone.
The adrenaline and cortisol flow round our bodies very quickly, getting different body streams ready to quickly respond to the threat. The adrenaline increases heart rate so that there is more blood and oxygen going to our muscles. The adrenaline makes our muscles tense, making them ready to fight or to run away.
The adrenaline and cortisol speeds up our thoughts, so we can make quick (potentially lifesaving) decisions. All of these changes can affect how we are feeling. The diagram below shows some of the effects activation’s of the threat system can have.
When we feel under threat it is common to act automatically. We tend to act first and think later, and may behave in a way that we would not have if we were feeling safe or calm. We have very little, if any, control over these instinctual reactions and we rarely get to choose which ones we employ when we feel scared. Common instinctive reactions include:
The slow, deliberate, rational, ‘thinking’ part of the brain (Hippocampus) often takes a back seat when we rely on our basic survival instincts. Cortisol also shuts down this rational part of our brain as the body mobilizes to protect us from whatever this perceived danger is.
Bottom line: When Emotions are High, Thinking is often Low.
It is very important to keep all this in mind as we can often blame ourselves for the way we may react during uncertain or traumatic events and wish that we had done or said something different. However, we probably just reacted automatically to protect ourselves in the best way we could at the moment.
So be empathetic to yourself, to others and to the world at large for how they are handling this crisis. Everyone is literally just doing the best they can.
Understanding the stages of grief is a start. But whenever I talk about the stages of grief, I have to remind people that the stages aren’t linear and may not happen in this order. It’s not a map but it provides some scaffolding for this unknown world. There’s denial, which we say a lot of early on: This virus won’t affect us. There’s anger: You’re making me stay home and taking away my activities. There’s bargaining: Okay, if I social distance for two weeks everything will be better, right? There’s sadness: I don’t know when this will end. And finally there’s acceptance. This is happening; I have to figure out how to proceed.
Acceptance, as you might imagine, is where the power lies. We find control in acceptance. I can wash my hands. I can keep a safe distance. I can learn how to work virtually.
Let’s go back to anticipatory grief. Unhealthy anticipatory grief is really anxiety, and that’s the feeling you’re talking about. Our mind begins to show us images of the worst scenarios. That’s our minds being protective. Our goal is not to ignore those images or to try to make them go away — your mind won’t let you do that and it can be painful to try and force it. The goal is to find balance in the things you’re thinking and find ways to come into the present.
Here are some steps you can take right now…
- Create a GROUNDED ROUTINE that you can go back to every single day, morning, noon and night. An example includes:-
- Get UP with alarm I set the night before
- Take my Immune Booster supplements (Vitamin A, D, C, Zinc and Magnesium) with hot water and lemon which I wash my mouth out with
- Gargle with Mouthwash to wash away any possible lurking viruses
- Go get some exercise (30 minutes of HIIT on an app, join an online class
- Shower and get dressed as if I am going out
- Set the table and have breakfast
- Clear table and wash dishes
- Begin productive work session for the day (whether that be my job I can do remotely, DIY project I am doing, Course I am taking online with Udemy or MindValley or any other productive activity)
- Mid-morning cup of tea and rest
- Continue work
- Set table and have lunch
- Continue work until 4pm
- Go for walk and get fresh air
- Set table, cook and make dinner
- Clear table, wash dishes and rest, play board games, connect with friends online or watch television
- Self care activity: Paint nails or apply moisturiser, etc.
- Make list of everything you are grateful for in your life and write down what you like about yourself
- Listen to a calming audio program. If you want to use the Naked Recovery Anti-Anxiety audio program, just email my team and we will send it to you with my compliments ([email protected])
- Bed time and plan the next day
- Don’t allow anarchy to develop in your home. Create a cocoon of safety and routine. Keep things as “normalized” as possible incorporating lots of self care
- Keep up with exercise and activity to release the excess adrenaline and cortisol in your body. Go for a walk or bike ride; put on the radio and dance; walk briskly up the stairs; stretch or do yoga; go for a jog; do some vigorous cleaning.
- Be creative. Draw, paint or sculpt; write in your diary; sing; play a musical instrument; knit; sew; carry out a DIY project.
- Connect with others. Sharing the thoughts to normalise them: talk to others about your thoughts and feelings. This in itself may help. Phone or text a friend; help someone else online; talk about your problems with someone you trust; contact someone in my team if you feel isolated or alone. Message us on ([email protected])
- Practice soothing and calming activities. Take a bath or shower; stroke a pet; have a warm drink; have a massage; listen to soothing music; practice meditation, mindfulness or relaxation activities.
- Practice constructive activities. Send an important email; spend 10 minutes tidying or organizing; cook or bake; garden; write a ‘to-do’ list; volunteer your time.
- Practice activities which require concentration. Do a puzzle, crossword or Sudoku; play solitaire, computer games or apps; watch a movie or a funny video clip.
- Try these grounding techniques:
- Organize your drawers and declutter your house
- Thoroughly clean your house
- Complete your filing
- Sleep with a cat or hot water bottle
- Take a kick-boxing class
- Rub Vicks Vaporub on your feet and put socks on
- Have an Epsom Salt bath to replenish Magnesium depleted through stress
- Soak your feet in hot water with Epsom salts
- Go to bed earlier
- Eat one home-balanced meal a day
- Cook your own meals
- Bake Bread
- Do Gardening
- Set the table and eat at the table
- Go for a long leisurely walk once a day (keeping social distance of 3-4 meters from others)
- Have a picnic with your family in your garden
- Complete your year-ed accounting
- Eat root veggies like potatoes, turnips, carrots and beets
- Take a class on healthy cooking
- Foster a pet from a shelter
- Establish comforting routines
- Focus on what you can be grateful for each day. Completing a gratitude journal where you identify 3 things each day that you are grateful for. Gratitude is a great antidote for anxiety as it is (almost) impossible to feel both things at the same time.
- Challenging (re-framing) the thoughts, e.g. my mum is going to die, what if I get it and die, how will my kids cope, what will my funeral be like… Look at the balance of evidence for the REAL rather than mind-created risk. then reframe it, e.g. the story I’m telling myself is: I am going to die and my children will be left without a mother, and compare this with the reality: It is unlikely I will die; I am relatively young and have no other health problems.
- Control what you CAN control
- Social media: reduce the amount overall. Notice how it makes you feel and find your own balance. There is good and bad – it can be helpful to reach out, connect and find support, but it can also escalate things.
- News updates: set specific and time-framed periods to look at the news, e.g. 10 minutes twice daily. Consider using the press conferences.
- As far as possible, try to keep your usual routine and participate in usual activities, even if you have to be a bit creative, e.g. virtual coffee with a friend, watching a family film and chatting about it by WhatsApp as it takes place, doing a HIIT workout in the garden or indoors.
- Think of life one day at a time. What can you do to stay in the moment? – use mindfulness techniques (https://www.headspace.com).
- Practice the Calming Techniques I lay out below…
Try these CALMING Techniques
Calming the threat system: Relaxed Breathing
Controlling your breathing sends a signal to your threat system that everything is ok. Calm breathing is slow, relaxed, and from the diaphragm (‘belly breathing’), whereas anxious breathing is quick, tense, and high up in the chest.
- Begin by sitting somewhere comfortable but supported
- If you feel comfortable to do so close your eyes, otherwise stare off into the middle distance
- Breathe in slowly and steadily for a count of 3
- Breathe out slowly and steadily for a count of 5. Our bodies relax most on the out-breath
- Repeat for a few minutes. It’s normal for your attention to wander off. If it does, just gently bring it back to focus on your breathing.
Calming the threat system: Colored Breathing
Another technique for slowing your breathing and calming your mind is to use imagery while you breathe. Some people find it helpful to imagine breathing colored air. You can memorize these instructions, you could ask someone to read then slowly for you, or you could record yourself speaking them and then listen to the recording.
- Imagine a color representing tension, or tense feelings
- As you breathe, calmly and steadily, imagine breathing out air tinged with that tense color
- See the colored air in your mind’s eye, and watch as you breathe it out and it floats away
- Allow the tense colored air to become paler and paler, as you breathe out all of the tension
- Now bring to mind a color representing calming, soothing feelings
- Imagine breathing in this relaxed colored air
- Just notice what happens in your body as you imagine breathing in the relaxed air
- Continue breathing this way for a few minutes
Calming the threat system: Swing Breathing
Swing breathing is another imagery technique for slowing your breathing and calming your mind. You can memorize these instructions, you could ask someone to read then slowly for you, or you could record yourself speaking them and then listen to the recording.
Allow your breathing to become slower … and more regular. Just focusing your attention on your breath … on the air flowing in … and out … of your mouth and nose.
Your breathing finding a steady rhythm. Breathing gently from low down in the belly. Taking slow steady breaths. Breathing in gently … and slowly and smoothly exhaling … Breathing in gently … and slowly and smoothly exhaling.
And as you continue to breathe slowly and gently … in a rhythm that’s comfortable to you … I’d like you to imagine … and then begin to feel … that you’re on a swing. Gently swinging backwards … and forwards … backwards … and forwards … finding that you’re swinging in rhythm with your breathing … just gently swinging … relaxed and peaceful. Pay attention to how it feels to swing gently forwards … and backwards … peaceful … relaxed … at ease. Just swinging gently … and smoothly … smoothly .. and gently.
And you can carry on breathing calmly and gently for as long as you like. Relaxing into this gentle rhythm more and more as time goes by.
Calming the threat system: Muscle relaxation
When we feel under threat our muscles tense up – ready to fight or take flight. Keeping the muscles tense is one of the body’s ways of trying to keep you safe. One way of letting your body know that you are safe is to deliberately relax all of your muscles.
Progressive muscle relaxation involves tensing, then relaxing, all of the muscle groups in turn. Find a comfortable spot, sitting or lying down. Then, for each of the muscle groups in turn, follow this pattern:
- Tense the muscles
- Notice the tension for a few moments
- Notice the sensation of relaxation as the tension drains away
Relax each of the muscle groups in turn:
Shoulders (lift up slightly)
Upper back (shoulders back slightly)
Lower legs / calves
Neck (gently move neck back)
Muscles around eyes (scrunch face up)
Calming the threat system: Creating a safe place
A safe place is somewhere that you create using your mind and imagination. It is a place that you can go anytime, wherever you are. For some people, it is a place that they remember from their past as being particularly safe and calm. For others, they cannot easily remember a time like this from their past and so they work on creating one for themselves now. Either way, the same process applies. You can have more than one safe place and it can change over time as you wish. It is your creation and your own personal ideal.
It is useful for your safe place to have certain qualities though: it needs to be a place you feel calm, not judged, warm, free and above all safe.
How to create a safe place:
- If you feel comfortable enough, close your eyes and take a deep breath in and count to three. Then breathe out slowly to the count of five. Do this several times. As before, spend some time slowing down and controlling your breathing until you reach a calm and soothing rhythm. As you breathe in, imagine you are breathing in a sense of safeness and relaxation. As you breathe out, imagine you are breathing out all of the tension in your body.
- Begin to imagine a place where you feel calm – where are you?
- Focus on what you can see, take a minute to look all around you in your mind. You may perhaps even turn around to see what’s behind. Concentrate on any objects that you can see, the colors around you and areas of lightness and darkness.
- Focus on what you can hear, take your time to notice the noises, even the subtle ones. What noises can you hear close by? What noises can you hear in the distance?
- Focus on what you can smell. Again, take a minute to really notice the smells around you.
- What can you feel? Is it hot or cold? Are there textures under your feet?
- Focus on any taste in the image and notice this for a minute or two.
- Now focus on how you feel in your body, feelings of calm and safety in this image. Focus on the release of tension. Where do you feel this feeling in your body?
- Keep imagining your safe place in as much detail as possible and revisit that feeling of calm and safeness over and over, noticing where you feel it in your body.
- Is there a word that might remind you of your safe place? If so, what is it? If you have a word, repeat it in your mind over and over as you keep your safe place in your mind.
- When you are ready, take some deep breaths in again and slowly open your eyes, trying to hold onto that calm feeling.
Remember, you can come back to it whenever you want to. The easiest way to do this is to start by slowing down and controlling your body and to repeat the word that you picked that reminded you of your safe place. In doing so, it will be easier to return to your safe place whenever you would like.
Safe place: Write
a description of your safe place in as much detail as you can. Remember to
include information from all your senses. What word have you chosen to remind
you of your safe place?
Coping with nightmares: Use all of your senses
When we wake up from a nightmare, our awareness of the things around us in the here-and-now can be diminished. Just as we can re-experience traumatic images from the news or social media in all of our five senses, we can use those five senses to try and ‘ground’ us back in the present.
Look around you and use those sights to remind yourself that you’re in the present and that you are safe.
It can be helpful to carry an object with us that remind us that we are safe, such as a stress ball, a pebble, or a flower.
Focus on all of the noises around you in the present moment. Use them to remind you of where you are.
Smell can be one of the most powerful ways of learning to soothe and comfort yourself Try using essential oils, your favorite plants, or any comforting aroma.
such as chewing gum can be helpful. For people who re-experience ‘taste
memories’ it can be helpful to focus on the absence of taste in the present
Coping with memories: 5-4-3-2-1
When our minds and bodies feel as if they are fully immersed in the past, using all of our senses at once can be a very effective way of bringing ourselves back into the present. Focus on:
5 things you can see
4 things you can feel / touch
3 things you can hear
2 things you can smell
1 thing you can taste
Sleeping better: Sleep Hygiene
Feeling stressed often affects our ability to sleep. We may have difficulty getting to sleep if we lie in bed thinking about how our life has changed and wondering if things will get better. We may avoid going to sleep for fear that we might have more nightmares. If we do manage to get to sleep we may then wake up after experiencing nightmares. It is normal to have difficulty getting back to sleep.
The tips and ideas below have been selected to try and help you increase the chance of getting better sleep.
1. Bed is for sleeping and sleeping happens at night-time
- Try and keep your bedroom and bed for sleeping only
- Avoid sleeping in the day
- Develop a routine before bed time such as having a relaxing bath or listening to some relaxing music and go to bed at around the same time each night. Try and wake up around the same time each morning. Small children find habits and routines comforting, and the same things work for adults too. As adults, we forget that these things apply to us as well
- If you cannot sleep after 30 minutes, get up and try an activity such as listening to some music. Do this for about 15 minutes then return to bed and try and sleep. Repeat this as often as is necessary until you go to sleep
- Make your bedroom a nice place to sleep – try smells or flowers (or some new bed sheets!)
- Put your phone on the opposite side of the room and if you wake up: DO NOT CHECK YOUR PHONE
2. Be kind to your body
- Do not go to bed hungry
- Try and avoid spicy food late in the day as this can act as a stimulant in our bodies
- Reduce caffeine but definitely avoid caffeine after 4pm-remember caffeine is also found in tea and fizzy drinks like pop. You can buy de-caffeinated versions of these drinks if needed
- Although alcohol can initially make us feel sleepy, it stops us from experiencing restful sleep and is not great for stress or Adrenal Fatigue. It can also make it harder to fall asleep again, if you wake up in the middle of the night
Try: Any of the other grounding strategies that you have developed can be helpful if you wake from a nightmare
Many different treatments have been developed for coping with uncertainty and traumatizing events. Research has shown that they can be extremely effective.
Every crisis represents an opportunity for transformation
Sometimes it’s hard to find opportunities when we are right in the middle of the storm. BUT they are there.
Every day I want you to try to find ONE GOOD THING. Examples are below…
- Finding time to do the things you have always been traditionally too busy to do
- Spending more time in nature doing simple things
- Many organizations suffer from slow procedures and rigid ways of working. The coronavirus has forced many of them to skip or change rules instantly. Suddenly employees are allowed to work from home without direct supervision. COVID-19 shows that, as soon as there is a strong enough stimulus, things can change. This leads to remarkable innovations. Not being allowed to open their doors, restaurants, for example, are shifting to delivery mode. And schools suddenly do much of the teaching and even some of the testing online. This brings the opportunity to create innovations now that can be maintained after the crisis. And it also can help to keep the current speed and innovation mode afterwards.
- We are spending quality time with family
- Connecting or reconnecting with people online that you have lost touch with
- Nature is taking a breather from all of us humans: COVID19 causes a significant reduction in green house gasses and other air, water and land polluting outputs. In Venice this has allegedly led to dolphins return after just a couple of weeks. Polluted skies are blue again, rivers and streams are clear again, animals are curiously coming out to play again. Perhaps when all this is over we will become more aware of the planet and the role we must play as caretakers
- In today’s overheated economy, TIME is often seen as the most valuable and sparse thing we have. We are always SO BUSY. We fill our week with social gatherings and entertainment such as going to the theater, birthdays, cinema, restaurant, bar, sport clubs, gym, music, festivals, concerts and what is more. Suddenly, all of that is cancelled or forbidden, giving us significant amounts of extra time. DO NOT fill your time immediately with other activities. Rearrange how you spend your time and reserve time for nothingness. Not just during the crisis, but also after it.
- COVID-19 provides an opportunity to reflect on things and to reconsider what we do, how we do it and why we do it. We have a great opportunity to rethink our habits and routines and make changes. Now that you haven’t been able to go to the restaurant twice a week, commute 2 hours per day, hang out with your friends or go to a party every weekend, you can reflect on whether you really want to continue doing so after the crisis. The virus forces you to make changes to your daily life that you might actually want to keep also after the crisis.
- As such, the virus shows us that, no matter how well-planned and organized we are —we are not in control. One simple virus is disrupting everything. This offers a great opportunity. In almost every aspect of life we want to be in control. Whether it is health, airline safety or our calendars, we live in the illusion that full control is possible. The virus can help us create awareness that this is not the case. It provides an opportunity to take a more modest role and accept that many things are simply beyond our control.
- An opportunity to end something which has been intolerable before. In the book Necessary Endings, Henry Cloud lays out that for new things to begin, some things need to be let go of like business partnerships, relationships, the job that you hate…
- Challenging times offer a great opportunity for social bonding and other ways of connecting to and helping people. Of course, not being able to visit friends or family has increased isolation and feelings of loneliness in some cases. But the feeling of “we’re in this together” has also triggered interesting ways of connecting. Some of those have gone viral—such as Italians singing together from their windows and balconies—but there are many small, local initiatives too to connect and help people who need it.
When everything becomes uncertain, everything that is important becomes clearAnonymous
If you are really struggling…
Many different treatments have been developed for coping with uncertainty and traumatizing events. Research has shown that they can be extremely effective.
At Naked Recovery, we practice many different Trauma therapies including:
- Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) Involves talking in detail about the events you experienced. Going through the events with you and will help you to make sense of what happened.
- Narrative Exposure Therapy (NET) which is suitable for people who have experienced multiple traumas
- Compassion-Focused CBT is helpful for people who experience a lot of shame or self-criticism.
- Eye Movement Desensitization Reprocessing (EMDR) – Involves holding an image of your trauma in mind while your therapist guides you in making specific kinds of eye movements. This method can be effective but the previous 3 methods are the most effective for processing trauma.
If you need to talk to anyone about your feelings, myself and my team are available and here to help. Working with a Clinical Trauma specialist can help you cope better with all the stress you are experiencing. Don’t suffer in silence, contact us.
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My thoughts and prayers are with you all during this uncertain time. Stay safe and self isolate please.