Mental Health in the Time of COVID Self-Care, Self-Compassion and Building Family Resiliency
We’re all trying to take care of ourselves and our families during this stressful time, but doing so is often easier said than done. With children home BMM day, distance learning, parenting responsibilities, work demands, health concerns, lack of services, and social isolation, it can all add up to the perfect storm. And the storm can be even stronger for those managing the additional stressors of caring for children and young adults with special needs. Stress can impact family functioning, relationships within the family, and individual family member functioning. That’s why it’s so important to think about and take specific actions to take care of ourselves, be compassionate, and strengthen the family unit. Here are four areas the Ivymount Mental Health Team recommends that we all consider to help manage stress in the time of COVID and beyond.
Reframe Self-Care • Controlling how we respond to challenges, stressors, and unwanted events • Acceptance of events outside of control • Avoiding criticism, judgment, and blame • Do not need to like or approve of unwanted events but possess a willingness or openness to experience them • Pain vs suffering • Pain = the conditions imposed by COVID-19 (inevitable) • Suffering = how we relate to the conditions imposed by COVID-19 (optional) • Accept “pain” while reducing “suffering” • Focus on what you can control: how you respond to thoughts, feelings, memories, how you treat yourself, the values you live by and act on
Practice Self-Compassion • How you treat yourself • How does negative self-judgement, criticism and blame impact your role as a caregiver? Is it helpful? • Self-kindness: being warm, understanding, and kind when we fail to meet expectations or experience difficulties • Common humanity: recognizing you are not the only one currently experiencing difficulties
• Mindfulness: being aware of painful thoughts, feelings, and situations without having them define who you are
Identify and Live by Your Values • Tendency to get “hooked” on unwanted thoughts, feelings, and situations, which then creates action that moves you away from the life you want to live • Use values to get “unhooked” and as a guide to move toward the life you want to live regardless of the situation you find yourself in
Build Family Resiliency • Family resiliency: capacity of family to withstand and rebound from adversity • Emphasis on relationships and the family as a unit • Family Resiliency Components • Family Belief Systems: making meaning out of adversity and making it a shared challenge that is manageable • Flexibility: resetting expectations, acceptance of possible role changes and changes in general (“bend but do not break”) • Connectedness: building a sense of cohesion, collaboration, and communal support. Identify activities that can build connectedness (family meals, family activities, conversations) • Mobilizing Resources: support from extended family, friends, community supports, mental health support • Clarity: sharing information while admitting unknowns • Open Emotional Expression: providing opportunities to share how family members are feeling. Remember – not everyone will feel the same way! • Collaborative problem-solving: shared decision-making where goals and priorities are established
The Bottom Line Focus on events within your control and not how you want or wish things to be. Be kind to yourself. Build a framework of resiliency for your family. There is no one way to achieve this. Build upon your strengths and remember how far you have already come in managing all of the impacts of COVID-19.
Returning to on-campus instruction amidst a pandemic and also managing continued distance learning can be anxiety provoking for students as well as their families. The challenges can be even stronger for those with special needs and family members whose resilience is low. Anxiety can impact individual family member functioning, family functioning, and relationships within the family. That’s why it’s so important to understand more about its characteristics, and potential treatment strategies. Here are four areas the Ivymount Mental Health Team recommends that we all consider to help understand and manage anxiety in the time of COVID and beyond.
Anxiety Overview •! Anxiety is the body’s response to perceived danger o! Acts an internal alarm system •! Defining characteristic of highly anxious people: inability to tolerate fearful distress o! Distress = danger o! Alarm system is malfunctioning •! Other common characteristics o! Sensitivity to specific triggers (sensations/feelings, thoughts, mental images, and memories) o! Disproportionate focus on future and catastrophizing o! Over awareness of thoughts and bodily sensation o! Intolerance of uncertainty •! Anxiety Cycle o! Trigger results in perceived danger → avoidant or safety behavior → brief relief → anxiety grows when trigger occurs again
Autism and Anxiety
Anxiety not part of ASD diagnosis but very common in individuals with ASD o! Likely due to increased stress (e.g., communication deficits, sensory processing challenges, difficulty understanding social cues, intolerance of uncertainty) and absence of buffers experienced by youth with ASD •! Difficult to measure and difficult to determine its presence o! Various problem behavior may be manifestation of anxiety •!
Treatment of Anxiety
Overarching goal: NOT to decrease anxiety but to increase willingness to tolerate discomfort and perceived distress o! Learn to respond to alarm differently •! Anxiety Paradox: the more you try to get rid of or avoid anxiety, the worse it gets •! What does NOT work? o! Reassurance o! Distraction, Suppression or Thought Substitution o! Avoidance of all stressful situations •!
Anxiety Management Steps as a Caregiver •! Instead, shift your focus toward yourself and what YOU can directly control o!How you perceive anxiety of student o!How you respond to the anxiety and anxiety-related behavior of your student o!Your expectations o!How you treat yourself o!Your own anxiety •! 2 possible approaches o!Option 1: Criticism, Judgement, Blame of self or others o!Option 2: Acceptance + Compassion and then shift into problem-solving mode •! Enhance Acceptance/Allowance of student’s anxiety o!Normalize feelings of anxiety o!Shift Your Language: Acknowledgement + Encouragement !! Validation without reassurance !! Goal is to encourage allowance of uncomfortable triggers o!Let go of attempts to control unwanted triggers !! Shift expectations – expect anxiety and triggers to appear !! Emphasis on control of response to triggers NOT control of triggers o!Encourage willingness to be uncomfortable o!Communicate that certainty is impossible to guarantee o!Use student values to guide behavior •! Modify Accommodations (your response to student anxiety) o!Evaluate your accommodation of student’s anxiety o!Decide on possible changes you would like to make !! Is this the right time to make changes? !! Safety considerations !! Small steps !! Communication to ensure consistency o!Goal is to move student toward “normal” functioning but need to find balance !! Guidance of mental health professional !! Accommodations should be temporary and dynamic Example of changing accommodations over time for student with anxiety about leaving the home due to COVID o! 1.! Take walks around the neighborhood once per day – gradually increase time of walks 2.! Take a short trip to store every few days 3.! Take a short trip to store every day – eventually pick stores that are more crowded 4.! Incorporate longer trips to public areas