It's the end of Week 4. I have been a telehealth therapist for 4 weeks now.
It's been hard. I wrote about ambiguous loss in the shock of the first week: the loss of normal life, sharing my office with lovely clients of all ages, the feeling of familiar comfort and even the way I recognized cues in my body. The onset of sudden and high stress is a different reality for perception, reaction and problem solving and I experienced not being able to find orientation in my bodily perception and emotional world as an ambiguous loss.
The last three weeks have been about frequently reorienting to my grounded centre while changing every system that makes up the infrastructure of life: grocery shopping, kids' appointments and school, work tasks like new consent forms and new billing systems for contracts. It's exhausting to have to find new processes and rhythms in so many facets of life while under the stress of worrying about loved ones or the potential impacts of the pandemic. There is a lot of work that goes into managing emotions and trying to up-regulate enough to get going again after a rest or to manage bubbling irritability that rises from inevitable road blocks that need yet more problem solving.
And in addition to the initial ambiguous losses and the changing systems, there are very real losses for many: cancelled events like grads, weddings and vacations; job loss; being able to visit loved ones in nursing homes and hospitals. Before this is over, many of us will be impacted by the death of a loved one from the virus. And as we all hear, the end of life with this virus is a lonely ending. Many people have already experienced those very real losses.
I don't think you need convincing that these are hard times. So how do we find peace? How do we find something between a high stress state and what has set in more recently for many: low-energy, irritability and numbing out.
Bessel van der Kolk is a preeminent trauma specialist and in a recent webinar he compared the preconditions of trauma to the elements of physical isolation. These are:
Lack of predictability
Loss of connection
Numbing out or spacing out
Loss of sense of time and sequence
Loss of safety
Loss of a sense of purpose
To improve our well-being and mitigate the impact of mental trauma arising from physical isolation, there are some habits we can develop. As a trauma and attachment focused therapist, these make sense to me. Some are more applicable to one person or one family over another. Take what fits for you and leave the rest. (And check out www.BesselvanderKolk.com for more information.)
Lack of predictability: Create a schedule/ rhythm/ routine. If you don't want to set specific times, have a list of activities that you plan to get through every day. They don't have to be Pinterest projects, just the basics. And create a calendar with events: who will you video chat next Friday in lieu of after work drinks or an event out? Have something to look forward to. Talk to your friends and enlist their creativity for planning a fun on-line event together.
Immobility: When our nervous system is activated, it wants to move. The irony is that we are all being told to stay home. To discharge the build up of tension in our bodies we need to take action: exercise, do a big clean, have a dance party with your little kids or your cat. And if that seems like a lot: shower, change your clothes and cook a meal. Moving is important.
Loss of Connection: We are pack animals. We create a synergy in our connection with others and we are used to doing that in the physical presence of others. van der Kolk says: "when we cry, we're supposed to get a response; when we laugh, someone is supposed to laugh with us. Those are the rhythms of life by which we develop and sustain ourselves." So when you are connecting on-line with family and friends, hang out together via video for a little bit. Tell stories and play music or games and eat together to mimic the experience of what it's like when you are together in person.
Numbing out versus Mindfulness: Ask any professional who works with people-- addiction and violence are real concerns right now. We need to try to notice ourselves and observe what is going on so we can be in a place of choice. The alternative is being a ball of reaction: lashing out or numbing out. Mindfulness practices are abundant online. I appreciate the work of Kristen Neff, Rick Hanson and Peter Levine for the therapeutic application of mindfulness-- which remember is just being aware of me in my world and the world around me. In times like this, we will default to our original self-protection emotions and strategies. That makes sense, but we don't have to get stuck there. We can come back to being present. Counseling can significantly help with coming back to the awareness of our self.
Loss of sense of time and sequence: In trauma, time stops. The joke for this pandemic time is we don't know what day it is or time of day- this is particularly true if you have been laid off from paid work. The response here is similar to the strategies above: develop a schedule/ routine/ rhythm and a mindfulness practice like meditation. van der Kolk says: "live with an inner sense that every moment is different from the last."
Loss of Safety: This one is a big one for me. A portion of my counseling work is with kids who live out of parental care, involved with Children's Services. I talk to care providers a lot about how to help a child *feel* safe. We know that scared and stressed adults scare kids so finding a calming breath and loving touch between family members is crucial. Consider when you feel safe and what helps you to feel safe. I have a few, but one of my stranger ones is, in my comfy chair with blankets on me, I have taken to adding a 'throw' sized very soft blanket around my shoulders and on top of my head in a way that I can turn my head and rest my cheek on the soft fabric. I'm sure it looks silly, but the full set-up is like a cocoon and I exhale deeply in this comfy contained safe place. When do you feel safe? With whom do you feel safe? Set that up for yourself.
Loss of a sense of purpose: The easy fix for this is to help others. I know how hard it is right now and how awful the world looks with every news item or social media scroll AND I can't help but believe that this is the time for us to shine as a dominantly compassionate species. Add something to your window that is interesting for the pedestrian's walking by; call an elderly neighbor or friend and offer some service; see what charitable act you can take that will help someone.
And care for your self with purpose. Write out your activity list for the day and week and follow it (being gentle with your self). I know that lots of days it will be enough just to shower and connect with someone but on the days you have it in you, what act of helping- yourself or someone else- can you do?
I see you. I know it's hard. And I know we will get through this. If you think having a video or phone counseling session would be helpful, consider reaching out. And in the meantime- take care of yourself. You're important and needed in this world.