This article is written by Claire Holmes who is Head of Counselling at Tanglin Trust School and a Certified Mindfulness teacher.
PDF can be downloaded here.
As we emerge from lockdown and adapt to our ‘new normal’ for most of us, it is going to be a mixed bag of emotions. This blog explores finding steadiness during the transition by being aware of thoughts, finding a pause button and gaining steadiness amidst change.
Thoughts can be tricky
Thoughts are important and worth paying attention to. They are our running commentary and perception of the world. Each of us has a constant stream of thoughts coming and going. At times of transition their flow may get faster and louder.
Increased ‘thought traffic’ is our natural response in changeable times. Not knowing how things are going to turn out is unsettling. Our minds tend to project into the future to fill the space of uncertainty with “What-if” thoughts. Before we know it, one of these “What-ifs” spirals into a story of how things are going to go wrong. It is all too easy to get swept along with our own narrative. We are pre-programmed to keep ourselves safe from threat in this way.
These mental simulations activate our fear response and we believe them to be real. We start to see these thoughts as truth. Our brains actively look for evidence in our environment to support these beliefs. This becomes our filter of how we see the world and these thoughts become our reality. Before long, the thought that began it all, which may or may not be true has begun to pull us all over the place mentally.
However, we are not our thoughts. They flow through us; they arise linger and dissolve again. It’s our weaving of stories around the thought that sucks us into believing them. Seeing thoughts as mental events that are not real, acknowledging that they are not facts helps us to reduce our reactivity.
Engaging a pause button
Our body lets us know when we get wrapped up in unhelpful thinking. Experience of this varies from person to person, it might be a racing heart, shorter breaths, butterflies in the tummy or sweating. We may be able to articulate that we feel a certain way, scared, anxious or sad for example. Noticing any of these gives you the opportunity to slow things down and ask; “What am I telling myself?” Our tendency is to push difficult or uncomfortable thoughts away, but this may only be helpful in the moment. They will most likely re-surface. Engaging curiosity to explore thinking can help us to gain clarity.
What is the evidence?
Here are a few questions that we could pause and ask ourselves; Do I know that this thought is one hundred percent true? Is there any evidence that this might not be the case? Is this projected scenario certainly going to happen? What’s the evidence for and against this happening and is this really a balanced view? Could this all play out in a different way, is it possible to imagine this scenario turning out better?
What sort of thinking?
We might become curious about what kind of thinking is happening. It might be worrying, imagining, catastrophising and the like. Is it a pattern of thinking that doesn’t serve you well or an unhelpful repetitive thought? We tend to generalise and become black and white in our thinking at a time like this.
It may help to notice the “What if’s” and turn your attention to “What is”? For example, if the “What if” is “What if the cases increase and we get ill?” the “What is” may be “We are safe right now and we are doing all we can to stay well.”
Finding a different place to stand
You might like to imagine yourself lying in a field and watching your thoughts as clouds appear in the sky. Perhaps you can visualise them moving across the sky and dissolving. The next thought may do the same. Not reacting, simply noticing, being curious. Another practice is to see your thoughts as leaves, you may write your thoughts on leaves and then watch them float off down a river, or stones on a beach and throwing them out to sea. You might find it helpful to set a timer for a minute or two to do this and practice it every day to get used to this skill.
One strategy that some people find helpful is to allow themselves a designated ‘thinking time.’ You might like to find a time in the day, in a certain place that becomes your unhelpful thinking moment – do put a time limit on this. Each time you find yourself noticing unhelpful thoughts, resist the urge to get caught up in the story. Tell yourself to save it for later, at your chosen time and place. When it’s time you may find it helpful to write your thoughts down in a journal, recall them in your mind or say them out loud.
Breathing into clarity
When we get swept away with unhelpful thinking, we shut down the part of the nervous system that enables us to be steady and calm. One simple yet effective way we can find a pause button is to take a breath, notice where you feel your breath and allow your attention to settle there. Having a gentle mantra that you repeat to yourself mat be soothing, something like “Let’s take this one day at a time” or “Steady and calm with each breath.”
There is so much that we can’t control or predict. Bringing yourself back to the now can help you to resist getting sucked into those thoughts that are causing worries and anxieties. Take a moment to reset and find a pause when unhelpful thoughts come along by listing the things that you can control in this moment. A simple grounding technique is 54321. Take a breath, look around and notice 5 things that you can see, 4 things that you can touch, 3 things that you can hear, 2 things that you can smell or smells you like and two things that you can taste. Take another deep breath.
To expand on the power of the senses you might like to try this an eight-minute Safe Space Visualisation. You can come back to this recording or parts of it in your minds-eye whenever you need to find a sense of calm.
An attitude of gratitude
Connecting with gratefulness is another pause button that may be available to you. Make a list in the moment. Finding a way to record these each time create a physical list that is available for you to revisit.
The more we practice recognising our unhelpful thinking, pausing, and drawing on our steadying strategies the better we get at it. Notice when you manage to do this, even just a little bit and congratulate yourself. Trust in your capacity to approach this ‘new normal’ with acceptance and steadiness and know that this has a ripple effect. It not only calms us, but those around us too.
You may also like to read Being Purposefully Present in Uncertain Times which compliments this resource.
Developing Resilience - The Danger and Opportunity of Covid-19 for International School Educators (Part 2)
Download PDF here.
By Suzanne M. Anderson, DPST
Westerners have often oversimplified the Chinese symbol for "crisis" to mean danger and opportunity, when in fact, it means "danger at an incipient moment" (Zimmer, 2007). Linguists argue whether "the moment" is neutral or has a positive inflection in its original language. A crisis is an incipient moment--a moment when change begins and has the potential for harm and growth. Part I addressed the danger, the emotional and social impact of the Covid-19 and can be found here. Part II discusses the opportunity for building resilience while coping with the effects of Covid-19.
How is stress like carrying a glass of water?
A psychologist walked around a room while teaching stress management to an audience. As she raised a glass of water, everyone expected they'd be asked the "half empty or half full" question. Instead, with a smile on her face, she inquired: "How heavy is this glass of water?" Answers called out ranged from 8 oz. to 20 oz. She replied, "The absolute weight doesn't matter. It depends on how long I hold it. If I hold it for a minute, it's not a problem. If I hold it for an hour, I'll have an ache in my arm. If I hold it for a day, my arm will feel numb and paralyzed. In each case, the weight of the glass doesn't change, but the longer I hold it, the heavier it becomes." She continued, "The stresses and worries in life are like that glass of water. Think about them for a while, and nothing happens. Think about them a bit longer and they begin to hurt. And if you think about them all day long, you will feel paralyzed – incapable of doing anything." It's important to remember to let go of your stresses. As early in the evening as you can, put all your burdens down. Don't carry them through the evening and into the night. Remember to put the glass down! (Source unknown)
What is resilience?
Resilience is the ability to bounce back when things get tough. When a crisis happens, we often talk about being the victim of the event. Resilience is moving from victim to survivor to thriver. When a crisis happens, we will not return to pre-crisis normal; we will need to create a new normal. Our goal must be to grow in response to the trauma. It doesn't mean we would have chosen to go through the crisis event. It means that having had no choice, we come through it and like who we are better than who we were before the incident. Perhaps our priorities are redefined. Perhaps we realize we have a new sensitivity and understanding of what others go through that gives us a greater sense of connection. Maybe we clarify our values and realign how we live in line with our values.
As with anything that challenges us, we have the opportunity to learn more about ourselves and even to develop ourselves. The reality is that many of the things we can do to strengthen our resilience we already know. However, when crisis arises--especially protracted ones--we can spend so much time coping with the effects of the crisis, that we forget to take care of ourselves in some of the most basic ways.
Resilience is not a characteristic that we have or don't have. It is a capacity we can choose to foster and develop. Resilience can become a lifestyle.
We are hardwired for connection. Scientist Matthew Lieberman argues that our need to connect is as essential as our need for food and water (Cook, 2013). We connect better when we are face-to-face in the same room with each other. For educators in countries that have closed schools, there is limited opportunity for face-to-face connection. Educators in China have shared a feeling of withdrawal, a sense of sensory deprivation.
While we are socially distant from our wider circles, we often face separate challenges from the social “support” of being cooped up with family members 24/7 day-after-day with little opportunity to get out. In this case, it may be that we have to find ways to structure some autonomy and independence. Perhaps an overnight in a guest bedroom for children who share a room, or even spouses. Perhaps creating an agreed-upon do-not-disturb time frame in which we can think our own thoughts and do our own things, knowing that we will be undisturbed.
There are several ways to address our needs for social support. Find time to be with people who bring you a feeling of joy. Plan what you are going to do with family and friends when you can get out and travel again. Remember that anticipation is a significant part of the fun. Talk with friends or a counselor to reduce isolation, clarify thinking, get feedback, or hear some new ideas or perspectives that may be helpful. Ask for help. We often say we don't want to burden others by asking them to do something for us, but the fact is we are depriving others of a "helper's high" when we don't ask.
Share vulnerabilities. We tend to isolate ourselves when we are not feeling emotionally well. We hide how we are feeling, and think that we are the only person feeling the strong emotions or struggling in the way that we are. So, we keep them to ourselves and may become shrouded in a feeling of shame and be isolated. Brené Brown (2017) has taught us that the antidote to shame is vulnerability. And that empathy (not sympathy) drives our connection. Find people to talk to who can be with you empathetically.
And, as the people around you open up with their vulnerabilities and needs, support them. Give help when asked.
Physical health is put under significant strain when our body is more stressed and exhausted from dealing with all the change, and sometimes accompanying fear that comes with crisis. We know that stress and exhaustion lower our immunity. Think about how our immunity is affected by how we take care of ourselves.
There are no surprises here. Remember to eat well (avoid sugar); drink water; get good rest; move and exercise (but don't over-train); take time to breathe deeply; practice progressive muscle relaxation (a favorite recording is by Beth Salcedo); and set an alarm or timer to take short rest breaks to move from sitting and give our eyes a rest from the computer screen. There are a great variety of routines on the Internet that can be followed in your home (a favorite is https://darebee.com with 1,300 workouts).
Part 1 of this article provided a review of the emotional reactions that are commonly experienced in crisis. It is essential that we don't stuff our feelings. That is like trying to hold a beach ball under the water with one hand. When we get distracted, our emotions, like the beachball, are going to come popping out. Find ways to express your feelings: talking, writing, or physical activity. Identify and name your feelings. That simple step can move us from reacting from the emotional center of our brain to responding from the cognitive center, allowing us to connect with more resources for analyzing and problem-solving.
Laughing and crying both exercise our muscles, bring more oxygen into the body, and provide a release of emotions. Like exhaling takes unwanted gases out of our body, tears carry away chemicals that build up in our body in times of stress. Give yourself an excuse to cry by watching a good tear-jerker movie or creating an "angst playlist" that will help you release those tears when you want to. Laughter can reduce stress and thus help strengthen our immunity. There are many ways to find an excuse to laugh, such as good comedy videos or, if you dare, do an Internet or social media search on "Covid-19 Memes."
Fear can be a significant and natural part of our reaction to Covid-19. We can use this as an opportunity for growth, to expand our capacity to cope with fear. Doing something outside our comfort zone every day (while being physically and emotionally safe), reduces the number of things that create fear in us, and puts us in touch with how bold, brave, and capable we can be.
Anxiety and panic are significant features of the unseen threat of the virus. For some of us, it can feel like nervous energy, with limited ability to move around to discharge it. Find ways to soothe yourself with calm music, a warm bath, mindfulness, or a moderate exercise routine.
Use worry and angry properly. When we use our emotions well, they serve a purpose. They get us what we need by moving us to action or getting others to move to action for us. When we worry or get angry, they are responses -- something has happened that has hurt us, or we think that something in the future could hurt us. Figure out what that dangerous thing is. And if you can do something about it, take action. If it is something outside of your control, let it go. Sometimes we might need our social support, our family and friends, or maybe a counselor, to get clarity on the problem, to sort out our power, what we can change and what we can let go.
Can you channel your emotions into creativity? Can you create art? Write music, short stories, poetry, novels? When we are out of our regular routine, we might have new eyes for seeing ourselves. Instagramer Amber Rae recommends journaling about what is coming up for you as an excellent way to channel this potential for learning and growing.
David Elkins, Ph.D. in a Psychology Today article, tells us that "The word spirituality comes from the Latin root spiritus, which means 'breath'--referring to the breath of life." Susan Santucci, in Pathways to the Spirit, shares that people in every country and language search for the unquantifiable spirit that nourishes the most profound part within us and brings joy into even some of the life's darkest moments. Trauma victims and survivors teach us that for our search for the spirit to be nourishing; we need to find what speaks to us individually, not what others tell us. One person's imposition of their spiritual practice on another can often be unhelpful or harmful.
For some, spirituality can mean a religious practice. However, during this time, many houses of worship have been closed or are harder to access. For others, it may be making a practice of gratitude by keeping a journal, compiling an A to Z list of gratitude, reading inspirational writings, spending time in prayer, mindfulness or meditation, or spending time in nature. During this time of being indoors in the winter, it may seem hard to find nature. "Forest bathing’ expert Dr. Qing Li describes a sixth sense that he says connects us with the world beyond ourselves. He suggests that we can bring the forest indoors with indoor plants, by bringing the essential smells of the outdoors in with aromatic oils, and bringing the sounds of nature indoors. He shares how essentials oils have been used in Taiwan to reduce the stress of primary-school teachers.
The hallmark of crisis is chaos. Chaos means that we lose our routines, the usual, predictable pace and cadence of our days, our weeks, and in the case of Covid-19 it seems months. For many educators, that has meant learning how to teach class on-line and learning how to use each of the tools needed to do that. Not only are educators engaged in teaching each day (an already exhausting task), but they have to do it in new ways.
Each time we step out of routine, we have to create new patterns that require new decisions. These multiple changes can lead to decision fatigue, which is not as easily as recognizable as physical fatigue. Making decisions about things that were otherwise mundane that we have not encountered before can require a lot of energy, and can sap us of the capacity we have previously allotted for the things that are most important to us.
While it might seem trite to say "our thoughts become our reality," it is fair to say that "our thoughts become our perception of reality." This is based in our biology. The thoughts we think the most, will cement themselves as neuropathways in our brain that fire faster and more often. Limit our media to the barrage of news and social media about this crisis so panic and fear don't become seared into our brains. Pick a couple of good sources and let the rest fall to the side.
Some of us who are staying indoors day-after-day may feel like the days begin to bleed together. Find a way to mark the days, to distinguish one from another: literally mark the days off of the calendar, have a different routine for weekdays and weekends, schedule specific things on certain days of the week.
We also want to normalize and create new habits around socially responsible behaviors. Create new routines around washing hands when coming into the home, when touching buttons out in the community, before touching our face. Pick a new greeting to replace the handshake. Our new greeting may be an elbow bump, the tapping of feet (affectionately called the Wuhan Shake), or a greeting with palms together in front of our chest and a smile as the Hindus greet each other.
The cliché "information is power" has been used by many survivors of crisis and trauma. Crisis and trauma--by their very essence of being sudden, random, and arbitrary--take away our control and leave us with a feeling of helplessness. For some, learning as much about the situation they are in serves to lessen feelings of helplessness. If we follow the path we teach our students, and find reliable sources, there is much to learn about this epidemic--people's reactions to them, the impact of confinement, the effect of internet communication on the effectiveness of mirroring neurons, the sequencing of genomes, how seasonal temperatures might affect the spread of the virus, the list is endless.
What have you learned about yourself and others? How has this situation changed you? How has it changed your values or priorities? Has this crisis helped you to clarify your perspectives on where you live, your employment, friends, and family? Is there anything that you have learned from teaching classes on-line that will inform the work you do when you return to the classroom? Will you return to the classroom?
Self-esteem is about valuing ourselves and what we can do. We can engage in activities that increase our sense of value and worth, either because we have made ourselves a priority or because we have something that is of importance to others.
For many, in the busyness of work-life we have given up things we like to do or are for which we are skilled. Now is the time to find some time to return to those things. Perhaps you can do them for a few minutes while you are taking the mini-breaks recommended in the Physical/Health Abilities section. The confinement of having to stay at home may mean we are not able to get out to do some of the things we enjoy. Still, we can make plans about what we would like to do in the future, or we can enjoy the memories of past adventures through photos or videos, or create a vivid memory to relive the enjoyment you have had doing those things in the past using all of our senses.
As you work on maintaining your social support network, described earlier, don't forget to spend time with people who admire you--the people who when you leave them, leave you feeling stronger, more capable, more creative, and knowing that you have a lot to offer the world.
Value yourself enough to make time for fun and to celebrate your successes and life events such as birthdays and anniversaries. Perhaps every night becomes "Friday night" until you can return to your routine. Maybe you find a place where you can go outside and play a game without a mask for a short time. Have a camp out under sheets in the living room. As expatriates, we so often live for the magic of travel, but in these times, we may need to find a way to create magic at home! And remember, we are living through times and situations we never thought we would have to. We are still working, caring for our children, caring for ourselves. Our coping and surviving are worth celebrating.
The goal of this discussion was to provide a buffet of options for developing and strengthening our resilience. Some items in this article may even be in contradiction with each other. What we need, what works, is different for each of us. What helps us to feel rejuvenated? What brings us joy? What reduces our stress? What helps us to be the best version of ourselves? We need to listen to ourselves and do, unapologetically, what is best for our own coping and resiliency development.
Developing a resiliency plan
Having read through this list, I hope that you have recognized things that you are already doing (Well done!), things you have done in the past (and will easily be reinstated), and some things that are new that you think might be helpful. Don't try to take on too much. Remember, change -- even good change – is stressful. Done too fast and our “slow-changing, stable brains” will resist (Guise, 2013). Aim for "Progress, not Perfection."
Psychiatrist and neurologist Vicktor Frankl, who survived three concentration camps in World War II reminds us "Everything can be taken from a man but one thing: the last of the human freedoms—to choose one's attitude in any given set of circumstances, to choose one's own way." I hope these ideas help you to find a resilient way through these difficult times.
The framework for this article is based on the concepts of resilience outlined in the Community Crisis Response Team Training Manual (NOVA, 2019). The content is a compilation of ideas generated by members Singapore-based crisis response team that the educators of the Jakarta Intercultural School in September 2014 found useful and ideas of educators currently based in central and eastern China. Thank you to long-time friend Pam Schuur for once again performing her editing wizardry.
Download PDF here.
By Suzanne M. Anderson, DPST
Westerners have often oversimplified the Chinese symbol for "crisis" to mean danger and opportunity, when in fact, it means "danger at an incipient moment" (Zimmer, 2007). Linguists argue whether "the moment" is neutral or has a positive inflection in its original language. A crisis is an incipient moment--a moment when change begins and has the potential for harm and growth. Part I of this article will address the threat, the emotional and social impact, and Part II, to follow, will discuss the potential to respond with or build resilience in the response of Covid-19.
Part 1: The Danger: The Emotional and Social Impact of Covid-19
Over the last couple of weeks, I have talked with international school educators in central and eastern China, where Covid-19 has forced the closure of schools since the Lunar New Year, and where they are expected to be closed for a number of weeks. These educators are both Chinese and internationals. Some have remained in China, some have gone to neighboring countries like Thailand, and some have returned to home countries, such as Australia and the United States. Not all had choices about whether to leave. Those who remain seem to mostly be Chinese educators whose homes and families are in China, and international educators with pets, who would have had to navigate finding care for, or moved with, their pet—often an expensive and drawn-out process in the best of times. Every educator with whom I spoke is working harder day-after-day, around the clock, to support continued learning for their students; to remain connected with their colleagues in various time zones; for some, to support their own children's education; and, to eke out, in the very little time left, some time to care for themselves.
Talking to people who have survived traumatic situations always has a profound effect on me. Usually, I am onsite. Usually, I have come to where the crisis has occurred and talked to survivors face-to-face. This time I have been providing support remotely—while living in a Covid-19 affected country—however, sitting in the relative comfort and freedom of my home and office in Singapore. Even at a distance, these conversations palpably conveyed the impact of the virus in a way that I have not often felt. And, as always, these conversations impressed me with a profound picture of human endurance, resilience, and creativity. There is no playbook, no set of guidelines on how to survive an epidemic, effectively on house arrest, or unable to go "home." These educators are making it up as they go along, trying to make the next best decision, professionally and personally.
For those who are not infected, but none-the-less have had their lives significantly altered, the emotional impact of Covid-19 can be overlooked. Unless you are infected, the danger of this virus is invisible, we only see its impact on the society writ large. And while the threat is active (the virus is spreading), the focus is on efforts to stay healthy—to survive. When infections subside, routines are reinstated without evidence of the previous disruption. Also, for those of us strongly affected, but who have not had the virus, the strength of the emotional and social impact can seem larger than it “should” be—after all we “should” be grateful we didn’t contract the dreaded illness. The very real emotional and social burden and accompanying recovery are not given proper due.
Even without the stressor of the Coronavirus or Covid-19 disease, everyone has a pre-crisis equilibrium that is either already distressed or already resilient. Educators have the day-to-day challenges that life brings—kids trying to get through exams, health issues, challenges with student’s parents, learning difficulties, elderly parents to care for, and living in a foreign country where ex-pats often don’t speak the language. The virus can feel like a weighted blanket coming down on top of all of life’s challenges. Those living with the impact of it must find a way to move around, to do the ordinary things of life, while lifting or holding up the weighted blanket at the same time.
While we may be tempted to want to jump to coping and resilience, for many people, the impact must first be acknowledged. There is a series of reactions and emotions that are not uncommon in crisis—the crisis reaction (NOVA, 2009). Just like Elizabeth Kubler-Ross’s stages of grief helped create order out of the chaos of grief and loss, so too can understanding the stages of a crisis reaction help to create some feeling of order and understanding out of our responses to a crisis or disaster. Without understanding this pattern of response to a crisis, victims and survivors often feel like "they are going crazy," and they use those exact words. They hold it together on the outside (think Facebook feeds of how good life is) and see each other doing that while experiencing a rollercoaster of emotions inside and assuming they must be the only one feeling some of the strongest emotions one can experience in a lifetime.
When a crisis first begins, we often experience shock, denial, and disbelief. Almost, universally our response is, "I can't believe it!" The event feels impossible, surreal, or incomprehensible. Some of us experience the unfolding of the incident in slow motion, others in fast forward. Some of us feel frozen, unable to move. Often, we are reacting with our old brain (the same one a lizard has), with only our instincts to survive. At this stage, we may also experience regression—we may look for someone else to tell us what we should do. Often, we may go back and judge ourselves harshly for having not used our human brains to organize, plan, analyze, and manage the crisis.
As the denial and disbelief begin to wear off, we can experience what feels like a cataclysm or roller coaster of emotions. Often the first reaction we experience is fear and terror. It may feel as if the “veil of immortality” has been ripped away as we “think” or “know” we are going to die. This may have been experienced by some who were sick for other reasons at the same time as the Coronavirus started, and ended up at the same medical facilities as those who are later found to have the virus. Several educators have described experiencing panic and anxiety attacks that they have not experienced before. We are also feeling ongoing fear when someone around us coughs or sneezes.
It is not uncommon in situations like this for us to feel anger, fury, and even outrage. This can be directed towards the cause of the crisis (the virus) or towards those trying to provide help in the aftermath. There can also be a strong experience of secondary injuries--when we go to people or organizations seeking help and support but perceive those responses to be unhelpful or insensitive. Employers can be guilty of creating these secondary injuries: employers often expect us to get on with our work, to keep functioning at past performance levels or maybe higher levels without recognizing the personal and professional impact of the crisis.
As we try to get help, fix what has been broken, and make sense out of what happened and why it happened, we often feel confusion and frustration. Confusion and frustration seem particularly salient with the Coronavirus because in the early stages, information about the disease and how to respond seemed hard to access and continually changing. Timing was another barrier to clear communication--the impact of Covid-19 began to unfold at a time when international schools in China were breaking for a week, and school administrators and educators were traveling. We are likely to see growing confusion and frustration as schools make plans to re-open (or not), student quarantines (or not), and so on.
As we try to figure out what happened and why it happened, we may experience guilt and self-blame, feeling that they “if only” we had done something different, our circumstances in the crisis could have been prevented. We will see our colleagues and friends wrestle with the many “should(s)” that survivors tell themselves. “I should have left,” or “I should have stayed,” or “why did I go overseas to teach in the first place?” The conflict between family left at home and those who have gone overseas can be highlighted: when something disastrous happens, those at home who didn't want what their loved ones to travel can begin to feel justified.
We may feel shame and humiliation if we blame themselves for how we chose to respond and cope, and especially if our lives are changed for the worse, physically, financially, relationally, or otherwise. Shame and humiliation can be exacerbated if details about our lives in these areas that have remained private become public. For educators, especially those who have left China, there has been for many an extra financial toll—renting temporary accommodations—sometimes needing to relocate during the duration, additional travel expenses, and more. For others, there is a subtler experience, of having to live indefinitely in the homes of family and friends without autonomous control of many of the fundamental routines of one's own time and space.
As we begin to realize how our lives have been irrevocably changed by the crisis, we may experience grief and sorrow. Each and every physical, material, and intangible loss we experience can trigger its own grief, its own sorrow. The apparent losses are for those who become ill and for those who succumb to the illness. There can be material losses of financial resources that are having to be re-channeled into staying safe. There are many other less tangible losses that are harder to identify. There is a fear of losing time and experience for many students and teachers. Many students have lost school trip opportunities they have anticipated for years. There could be a loss of afternoons and summertime if school days are run longer to make up for the lost academic time.
For many, there appears to be a sensory deprivation—the loss of being with people face-to-face during this time when most communication is done through a computer. The loss of independence as families in China are in homes—all day, every day, for days on end with little opportunity to go outside. When schools re-open, there are educators and students who may never return, and they left sadly without proper goodbyes. This compounds the grief of third culture kids and families who experience many transitions.
The loss of feeling the air on one’s face as masks are required to go outdoors. The loss of energy—every time we change our routines, it takes extra energy to develop a new pattern of activity. Educators have been forced to learn a new approach to teaching solely through technology, relating to their students while observing child protection protocols, as well as learning to use new technologies to deliver educational content, all being done in the context of unstable and inconsistent Internet connections. Some having left for the holidays without their laptops have found themselves running or taking classes with only a cell phone. Many educators have helpers who have not been able to return after the Lunar New Year, thus have taken on domestic workloads in addition to increased professional workloads.
The loss of certainty that comes with the normal anticipated pace and sequencing of life and the school year. Educators are having to meet and run classes across international times zones. Typically, families are setting dates and making reservations at this time for the school summer break. The most essential looming question is, "When will this end?" Without knowing that answer, we are not able to plan.
Having experienced this cataclysm of emotion, our hope and goal is a reconstruction of equilibrium--otherwise described as creating a "new normal." It is not possible to go back to normal as it was before the crisis. Still, it is possible to create a fulfilling new normal--that while recognising the losses of the crisis--recognizes the unique strengths and growth that have occurred as a result of the crisis. More discussion on the reconstruction of equilibrium throughout and after this crisis will be addressed in Part II.
It is essential to recognize that we will all have very different reactions and ways of coping or creating a new normal. Strong opinions about the “right” and the “wrong” way to cope can create tears in the social fabric of an organization. In this situation, these tears in the social fabric may emerge between the "stayers" and the "leavers," and between those who had a choice to leave and those who did not. By recognizing that each individual will have their own unique experience of reacting and coping and by allowing and supporting each other, we can help to maintain or strengthen the fabric—the relationships—within our organizations.
In a crisis that is time-limited—the disaster comes and goes, and recovery begins quickly—these strong emotions will most often taper off after the one to three months. But in a long-term crisis where the disaster keeps unfolding, these reactions can last much longer and can come on strongly over and over as the crisis comes closer—there is an infection nearby, a friend is infected, as teachers return to China to start school again, or as there are notices that teachers may have to work differently to deliver a complete school year for students. Essentially, the longer the duration of the incident, the more significant the impact. As of this writing, the WHO has issued its 44th daily report and with no definitive end in sight.
We don’t have to wait until the crisis is over to take care of ourselves and build our resilience, we can start now. Part II will address ways of coping and developing resilience during the extended duration of this epidemic.
If you are reading this and wondering if it would be helpful to reach out for support, I encourage you to answer the questions of the Trauma Screening Questionnaire. This can provide another perspective on how the circumstances of Covid-19 are affecting you individually. We would encourage you to consider the resources and support offered by your school, or the counselors who may be available in your community. You can also consult the International Therapists Directory for therapists familiar with the issues of expatriates and third culture kids and families.
I know that there are many other significant ways that we have been socially and emotionally affected and losses endured as a result of Covid-19. Please feel free to share your experiences in the comments section below.
While they will remain anonymous, I would like to recognize the educators in central and eastern China who contributed to this article and add a thank you to long-time friend Pam Schuur who expertly provided editorial support.
NOVA. (2009). The community crisis response team training manual: Edition 4.0. Washington, DC: National Organization for Victim Assistance.
Zimmer, B. (27 March 2007). Crisis = Danger + Opportunity: The Plot Thickens. Retrieved from The Language Log.
How can families find balance in these uncertain times – does this temporary ‘new normal’ provide us with an opportunity to recalibrate?
By Claire Holmes, Head of School Counselling, Tanglin Trust School Singapore (Guest contributor)
The Covid-19 virus presents us with uncertainty. As humans we are programmed to get drawn to the “What ifs” at a time like this. This is normal and helpful to some extent to keep us alert and prepared, however, the challenge is to find a balance between this and keeping our families safe, remaining calm and choosing rational fact-based responses.
The constant flow of information through our devices, some that’s accurate and some that’s not makes this balance difficult to strike. We lived here in Singapore in 2003 when the SARS virus hit, then media consumption felt more choiceful, the sources a lot less prolific. Today relying on trustworthy information and choosing when we engage feels very necessary in the pursuit of balance. This time round I have noticed an increased tendency to pick my phone, to check the latest statistics and search for news articles. To be honest, I’ve not been sleeping as well as usual, I have been waking up during the night with an urge to take a sneak peek at my phone for an update. This ‘on tap’ information feels like a constant stream always there to dip into. This can be consuming and begin to take over our lives, it’s certainly not helpful for us to get sucked into this 24/7 but it’s so tempting, moderation feels key. In an attempt to be more discerning I’ve joined the Singapore government What’s App group and given myself a window in the evening to visit the BBC website and The Straits Times rather than searching all over internet to read potentially unreliable sources many times a day. This has helped me to feel more in control and I’m certainly thinking less about the “What ifs” because of it.
As a counsellor, I am acutely aware of the positive impact of modelling a calm, measured and rational response for my own children. Our kids just aren’t programmed to be calmer than we are, they take their lead from how we deal with situations. It’s likely that this is the first worldwide disease outbreak that they have experienced and it’s normal for them to be worried and concerned. How we respond to these worries is key in supporting them to manage their anxiety and find a balance too. Validating and normalising their experience is vital, let them know that it is okay to be worried at a time like this and that they can chat to you about their concerns anytime. Keeping the door open for those conversations and making yourself available to chat when they need to will help to reduce their anxiety. Avoid the temptation to tell them not to worry as this minimises their experience, may deter them from sharing with you again and increase their anxiety. Instead, normalise, validate and empathise with whatever they are feeling. Reassure them that the family is doing everything to stay safe and healthy, give them examples of the common-sense precautions that you are all engaging in day to day.
Staying safe might begin to feel like a new normal, routines of hand washing on arrival home, taking temperatures daily, not touching our faces and keeping a measured distance from others who seem unwell. Perhaps you and your family are more aware of immune-booting practices like eating healthily, sleeping well and taking regular exercise. It might even feel like a refreshing reset, a reminder of how to take care of ourselves in a more balanced way. Perhaps this might be an opportunity to strengthen family unity, to set some new healthy routines and rituals in place such as family walks, eating meals together and having a movie night at home. You may even have a bit more time available at the moment as your children’s clubs, matches and events have been cancelled, this may be an opportunity to connect more with others. Encourage your children to maintain their connections with friends. Stay connected to yours too, especially those that help you to feel relaxed and provide a measured and calming approach to all this uncertainty. Positive connections are a robust coping strategy.
Being cognisant of coping strategies that help maintain a balanced outlook is imperative right now. What things do you do in your day that help feel you to feel more in control of things, how do you slow things down increasing the chances that you’ll respond rather than react? This is different for everyone and our children may have different ways of coping than we do. For me, spending time exercising in nature, practicing yoga and meditation as well taking time to connect my family, friends and colleagues helps me to feel centred. For my kids being active, being with their friends, watching their favourite movies or shows and talking through their worries seems to help. Other people love to read, paint, draw, journal or garden. Acknowledging the things that you do to help you to cope and ensuring that you and your children are still weaving them into your day is important for ongoing wellbeing. Modelling this by talking openly about how you are taking care of yourself to your children is a wonderful way of sending a message that self-care is a vital piece in helping us to cope well. Remember the calmer and more collected you are the kids your will take your lead.
Could this be a chance to recalibrate? To take stock of what’s important, appreciating ways of taking care of each other, being kinder to others and ourselves as we adjust to our temporary ‘new normal.’ It could be that in the long run this recalibrating might help us to be healthier, more connected and more thoughtful long after the crisis has abated. It may be that you notice that some of the things that your family have put in place make a positive impact. Perhaps this is the silver lining of all this unsettling uncertainty and whist this crisis presents a significant challenge for us all it may also present an opportunity. An opportunity to appreciate each other, each moment, be thankful for the little things and the enormous resilience of our community.
Understanding the Mental Health & Social Impact of the Coronavirus: Finding the Middle Path
Download PDF here.
Also published on TherapyRoute.
By Suzanne M. Anderson, DPST
Singapore has been my home for 20 years. It has been 17 years since I lived through SARS with three kids under 6 years of age. My strongest memory was grabbing the newspaper each morning and taking in the numbers found in the center column of the front page. Were they going up or down? Had we hit the low point (the worst it will get) or was that still to come? I was trying to answer an essential question, “Are we safe? Are we not safe?” And then to decide what my children and I could safely do that day.
This time my “go to” for monitoring the numbers are Singapore’s MOH reports and the WHO Situation Reports. Asking the same essential question, “Safe? Unsafe?”
Carrying the news of an increase in alert levels and news stories of emptying grocery store shelves into the darkness of night can make us worry what the world will be like when we wake in eight short hours.
And yet when we wake, checking the numbers is not our only way of centering ourselves. We can also look outside and see that the sun has once again risen to a day of sunshine, birds chirping, and connections with loved ones and neighbors.
It is a rollercoaster of emotion to manage from sun-up to sun-down, regulating ourselves, even when we see the dysregulation of others.
A friend of mine, a measured, thoughtful, and non-reactive friend shared with me the story of heading to Cold Storage to pick up some fruit for breakfast the next day and seeing the number of people, the lines at the cashiers, the emptying shelves and later reflected, “I am normally calm, but seeing people going crazy, made me react.” Strong, a sociologist says, “…the subjective experience of the first social impact of such epidemics has a compelling, highly dramatic quality (Rosenburg 1989 in Strong 1990, 249).”
What is your first memory of the Coronavirus? When did it first become a real concern or threat? That is where your story begins. It will be different for each of us, and yet there will be some commonalities. How we think and what we do matters. It matters to your own well-being and it matters to the well-being of each person who looks at you – who reads your face and interacts with you throughout your day.
I knew I needed to “make patterns out of the chaos of events” so that my actions wouldn’t be bouncing on inevitable waves of disaster chaos, contributing to it. Ideally, I would engage with measured, thoughtful understanding of the larger narrative. More simply put, I didn’t want to feed on fear or put out fear for others to feed on.
As a mental health provider watching the Coronavirus unfold, I began looking for words to codify and communicate internal and social experiences into thought and language. And as I always do, I started to read.
A Google search elicits only six to a dozen articles. Some of the articles were quite dated. My “go-to” trauma resource pages focus much more attention on coping with bush fires, mass shootings, but not coping with an epidemic. The trauma literature is skewed to the Western world, even as the numbers of those affected by disease in the Eastern world surpasses many of the apparently higher priority crises. I was surprised that I was surprised. It is a dilemma known to survivors of and responders to crises—the confusing inequalities of the world’s attention.
The search surfaced an insightful discussion of “epidemic psychology” (Strong, 1990, 251). Philip Strong coined the term as he sought to identify a model for understanding people and societies reactions in the wake of the AIDS/HIV crisis. He described epidemic psychology as consisting of parallel epidemics. Not only is the epidemic biological. There is also the potential for a psychological epidemic of fear. In the process of Strong’s proposed model after fear comes explanation and moralization and then the implementation of solutions or proposed solutions to the disease itself or the social and individual impact. These are concepts that affect both individuals and communities.
The following discussion looks at the epidemic psychology of Coronavirus and the role of the media. The article finishes with some recommendations for coping or finding a middle path through the almost predictable over-sized fears that can result in the midst of a disease outbreak.
Fear, suspicion, panic & irrationality
When we are rattled by the question, “Am I safe?” describing the feeling as fear does not quite encapsulate it. For many, when the danger is invisible or incalculable – when one cannot see the enemy or the threat, but only the results – the fear may become more intense: an uncomfortable feeling of terror or dread. The feeling of having the “veil of immortality” (NOVA, 2009) torn away when thoughts, “Could I die?, Will I die? Will others I know and care about die?” come. Humans have a natural tendency to catastrophize, an evolutionary survival orientation—a primal skill of survival designed to help us survive the worst. It is natural for us to start to view, every cough, sneeze, breath, communally-touched item (railings, doorknobs, elevator buttons), with fear, terror, and dread.
Suspicion and its underlying belief that that danger could be nearby, but can’t readily be verified, informs our behavior. We may suspect other people may have the disease. We may suspect medical practitioners are not doing enough to effectively respond to the medical threat. We may suspect governments are not releasing true and accurate information. We may suspect the media is releasing inaccurate or sensational fearing-inducing stories. We may suspect neighbors are stocking up on or getting the needed medical or daily living supplies and that there will not be enough left for ourselves when we need it. In a kiasu/kiasi (translated scared to lose, scared to die) culture that is scared to lose out it seems this fear of others getting what we might need could be amplified in this crisis.
For some, fear and suspicion can rise to the level of irrationality. In some cases individuals can believe they have the disease or illness when there are no facts to support it. This irrationality may be fueled in some parts of the world by the worldview that accepts magic and the unexplainable to be as legitimate as the empirical.
Explanation: stigma & moral judgment
On our way to action, we try to find an explanation or manufacture a rationalization. Unfortunately, our natural efforts at trying to understand what is happening and keep ourselves safe can at times lead society to respond with “avoidance, segregation and abuse” (Strong, 1990, 253). This can be in found in the form of shunning the doctors and nurses who treat the virus patients. It can be found sadly in explanations made by some that the virus is God’s judgment. It can be found in judgments of others ways of living.
The more quickly we can move through this phase, the more quickly we can get to a phase of interacting with the problem in a meaningful way and the less likely we are to harm relationships within our communities.
Action & solutions
Strong (1990, 254) describes the intellectual confusion at the start of a disease in which “People may be unable to decide whether a new disease or a new outbreak is trivial or whether it is really something enormously important.” There comes a time when someone becomes convinced in the proportions of a religious conversion of the danger of the disease and sets about to warn and educate people (Strong, 1990). In the present response to the Coronavirus I think many would be the Dr. Le Wenliang, who was among the first to warn about the virus outbreak and was subsequently silenced.
As the first responder “converts” learn and begin to educate, others begin their own journeys. They experience shock, denial, disbelief. And for a health disaster that spreads like Coronavirus, it seems natural to take longer for reality to settle in and propel one from the state of confusion to the full action of warning and educating others.
Like SARS and MERS before it, Coronavirus is yet another reminder that the actions and solutions of prior epidemics have affected, perhaps unrealistically, our expectations of current epidemics. When my grandmother was growing up in the 1920’s she lost two of her siblings before they were five years old. Her parents had two children die before they did. It was not uncommon at that time. The invention of antibiotics and childhood immunizations have lulled us into forgetting that life is often messy. Engineering, science, and medicine truly accomplished amazing things, but they cannot control all of nature. What was a common occurrence during the years that my grandmother was growing up has now been deemed unnatural. I am not suggesting that we want to go back to that time. I am suggesting that we need to acknowledge the frailty of life while we aim live life more fully and meaningfully, with hope for our future in all its messiness, supporting our scientists as they work to fight these diseases, as we take positive steps for our own mental health.
Effect of disease on social systems
Our daily lives are ordered by innumerable behaviours and actions that happen on auto-pilot (Strong, 1990, 258). Many of these auto-pilot behaviours are related to social interactions and hygiene. In Singapore these are made visible with the initiatives such as the National Courtesy Campaign and are closely related to generating a belief in the good will or positive intentions of friends and neighbors to live in harmony. When disease arrives, the essential positive assumptions are replaced with the parallel epidemic of fear and suspicion. From a sociological perspective, we humans then have the capacity to share those fears and suspicions through language to others. This phenomenon is heightened in the era of globalization; social media makes it easier and faster, and harder to contain. It is interesting to note that Facebook and other media platforms were not a part of the response to SARS.
Medical and mental health professionals have long known the foundational positive impact of social support in difficult times. It presents a unique challenge in the case of disease, where the very person who needs your connection and support may also be the person that is the carrier of the looming catastrophe.
Impact of media on mental health
Yotam Ophir from the University of Buffalo has studied the content of news information during the outbreaks of infectious disease. He concluded that the media does not generally provide the kinds of information that is most helpful. He identified three types of information found in the reporting of disease: scientific information, social stories, and pandemic themes—issues related to preventing the spread. Often the news is focused on the human-interest stories—and often the extreme behaviours (Lu, 2015), but is lacking in the information needed for the public to make fact informed decisions. Ophir finds that during the course of an outbreak such as Coronavirus, the public needs simple and clear information about the risks and healthy ways to cope. On average, however, in his study, only one in five articles included coping information. Unfortunately, information about diseases without coping information can result in an increase emotional distress and a feeling of not being able to take steps to protect oneself (Ophir, 2015).
Suggestions for coping & finding a middle path
A clearer understanding of how we as individuals and societies are affected by a disease crisis can lead us to a better understanding of how to take care of ourselves, and prevent a biological epidemic from becoming a mental health epidemic. The following, though not exhaustive, provide some ideas for effectively coping.
Recognize that the tasks of daily living take more energy when it takes place against the backdrop of an epidemic. Figure out what you can let go or postpone some things and spend more time in self-care.
Identify what can be controlled and implement measures to control them. Identify things that can’t be controlled and let those things go.
Recognize when our thinking is leaning towards a natural tendency to catastrophize and find a measured response the acknowledges the facts. For example, “It is possible I could get the virus, but it is not probable.”
Assert control where it will be useful such as routinizing new social patterns of washing hands, keeping hands from touching our faces and keeping a measured distance from others.
Engage in activities that develop our equanimity (calmness and composure, especially in a difficult situation (Oxford)), such as yoga, mindfulness, and meditation.
Turn off screens for several hours a day to engage in exercise, reading or other pleasurable hobbies.
Increase your connection with loved ones by spending time together and expressing affection.
Find support with a mentor, wise friend, medical or mental health practitioner if you find that concerns about the virus are interfering with your ability to engage in the responsibilities of daily life.
Look for opportunities to engage in “random acts of kindness” that will increase our own positive feelings as well as strengthen the social fabric that binds us together as community in Singapore.
Be clear about the type of media reports you are consuming. Media reports without clear messages about how to protect yourself will increase anxiety.
Listen to information provided by friends and family and share information with others discerningly. Is it fact? What is the source? Is it helpful or anxiety provoking?
When spending time getting informed about the Coronavirus be sure to spend more time on official sites that provide reliable information about risk and guidance on coping. Singapore’s MOH site or the Gov.sg WhatsApp Subscription are a reliable ones.
A special thank you to long-time friend Pam Schuur who graciously edited this piece and helped the content and flow come together.
Dingwall, R. (2020, January 29). We should deescalate the war on the Coronavirus. Retrieved from https://www.wired.com/story/opinion-we-should-deescalate-the-war-on-the-coronavirus/
Lu, S. (2015). An epidemic of fear: Psychologists’ research is guiding governments and health leaders in their efforts to communicate with the public during disease outbreaks. Monitor on Psychology, 46(3), 46. Retrieved from https://www.apa.org/monitor/2015/03/fear
Ophir, Y. (2018, August 15). How media coverage of epidemics helps raise anxiety and reduce trust. Retreived from https://www.niemanlab.org/2018/08/how-media-coverage-of-epidemics-helps-raise-anxiety-and-reduce-trust/
Strong, P. (1990). Epidemic psychology: A model. Sociology of Health & Illness, 12(3), 249-259.
Young, M. (2009). The community crisis response team training manual: 4th edition. Washington, DC: National Organization for Victim Assistance.
Photos: Bernard Spragg (Tree lined avenue). Flickr Public Domain Dedication (CC0).
Dr. Suzanne M. Anderson is a mental health counsellor and crisis responder and trainer in Singapore.