Psyche & Soul - 7: COPING WITH STRESS AND ANXIETY DURING COVID – Physical, mental and Spiritual strategies

  Podcast link:

https://anchor.fm/boscom/episodes/2-7-Psyche--Soul---COPING-WITH-STRESS-AND-ANXIETY-DURING-COVID--Physical--Mental-and-Spiritual-strategies-21-ei4v6b

 Hello, This is Jose Parappully, Salesian priest and clinical psychologist at Sumedha centre, Jeolikote with another edition of Psyche and Soul.

Last weekend we focused on self-care during Covid 19. This weekend we shall focus specifically on the stress and anxiety related to Covid, and the physical, mental and spiritual strategies that can help us cope with them.

With the growing data emerging on the lasting physical, mental and emotional consequences of Covid, it is likely that our stress and anxiety levels would be rising higher and higher. The prolonged exposure to stress arising from the crisis is likely to have insidious long‐term health effects including increased risk of physical (e.g., respiratory, cardio-vascular, neurological, reproductive) and mental (e.g., depression, anxiety and post‐traumatic stress, impaired cognitive function) disorders. These effects are likely to remain long after the pandemic ends and the lockdown measures lifted.

At the core of all these conditions lies elements of one of the most basic and primal human emotions--fear. In the case of the COVID pandemic, this fear is inextricably tied to feelings of helplessness and the loss of a fundamental sense of safety, security, financial stability, and the ability to envision a brighter future. Fear of infection in the presence of others, of contact with contaminated surfaces, and of passing too close to another human being evokes an increasingly familiar mistrust of others, avoidance, and withdrawal from everyday activities, thereby shrinking and constraining opportunities for essential human contact and social support, vitally necessary for adaptive functioning. All this leads to increasing levels of stress and anxiety.

There are specific physical, mental and spiritual strategies we can use to cope with this rising stress and anxiety.

 Physical Approach

 

Healing Through Breath

From ancient times breath has been used as a powerful tool for calming oneself. Doing some mindful (slow, focused) breathing affects our parasympathetic nervous system and calms us down and makes us feel more in control.

Abdominal, deep breathing is especially helpful. We take in the breath through our nostrils, hold it for a few seconds, and breathe out through our mouth. Make the exhale, that is, out-breath much longer than the inhale, the in-breath. Pay attention to the pause between the exhale and the inhale. Try to empty out the breath completely in the exhalation before inhaling again. Rounding our lips to create very small opening through which to exhale makes the exercise even more beneficial. After a while notice how the breathing is affecting our body and mind. Stay for a while with whatever we are experiencing.

 This form of breathing can be done often particular when we are feeling overwhelmed.

Mental Approach

Cognitive Reframing

Our beliefs about Covid and its effects play an important role on our capacity to cope effectively with stress and mitigate its maladaptive outcomes. Many models of stress suggest that stress appraisals and mindsets are central to determining whether our responses to stressors are adaptive or maladaptive. When we appraise the stress situation as challenging, that is, offering opportunities for growth, as opposed to threatening, we are able to cope more effectively. This approach is particularly effective in contexts where the source of stress cannot be avoided, as in the case of Covid. So, reframing our beliefs and attitudes, seeing opportunities in the Covid pandemic rather than dangers, will reduce our stress levels and help us cope better.

Are you experiencing the Covid situation as threatening or challenging? What opportunities can you find in the Covid lockdown?

 Spiritual Approaches

 

Healing Through Meditation and Prayer

Meditation and contemplative prayer have a calming effect on us and can heal us. The simplest and easiest, and yet a very effective form of meditation, is to simply sit quietly and focus on our breath. We don’t need to do any kind of deep or slow breathing. Simply be aware of our breath and the breath will do what it needs to do. When our mind wanders away from the focus on breath we gently return to it and keep returning. This will calm us down, relax and refresh us. Doing it even for short spells during the day, will reduce our anxieties and depressive feelings.

 

We can also turn this simple meditation into a prayer. Instead of focusing on our breath, we focus on the Divine (whichever way we understand it) dwelling within us. We simply sit in the loving awareness of this Divine presence within us. When our mind wanders away, we gently return to the loving awareness of the Divine within us, and keep doing this over and over again as distractions are inevitable. Thinking  of a simple monosyllabic word that has for us some association to the Divine (like the name we give it, or words like love, joy, peace etc.) can serve as a vehicle that takes us back into the loving awareness of the Divine. The deep relaxation this attention creates combined with the experience of the unconditionally loving divine presence, can activate healing mechanisms within us.

 

Loving Kindness Meditation

Loving Kindness Meditation is a technique used to increase feelings of warmth and caring for self and others. It consists of turning positive emotions (e.g., love, warmth, compassion) towards oneself, loved ones, other humans, and ultimately to all living beings. During Loving Kindness Meditation, we sit quietly with eyes closed, focus on our heart, think about a person who loves us very much being near us and experience that person’s love filling our heart with warmth. We now think of more and more such loving people around us sending us love and warmth. We feel our heart filling and overflowing with this love. We now send this love to people whom we know and love, and gradually to people all over the world and then to all living creatures in the universe, wishing them health, happiness and wellbeing. We remain in this experience of receiving and giving love for a while, and take a few slow breaths before we open our eyes.

Doing the Loving Kindness Meditation, even for short periods, is a useful tool during the COVID pandemic and other stressful times because of its many psychological and spiritual benefits. It relieves self-pity, sooths fear and anxiety, reduces depression, dissolves anger, and negates feelings of isolation and aloneness in coping with adversity. It enhances positive emotions such as love, warmth, empathy, joy, gratitude, hope and positive feelings toward others. Loving Kindness Meditation enables us to remain calm and peaceful not only when we engage in it, but throughout the day. The overall effect is increase in our emotional wellbeing and overall life satisfaction.

These physical, mental and spiritual strategies have been practised by Jesus of Nazareth in his healing ministry. He reached out and touched people, he breathed on them wishing them peace. He invited people to reframe their beliefs and attitudes. He loved people and invited them to abide in his love as he abides in his Father’s love. He exhorted them to reach out in love to others just as he reached out to them in love….

Whether we practise the healing tools presented in this podcast or not, we can focus on the presence of this loving and compassionate Jesus with us, reaching out to us in love, embracing us warmly and filling our heart with love and compassion. We can then visualize ourselves reaching out to others with love and compassion, thus filling the universe with healing energies, which can also positively affect those infected by Covid and bring them healing and peace…..

Have a pleasant and love-filled weekend. Bye for now.

Jose Parappully, PhD

 You can listen to a podcast of this psot at:

https://anchor.fm/boscom/episodes/2-6-Psyche--Soul---We-need-to-reduce-stress-and-anxiety-19-ehqc7k

Hello, this is Jose Parappully, Salesian priest and clinical psychologist at Sumedha centre, Jeolikote, with another edition of Psyche & Soul.

This week end we shall focus on some protective measures against stress and anxiety during these Covid times.

Ravi is a top level professional, admired not only for his innovative ideas but also for his genial personality and collegial style who has been forced by Covid -19 to work from home.

Few days ago Ravi emailed a close friend. “I am not the person I was. I don’t know what is happening to me,” he wrote.  “I find myself getting irritated quite unnecessarily. I find fault with my wife and criticise her, which I had consciously avoided in the past. I even blame her family. Two days ago I shouted at my two children for silly things which made them cry. I am feeling ashamed of myself.”

Covid -19 pandemic can be a stressful time for many. Ravi would not be alone in what he is experiencing. Uncertain times normally lead to stress and even to feeling overwhelmed.  Loss of routine and structures that sustain daily rhythm, inability to connect with people, not being able to go out, having to work from home isolated from colleagues, loss of a sense of safety, worry about contacting the infection, or lack of access to hospital care for other illnesses, and need to be alert and cautious, and especially uncertainty and unpredictability about the future lead to high levels of anxiety.

During times such as this we can be overwhelmed not only by worry but also by other emotions such as fear, anger, hopelessness, sadness and grief.  There can also be feelings of discouragement and being out of control. It is easy for the stressed-out mind to conjure up worst-case scenarios.

Relationship Strain

When we are deprived of social interaction with those other than we live with, there is increased potential for relational friction with those who are close by. When we do  not have much to keep ourselves busy and occupied (or, preoccupied) as when deprived of the daily hassles of travel and work, we have ample time to notice negative features in those we live with which we may not have earlier. When this happens, our mind tends to go back over memory lane and pull up more and more unpleasant situations and incidents involving the other. This can lead to bickering and recrimination that strain the relationship, leading to further emotional alienation.

Fear of Stigma

In case we had tested positive and recovered, there can be fear of social stigma. We fear that those who know of our condition are going to avoid us.

Increased Stress Levels

All this can lead to increased stress which in turn impairs our physical and emotional wellbeing.

The psychological effects have been already mentioned. Physical responses may include headache, stomach-upsets, muscle tension, fatigue and sleeplessness. It can also lead to poor cardiovascular function, and higher levels of blood pressure. It can aggravate existing ailments.

Stress increases the activity of genes involved in causing inflammation and decreases that of genes involved in antiviral responses, which is especially relevant in this time of Covid-19.

HELPFUL STRATEGIES

There are number of things we can do to stay healthy and happy during the pandemic. 

1.      Stay Positive: Fight Negativity

We need to make a special effort to weed out negativity and focus on the positive. Because persons can be high-strung during isolation, fault finding is easy.  We need to consciously choose to focus on the positive, and look for opportunities to express appreciation. Blaming, accusations, fault-finding are especially hazardous during confinement.

Too much watching, reading or listening to news about COVID-19 can cause us to feel anxious or distressed. Seek information updates at specific times during the day-- once or twice would be enough.

In terms of fighting negativity it is helpful to look for reasons to be grateful. We cannot be grateful and negative at the same time. Gratitude has also many health benefits. The positivity that gratefulness creates boosts the immune system with resultant health benefits. Even during these difficult times there is so many things for which we can be thankful.

Writing a gratitude journal (listing the gifts and blessings) at the end of the day is a helpful exercise. We may even begin to see blessings in the pandemic itself, seeing opportunities where we were earlier only seeing obstacles.

2.      Connect with Friends and Colleagues

Studies have shown that in times of social isolation, more than connection with our family members, what helps ward off loneliness is connection with our friends and colleagues. Hence keeping in contact with our friends and acquaintances outside immediate family is important. This can be done easily today through the means of communication available to us. An easy topic for conversation with friends and colleagues is discussion on how we and others are facing this imposed isolation and how our lives and our work are affected by it.

3.      Reach out to Help

Reaching out to help those in distress has personal benefits. There are so many ways we can do this. Helping others creates positive feelings in us and boosts our immune system, decreasing our vulnerability to illness. It is nature’s way of rewarding our generosity.

4.      Create a Pleasant Environment

Creating a pleasant environment in the space to which we are confined is especially important. We can do this first of all by avoiding negative and critical conversations. Planning and executing common activities (a celebratory event is especially helpful) brings joy and togetherness.

Busy parents who otherwise have not had enough time to spend with children are given a golden opportunity. Play with them, do fun things with them. Read stories to the very small children.

A clean environment matters. Studies have found that when we are surrounded by clutter, the visual chaos affects our brain. It gets in the way of our ability to process information. Research has also shown a cluttered home environment increases the levels of the stress hormone cortisol.

The way we dress also has an impact on our feeling of wellbeing. Since we do not need to go outside or work in an office, we might tend to be too casual or even shabby in our dress. Dressing up, as though we were going to office or visiting friends, will put us in better frame of mind and energize us.

While doing things together is important, it is also helpful, even necessary, to create some personal space where we can be by ourselves do things undisturbed by others. The solitude that such personal spaces provide can also help us devote time and energy to projects we are interested in, but could not find time earlier.

A quiet space is especially important for us to engage in meditation, which is very helpful to reduce stress and anxiety and create positivity.

5.      Fight Boredom

Reduced activity caused by absence from our place of work and the hassles of travel leaves time on our hands. Not knowing how to utilize it can lead to boredom and irritation.

Having a structure helps. Create a schedule for various activities and stick to it. Go to sleep and get up (even if we choose to sleep longer) at the same time every day.

6.      Exercise and Relaxation

Physical activity improves overall health, reduces risk of diseases, and can make us feel better and function better.

Exercise energizes mind and body, reduces anxiety and increases feelings of wellbeing. Even short spells of physical activity are beneficial.

Even though outdoors are the best for exercise, it can also be done with great benefit within the narrow space to which we might be confined during the lockdown. Yoga, qigong, tai-chi, and simple aerobics, besides beating boredom, help stimulate and strengthen the immune system. Acupressure - rubbing or tapping some specific pressure points in the body helps release tension, lessen anxiety and improve blood flow.

Dancing is another way to exercise. It relaxes body and mind and creates a good mood.

Listening to music has a calming effect on the nerves. So, pull out our favourite music CDs, plug in the head-phones (not to disturb others around) and let the music flow.

Tending to plants is another stress reliever. Some of us may have potted plants inside the room. Some may be even more fortunate and have a garden to tend.

Settling comfortably with a favourite book can be both exciting and relaxing. It can also promote mental wellbeing. Studies have linked reading to improvements in depression symptoms, as well as mental flexibility and brain function.

7.      Surrender

There are many things over which we have no control. We do not know how things are going to be. Worrying about things over which we have no control is a futile and useless activity, which only increases our stress levels.

In this context surrendering in faith to a God who loves and cares for us can relieve stress and anxiety. The Prophet Isaiah reminds us of God’s protective presence during difficult times. He says:

Fear not…

When you pass through the waters I will be with you;

And through the rivers, they shall not overwhelm you;

When you walk through fire you shall not be burned,

And the flames shall not consume you….

Because you are precious in my eyes,… and I love you.

Fear not I am with you.” (43, 3-5)

……

What do these words of Isaiah evoke in us as we struggle with our anxieties and fears? How do they move us? What are the feelings rising to surface as we stay with these words and images?.....

As we conclude, we could imagine God being with us, and place ourselves in the caring and protective arms of God and enjoy for a while the security and comfort this provides.

…..

Have a pleasant weekend, feeling safe and secure in the arms of God. Stay Safe. Stay Blessed. Bye for now.

Self-Care Measures for Health-Care Providers During Stressful Times

Jose Parappully, PhD

Health-care providers are vulnerable to high stress during this Covid-19 crisis. They are exposed to enormous pressure as well as danger: anxiety about their own safety in the absence of Personal Protective Equipment, lack of resources to treat patients, discouragement over inability to cope with patient demands, discouragement and grief over inability to save lives, anxiety about the wellbeing of their family members, as well as absence from them and so on.

In this context, it is essential to take care of their own wellbeing. Here are some suggestions.

Talk to Colleagues and Friends

Talking can be a great stress-reliever. Talk to friends about what you are going through. Share with colleagues about the difficulties you are experiencing at work place and check with them how they are doing. While you need relief for yourself, reach out to help them as well by being available to listen to their difficulties. Talk to family members about how they are coping.

When you cannot do the talk in person face-to-face use the social media avenues and apps available. You can also post your experiences online and enter into a written conversation.

Recognize your Limitations

Do not see yourself as superman or superwoman. There are limits to what you can do for your patients. There are many things not within your control. Even with all the expertise you have, and despite your best intentions, you cannot help all or save all. The virus is too powerful

Take a Break

You are more vulnerable to compassion fatigue at this time. Working long hours under stressful conditions can exhaust you physically and emotionally. Anger at your lack of control over situations or availability of needed medicines or equipment is a real possibility which in turn is going to affect both your work and your relationships. You need time and space to cool down.

When working in a team, organize mini-breaks where you can relieve one another from duty for short intervals.

Sleep

Your devotion to duty can make you deprive yourself of sleep, which will add to the stress and exhaustion and the resulting irritability. Make sure your get some sleep, at least. Take short naps. Just remaining in a quiet place with your eyes shut in the midst of busy schedule will help.

Exercise

Do some simple aerobic exercises. Even taking five minutes to stretch yourself can be helpful. If you have time and opportunity, try some yogic asana or qigong movements. Taking a short walk (even for 5 minutes) from time to time and a longer one if you can afford it will refresh and revitalize you.

Pressing, rubbing or tapping acupressure points occasionally is something that you can easily do when you get a few moments to be by yourself away from patient-care.

Breath Mindfully

Do some mindful (slow, focused) breathing when you move from place, for example, from home to office or from office to patient’s room or ward or workspace.

Abdominal, deep breathing is especially helpful, if you can find some leisure to do it.. Take in the breath through your nostrils, hold it for a few seconds and breathe out through your mouth. Make the out-breath much longer than the in-breath. Making a slight swishing sound, rounding your lips to create very small opening through which to exhale makes the exercise even more beneficial. As you do so, imagine you are taking a spoonful of hot soup to your mouth and gently blow on it to cool it, taking are that you do not spill it. That is, be very slow and gentle in your breathing. This will greatly relax you.

Enjoy Touch

At this time of Social Distancing you are deprived of one the most soothing and healing measures available to us: physical touch. However, imagination and fantasy can help. We know that the brain cannot really distinguish between fantasy and reality. Physically holding some one lovingly or imagining doing so creates identical reactions, I am told. So imagine yourself being comforted by the gentle, soothing and reassuring touch of a loved one.

Eat Healthy

It is easy when one is stressed to find relief in caffeine, nicotine or alcohol. However, these will only add to your stress and tension. Try to avoid them as fare as possible. Instead, have healthy food – nuts and fruits during breaks and a wholesome meal when you can afford the time and possibility. Eating with others, if Social Distancing allows it, is helpful. You can sit at a distance and hold conversations while eating, with colleagues at the workplace or family members at home.

Have Fun

Take some time to do the kind of things you enjoy doing. Reading, writing (keeping a journal besides reliving tension can also be a good record of your experiences and emotions during this time), swimming, biking, virtual and physical games you can engage in by yourself or with others can be relaxing and rewarding. :Listen to music. Watch  movie. Watch the trees, the birds or even the cloud formations and fantasize as we used to as children!

 Meditate and Pray

Take time to meditate. You may have your own favourite type of meditation. The simplest and easiest form and yet a very effective one, is to simply sit quietly and focus on your breath. You don’t need to do any kind of deep or slow breathing. Simply be aware of your breath and the breath will do what it needs to do. When your mind wanders away from the focus on breath gently return it and keep returning. This will calm you down, relax and refresh you.

If you are theistically inclined, you can turn this simple meditation into a prayer. Instead of focusing on your breath, focus on the Divine (whichever way you understand it) dwelling within you. Simply sit in the loving awareness of that Divine presence within you. When your mind wonders away gently return to the loving awareness and keep doing that over and over again as distractions are inevitable. Using a simple monosyllabic word that has for you some association to the Divine (like the name you give it, or words like love, joy, peace etc.) can help you easily return to the loving awareness of the Divine when you realize your mind has wondered away. This is the essence of what today has come to be known as Centering Prayer. According Thomas Merton, monk and clinical psychologist and one of its promoters, Centering Prayer, besides calming oneself, has also profound therapeutic properties.

Mantram prayers too are very useful. A mantram is a short phrase (seven or less words recommended) that you keep repeating. Examples are (Heal me O Lord; Keep me calm and safe; Heal my patient; May all being be happy, etc.). These mantram prayers too will relax you and reduce your stress levels, besides connecting you with the Divine.

 Get Help

If your stress levels are high or you are experiencing high levels of anxiety and other debilitating emotions, speak to a counselor or therapist. You may also want to take a short leave from work, if things are really becoming difficult for you, even if that is against your commitment and devotion to duty.  It is good to act on the dictum, “Healer, heal yourself.”