As the COVID-19 pandemic crisis continues, we can all benefit from taking a closer look at our coping skills; by doing what we can in the present we can help buffer against longer-term health issues.
Crisis management is different than trauma treatment. I know this firsthand, as a Clinical Psychologist for the past 15 years, with over a decade of that spent working with PTSD at a VA Hospital.
Therapists don’t usually begin trauma-focused treatment until a month after clients have reestablished relative safety and given the body time to initiate its natural healing and recovery process. In cases where symptoms don’t subside after a month, a trauma-focused therapy can be considered. Often these therapies require clients to metaphorically keep one foot in the present (where they feel relatively safe) and put one foot back in their past pain (where they felt unsafe).
A 2018 study by Dana Rose Garfin, PhD and colleagues found that those who experienced high levels of acute stress following a trauma were at increased risk for subsequent mental and physical health issues. Understandably, many of us are feeling increased stressed levels secondary to the pandemic. A recent poll from the American Psychiatric Association showed that 48% of Americans are anxious about contracting COVID-19 and 62% are anxious about a loved one getting it.
Given that we don’t yet know when the crisis will give way to relative safety, we can manage our anxiety now to help mitigate future mental-health issues and strengthen our resilience through a present-focused, skill-building approach.
At a time when we could use every last coping skill in our tool box, social distancing and quarantining has reduced access to many of our usual coping strategies (e.g., going out for a meal with friends, time at the gym, shopping, going to work or school, etc.).
I believe we can and will rise after the pandemic, but for now, we need to sharpen and increase our coping skills to ‘get through the night’ so-to-speak. As you read the suggestions below, filter out what is helpful to you and leave the rest—we’re all unique. Also, by no means is this list exhaustive. We can all run “experiments” in our lives (collect new data points) and find our most helpful coping tools during this time.
Let’s identify the helpful coping skills we can still access, minimize the unhelpful ones, and build new coping skills for our toolboxes.
Identify Your Helpful Coping Skills:
These are the self-soothing actions that pour back into you. You probably feel stronger after using them, and they don’t have negative consequences. For example:
- Going for a walk
- Talking with a trusted friend
- Taking a shower
- Spending time with a pet
- Listening to music
Minimize Your Unhelpful Coping Skills:
These are the self-soothing actions that deplete you. You probably feel weaker after using them, and they likely do have negative consequences. For example:
- Overusing alcohol, food, sex, Netflix, etc.
- Raging at loved ones
- Over working
Make lists of your helpful and unhelpful coping skills–it’s good to have it written down (not just in your head).
If you’re like me, you may have already noticed some unhelpful coping skills– those tend to come out during stress. The other night I felt pulled to buy something on Amazon. I didn’t need anything… some part of me likely wanted the little hit of dopamine that comes when I buy things.
Get curious about this and talk with a trusted friend or therapist about what you’re feeling pulled toward, particularly if you have a history of struggling with addiction.
Build New Coping Skills for Your Toolbox
Below is a menu of coping skills options you can experiment with and figure out what works best for you…
1. Feel Your Grief
A couple of years ago when I was going through breast cancer, this quote from Madeleine L’Engle meant a lot to me. It keeps coming to mind again in this season of uncertainty and loss:
“My dear, I’m seldom sure of anything. Life at best is a precarious business, and we aren’t told that difficult or painful things won’t happen, just that it matters. It matters not just to us but to the entire universe.”
The last sentence became a mantra of sorts… “It matters not just to us but to the entire universe.”
To honor my losses during cancer, I started snapping pictures with my cell phone: the new bottles of medication on my bathroom sink, the paperwork to take medical leave from work, the first form where I had to check the box identifying myself as someone with cancer. How would that look for you today; what might you take pictures of?
Having compassion for the high school senior who no longer gets to have a prom takes nothing away from the neighbor who lost a job. As Brené Brown says, “Empathy is not finite, and compassion is not a pizza with eight slices” (2015).
Let the losses matter. We can’t heal what we won’t feel.
2. Practice Gritty Gratitude:
Sometimes gratitude seems “Pollyanna” or “minimizing.” Certainly, I’m not suggesting that we’re grateful for a pandemic or the losses associated with it. During breast cancer, I discovered that gratitude was a weapon of sorts. I made lists of all the things that I could still do (things that cancer couldn’t take). It helped. What can’t the pandemic take?
3. Embrace the BOTH/AND
Cry AND laugh. Grieve AND use humor. This idea isn’t mine– therapist Lori Gottlieb’s recent Atlantic article highlighted this need. A pandemic is clearly NOT funny, yet many of us cope with humor. As a graduate student I worked nights in the ER screening patients who came in with psychiatric emergencies. “Gallows humor” helped my colleagues and I cope with the tragedies. It’s ok to laugh at a funny meme and to cry at the next.
4. Anchor to Larger Things
If you are a person of faith, you have likely already been tapping into your religious/spiritual practices. I especially find old spiritual practices grounding—they allow me to feel small in a comforting way, like one drop in the mighty ocean, but also connected to generations of suffering people through the centuries who also used them.
We can find solace in nature. The seasons ground us by keeping time for us: spring is coming anyway this year, pandemic or not. The river keeps running and the sun traces its familiar path in the sky.
This is a time to remember our values and do our best to live into them. How do your personal values inform the way you cope with this situation? If you’d like to take a deeper dive into exploring your values Dr. Miller and colleagues at the University of New Mexico created a free Values Card Sort activity that can be helpful with narrowing down and identifying personal values.
5. Practice Self-Compassion / Acknowledge the Suffering
Psychologist and self-compassion researcher, Dr. Kristin Neff, has a practice that she recommends in challenging times. She speaks about placing our hand on our hearts (like the skin-to-skin touch that we do with babies) and repeating the phase, “This is a moment of suffering.” This has been helpful to me in the chaos of this season–pausing, hand on my heart, and acknowledging that I am suffering—not trying to make it okay or compare my situation. Just letting it be what it is.
6. Take Comfort in Small Things
If you have children in your home or neighborhood, notice how they still goof around. How they make up games, laugh easily, move joyfully.
Continue to do the parts of your routines that we still can: empty the dishwasher, pet the dog, brush your teeth, go outside, breathe in, breathe out.
Check in with yourself about the “basics”—have I had something to eat, gotten some rest, spoken to another person, taken a shower, etc. Think about how you might care for a child, then care for yourself that way.
7. Discover Bright Spots
During the early days after my breast cancer diagnosis (a couple of years ago) I told a close friend my deepest fears about how the cancer could impact my children.
She said, “I will be praying that they remember this season as a bright spot when they think back on it- a time when loved ones supported and carried your family, when they got to see and feel community in a new way.” I longed for a bright spot—for my children and for myself, too.
The tiniest bit of hope began to stir, like the sip of cool water I’d been waiting for. I felt myself start to steady and began to put one foot in front of the other.
Without minimizing or silver-lining the hard, painful, trauma of any of this current situation—it has torn the world right open—but within the pain and fear, we will uncover bright spots. The viral video of Italians singing on their balconies while in quarantine, the person who put toilet paper out on their porch for neighbors in need, and the social media offers to get groceries for the elderly.
8. Let it Make You Brave
Suffering can clarify what is truly important to us. Let the “off-ness” of this situation spark courage, because….because what’s the alternative? Because we might as well. Because the alternative doesn’t suit us.
Being brave doesn’t mean being foolish. Heed the recommended cautionary measures and step out in other areas of your life: take on the project that’s been scaring you, work toward reconciliation with yourself or others, etc.
9. Identify Your Strengths & Use Them
We all have natural strengths. Once we know what they are, we can be more intentional about using them during this stressful time. Take the Character Strengths Survey online assessment to discover your top strengths (there’s a youth and adult version available for free).
10. Adjust Your Expectations
As humans, we grow in fits and starts. We’d love to have a continuous positive growth trajectory, but that’s not realistic as human beings. We plateau for a time, gather our strength/take stock, and keep climbing when we’re able. If this is a season of plateauing for you or your loved ones, let it be what it is.
Develop copious amounts of self-compassion and grace for yourself and others as you make your way in this changed world. You will likely struggle more if we try to impose pre-pandemic expectations.
11. Limit Your Screen-Time:
As Anne Lamott once said, “Almost everything will work again if you unplug it for a few minutes, including you.” It’s important to stay educated from the best sources we can access, and then place limits on the time we spend on social media and the news. Marinating in it all day increases anxiety. Consider limiting yourself to checking the headlines once or twice a day.
12. Complete the Stress Curve:
When you experience stress, your adrenaline spikes and you may find yourself in fight, flight, or freeze. Drs. Emily Nagoski and Amelia Nagoski wrote about how you can complete the stress cycle (bring yourself back down) in their recent book, Burnout: The Secret to Unlocking the Stress Cycle (2019). They suggest such practices as exercise, crying, laughter, connecting with a loved one, deep breathing, creative activities; even a primal scream can help resolve the stress cycle.
Because a pandemic is ongoing, we will need to resolve the stress cycle many times throughout this experience. Here are a few other experiential (holistic mind-body) ways to reduce stress:
- Tune into a restorative yoga session on YouTube.
- Practice “grounding”—use all of your senses to stay in the present moment (rather than allowing your mind to go down an anxiety-producing path). List 5 things you see, 4 things you feel, 3 things you hear, 2 things you smell, and 1 thing you taste.
- Walk outside.
- Sit by a body of water (even a small creek will do).
- If you are quarantining with others, PLAY. It will help.
- Deep breathing – (for a free audio recording and PDF handout on this technique)
- Progressive muscle relaxation – (for a free audio recording and PDF handout on this technique)
- Guided imagery – (for a free audio recording and PDF handout on this technique)
13. Get Curious About Your Thoughts:
We all have thoughts going through our minds all day long. Some of these thoughts throw gas on the fires of anxiety and depression and some throw water. Slow down and write out your thoughts so you can start identifying them.
Dr. James Pennebaker’s research shows that writing down our thoughts and feelings about a difficult event for just 20 minutes a day for 4 consecutive days has mental and physical health benefits.
14. Set Yourself Up for a Good Night’s Sleep
Cognitive Behavioral Therapy for Insomnia has a few tips that can help us here.
- Let Your Helicopter Land: It’s not uncommon to experience busy/anxious thoughts when we try to go to sleep (or in the middle of the night). These thoughts are like a helicopter that flies around our heads all day and touches down in our unguarded moments (before sleep). One way to address this is to ‘let your helicopter land at another time.’ Write about your busy or anxious thoughts during your lunch break or in the afternoon.
- Get Out of Bed: We’re creatures of habit. If you can’t fall asleep within 20 minutes, get up out of your bed and do a quiet activity (preferably in another room). We want to associate our beds with sleep, not worry or busy minds, or frustration.
- Resist Napping/Dozing: Napping is to sleeping what snacking is to eating. Naps will lower your sleep drive and can make it difficult to fall asleep and stay asleep.
- Be Strategic About Your Pre-Bed Routine: Watch ridiculous television or read lighthearted books before bed–nothing heavy! Certainly not the news.
15. Seek Support
Social support provides buffers against anxiety and depression. Connecting with others virtually, on the phone, in writing, or from a 6-foot distance is still connecting. Remembering our common humanity can help as well: we’re all in this together. Know that you are not alone.
Additional Mental Health Resources:
- For those on the front line (essential workers who don’t have the privilege to stay at home during this pandemic)—access short-term, reduced fee online therapy sessions here: Coronavirus Online Therapy
- Many therapists have shifted to offering online therapy
- Check out a virtual 12-step meeting
- SAMHSA Behavioral Health Disaster Response App Author: SAMHSA
- Psychological First Aid (PFA) Mobile App Author: U.S. Department of Veterans Affairs.
A Note About Safety:
The world feels heavy right now. If you are experiencing thoughts of harming yourself or someone else, reach out and get help.
SAMHSA’s Disaster Distress Helpline
Toll-Free: 1-800-985-5990 (English and español)
SMS: Text TalkWithUs to 66746
SMS (español): “Hablanos” al 66746
National Suicide Prevention Lifeline
Nacional de Prevención del Suicidio
Options For Deaf + Hard of Hearing
Veterans Crisis Line