Episode 11 - "How To Cope During A Crisis" with Therapist
How are you feeling today? With a worldwide pandemic going on, there's a lot to cope with: family, isolation, stress, and so much more. Family Therapist, Sharon Ellenbogen, and Robb Report Health & Wellness Editor, Janice O'Leary, share how to cope during these unprecedented times.
Family Therapist Sharon Ellenbogen and Robb Report Health & Wellness Editor Janice O'Leary talk about coping with the emotional stress of dealing with isolation, social distancing and the effect on individuals and families in a time of COVID-19.
(1:00) Five Stages Of Grief, (4:30) Dealing with Anger, (5:30) The timeline of grief, (8:00) Job loss, (10:30) Past experience and PTSD (13:30) Uncertainty and a cultural shift, (16:30) Singles and elderly at home, (20:15) Kids at home and relationships at home, (22:00) Intimacy and passion, (24:15) How can each person help?
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Bill Curtis: So you think you're healthy. You don't have a temperature. You're not coughing, so far so good. But then there's that feeling you have when you watch the news. There's that feeling you have when you see the numbers of the people who are infected and the people who've died. And there's that feeling you have when you're not sure about your economic future. We decided that this coronavirus edition of Medicine, We're Still Practicing should focus more on the feelings that we're struggling with, should focus on how we're going to get through this successfully, even if we don't get physically sick. We've been listening and watching the news for weeks. Socially distant and psychologically challenged. We thought it would be a good idea to look at a different aspect of our corona crisis. Sure. This is a crisis threatening our physical health, but even more invisible than the virus itself is the challenge to our psychological and emotional well-being. Welcome to a Corona's psychology edition of Medicine. We're still Practicing. I'm Bill Curtis.
Bill Curtis: Today, I've got a good friend of mine, again joining us who's been with us in the past. Janice O'Leary, executive editor of Robb Report. And as a matter of fact, she built and edited the Robb Report, Health and Wellness Division for at least half a decade.
Janice O'Leary: Hi, Bill.
Bill Curtis: How you doing? How's it going, Janice?
Janice O'Leary: Great. Thank you for having me on.
Bill Curtis: And we're joined by Sharon Ellenbogen. She's a licensed marriage and family therapist for over two decades. Sharon's practiced Marriage, Family Therapy. She earned her master's degree in clinical psychology from Antioch University. She's affiliated with the American and California Associations of Marriage and Family Therapists. She's a member of the Eating Disorder Referral Network. And today, I had to stop eating because I had to take a nap. Sharon, how are you doing? Thank you for joining us.
Sharon Ellenbogen: Thank you for having me. Bill.
Bill Curtis: It's likely that our listeners have spent a thousand hours reading and listening and watching news focused on the escalating numbers and cases of deaths in different cities. And we'd like to focus on the other side of that crisis that we haven't really addressed enough for our listeners. And that's the psychological aspects and how to deal with it. There's so many aspects of this situation that cause stress and grief for even the most resilient of us. Should we discuss this crisis in the terms of, well, the five stages of grief?
Sharon Ellenbogen: Yes, I think that really is appropriate because everybody has their own responses to this crisis. So the stages of grief are denial, bargaining, anger, sadness and acceptance. And they're not linear. There are some people that are in denial. There are some people that are bargaining with this disease. Some people are really angry. And some people are really sad. And some people, surprisingly, are accepting this and they're hunkering down. And they're saying life is so simple now, I don't have to think about where to go and where to be. And they're getting very connected online and they're doing things that they've never experienced online. But we're social beings and we need to stay connected.
Bill Curtis: The kids on the beach in Miami. Would you say that that's the denial part of things? Or do we all personally go through a denial stage?
Sharon Ellenbogen: I think that we all personally go through a denial stage. And these kids, they want their spring break. They've worked really hard. This is really upsetting that they don't have the mobility that they want and the celebratory experience that they want. So I think at that point they just said, hey, YOLO, you only live once.
Janice O'Leary: Like we had the same thing in Malibu last weekend, Bill, with terrible traffic that was on our highways and on our beaches. It was sort of like all of Southern California decided they were on spring break and we're coming to the beach. But they were not standing six feet apart, not even three feet apart. So I do feel like there is a certain amount of denial that happens.
Bill Curtis: Is there a timeline for this?
Sharon Ellenbogen: There's not a timeline. And it's not linear either means you can go in and out of denial and in an out of depression and an out of anger.
Janice O'Leary: Can you be in two stages at the same time?
Sharon Ellenbogen: Yes, because we're not linear beings. We're very much chaotic people. We can feel more than one. Feeling at a time. Right. Exactly.
Bill Curtis: The insecure feeling, the uneasiness, the confusion, the a little bit of anger and being in the dark. Tell us about how we should be thinking about these issues.
Sharon Ellenbogen: Well, anger is a very innate response to anxiety and stress. Most people get angry when they feel out of control. What I say to people usually is that the only thing that you have control over is your own behavior and your own response. When you don't know what's going to happen, I call that anticipatory anxiety and the not knowing can really dis-regulate your system into a fight or flight or freeze response. The practice is is to come back to the present and censor yourself. And when you're agitated, you're not in a state of rational thinking. We're pack animals. We don't really survive alone very well. And so sometimes it's going to a friend. Sometimes it's going to a family member. And it's not about telling somebody what they should do, but meeting somebody where they are and comforting them in that condition.
Bill Curtis: Well, let's talk about those folks that lost their jobs. And right now is not a good time to get a replacement job. Tell me how someone can get comfortable productively to proceed from that point. Because I know in my case, if I'm overwhelmed by a problem, I don't think clearly and yet I'm not necessarily productive. So, you know, there would be an overwhelming problem to lose a job and not have a replacement, be running out of money. How does someone deal with it?
Sharon Ellenbogen: They get scared. I mean, fear is the great common denominator. And you have to be able to feel the fear and go to that place of how do I take care of myself in this? And sometimes it's one step at a time. It's about being able to center yourself in your own abilities and think about what it is that you can do. So there's LinkedIn, there are friends to tell about the fact that you've lost your job. And first they have to, you know, go and lick their wounds and come out of the shock of it, but allow for the shock of it. Allow for the fear of it. Most of us are numbing ourselves with alcohol or other substances because we don't want to feel these deep, hard, painful feelings. But they need to be able to come to the surface so that you can get to the higher functioning of what your abilities are. But you can't push away the fear and you can't push away the pain or the loss. You have to embrace it before you can get through it.
Janice O'Leary: Sharon, is there a kind of muscle memory that occurs during times of crisis? I think about a lot of the New Yorkers who have also been through blackouts, who've been through 9/11. And I think about people on the West Coast who have been through traumatic fires, just some of. Does that complicate that fear equation and the ability to cope and move beyond fear, embrace it and then get beyond it?
Sharon Ellenbogen: Yeah. What happens is that that same wave of fear comes up because you've had a past experience with that. But then with that past experience comes your survival techniques. So a lot of people can get into post-traumatic stress disordered behavior where they're going to stay in bed and they're going to not function. And that's where family and friends come into play. So when somebody goes down for the count and somebody is centered in their well-being, you actually have the person and their well-being has the responsibility, the ability to respond. That's responsibility to the person who is down for the count.
Janice O'Leary: I like how you said that.
Sharon Ellenbogen: There's three things that regulate your system. It's sleeping, eating and exercising. And so as a family member where somebody is not functioning well, you're going to be monitoring that for them. And you're not going to force them to eat. You're going to put the food out there and you're going to say, you know, there's food on the table when you want it. It's there. You know, we love you and we want the best for you. So let us feed you. You don't know what you're going to get by offering some things to another person who's not feeling well. But what you get is their response, not your response. So allow for their response in the face of what you want them to do.
Bill Curtis: Let's look at a slightly different side of this on the employer side. Someone who owns their own company, maybe their company is really challenged during these times and then they have to deal with employees. And some of the employees are friends and co-workers. Tell us a little about how that person has to get their arms around the combination of responsibility to the company and themselves, as well as their feeling of responsibility to their friends and co-workers.
Sharon Ellenbogen: They really have to get very presence oriented and they also have to get strategic in their planning. And they have to tell the truth. They have to speak up for what they can do and what they can't do. So people can prepare themselves.
Bill Curtis: But some of the uncertainty certainly adds that complexity where you don't know if we're going to be let out of our cages in a month or three months. And it's really hard to give anybody some straight talk.
Sharon Ellenbogen: Well, this is going to shift culture. It definitely will. Employers know now that their employees can work from home and they have to allow for the employees to pace themselves and to speak up for what they can do and what they can't do. And to be able to disseminate information for an employer that has a multi faceted business, they have to establish policy and they have to communicate policy effectively to their employees so that they know what to expect. And then when the rules change, they need to say, and now in this next phase, this is what's going to happen. So people can prepare.
Bill Curtis: Well, I'm going to go have a quick panic attack. We'll be right back.
Promo - AMOYT: Hello out there. This is Jenny Curtis. I am a human of the world, a podcast producer at Curtco Media, a performer, a creator, a very sensitive soul, as I've sometimes been told. And I am currently sitting alone in a very empty podcast studio surrounded by hand sanitizer. And I'm recording this in an effort to reach out. It's not an easy time right now. I think a lot of us are thrown completely off balance by this sudden shift into isolation and anxiety. We don't know what the day to day is going to look like for the next few weeks or even months. So I'm proposing something. Let's all make something together. We're launching a new podcast called A Moment of Your Time. These are bite-sized episodes. And each one features you, out there. You've a statement to make? Make it. A story to tell? Tell it. A song to sing? Sing it. An open letter to read, a comedy bit, a place to share your hopes and fears. A poem, a peptalk to yourself? We just want to have a place where people can express themselves, where you can listen to each other, where you can support one another. If you have questions or to submit, just email amomentofyourtime firstname.lastname@example.org. We may have to stay apart. Let's create together.
Bill Curtis: Ok, panic attack is over. We're here with Sharon Ellenbogen and Janice O'Leary. Let's talk about the single person alone, socially distancing right now who doesn't have family or doesn't have other people in their homes.
Janice O'Leary: That's me,.
Bill Curtis: Frankly. Yikes. That's my worst nightmare. I'm not fond of my own company, so I generally feed off of other people. So I've been burning up the zoom in the face time airwaves. But how do you suggest that someone who's all alone in this process get their arms around this?
Sharon Ellenbogen: Well, do what you do. Burn up the Zoom and burn up the the Facebook. But also there's a whole Internet out there of people that are reaching out to other people. And it's an amazing time that we're living in where technology allows us to connect.
Janice O'Leary: I have to say, I am one of those people. My family lives in other parts of the country. I live at home with my dog. And the dog actually is a really big help getting a lot of exercise seems.
Bill Curtis: How does the dog feel about you being home all the time Janice?
Janice O'Leary: You know, he hasn't said specifically, but I think he's pretty happy, OK, because he's getting more walks because that's the other part of my strip. My personal strategy is more exercise. But I also have been on Zoom. I work full time still and working from home. I have conversations with colleagues all day long, but I think about people in a worse situation than I am who don't have a lot of tech savvy. I think about someone like my mom. She is in her 70s. So she's in the most vulnerable part of the population. And she doesn't have Zoom. She can text and she can call, but she has a sort of limited tech abilities. Any advice and strategies for that population?
Sharon Ellenbogen: So call her more often. Well, I have a lot of people that are very mad at their parents because their parents are taking this very nonchalantly and they're in the danger zone.
Janice O'Leary: My mom was there to begin with. She. She kept telling me, well, I'm going to go out to Costco now. Then I'm going to go to the mall. And I'm like, no, please don't leave the house.
Sharon Ellenbogen: That can be difficult in and of itself. But socially isolated people are usually introverts and they also have strategic ways of taking care of themselves outside of a pandemic.
Janice O'Leary: That's the case for me. But for my mom, she's very vivacious. And this has been incredibly hard for her because she's the opposite of an introvert. Absolutely an extrovert.
Sharon Ellenbogen: So for that group of people who are usually extroverted and elderly, I would probably resource them to their friends.
Janice O'Leary: Yeah.
Sharon Ellenbogen: And resource them to their hobbies. And get them into more contact with maybe even social services.
Bill Curtis: I'd really like to ask you to dive into this situation because so many people are in it. The overwhelming challenge, a single mom or dad or even a couple who are distancing at home alone with their four year old and their 2 year old who normally would go to, they'd be a daycare or school. But now the parents get no break at all. And arguably no break in the foreseeable future. Tell us about that whole circumstance, how someone should think about that, how they should deal with that kind of pressure. It's a different kind of pressure.
Sharon Ellenbogen: Yes, it is. Relationships with family may get tense. And remember, no one wants to be fixed. Everybody's looking for attention, acceptance, appreciation, affection and allowing for their way of operating in the world. But for parents, this is particularly stressful because they have to set boundaries for their children and some of them do a really good job of it. And they have kids that will listen to them, but they have to be listening to their children and their children's need in the moment. Now, if you have a partner, you take turns. You tap out and you go for a time out when you get overwhelmed. When somebody gets disregulated and out of sorts, there needs to be an adult in the room that's taking over and centered in their own well-being and being able to be available to fulfill other people's needs.
Bill Curtis: So a completely different subject for a minute. Have you seen this crisis affecting your patients or couples intimacy and passion?
Sharon Ellenbogen: In a variety of ways. It just depends on how they were able to cope and relate before this. For some people, they are feeling that these are extraordinary circumstances and it's brought them closer and appreciative of each other. Other people who were going to break apart, they're being a lot more separate. But the affection part, people are being a lot more kinder and considerate of each other and their understanding from their conversations with me what their limits are a bit more and they're giving each other more leeway. It's difficult with parents who have the home schooling and the children. So there is less time to be playful and having fun. It's hard because I tell people, you know what, if you want to hug, you ask for a hug. People don't know that you want to hug until you ask for it. And so we have to get a little more verbal.
Janice O'Leary: What's the chance that some of these really positive behaviors in a relationship, like more kindness, more affection, more communication, will these survive past a crisis?
Sharon Ellenbogen: Yes. I believe in relationships. I wouldn't be a marriage and family therapist if I didn't believe that if people were given the proper tools, they could behave better with each other. But there needs to be some education and some coaching for people who don't innately know. And there are three types of ways to get your needs met. One is by invitation. Would you like to? The other one is request. I would like you to. And the third one is demand. If you don't do this, then this will happen. And what you want to do is keep your needs between an invitation and a request. That's the practice. And I call it practice because it's not perfection. But that's the work of relationships.
Bill Curtis: Just have one more question, and it's a weird guilt that I think some of us are struggling with. I'm not doing enough to help. Is it possible for us to do enough to help? And how do we deal with that feeling in our souls that there must be something more we can do?
Sharon Ellenbogen: We have to tackle this one person at a time. If you can be doing your part, which is to keep your health and your well-being up and to be there for your family and your friends and your community, then you're a helper. If you can keep yourself out of these catastrophic numbers by doing your part to stay home and do your exercise, do your eating and doing your sleeping and regulating your own system. You are helping. You are doing your part.
Janice O'Leary: So, Sharon, with all of the ways that we could be overwhelmed right now between unemployment, family needs, child care and the devastating news that we hear every day, I find myself in a panic about this and verging on a panic attack. Is there anything that we can do in a moment to feel better?
Sharon Ellenbogen: What you have to do is you sit on a couch and you take three deep breaths in and out and in and out. Noticing the breaths, if you can, you count four breaths in and eight breaths out. We do that three times. And then you look around the room and you see five things that you can name and you name them out loud or you name them to yourself. And that's what you can see. Four things that you can touch and you name them. Three things you can hear, two things you can smell. And one thing you can taste. And that engages all five senses. And you're thinking about something other than the news.
Janice O'Leary: That's awesome. Thank you.
Sharon Ellenbogen: You're welcome. And you can use it anywhere at any time.
Bill Curtis: Janice O'Leary, thank you for co-hosting on today's show. And we always love having you here. And Sharon Ellenbogan, thank you so much for your well thought out advice. We no doubt will call you again because we'll have more questions and more challenges. How would someone get a hold of you if they want to?
Sharon Ellenbogen: First of all, thank you, Bill, for allowing me to be one of the helpers. And if anyone does want to get in touch with me, they can access me on my Website, by email at Sharon@ Sharonellenbogen.com. And I do have a Facebook page called Sharon EllenbogenLMFT.
Bill Curtis: Wonderful Sharon. And of course, you can read Janice O' Leary in the pages of the Robb Report. This is Bill Curtis thanking you for joining us on Medicine. We're still Practicing. We'll see you next week.
Bill Curtis: If you like what you hear, please tell your friends. And let us know how we're doing by leaving a comment. It really helps if you give us a five star rating and we really appreciate it. You can also subscribe to the show on Apple podcasts, Stitcher or wherever you listen to your favorite podcast. This episode was produced and edited by Mike Thomas. Audio Engineering by Michael Kennedy. And the theme music was composed and performed by Celeste and Eric Dick. Thanks for listening.
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