MWSP EP 12 - 12 - Dr. Allen Berger: Overcoming Anxiety And Fear During Quarantine

 

Announcer: From Curtco Media.

 

Bill Curtis:  At a time when turning on the TV is bound to depress even the strongest of us. And we listen to bizarre numbers of Corona virus afflicted people, not to mention the thousands who have passed. Combine this with everyone we know, having been grounded, millions out of work, many of us financially struggling. And just to round out this picture, imagine how this must be for people who have trouble with sobriety, addictions or depression. Corona virus is creating far reaching impact, but especially for those who also have to deal with addictions and some of you have family or friends who are dealing with this challenge. So welcome to perhaps the most challenging Corona  psychology edition of Medicine. We're still Practicing. I'm Bill Curtis. With us by the wonders of remote telephony, My co-host, the quadruple board certified doctor of Internal Medicine, Pulmonary Disease, Critical Care and Neuro Critical Care. My very good friend, Dr. Steven Taback. How are you doing Steve?

 

Dr. Steve Taback:  Hey Bill, it's good to be here. Good to see you.

 

Bill Curtis: You know, Dr. Steve has been working 15 hour day is running the ICU at Providence Medical Center. And we thank him for his willingness to be on the frontlines of this battle every single day. Also, thanks, Steve, for making time for us again today.

 

Dr. Steve Taback: It's my pleasure.

 

Bill Curtis: And joining us through the magic of remote zoom conferencing, Dr. Allen Berger, a nationally renowned psychotherapist and clinical director of the Institute of Optimal Recovery and Emotional Sobriety. He's the author of a bestselling book called The Twelve Stupid Things That Mess Up Recovery and its sequel, The 12 More Stupid Things That Mess Up Recovery. So, Doctor, here's the 13th stupid thing. Coronavirus.

 

Dr. Allen Berger: Yeah, we've got to add that now, don't we, Bill?

 

Bill Curtis: I'm afraid we do. So, Dr. Berger, what can you tell us to help us cope with these massive psychological challenges in these massively weird times?

 

Dr. Allen Berger: Well, I think the first thing that I'd want to say is that we're all experiencing anxiety to some level right now. That is the new normal today. We make a distinction between fear and anxiety and a lot of us are feeling fear because there is a real threat out there. And Dr. Taback can really help us understand that. So our reaction to this, the fearful part of it is quite appropriate. That's the reality of it. But I think what will be important today, Bill, is for us to make that distinction between fear and anxiety and to talk about the anxiety part. The fearful part, we need to do what everybody's telling us to do in order  to stop the spread of this thing and to, you know, decrease our risk of being able, in getting the Covid 19.

 

Bill Curtis: And that's different from anxiety?

 

Dr. Allen Berger: Well, no, that's  the fearful part. That's the appropriate reaction of fear, is taking the steps necessary to protect yourself. The anxiety gets in,  when we start imagining what's going to happen. So when we leave right now and we go into the future, you see as soon as you start imagining catastrophic outcomes, I'm going to be in bad shape emotionally.

 

Bill Curtis: How does this get all the worse for someone who might be home these days, who's already been struggling with some kind of addiction or challenge with alcohol or drugs? How did they get through this?

 

Dr. Allen Berger: That's such an important question. Look. And we're all trying to mobilize as many resources as we can to reach out to people that are isolated. And it's a weird thing, isn't it? We're isolated, but in some way we're even more in community now than before. And I think that's an important thing for us to realize. We're really connected right now and we really need each other more than we've ever. In addiction and recovery we talk about, "I can't, but we can". And that whole idea is so important at this moment more than ever.

 

Dr. Steve Taback: I mean, if we can remove ourselves really from this particular, you know, terrible crisis that we're in and just sort of look at it from a bird's eye view, there's an amazing message in the global nature of this disease. Right?

 

Dr. Allen Berger: It's to me, the message is one of humility. I mean, it's really right sizing us in an incredible way, isn't it, Dr.Taback?

 

Dr. Steve Taback: and also just how universal this is. We're all human beings. We're all going to be vulnerable. We all need to take care of each other and take care of our planet. I mean, you can debate back and forth. Global warming, this or not, there's no debate here when it comes to corona virus. And it's almost as if the forces of nature have said, wake up, people, you need to be banding together to work for a common goal, not just corona, but the health of the world for your own sake.

 

Dr. Allen Berger: Well, I love that. It's almost like nature is saying, hey, everybody, wake up. Wake up. You know, a wake up call. It's a big wakeup call for all us right now.

 

Bill Curtis: Some of us, like myself, are watching CNN all day long. And, you know, watching those numbers on the right hand side of the screen continue to go up and the stress gets more and more overwhelming. You do find yourself, even if you're not struggling with things like depression normally or addiction, you find yourself kind of different. It does something to you just listening to what's going on in the world and then dealing with the - am I going to get it? Are any of my family members going to get it? What should I be doing to protect myself at home? And this is weird because my business could be falling apart. Can you give us some ideas on steps we can take personally to try to manage that kind of thing and how can we recognize if we're not managing it well?

 

Dr. Allen Berger: Yeah, that's a very important question, Bill. The American Psychological Association came out with some guidelines and one of their top guidelines was limit your exposure to the news right now. Now, that's not the same as saying, you know, become, you know, an ostrich, stick your head in the sand and don't pay attention to what's going on. But we've got to find a balance between being informed. But at the same time, taking care of ourselves. And so limiting exposures is important thing. That's what I've started to do. I give myself a 10 minute quota. For 10 minutes I get to watch news a day and that's it. And then the rest of the time, you know, I'm engaged in other things. So that's the first thing, right? Is really pay attention to limiting your time. And that's going to help people with their anxiety a lot.

 

Bill Curtis: So tell me, what are some of the other things I've heard about diet and exercise and sleep, but maybe you can kind of help our listeners understand what are the steps that they should take to try to keep as healthy as possible.

 

Dr. Allen Berger: Let me put it in the context of this concept. In addition to our physical center of gravity, there's an emotional center of gravity. And when I keep my emotional center gravity over my two feet, then I cope a lot better. If I give this virus my emotional center of gravity or what's going on in the world, my emotional center of gravity, then my well-being depends on what's going on around me. And today, that's really bad news.

 

Bill Curtis: But it's  pretty common.

 

Dr. Allen Berger: Listen, it's what we're all doing.  And see, this is the opportunity to see if we use, this is an opportunity to become aware of ourselves and how we function, what's our habitual ways of thinking and feeling. We've got an opportunity to really do some phenomenal growth.

 

Dr. Steve Taback: So would you say that there's a difference between fear and anxiety? You alluded to that. Would you say fear would be the rational perspective of the challenge that we're under at the moment and that the anxiety is the irrational portion of that?

 

Dr. Allen Berger: That's correct. So if I stay grounded in, in and respond to my fear appropriately, what am I going to do? You know, the steps that we need to take to stop the spread of this and to protect ourselves. You know, finally, we're talking about everybody putting a mask on before you leave the house. You know, if there's no host for this thing to survive in, then we're going to be able to stop the spread of this thing. So that becomes an incredibly important thing. And I think that's what they did to finally, you know, get control the Spanish flu back in 1918.

 

Dr. Steve Taback: So from a day to day perspective to sort of live in the moment and realize that right now you're fine, you're not sick. Let's focus on what's good. Let's do what I can do, what I am in control of. Let me take control of that. What is it what is your recommendation for how the average person who may have just low level anxiety and even more so those people who have a heightened level of anxiety, how do you keep people away from delving into that  "what if" scenario?

 

Dr. Allen Berger: Well, that's such a great question. Let me tell you how I work with that in my office. Right. There's a rational part of me that you just referred to. There's a healthy part of me that that responds appropriately to situations, takes care of myself from a rational basis. Well, there's also a part of me that I call my anxious self. Now that part of me can take a situation like this and come up with all kinds of catastrophic outcomes. I'm going to get this. I'm going to die in a hospital alone, although I think that's a possible outcome. Whether that's going to happen for me or not is yet to be determined. So when I start to project into the future, I've got to start to think about that side of me that's projecting into the future is the part of me I need to deal with. So I need to start separating myself from the part of me that's making me anxious. And see, this is a very important step in terms of being able to now manage our anxiety well or what I would say in the way I'm talking about it now, manage our anxious self.

 

Dr. Steve Taback: But do you think that on some level that the human being with our existential reality, that to some extent this anxiety you put yourself through the what if in a way to try to prepare yourself in the event that it takes place, thinking that maybe that may cushion the blow, to try to put yourself through the potential horrendous aspects of the future so that you will not be shocked and unprepared if it were to take place?

 

Dr. Allen Berger: We call that anticipatory coping. And you're right on. We do that right. We anticipate these situations.

 

Dr. Steve Taback: Is it helpful?

 

Dr. Allen Berger: Well, it is if you do it once, maybe twice. But when you do it a thousand times and you've run through this scenario over and over again, you're no longer preparing. Now you're throwing yourself into a big, into a panic. Right? You're going to have a panic attack.

 

Dr. Steve Taback: I do go down that road of what if. And then I have to reel myself back to rational thought.

 

Dr. Allen Berger: How do you reel yourself back ? Tell us what you do.

 

Dr. Steve Taback: The first thing that I do is say, OK, you know what? You've got a job to do. Focus on what's going on right now. Number one. Two, I try to become  more philosophical. And I say it's the here and now anyway. We all know that we're dying, eventually. We don't want it to be tomorrow. We don't want it to be two weeks from now. But we all know we've been preparing for this in many ways our whole lives. And so I try to be philosophical about it and say it's going to happen. But let's focus on what's good. Let's focus on what we can control.

 

Bill Curtis: Let's talk about the psychological stress on medical staff who have to deal with this every day. Not only do they have a concern, they have to, even if they claim they don't, they  have to have a little bit of concern for themselves in this case, multiplied by just an overwhelming feeling of almost lack of control, because this virus seems to have its own trajectory and they get surprised. Suddenly there's  a patient who was doing well a few minutes ago and all of a sudden now they're crashing and need to be put on a ventilator. How are health care workers supposed to deal with that kind of stress?

 

Dr. Allen Berger: You guys are all in my prayers right now in terms of what you guys are facing. Here, here's what we know, Bill, is that when you let the situation control you, then you're going to have the best possible response to it. Now, let me explain it, because intuitively that seems what do you mean you're abdicating any responsibility if you're letting the situation control you? Well, the opposite is true. You see, if I go into a situation thinking I'm going to control everything and Dr. Steve, you know this better than most. If I think I can control everything that's going to be happening in front of me, I'm setting myself up for some big trouble because then I become fixed in my response. If something has to be a certain way, if it's supposed to look like this, then I'm not going to be able to respond to what it is. And what we know is your coping increases when you let go of what's supposed to be happening and you start to deal with what is. If I let go a wall of my rules of what's supposed to be happening, Bill, I can respond much better. Inside every one of us and every one of those health care professionals right now is an incredible ability to adapt and to deal with situations as they are. You know, a book that I've heard mentioned a few times, and that's meant a lot to me is Man's Search For Meaning. And it's by Viktor Frankl. And if you've read that, you'll know what I'm talking about. You know, he talks about how did you, how did he get through the concentration camp, these Nazi death camps? He was in four of them. And what did he see other people doing to survive from a psychological point of view? Obviously, sometimes the physical demands were too much and people died from the conditions that they were facing. But psychologically, what they had to do to get through this was let go of every expectation they had about how things were supposed to be. And that's the attitude that got them through it.

 

Bill Curtis: Steve, I have to ask you. Can you tell me what kind of conversations are you having with your associates at the hospital and your friends who are doctors and nurses? And how are you guys dealing with it? You know, day to day. Do you talk about it?

 

Dr. Steve Taback: You know, we talk about it all the time and doctors and nurses, we're all human. And so we are dealing with our own fears and anxiety and at the same time trying to do our job. It's amazing to see the people that I work with. Doctors and nurses who have risen to this challenge and they're taking it on boldly. And yet I can see the fear in their faces. So it's a question of we feel our fear. We feel our anxiety. We work through it anyway.

 

Bill Curtis: You're actually dealing right now in the corona war with a lack of knowledge. You actually are learning as you go. The whole of society is trying to figure out what makes this disease tick. So you've got to be feeling in addition to a little bit concerned for yourself, a lot concerned for your patients. You actually don't have marching orders and don't know what's going to make this virus stop killing.

 

Dr. Steve Taback: All of the things that you just said are actually very true. But in spite of that, you can compartmentalize it a little bit into our game plan. And it's not a great game plan, but our game plan is to be as safe as possible every day. Flatten that curve so that the vast majority of people will eventually benefit from the scientific advances that will be forthcoming. But at the end of the day, our orders are stay healthy, take care of your patients, flatten that curve. Do what you're supposed to do. And we're all waiting as human beings for the scientific advances that hopefully will be forthcoming with that.

 

Bill Curtis: We're going to take a quick one minute break and we're going to hear about something that you can all do to feel good. Share your thoughts and stories with our listeners. We'll be right back.

 

Promo - AMOYT: Hello out there. This is Jenny Curtis. I am a podcast producer at Curtco Media 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. We don't know what the day to day is going to look like for the next few weeks, even months. So I'm proposing something. Let's all make something together. Curtco Media has launched a podcast called A Moment of Your Time. These are bite sized episodes and each one features you out there. Go to Curtco.com/amomentofyourtime for more information. We may have to stay apart. Let's create together.

 

Bill Curtis: You can also go to Curtco.com/amomentofyourtime. We're here with Dr. Alan Berger and Dr. Steven Taback. Alan, I wonder if I could put you on the spot a little more, whether it's a health care professional or the rest of us or people who might be struggling with with addictions and other challenges and depression in their life, if they're feeling overwhelmed - in New York, a place where it's got to be considered ground zero for this virus as cases multiply exponentially. They've apparently got over 6000 mental health professionals that have signed up to provide free online services for people in New York State. Are there other programs like this that our listeners can go to if they kind of run out of coping ability themselves?

 

Dr. Allen Berger: We've all of us mental health professionals here in California just got a notice from our boards that the governor is mobilizing a mental health and health care task force, and he's calling it the Health Care Corps and he's wanting psychologists, licensed marriage and family counselors, social workers to sign up so we can start to develop that. And so all of us, health care professionals, especially psychologists and psychotherapists, we they have relaxed the HIPPA requirements. And now we can do psychotherapy over Zoom, over Facetime, over Skype sessions. And we're still not going to be held accountable that we're somehow not protecting a patient's confidentiality. There's a lot of things happening out there. I'm open-sourcing some of my talks. They're available for people in recovery to support them. And there is a lot of my colleagues, I'm doing pro bono work right now. A lot of, several of my patients have lost their careers right now. They can't work. They're not making any money.

 

Dr. Steve Taback: Let me ask you this tough question about a very selective type of anxiety. What do you say to my patient who is locked in a room, short of breath? Getting progressively more short of breath, fearful about what might be, not going to the future for you and I who right now are healthy, but somebody who's ill? Somebody who is really wondering, is this going to get worse or get better? How do they cope with that? What can I, what information do you have? What can I say to that patient that will somehow allay or minimize their anxiety?

 

Dr. Allen Berger: And now we've got how many, you know, thousands and thousands of patients possibly confronting that same situation with no psychotherapist sitting at their side to deal with this. You could tell me better what resources are available. Can they write a letter at that particular point in time? Now, start expressing some of the things that they want to express to those people they cared about and that they love and to be able to communicate, because I know, you know, that visiting is limited, if not completely locked down in most hospitals. So are there ways to be able to communicate what we, what we need to communicate and say to those people we love and care about? That becomes a very important thing, because my own experience with my anxiety is that in addition to it being a projection into the future, it's also at times related to me needing to experience something that I'm stopping myself from experiencing. So I hope that makes sense. So as soon as I shut myself down from, let's say, crying about and feeling my fear and owning it at that point, when I shut that feeling down, it converts into anxiety. So the more I can keep myself expressing that either through writing, through journaling, through talking to someone, through sharing what's going on and owning it, then I'm going to be able to manage it to the best of my ability at that time.

 

Bill Curtis: Wouldn't the most productive thing to do from doctor to patient in that kind of case is somehow provide a little modicum of hope, giving them maybe the strength to get through it?

 

Dr. Steve Taback: That certainly is my strategy every day, because there is hope. It's not a foregone conclusion that it's over. They could certainly get better and there could be a new therapy and treatment right around the corner as soon as the very next day. So I think there's a lot of reason for hope. And I always give them hope when there's obvious true evidence of hope.

 

Dr. Allen Berger: Yeah, that's a great point. The installation of hope at that point becomes very important. And look, even if somebody is hopeful, they'll still going to have those thoughts and feelings. See, and that's the thing they're going to say, well, if there's a 50 percent chance, which side of that am I going to fall on? And still, if that feeling comes up, there's ways that they can be encouraged to deal with it.

 

Bill Curtis: One of the things that got me so frustrated and I'd have to say is adding stress to my day is all the contradictory information that we get from our various leaders and authorities. And whatever we hear today is likely going to be different from yesterday. And we know it's going to be different from tomorrow. So that to me, that sets up a kind of a stress that I personally find a little annoying to deal with. Can you give us some thoughts on how to think about that kind of situation a little differently?

 

Dr. Allen Berger: You're really highlighting, I think, something that is exacerbating this whole situation. But when we're also confronted with an inability to be able to count on clear direction and solid direction and based on scientific information, I feel that personal crisis with all of this. I was in Vietnam in 1970 and I was fortunate to have a captain over there that really was a veteran of combat. And we had a gunnery sergeant that knew what to do when a firefight would start, when we would get hit. I could trust the direction that these two gentlemen were giving us as a battery to get us through that situation. And there was, our training came into play, like you talked about, Doctor Steve. But at the same time, having a leader that I can have faith in also did a lot to help me remain calm in those situations and to do what I needed to do to have an appropriate response. Well, we don't have that right now. I know for me, I'm being very, very selective of who I'm turning to information for. I love the discussion that Bill Gates had the other day on CNN about his work and his research into this. It was solid information and it wasn't all Pollyanna. It was just the facts about what we're up against. But there was something about the way he was talking about it. The reality that he was talking about helped me feel calm, even though it wasn't great news. And there's something to be said about that, is that when you can trust the information you're getting. We can start to deal with that.

 

Bill Curtis: What do you see as needing from our leadership to help us through these kind of times economically, worried about health. Worried about friends, having guilt that we're not doing enough for friends. So many different walls closing in on us. What do you think a leader should do to try to help us through this?

 

Dr. Allen Berger: Well, to me, I would love a leader that could show some empathy and could make some decisions that were based on scientific information. If there was some confidence we had in the direction we were given, it would help us tremendously, as well as if we had someone that understood what our experience was and how challenging this is for every person. Those two elements would be priceless at this particular point in time.

 

Dr. Steve Taback: You know, you need an evolved human being that has heart and mind that both work collaboratively.

 

Bill Curtis: Let's talk to some of our listeners who have been sober for years. They're off drugs, but people really are never really cured in those kind of cases, right? They always have to, you know, keep track of themselves. So now we've got stressful times like these and now we need to consciously manage a tendency toward addiction. Tell us how we do that in the case where we're home alone.

 

Dr. Allen Berger: Well, we got to guard against that hopelessness that we were talking about before, because if I feel hopeless, then I give up on managing my recovery. I give up on protecting myself from my illness. And if I think that there's no hope. Why not go out with a bang? See, what I say in one of my books, Bill, is that the addict self has a way of making wrong seem right and right seems wrong.

 

Bill Curtis: So does the addict know when they're moving toward a relapse? Can they react from a solid thought process or is it really just creeping up on them and all of a sudden they find themselves in a bad place?

 

Dr. Allen Berger: I think it happens that way for a lot of people, Bill. Is it creeps up on them. And we say that the relapse starts way before a person picks up a drink or or uses any other kind of a drug. And look, underneath all of this is how much faith do we have in ourselves and our ability to grow and to cope with whatever is set in front of us.

 

Dr. Steve Taback: I think also an important message would be that, you know, we can take care of ourselves and we have responsibility for ourselves. But what an important time for all of us to reach out to each other. And thank God for Facetime and Zoom. And sponsors can reach out in ways that they never could before. There's so much that we can do together to support each other emotionally in this day and age with this technology. And I think it behooves us all to really maximize that, you know, to its greatest potential.

 

Bill Curtis: What are some ways that someone at higher than normal risk for relapse can get the in-person support that they need to get through an extended crisis like this?

 

Dr. Allen Berger: Well, if that person doesn't have a sponsor to reach out to someone that they've been going to meetings with and make that person your temporary sponsor, you know, all of us, you know, are available for that at this particular point in time. But, you know, back to the question about the Zoom technology. We just started a meeting the other night called Emotional Sobriety Anonymous to try to help people get through this crazy time. A fellow reached out to me from Scotland the other day,  I want to go to a meeting. How do I do that? He's never Zoomed before. So we're connecting him with someone to teach him how to Zoom. And so people are out there that can help you learn how to use this technology. And you know what I found is it's not as intimidating once I start to get into it.

 

Bill Curtis: How do you know how to approach, the best way to approach a friend that you feel may be at risk?

 

Dr. Allen Berger: You ask for permission, yeah, ask for permission. Call a friend and say, look, I know you're going through a lot. You're really concerned right now. Would it be helpful if I talked to you about this? But I want to see if that's something that you want to do. You know, that checking in and I call it being coordinated with someone, becomes very important at this time. Not assuming they don't want to talk about it or not assuming that they do, is give that person the opportunity to let you know what they need. And this situation is the time for the Serenity Prayer. If the one thing that people can take away from what we say, use that prayer as often as you need to. God grant me the serenity to accept the things I cannot change, the courage to change the things I can, And that's me, and the wisdom to know the difference.

 

Bill Curtis: We're going to take a quick break. We'll be right back.

 

Bill Curtis: While we take a little breath. I want to tell you about a good friend of mine named Kimberly James. She's CEO of Beach House Treatment Programs. Her Web site is BeachHouse Treatment.com and her phone number is 310-977-4018. So if you're struggling with addiction, trauma or depression or for that matter, you know someone who needs help, the Rolls Royce of treatment centers is Beach House Treatment Programs in Malibu, California, beachhousetreatment.com, 310-977-4018.

 

Bill Curtis: Well, we're back. How do you deal with guilt as a friend, as a family member? The guilt of thinking you're not doing enough. You're not doing it right.

 

Dr. Allen Berger: Well, God. I knew this would get to a personal thing for me, so I just got a call yesterday. The man who sponsored my recovery, I came in recovery in 1971. So he's been involved in my life for over forty-eight years now. His wife has had stage four lung cancer and she was responding pretty well to chemotherapy. And then the other day her lung started to fill up with fluids a lot quicker than before and they suspected something else was going on, brought her in the hospital, did a CAT scan and they found something growing quite rapidly in her chest. So she turns out having corona virus. So the family doctor, the oncologist said there's nothing we can do for her. We're recommending that she stops the chemotherapy right now. So their family doctor says, well, look, if she goes into hospital, there is very little chance that she's going to make it. She's going to be put on a ventilator. But because of her condition and her vulnerability, she's going to die in the hospital. He shared that with me and they made the choice together to face this at home. So, you know, Bill, as he's telling this to me on course, I can sense the challenge that he's facing at this point to be with his wife and on top of this he's also positive for a Corona virus. And he's 72 years old and he's got concerns. Well, under any other condition, I'd be on a plane flying over there to be at his side and to support him while he's going through this. I've got a family. I've got a two year old and a seven year old. And it would be irresponsible at this point to go expose myself to that and into what that would do with my family. But the guilt I feel is terrible. I so much want to be there for him. He's been there for me so many times.

 

Bill Curtis: It doesn't sound like this is something that even someone with your training can manage.

 

Dr. Allen Berger: No, it's, I'm in a lot of pain about it. Obviously, you hear it in my voice and you hear what's going on and I'm going to be there for him. I'm going to check in with him as often as I can. But there's a part of me that feels like the right thing to do would be to stand at his side and just, you know, be at his house and prepare meals and do whatever I needed to do to help them.

 

Dr. Steve Taback: But, you know, I see that and I feel that. But there really should not go there. You're doing everything you can do. In fact, to go there would be irresponsible.

 

Dr. Allen Berger: It would be. That's the rational side of me figured that out.

 

Dr. Steve Taback: That responsible thing is to take care of your family. But you're also going to take care of him in any which way you can. And so you do the best you can, which you will do. You're obviously such a compassionate guy and he's going to feel your compassion. Whether you are at his bedside or whether you’re zooming or telephoning. So I'm sure he's going to feel you there.

 

Dr. Allen Berger: No, and I got that. I mean, I could really sense that when we were talking about it the other day. And he appreciated my compassion and empathy for him and all of that. I do. I hear what you're saying, Steve, and I appreciate that.

 

Bill Curtis: So is logic and good sense a good weapon against the guilt that really isn't gonna do you any good at all?

 

Dr. Allen Berger: I was trained to think of guilt as pain and that I need to give expression to the pain behind it. As irrational as it is for me to think of going there and doing that. I need to cry like with you about it and share that with you. Right now I feel better. Just having cried for a few minutes with you that it just helps me deal with that situation. So if I can just allow myself and not have some of these rules about how I'm supposed to deal with this and how I should be strong. It's nonsense. Forget that. Just allow yourself to have the reaction that you're having. And that's what I would encourage people do. If you're feeling guilt, try to get at the pain that's underneath that guilt. Give some voice to it. And then like Steve says, then the rational part of you can step in. And, you know, you don't have to be driven by that. And you can now understand that we're all faced with a two choice dilemma. And there's no choice that doesn't have a dilemma to it.

 

Dr. Steve Taback:  The fact that you can't make it to the East Coast.  That's you putting an extreme set of circumstances and pressure on yourself that isn't rational.

 

Dr. Allen Berger: Oh, I get that, Steve. And I understand that. I understand it. You know, and you're right. I what I do, I do put a lot of pressure on myself to live up to some pretty high expectations.

 

Bill Curtis: What I have an overwhelming issue. I become mentally unproductive. It takes over everything. I can't be creative. I can't really work through things because it keeps on coming up. And I get that drowning moment. And it's not terribly productive. What kind of steps could I go through to get hold of myself and be more productive in that kind of case?

 

Dr. Allen Berger: Bringing yourself back to the moment can be a very, very powerful thing because all of that concern you have is about what's going to happen and what's going on in the future. So what I'll do is if I have a patient in a session with me that's getting overwhelmed and really getting flooded by their feelings- That's what we call it, is that when your emotions start to flood you, I will have them get connected to right now, say, look in my eyes. Tell me what color you see my eyes. Look at the room. What color do you see? What colors do you see in the room? Pay attention to sensations in your body. Describe them to me. So the more we can bring a person back to right now, it helps them get grounded again, Bill. And that grounding becomes a very important thing.

 

Bill Curtis: Interesting ,is that kind of a meditation sort of a,

 

Dr. Allen Berger: You can think of it as that, it's kind of an awareness exercises, the way I call it, is just bringing your full awareness to this moment, describing every sound you're hearing, describing colors in the room, where you see the illumination and how it's casting shadows. I mean, all of that can ground us because all that is sensory information available to us in this moment. And that can bring us right back to now. And that'll stop you from spinning out and flooding yourself and going into the overwhelm. Then after you're grounded you might think of separating yourself once again from the side of you that's overwhelmed, that's concerned about all these things and actually having a dialogue with that side. You know, let that side speak to you. What does it say? Well, I'm worried about this and what if that happens and then you go to the other side. You could do this on a piece of paper. On one side you let the person inside of you that's overwhelmed talk. I'm overwhelmed because of this and that. And then on the other side, your healthy self, your mature self, your wise self. Bring that into the foreground and have your wise self respond to that part and let a dialogue go back and forth. That can be incredibly helpful after you get grounded, but you've got to get grounded. Sometimes taking a walk when you're in that place can do it. Doing some exercise, there's a lot of things that we can do to change what's happening right now. Physical. You're looking at the kind of language we're using.

 

Bill Curtis: What do you mean by the language we're using?

 

Well, if I start to should on myself, you know, like Steve was catching me a minute ago, when he says, Alan, you're shoulding on yourself, you're putting all these shoulds. That you should  be over there. You should be doing that, right. When I do that, then I'm going to start to feel overwhelmed. You know, I'm putting this incredible pressure on myself or this side of me as the shoulder is shoulding on me and putting pressure on myself. And if I listen to the should, I can get rid of it. There is no should here. Healthy people don't live their lives with a lot of shoulds.

 

Dr. Steve Taback: You know, the interesting thing I think is that we can be in many ways, especially as overachievers who have high expectations for ourselves. We are capable of being compassionate with our friends, but we're not so compassionate with ourselves. If I called you Bill, I said, listen, I'm feeling all of these things. What would you say to me to comfort me? And then say it to yourself, damn it. I would say that to yourself. Comfort yourself. It's OK.

 

Dr. Allen Berger: Think about it, a lot of times that we save our worst behavior for ourselves. We're much nicer to family and you know, or for especially friends, our families, we probably end up treating them more like we treat our self. But friends, we treat them a lot better than we treat ourselves.

 

Dr. Steve Taback: We're certainly much more forgiving of our friends and more nurturing of our friends than we are of ourselves.

 

Dr. Allen Berger: Such a great point. Great point.

 

Bill Curtis: Let's make a little bit of a left turn here. And I know this is a situation that's going on a lot right now. A normal working mom and dad home alone with their eight or 10 year olds who, by the way, normally would be going to daycare and schools and soccer practice and baseball practice. But now there's no break at all. There's no rest for the foreseeable future. How are parents supposed to deal with the kind of pressure nonstop kids, I'm bored, mom. You can't go out and play with your friends. Give us some advice for parents.

 

Dr. Allen Berger: This more than any time, is just about being a good enough parent. You're not going to pull this off perfect. None of us are. Even if you're a health care worker, you're going to do the best job you can do. You're going to still make mistakes, especially as you get tired and fatigued and more stressed out. As a parent give yourself a break. And when you make that mistake, come back to your kids and just say, you know, I just lost it. You know, and  just make amends for it. Good enough is great right now. Good enough is fantastic. You know, and we need to really, really, really understand that.

 

Bill Curtis: But how do how do you give yourself a break? Because every parent needs a break.

 

Dr. Allen Berger: Look at if you've if you've got a partner at home, you get that break by turning to your partner and doing a tag team.

 

Bill Curtis: It's your turn, honey.

 

Dr. Allen Berger: It's your turn honey.  You know, if you're a single parent, that's really tough right now. But look, that's where a Zoom can come in. Let's call Grandma. Let Grandma read you a few stories right now.

 

Bill Curtis: That's a good idea.

 

Dr. Allen Berger: But it's challenging for the kids, too. And that's the other thing. Give your kids a break. The meaning it has to them is going to be in many ways determined by what it means to you.

 

Bill Curtis: What do you tell your 8 year old, Allen?

 

Dr. Allen Berger: I talk to my 8 year old about the fact that the world is facing a real challenge right now. There is this virus. My wife's a scientist. And so she's able to come in and help Maddie understand what that virus means and talks to her about it. We just try to be grounded in we're taking all the steps we can to protect ourselves and protect our family. She reaches out to her older sister a lot, to her cousins and her grandma and grandpa. And, you know, and we just try to make her world what it can be at this particular point in time.

 

Bill Curtis: What are some signs that kids aren't handling it that well, that you're 8 or 10 year old needs some help that I may or may not be trained for?

 

Dr. Allen Berger: First of all, let's understand, nobody is going to handle this well, let's get rid of that. And let's just talk about handling it right. Look, if a child that is typically not withdrawn becomes incredibly withdrawn at this particular point in time, that's at least a yellow flag, if not a red flag. If your child goes the opposite way and you've got a child that is typically pretty subdued and more on the passive side and becomes incredibly energetic.

 

Bill Curtis: So any change, any massive change from.

 

Dr. Allen Berger: Any massive change from what you typically experience is something I'd be concerned about. And I would connect with someone to do some telemedicine at this particular point in time.

 

Dr. Steve Taback: Now, let me ask you a question. Let's take ourselves a year down the road. What do you expect to see in terms of post-traumatic stress and the reaction that many people are going to have after this?

 

Bill Curtis: That's a good question, Steve.

 

Dr. Allen Berger: That's one place my head has gone to, Steve, a lot in terms of what is this going to mean for all of us? We're going to have a nation that's been traumatized by this whole thing and more than ever before our mental health and our well-being is going to be coming to the foreground. I think in terms of you in medicine, you guys are going to see more stress related issues than you've ever seen before. You know, sometimes what happens in a crisis like this, some people just kind of push off their feelings to decide to take care of business, especially if they've got children and stuff like this with down the road. All that's going to come back.

 

Dr. Steve Taback: Right. You just got to bottle it up. You got to just wall it off.

 

Dr. Allen Berger: Got to wall it off. And a lot of health care workers are going to go through the same. I mean, you guys are going to be experiencing a ton of that post-traumatic stress in terms of what's going on. You know, there's that psychotherapy today is much better than it's ever been. And if you have a decent relationship with a person you're working with, there's a very good chance it's going to be helpful.

 

Bill Curtis: Dr. Alan Berger, I want to thank you so much for joining us today and shedding some light on a very complicated subject that clearly we didn't handle all of today. But maybe you'd come back and join us again sometime.

 

Dr. Allen Berger: I'm here whenever you'd like me to, Bill.

 

Dr. Steve Taback: I just want to echo what those said. Allen, it was a real pleasure meeting you, getting to know you, getting to know your heart and your mind. You must be an incredible therapist and your patients are very fortunate to have you.

 

Dr. Allen Berger: Thank you. Thank you. That means a lot.

 

Bill Curtis: You can learn more about Dr. Berger and his work at www.abphd.com. Any place else, Doctor, that you can suggest people go if they want to look further into some of these issues.

 

Dr. Allen Berger: You can go on Amazon. I've written a bunch of books, but this is also a great time to read Man's Search for Meaning. There's a lot of truth in that that can help us get through this dark time.

 

Bill Curtis: Dr. Steven Taback, as always, you round out the conversation and really help out, I really appreciate you, especially under these circumstances, breaking away from everything else that's really challenging and coming in and helping us today.

 

Dr. Steve Taback: Well, always a pleasure to see you and speak to you.

 

Bill Curtis: Until next week, where we will hit part 3 of the Corona virus editions of Medicine, We're still Practicing. We'll see you soon. Stay together.

 

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 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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