Somewhere back in human history some bright ancestor thought that putting a label on a pot, jar, or container of some kind was a useful idea. Perhaps it was some ancient Pharaoh who wanted to be sure his chef knew which clay pot contained the beans and which contained corn. Who knows? My guess is that it made a difference to the Pharaoh as to whether he had bean soup or curried rice casserole.

In any case, it became a standard practice from that moment on to put labels on containers. It's been a well accepted normal behavior that has made life infinitely easier for everyone. It may not rank with the invention of the wheel or discovery of how to make fire; however, it is a useful practice that we are all using every day generally without giving it too much thought. Just this morning when I stumbled out of bed and made my way to the kitchen I was able to identify which jar had coffee in it and knew I could take it from there. Just one label, "Coffee", was all I needed. In short, part of what makes a household run well is to have a good supply of food, clothing, and necessary items that are organized in convenient places in containers with labels on them. To sum it up labeling is a good thing to do and a great time saver because we don't have to open every container to discover its contents. Labeling food is GOOD.

This becomes extremely significant when we come to the issue of what is safe to put into our bodies as opposed to any unsafe materials that could be life threatening for us to consume. For this reason we have certain symbols, in addition to words, to help safeguard our health. For example, if you are looking though your pantry and you see a box that says "Rat Poison" you have a pretty good idea that you don't want a bowl of it for breakfast. Just to be sure you are properly informed as to the contents there is often a skull and crossbones to emphasize that this is dangerous. The container may say, "Not for Human Consumption" in addition to the skull and crossbones. Even in our automobiles there are warnings signs that are often included with illustrations to make the point. Above the visor in our cars there is a warning to "Flip the Visor Over' to read about the airbag operation that may potentially injure or even kill children who ride in the front seat. This message is fortified with an illustration of a child in a car seat being injured In other words, it is important to to have labels that let us know what is BAD.

All that being said, it is also important to understand that labeling people in our lives may have a certain utility and convenience. We all learned that early on in school when we took tests and were eventually labeled ourselves. Some of us were average students and could be predicted to have a C average. Others were A students or even Honor Students and would be predicted to have much higher grades. Those unfortunate students who did not do well in school, for a variety of reasons were often labeled "slow readers" or "problem children". They begin to see each other according to the label that they've heard other's apply to them. For example, my next door neighbor received straight As in school and even got up early to study algebra on television classroom while he was in grade school. Clearly Arthur was labeled a "smart kid" and would eventually go on to get a Ph. D. in physics. One other neighbor kid, Larry, flunked the 5th grade and became a very angry adolescent and was label "a bad kid". Did these two boys suffer or benefit because they knew what their labels were? Did Arthur try harder because he was labeled "smart"? Did Larry give up on school because he was labeled a "bad kid"? Would these two boys have followed a different lifestyle and had different outcomes in their adult life had they not been labeled? Did either of them feel trapped because of the box they had been put in and the label on their box? It's a good question.

When we label people, a process known colloquially as "stereotyping", we are in a sense using a shortcut. We quickly put that person in a category. We decide early on if they are interesting and approachable or uninteresting and possibly dangerous. Stereotyping saves time and energy for our cognitive processes. For that reason it is a common practice to knowingly, or perhaps more often unknowingly, stereotype people that we meet and then leave them in that stereotyped category or container forever. It just makes life much simpler and more energy efficient to do this. This is especially true if you routinely meet a great number of people. As a teenager I frequently decided if someone was attractive or interesting to me by putting them in one of two categories of either "Cool" or "Uncool". Once they were in their respective category it was difficult to get them into another category. Teachers were rated "Cool" and "Uncool" as were areas of academic interest. For me art was "cool" and science was "uncool". Not surprisingly my grades reflected my stereotypes.

It doesn't take long to establish a label or stereotype when meeting a new person. According to the research of two Princeton researchers, Janine Willis and Alex Todorov, it takes only 1/10th of a second for a person to render an internal judgement or stereotype regarding the person they just met. You can review their work by going to https//doi.org/10.111/j1467-9280.2006.01750.x. Rightly or wrongly we judge people and put them in categories often without meeting them but judge them solely by their appearance.  They also confirmed that once in a box or stereotype it was very difficult to get out and be viewed objectively.

Stereotypes in the media are often used to quickly establish a character by the directors use of costuming (i.e. heroes usually where white hats or light colored clothing while Villains generally dress in black) or other well established stereotypical characteristics. For example, usually the most attractive actors play the leading roles and least attractive actors are in marginal or even malevolent roles. By using stereotypes the audience is able to quickly follow the plot line and follow the story. Consider actors that you have noticed that play villans; they are thereafter stereotyped in that role and oftened no alternatives.

It is interesting when media directors begin to experiment with putting actors in unexpected and nontraditional roles. For example in the recent Broadway hit "Hamilton", the actor playing Alexander Hamilton is a Puerto Rican and the actor playing George Washington is an African-American. Having members of another race play well known historical figures is certainly a means of making the audience aware of the racial stereotypes and perhaps opening the label or box to view others in a different light.

According to the well respected Pew Research Center in their article dated October 13, 2021 entitled "People in U.S. see stronger conflict in society than in other countries" there is evidence that disagreements in our own society that are more intense than in any of the 17 other developed countries that were researched. Their research noted that members of the three categories surveyed (White Non-Hispanic, Black Non-Hispanic, and Hispanic) all believed that there was "very strong conflicts" between Americans of the two different political parties. The percentages respectively were 93% among Hispanics, 82% among Blacks, and 84% among Whites. These percentages regarding political differences were higher than the three different groups believed regarding strong conflicts over ethnic or racial backgrounds which by comparison were 69% among Hispanics, 82% among Blacks, and 70% among Whites. Perhaps even more disturbing was the Pew Research finding that between members of the two political parities there was strong conflict indicating that both Democrats and Republicans disagreed with the opposite party regarding what were the basic facts of what was happening in the country regarding politics. Approximately 60% of both parties felt that they did not agree with their opposites on even the basic facts of what was happening politically in America. This seems to reflect a major discrepancy between what is portrayed as being honest and true between news networks and social media.

What I have noticed in my own life is that it is very easy to use political stereotypes in our everyday interactions to label people that we agree with as good people and those we disagree with as bad people. I have caught myself reacting to people that I have known and loved, but who have a different political orientation as if they were bad or even villainous people. In a recent encounter on social media I was disappointed to find that the bulk of the interactions online were simply an exchange of insulting names and mindless cussing from the comfort of their computer. As I write about this I am aware that I was primed by the news media that I follow to be very biased in my beliefs and easily angered by those with opposing views. That is not a normal state of mind for me; it is not something that I value in others, yet never-the-less here I was involved in a name calling match that was clearly reminiscent of school yard fist fights than anything close to civil discourse. This is becoming an ever more common occurrence and it does not bode well for the country or myself. It is imperative that I demonstrate a more objective frame of mind and not be lured into mindless and useless name calling that accomplishes nothing but an increase in anger and bodily tension. I have to look past the politics and see that other people are being led by their own sources of information, or perhaps misinformation, to stereotype me as a bad person (i.e. "White Supremacist", "Racist", "Baby Killer", "Anarchist") in whatever is the most painful of the current social media jargon. What a shame that so many people that I meet now stereotype me, without ever getting to know me.  Likewise, what a loss for me, if I am unable to see their admirable qualities because of my own tendency to stereotype them. Please join me in working to see the person, and not the politics, before something irreversible happens to our fragile republic.

In summary, while stereotypes can be useful, they have the potential to be UGLY!

Many of us will look back at 2020 and the pandemic with relief at having the year over as well as the promise of "normalacy" returning.  We are now aware that with the dissmination of the vaccines we can begin to see  businesses and schools opening, social gatherings flourishing, as well as need physical contact with friends and loved ones.  It's been a tough challenge for everyone around us and especially hard on those who have suffered from severe losses.  That loss may have come in the form of a lost job, a lost business, a lost opportunity to go to college, a cancelled trip abroad, or tragically the loss of a loved one. Certianly the loss of a family memember is often the most devestating of all.  To make matters worse for the grieving family during the pandemic there were restrictions on how many people could gather together to do a celebration of life or a funeral.  This need for social distancing, while necessary, has curtailed or even eliminated a necessary ritual that helps all of us come to terms with the final and eternal loss of a loved one through death. Here are some guidelines developed from my own personal losses,  readings, and observations over the past 34 years of being a therapist that may be helpful to those who are going through grief.

.1. The first stage of grief is shock and denial.  This means that when something happens to a loved one our first reaction is often to say to ourselves or even outloud, "No!".  It is a means of trying to control what we have just heard or witnesses about a terrifble loss.  It is our instinctive reaction to try to stop what has already happened.  It is self-protective and self-defeating because logically we are helpless to control all the events in our lives that we would wish to and especially the loss of a loved one.  The shock often is accompanied by an emotional numbness and allows us to feel almost nothing for a period of time as our emotions go from overload to nothing  It is analygous to tripping a circuit breaker and having the electiricity cut off for that line so that nothing is registered.

2. The second stage we wil go through often is anger and guilt.  These two emotions may bounce us back and force between feeling aggressive to the pont of waning to lash out at someone or something alternating with a deep sense that we should have done something, anything to change the course of events to have saved this person's life.

3. The third stage of grief may then be "bartering with God" or attempting to "make a deal with God".  Often I have heard from clients that I have seen that they want to ask God for a favor such as "save my loved one and I will be in church every Sunday" or "cure me of this fatal illness and I will help the poor every day of my life".  These acts of contrition may in fact actually lead to the restoration of health and then the good works that were promised.  Regardless of the outcome they represent a normal and deperate attempt to control an outcome that is cliearly out of our control.

4. The fourth stage is often depresson.  This stage is where the actually deep emotional coming to terms with the loss occurrs.   The feelings of depression and sorrow often comes in waves.  I remember that when my father died in 2003 that I experienced what I would call "waves of sorrow" that seemed to wash over me and leave me sobbing in tears.  It was not unlike similar experiences I have had while surfing in deep water except this time instead of being exhilirated by the pleasure of being lifted by the waves and then dropped it was the very unpleasant feeling of sorrow literally washing over me then pounding me down deeper into depression. There is often a loss of energy to the point where the grieving person has no interest in going to work, enjoying hobbies, taking care of their personal hygiene or even getting out of bed.  Other symptoms can include overearing or loss of appetite, obsessive thinking about what could have been said or done differently in their relationship (inappropriate guilt), social isolation, extreme need for companionship, problems with concentration, indecison, loss of self confidence brought about by severe negative self-talk and sometimes suicidal ideation.  The degree of depression can range from minor symptoms such as only minor insomnia to suicidal thoughts with a plan to kill oneself.  Obviously these symptoms need to be discussed with one's primary care physician, other family members and friends and probabliy a clergy member who has training in grief counseling.  Behavior health professionals who have graining in treating grief, bereavement and depression can be very useful as well.

5. Eventuall the individual reaches the stabe of acceptance of the loss.  As the old saying goes, "When one door closes soon another door opens" and this is certainly true in greiving a loss.  It will not happen as soon as one would want (it never is) but if the indivdiual keeps talking about their feelings the day will come where the pain is lessened and enthusiasm for live blooms once again.  It is always a good thing to weep when it feels overwhelming because this is a natural release of tensoin that moves one closer and closer to acceptance and peace.  The Bible verse from Corinthians 4: 17-18 states, "And this too shall pass." is a comfort for believers because it brings to mind all the previous losses that have been successfully navigated in the past that have eventually led back to normalacy. 

6.There are a number of things that can be done to hasten or at least facilitate the moverment through the grieving process.  One of the most important is to be open and talk about the loss that one has suffered.  Many churches have "Grief Groups" with lay leaders who are skilled faciltators who can guide the participants through the stages of grief.  It is important to know that it is possible to "get stuck" in the grieving process when an individual does NOT talk about their emotions.  I can remember one of the first clients I saw some 33 years ago came to my office and was always irritable and in a bad mood.  The client worked to repossess automobiles from individuals who had stopped paying for their cars.  The client was gruff and aggressive which seemed to be an asset for the type of work they had chosen.  I confronted them on their third visit to my office by sayng, "When you come in here to see me I am a little bit intimidated by your anger and irriaitibility."   What they said in response to me was shocking.  The client replied, "I am not angry really I am just so sad that my husband divorced me after 30 years without even explaining why he was leaving".  That was an eye opener.  The client was stuffing her sadness and hurt so much that it came out as anger in her behavior.  This was something that once she started talking about it she was able to work it through to final acceptance, but only because she finally chose to talk about her emotions.

7. Along with talking about feelings it is important to examine one's own feeling about death.  Part of the reason  for avoiding the pain of grieving having a family member die is that we generally don't want to face the fact that we will have to face our own death one day.   There are numerous books, both religious and secular about death and how best to face that reality.  One book that I found to be helpful to my clients and also to myself was entitled,"7 Lessons From Heaven" by Mary Neal M.D.  This book details her near death experience of being trapped under water in a kayak for 30 minutes and emerging alive.  How this seemingly impossible event occurred is fascinating stuff and riviting reading.

8. It is important to remember to take good care of one's sefl when grieving because the act of greiving is itself very stresful.  For this reason it is important to find comfort in the company of old friends, familar hobbies, comfort food, regular exercise to loosen the tension in the body that accompanies emotional pain, and to have specific goals to accomplish each day (even if that goal is only to write three pages in your journal or talk for 30 minutes to a friend or pastor about the feelings that are coming up).

9. While grieving it is important to suspend making any big decisions until the work of grief is over.  This is not a great time to change careers, life partners, or move to a new state.  It is a time to slow down and to take stock of life.  As one sees the door closing to a loving relationship it is important to see how another door opens and new possibliites as well as insights become availble.  The net results can be a new set of insights and awarenesses.  The French have a term for this new apprecaiton of life and they say "La Joie De Vivre" has ben found.  Translated roughly it means "The Joy of Life" has returned.

On this Veterans Day, I wanted to thank all the Veterans who are currently serving or have served in the past for their service.  It takes a great deal of courage to sign up for the Armed Forces and allow the military to place you in whatever job and whatever country that you are needed to protect our country.  Today I also wanted to talk openly about some problems treating PTSD and a simplified overview of the nature of this most dangerous but also most misunderstood diagnosis.

The words PTSD or Post Traumatic Stress Disorder have become a part of our present American culture.  I hear it frequently mentioned in the news, especially regarding Veterans, and it is often mentioned as a significant contributor the Veterans the very high suicide rate which is currently quoted as approximately 20 per day.   These are Veterans who often take their lives out of a desperate futility that they cannot take the emotional pain and have finally given up trying to find any meaningful solution for their chronic suffering.   There are several reasons for this stunning and terribly sad phenomenon.  The first is the ambivalence on the part of the Veteran to seek help.  Most Vets have been told that they were weak if they sought the help of a psychologist or other behavior health professional.  This is true to all branches of the service and especially true for those Veterans who want to be make the military their career.  I have talked to many "Lifers" who have stayed in the service for 20+ years and asked them when they come in for an evaluation "What took you so long to come in and get help?"   The answer, almost universally is the same, "Doc, if I had come in earlier in my career I would never have been allowed to advance to the next rank!"  So an initial problem for Veterans is allowing themselves to ask for an evaluation and then possible treatment for whatever is emotionally distressing them (whether it be PTSD, Anxiety or Depression). So problem number 1 is that Vets are discouraged from seeking help and then they are often embarrassed when they do show up because they have been taught that it is a sign of weakness to need help and shameful to be sitting in a psychologist's office.

A second problem for Veterans is that they come back from deployment and the life they had before they went overseas later feels very different upon their return to civilian life.  What makes their perception so different is that they have been exposed to a dangerous situation or even combat. This experience of being exposed to a serious threat to their lives or to those around them is that it has activated what has come to be called "The Fight, Flight, or Freeze Response".

When they see real and present danger that is a serious threat to their lives (i.e. a terrorist with a gun, RPG, or a grenade) something in their brain mobilizes an extremely rapid and powerful response that initiates a chain reaction of events that equips them to survive the threat. This response increase hear rate, tenses muscles, and pumps adrenaline almost immediately. The Veteran is suddenly aware of imminent death and prepared to do whatever it takes to live through it. In addition to the sudden physical changes in the body, the Veteran's perception also makes a immediate change to start identifying anything around them in their five senses that might be an additional threat.  Every sight, sound, smell, touch or taste becomes acutely analyzed as a potential source of threat.  This sudden shift in every body system means that the Veteran will never again be comfortable with deep relaxation that my have been normal before deployment.  This is a life changing moment that can never be fully reversed.  For the Veteran, life has suddenly changed and everything in their awareness must now be analyzed to determine if it is an important trigger of a potential ambush by deadly enemy.  This shift, although it is felt as a dramatic increase in tension at every level is actually meant by the primal brain defenses (Limbic System) as a good thing.  This is the ultimate act of protection.  This elevated level of alertness and tension (like a coiled snake) is meant to provide the maximum protection to keep the Veteran alive least they be caught off guard.  The problem is that once this shift from relaxation to Fight, Flight or Freeze takes place it is very difficult to turn off.  For the Veteran it may feel like a fuse to a bomb has been lit and there is no way to turn it off.  Nothing will ever be the same and all five senses will now be assigned a new task of constantly analyzing every bit of information to see if it is in any way an incoming threat or even the hint of a threat.

What seemed normal to them in their everyday lives now feels strange and even scary.  There are a number of reasons for this but simply stated it is because a part of their brain has been activated by the realization that they could be killed and this realization sets off a chain reaction in their brain that changes the way they react to situations for the rest of their lives.  This change is dramatic and feels irreversible (although it is quite reversible) because most Veterans do not know what is happening to their thoughts, feelings, or bodily sensations.  Whereas before deployment they may have had a fun loving, carefree attitude and enjoyed socializing without a care in the world.  After they return from deployment they often have great difficulty relaxing and turn to excessive alcohol or drug intake to try to calm themselves. Whereas before deployment, they could meet people easily and form trusting relationships, but after deployment, they are often very suspicious of others intentions or behaviors. As a result, the post deployment Veterans become socially isolated even to the point that they only shop for essentials at Walmart at 2 am so that they can avoid crowds of shoppers.  Veterans often stop keeping in touch with long time friends because they don't feel they have much in common with them anymore because their friends have never been in combat or faced dangerous situations as the Veterans have.  The Vets who make friends during their deployment look to those same friends later on  (AKA "Battle Buddies) for understanding and support.  This may leave out their spouses and their children who do not understand what the Veterans have been through and are therefore in a sense "Outsiders" to the special experience of being under fire together.  This closed group of "Battle Buddies" becomes a lifeline of hope and understanding for the Veterans.  Unfortunately the rest of their social circle gets left out and this leads to a high divorce rate among military families which can range as high as 85%.

So let me try to simplify the dynamics of PTSD in the hope that just understanding how it works may be very helpful in reducing the mystery of the PSTD diagnosis and its many ramifications.  The Limbic System is a small portion of the brain between the spinal cord and the neocortex (the wrinkly gray stuff just under the skull) that is extremely specialized in detecting a possible fatal threat from the environment around us.  As I stated previously once this has been activated by a perceived threat it is very difficult to turn off.  It's like a smoke alarm that is loudly alerting you to "Do Something" with a disturbing message that Vet's cannot ignore.  This "Fight, Flee, Or Freeze" response is accompanied by a searching mental inquiry as to the nature of the threat.  Often Vets begin to ask themselves things like, "I know that guy I just saw looked harmless but he might have been packing a weapon so I will just turn around and follow him."  Or "I know I am awake in the middle of the night in my own home, but what if someone is outside just waiting for the lights to go out. I think I will just get out my gun and walk the perimeter of my home one more time, just to make sure everything is OK."  These kinds of thoughts may be perceived as paranoia by the Veteran's family or friends; however, for the Vet it makes sense to them to be extra precautious and act on their fears anyway. Just to make sure.  Some Vets carry a gun all the time and keep extras in their car, closet, or even in every room in the house. Does this seem insane?  Not if the Vet has been in combat themselves or seen other friends get killed while deployed.  For them, no behavior is outrageous or unnecessary because in their mind it is a matter of life or death.  This over abundance of caution by the Vet's sometimes unusual behavior is easy to understand once it is clear that the Limbic System and not the neocortex or logical part of the brain is running the show.  In some ways it is like a overprotective helicopter parent who, in their deep concern for their child, runs interference for them by over reacting to anything they perceive could be a threat to their life.  For the helicopter parent, even normal developmental tasks like major tests or seeing their child go on their first date, are cause for the parent to find ways to protect their child from pain even to the point of interfering with the child's ability to manage stress and as a result inadvertently crippling emotionally crippling their children.

So the bottom line for Vets is this: the symptoms of PTSD which include hypervigialnce (always scanning for threats), nightmares (visually reliving the threatening event), obsessive thoughts, and intrusive thought triggered by those things that remind you of the traumatic event are all attempts by your Limbic system to make some sense of what happened to you by keeping the memory alive in your mind.  This is the Limbic's systems way of saying "Hey don't forget what happened to you and stay aware that it might happen again anytime you become apathetic to the possibilty".

Here are some ideas for Vets that often work well to understand and then eventually change theirsymptoms:

1. Read what is available to understand what is going on with you.  Knowlege is power and if you gain an understanding of what is happening within your then you may be able to lessen the intensity of your symptoms a great deal.  In my own life, I reduced by symptoms of anxiety by 30-40 percent just by reading about anxiety in general and PTSD in particular. Here's a short list of books that I personally have found helpful: "The Body Keeps Score" by Bessel Van Der Kolk M.D.  Dr. Van Der Kolk is an expert in the field of trauma and bases his writing on research done in PTSD over the past 20 years. A second book I highly recommend is entitled "The Anxiety and Phobia Workbook" by Edmund Bourne, Ph. D.  Dr. Bourne has written extensively on anxiety and provides a large number of coping skills so you can try several until you find the ones that fit you best.  There is no single coping skill that universally works well for everyone. The reality is that recovery from PTSD is a matter of trial and error so that each person finds the combination that uniquely works well for them. The Third book is entitled" The PTSD Workbook" by Mary Beth Williams and Soili Poijula.This is an excellent workbook designed specifically for those with a PTSD diagnosis and has some excellent self-help exercies. The fourth and final book that I will recommend is entitled, "Courage After Fire: Coping Strategies for Troops Returning from Iraq and Afghanistan and Their Families".

2. Find a VA Clinic and get involved in doing individual and group therapy.  There are many VA Clinics in the Southwest Missour and Northwest Arkansas area that offer behavior health assistance either face-to-face or over the internet using Telepsycholgy as a means of deliversing service.  If you don't have a computer and want to do therapy at home you can often use your cell phone for Facetime or just a telephone conversation.  Don'tt hesitate to do this now.  The VA has been overhauled recently and is ready to serve you.  You earned this service so please use it.  By the way, if you don't feel your VA therapist is being helpful to you then ask for another one.  The comfort you feel with your therapist is extremely important in how quickly you recover from PTSD.

3. Finally, please take pride in your service.  When I say to you thank you for your sevice I mean it and so do many others.  It isn't just a ritual like "How are you doing?  Oh just fine thanks for asking".  No, we mean it.  Anyone who is courageous enough to enlist in the military knowing that they could be sent to the front lines of a battlefield and suddenly lose their life is a patriot and we certainly need more citizens like that . For the past 245 years we have relied on people just like you to go out and fight for our country even to the point of giving up your precious life for all of us.  For that I give you my heartfelt thanks.

Thoughts on overcoming the stresses of COVID-19

We certainly live in a difficult time don’t we? The headlines tell us about the catastrophic number of deaths worldwide from the virus, which is now over 144,000 just in the USA. We are bombarded by discouraging news of an unseen danger that is unprecedented in its scope and unknown to science in the nature of its symptoms as well as treatment. The result is that for the first time in anyone’s memory we are all huddled in our homes while consciously avoiding social contact that was normal and comfortable for all of us. The question for me as a psychologist is “What is the best practice to cope with such widespread stress that effects all of our population?”

The first thing that we DON’T want to do is panic! There are very few situations that are best addressed by panicking. Although not everyone in America is panicking there are a large number of citizens who are suffering from COVID-19 related mental health issues. According to a May 26, 2020 article in the Washington Post written by Alyssa Flowers and William Wan approximately one third of all Americans are currently struggling with anxiety and/or depression that is related to the pandemic. They break the numbers down specifically to 10% struggling with anxiety, 9% with depression and the rest a combination of both anxiety and depression. A similar survey conducted by the American Psychological Association put the number for anxiety and depression totals at 11%.

Whether you believe either study, it is a huge problem in our society that is effecting upwards of 30 million Americans and worthy of being addressed. Two researchers writing for the Journal of Trauma Psychology: Shuquan Chen and George Bonanno of Columbia University (https://dx.doi.org/10.1037/tra0000685) studied psychological adjustment and resiliency during the pandemic. They noted that the stress came not just from the numerous unknowns about COVID-19 but the secondary stress of not working or working from home, homeschooling children or helping care for the aged, adapting to financial stress of dramatically reduced income, as well as fear of infection and possibly a painful agonizing death struggling and failing to breathe. Much of their work was based on previous studies of the SARS virus (Boanno, 2008) which was actually more lethal than CoVID-19 and what coping skills worked during that epidemic. Given what is known thus far in their studies the authors believe that approximately two-thirds of all Americans will remain resilient in the face of the pandemic and not just survive but may actually thrive in the fact of this danger.

Several findings from their studies are worth noting:

1. Those individuals who are able to remain optimistic despite the overwhelming negative news were much less stressed than pessimists.

2. Having strong social support and bonding with loved ones as well as friends was also a significant stress inoculative factor against stress. Drawing strength from other’s presence had a significant calming effect on individuals.

3. Staying informed about the details of COVID-19 was important in maintaining resiliency. This meant being current on what was being discovered about self-protection and yet not allowing themselves to be overwhelmed by too much information which would result in an uptick in anxiety and depression.

4. It was also discovered that having a playful attitude of “making the best of a bad situation” was very helpful. Individuals who could employ hobbies and games with their families seemed to fair much better as a result of “play” and distraction.

5. In addition to bonding it was found that building an online social media support group was helpful in building resiliency to stress. The study also found that among those individuals who actually contracted COVID-19 that it was essential that they mobilize social support, increase help-seeking behaviors, and maintain ongoing physical care in order to maintain resiliency. The study also found that maintaining a “flexible attitude” was very significant in maintaining health and resiliency. In other words deciding on an initial strategy (i.e. work from home) but being willing to periodically re-assess the situation and change when it seems to have become ineffective (i.e. mask up and go to the office two days a week).

In a study by American Psychological Association (APA) from the APA Monitor November 2016 issue, Lorna Collier wrote about a case study in which her client, who was brutally stabbed and left for dead, made a long recovery in therapy only to find that she was much improved. She not only recovered from PTSD, but more importantly, her quality of life was much improved in the areas of having a new found personal strength (she was much more resilient than she had previously thought), a deeper appreciation for her gift of life, and a new focus on wanting to give back to and help other people. Researchers Dr. Richard Tedeschi, and Dr. Lawrence Calhoun working with this phenomenon in the work published in 1996 in the Journal of Traumatic Stress have dubbed this result of working through trauma “Post-Traumatic Growth” or PTG. They described positive changes in five areas: Spiritual change, personal strength, a deeper appreciation of life, improved relationships with others and an openness to new possibilities in their lives.

What are some very practical coping skills that we can use to cope with the day to day reality of COVID-19 in our lives?

First of all, we all need to realize that as a nation we have survived national crises that were potentially lethal to every American and yet the United States is still the envy of the world. As proof simply consider how many others wish to immigrate here every year (8 million visa granted in 2019). As a nation, we fought off Nazi Germany, Imperial Japan and Fascist Italy in World War II in battles that claimed more than 60 million lives worldwide. We were totally unprepared for that war, but when Japan attacked Pearl Harbor we attacked back. The U.S. military was able to carry on an all-out war in both the Pacific and Atlantic Ocean as well as in Africa and later the European continent. Less than five years later we had beaten Japan, Germany and Italy to the point that they all surrendered unconditionally to the U.S. A and our allies. How did we do that amazing feat? We pulled together and realized that though we had our differences we’re still all Americans and have a stake in preserving our nation and all that it stands for.

Secondly, we need to take one day at a time and perhaps even one minute at a time. This is often referred to as “Mindfulness” training. It simply means quit worrying about things over which we have very little control and focus where you do have control…meaning what can we do right now? Fundamental to being able to limit our scope of awareness is the ability to self soothe. This means taking the time out periodically in our day to take a few minutes to breathe deeply and remind ourselves that we are doing fine at the moment. Sounds silly that we should want to reassure ourselves of our worth and well-being but it works well and is the foundation of prayer and meditative practices.

Thirdly, it is important to get some sort of physical release from tension. The book entitled “Younger Next Year” by Crowley and Lodge suggest that we can enhance and lengthen our lives by exercising an hour a day has good research support. However, if we don’t have that much time or energy we can all at least take a walk outside (or on a treadmill) in addition to taking up yoga, Pilates, or simple calisthenics. Whenever we physically exert ourselves we literally drain off the tension in our bodies that accumulates during the day.

Fourth, stay focused on achieving short term goals and reward yourself with at least acknowledging that we have accomplished something worthwhile. When I have managed to work on my website (a never ending chore) I acknowledge that I spent an hour on it whether I accomplished all I wanted to or not. There is some important satisfaction on achieving something by spending time on the project even if it isn’t perfect. Having a Fitbit on my wrist has given me some built in goals each day that has allowed me to lose 20 pounds over the past two years by having simple goals and getting feedback each day on my efforts to meet those goals. Over time nothing is more encouraging than meeting a goal and then the excitement of setting up a new goal.

Note: always a good idea to make goals small and achievable so that we aren’t discouraged and give up. Part of setting goals is daring to dream for the future and be specific about what you want to have happen. This is an essential skill that it taught in therapy.

Most clients come to therapy because they have focused almost exclusively on what they did not want to have happen and then spent most of their energy worrying about when this awful future will arrive.

It is much more healthy, and courageous, to dare to dream about a specific set of circumstances that we want for ourselves in the future and then break down the individual steps to make it happen and bring that future into existence. It is especially helpful if we have a faith and relationship with God and that we feel we deserve to be happy, healthy and capable of the pursuit of happiness.

Finally, there is always the option to obtain professional help. At this time in our history that professional help can be easily obtained over the internet via our computer using a variety of platforms (i.e. ZOOM, Doxy.me, Vsee, and Spruce to name a few) and with a variety of health professionals (i.e. psychologists, psychiatrists, social workers, counselors, Nurse Practitioners, physicians, and P.A.s). Telehealth provides the comfort of getting professional help and we never have to leave our homes or our loved ones. It has been proven to be as helpful as face to face contact and infinitely safer in terms of COVID-19. Hopefully this short review will be of help to all of us and we strive to not just survive but also thrive in this challenging time.

Michael Murrell Psy. D.

www.murrellpsychologicalservice.com

July 22, 2020