Posted on by Dr. William Vlach

Negotiating Relationships During ‘Shelter in Place’

What happens when, in this time of pandemic shelter-in-place, one roommate, partner, mate, best friend keeps pushing the boundaries?  “It won’t hurt to …”. “These rules are overdone anyway.”  “They don’t expect everybody to follow them.”  

They are more likely to get in a grocery line even if they are well past seventy.  Or twenty-somethings heading to a beach party.  This can get them in trouble, sure, but here’s the behavior that can get all of us in trouble.  It doesn’t just fall on them, it falls on all.

There are cultural ingredients here—  The American rugged individualist.  Emersonian self reliance and all that.  Independence over interdependence.  In moderation, these traits can be highly effective.  They’ve led to creativity in the arts, sciences, and industry.  Even in this extraordinary circumstance,  individualism  can be an excellent trait— scientific research, creative ways to cope,  the creative and now necessary redesign of social institutions.  

Another dynamic happens for the compliant.  They pretty much follow the rules.  Safer there.  There’s less anxiety on this side of the line.  Perhaps this comes from the ability to visualize the catastrophic results if they, their friends, and/or their family get sick.  They can get annoyed and angry when their roommate, family member, partner pushes the limits.  On one hand this compliance is a useful safety measure, a governor on the system.  On the other, it can become like a harpy, an annoying car alarm that after a while everybody simply ignores.  Ineffective.

Negotiating these two styles is tricky.  Especially in these emergency conditions.

On a microlevel, at home, at one’s apartment, condo, it gets complicated.  These living spaces can be mini safety blankets.  Home Base.  Womb-like.  They also can be toxic pressure cookers.  The lone wolf negotiating with the compliant can disintegrate into a something destructive fairly quickly.  For the independent, their identity is at risk.  For the compliant, their body is at risk.

At worst these two styles simply clash, rotating between anger and hurt, need and avoidance.  The isolation of shelter in place and quarantine decreases the moderating influences of others.  

Some steps toward a shelter in place dialogue: 

1.  Acknowledge our vulnerability and helplessness in this pandemic.  We are all at risk; we are all vulnerable.  Begin the conversation based on honesty rather than contention.

2.  Catch the anger as it arises.   Anger is an expression of frustration and fear.   Giving voice to the underlying feelings allows the other to engage in a non defensive way.  Step back.  Breath.  Beforehand, think through what you want to accomplish in the dialogue.

3.  “You always…” “You never…” These fighting techniques pin the other down rather than open up a dialogue and negotiations.  

4. Make sure you have taken care of yourself before you begin the negotiations.  You are less likely to lay your emotional turbulence on the other.

5. We all need trusted people to check in with in these times.  This can range from a family member, best friend, AA sponsor,  perhaps a common sense work companion.  

6. Sometimes a blow out can be helpful.  Things have finally built up to the point that it needs to be released.  Extended isolation afterward is damaging.  The sorting out of the feelings and issues, the ‘debriefing’ can be a positive payoff.  

7. Cut a deal with your in-house group:  it’s ok to step back from solving these problems.  Long debates typically end poorly.  Keep it short, then move on.

8.  Reach out via social media.  Share your experiences.  Ask what others are doing.  Ask how others are doing.  Join a sing a long.  

9.  Conversely, pull away from the ongoing interactions.  Be by yourself for a bit.  Meditate. Draw.  Fix something by yourself.  Dance in the mirror.

10.   As Nelson Mandela said—“Resentment is like drinking poison and then hoping it will kill your enemies.”   

Go easy, folks.

Posted on by Dr. William Vlach

Psychological Reactions to Covid 19

There’s a lot of theories of psychology.  If I tried it enumerate them, the list would  long.  The one that comes to mind when looking at folks’ reaction to this pandemic, including my own, is attachment theory.  See John Bowlby, Mary Ainsworth, and others.

This approach suggests there are different ways we attach to loved ones early on, and then how we relate to the social world as we grow older.  These patterns of behavior are broken into four approaches: Secure, Avoidant, Anxious/Ambivalent, and Unresolved/Disorganized.

Let’s see how these might line up with one’s relationship to the Covid-19 pandemic, especially in terms of living with the unknown, ‘shelter in place,’ and mortality.

Secure:  I am not easily frightened, am not particularly worried about being abandoned or fearful in matters of intimacy.  In chaotic and frightening situations, one can expect a reasonably resilient response.  Of course, this person can become upset, but there is shorter recovery time.  The deep enclosure of quarantine and mandated social distance from some and in house physical intimacy with others are problematic, but the problem solving skills of the securely attached come to the fore.  This is an autonomous reaction.

Avoidant: I am nervous in close contact with others, I don’t like to trust others, and I really really don’t like to depend on others.  The avoidant’s response is to be dismissive.  Each new situation for the avoidant becomes a challenge to maintain independence and self reliance.  Because this pandemic has so many unknowns and has jammed roommates, friends, and family members into close quarters, the style’s response would be to retreat and be dismissive of the dangers and seriousness of this pandemic.  This retreat would look like isolating and/or anger if pushed to interact.  In response to the pandemic, their avoidance could lead them into a “Minimizer” approach.  

Anxious: The anxiously attached are preoccupied with their relationships.  Constantly worried about the stability of my social world, I anxiously want social contact and reassurance, and am disappointed and hurt if that reassurance does not arrive.  This attachment style would feel highly pained that we are now mandated to have ‘Social Distance.’  Here, anxiety and preoccupation would be the key themes— worry about family, friends, the world.   Of course, one must be concerned about these, but to be effective in this global crisis, it is crucial to recover from the worry and be able to manage the problems.   In response to the pandemic, this anxiety could lead them into a “Maximizer” way of coping.

Unresolved/Disorganized:  Typically, this attachment style is a result of trauma and chaos.  Here there are tremendous swings of sense of identity, intense inner chaos, and extremes in differing responses to the world.  Coerced quarantine and the lack of safety would suggest a fair amount of disruptive actions for this person and some amount of distress for those in close proximity to them.

These attachment styles are vastly general, but they are a way to think through our own reactions to this rapidly changing and frightening world.  They can also be signposts for healing change.   More about that next time.

Go easy, folks.

Posted on by Dr. William Vlach

First Responders in the Time of Covid-19

Medical Personnel, Cops, and Firefighters know how to steel themselves against their natural feelings.  They have to.  Who else would touch someone with a disease that could kill you and your loved ones?  Run into a fire when everybody else is running the other way? Run toward gun shots?   This ability to hyper focus on the task at hand is both a gift and a curse.  The gift side of it allows for the rest of us to live a reasonably secure life.  The gift side of it allows the cop to wrestle down an inflamed meth addict before he attacks a citizen.  This is the job.  These well trained first responders live in a complicated world.  The downside, the curse if you will, is it takes a toll on the body, the psyche, the social life, and the family.  

The ongoing stress of the job blows up in times of community crisis— long hours, separation from loved ones, an inability to ‘let go’, to work out, to joke around with the dark humor that makes the job easier.  I saw this in the 1989 Loma Prieta  Earthquake.  Some of the debriefings showed that much of the stress first responders felt was the inability to connect with their families.  All of this is exacerbated by the loss of sleep, the continual facing of a situation that seems out of control, inability to have a regular meal, and the frequent upper administration flubs.  

Based on that experience and 40 years of clinical work with first responders, here are a few thoughts on first responder psychological survival in this time of Covid-19.

Ten things that will get you in trouble:

  1. Lots of coffee to rev up; lots of booze to calm down.
  2. 24/7 on top of the news
  3. Anger at the family and friends that they ‘don’t get it.’ (Don’t understand the seriousness of the pandemic, or massively overreact to it.)
  4. Impatience and then pulling back from family and friends.
  5. Random sexual activities.
  6. Stopping the workouts.
  7. Eating everything in the room; eating nothing in the room.
  8. Taking on lots of extra duties.
  9. Ignoring your body.
  10. Not reaching out.

Ten things that will help:

  1. Work out.  
  2. Reach out.  
  3. Cut the family some slack.  Takes civilians a while to catch up.
  4. Stop and check out what’s going on with your body.
  5. Take a break from the news.
  6. Pray, meditate, or simply breath— deeply and slowly.
  7. If you start to get into trouble (exhaustion, numbness, insomnia, feeling other’s trauma is yours), connect with your close friends, peer support folks, or your organization’s stress unit.
  8. Work with your family and/or friends to create a strategy for the worst case scenario, then let go.  
  9. Remember your supervisors are stressed and confused like everybody else.  Keep your expectations low.  Be clear on your boundaries and role, but, paradoxically, add creativity to the work.
  10. Most importantly, remember that you can’t take care of anyone else unless you take care of yourself.

Go easy, folks

Posted on by Dr. William Vlach

Stepping up to the fear

The phrase “If you’re not afraid, you’re not paying attention” has been around in various forms for twenty or thirty years.  In this era of Covid 19, we can’t not pay attention as much as we might like to.  We have to pay attention:  shelter-in-place, lock down, quarantine, all the usual social gatherings banned.  We get it.  But, along with the obvious economic stress, there is the enforced intimacy of family, friends, roommates, or the pain of a single living alone.  Throw in the constant reminders of illness, mortality, and the unknown.  Here you have a perfect storm for stress, anxiety, worry.

Let’s take a look at some practical steps we can take to ease up these fears.

1.  Take a break from the bad news.  The constant stream of political-medical information is compelling and helps us prepare and strategize, but an overdose leads to extra shots of adrenaline.  This can become addictive, then counterproductive.  The trick is ‘switching channels.’  It’s hard to just turn it off.  One way is to have something to turn on: music, favorite TV show, good movie, bad movie, face time with a friend, a book, cooking.  

2. Go outside.  The typical rules in a ‘shelter in place’ situation allow for outside walks, exercise, bike riding.  Just stay six feet away from folks.  Ideally, this would be a walk in the park, noticing bird songs, new flowers, the steady trees.  

3. Meditate.  This is a proven method to deal with both anxiety and depression.  Check on these apps:

Kaiserpermanente reviewed meditation apps:

14 meditation & relaxation apps reviewed

And these are UCSF resources for mindfulness apps:

https://studenthealth.ucsf.edu/stress-tool-kit-and-resources

And here is a discussion on other ways to sort through other possible responses:

https://www.kqed.org/science/1959292/controlling-the-double-whammy-of-anxiety-and-isolation-heres-what-you-can-do-%E2%80%A8

4. Go easy or yourself and others.  We all have different ways of dealing with this.  Our family, friends, roommates, guaranteed, will have other approaches.  The time we are in requires thoughtful negotiations.  If it starts to get heated, back off with a comment that we can continue this later.  Same goes for the self.  We are all used to ‘taking care of business.’  That’s how we got to where we are.  Time to be gentle.

5.  Stay in contact.  Defy the isolation by contact.  Family, friends, workplace colleagues are available by phone, email, text, FaceTime, video conferencing.  A family member or an old friend where there was a falling out?  Good time to call.  There are profoundly creative way being developed to help us with this.  I’d bet these will increase as we go.  It is the human yearning for connection coupled with creativity that will get us through this.

6. Workout.  Your apartment, your house, is a gym.  Stairs are really a stair master.  There’s the floor: push ups.  Yoga on the rug.  

7. Schedule something everyday.  Some of us need a higher degree of structure than others.  Getting a task list gives us both direction and goals.

8.  Try something new.  Poetry, painting, gourmet cooking, house project, singing.  

There are other psychological creative ways to deal with this global mess.  For some, it may be helping a neighbor’ others political activism, and others having spiritual approaches.  

Most importantly, go easy, folks.