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The Corona virus can affect us physically, emotionally, economically, socially, psychologically.

When we are facing any type of crisis, fear and anxiety are inevitable, normal responses to uncertainty and threatening events.

It’s very easy to get lost in rumination and worry about all kinds of things that are out of our control; what may happen in the future; how we and our loved ones might be affected; how our community or the world around us may be affected and so on.

The following tips may help us all to cope with living with Covid-19/ the Coronavirus

Focus on what is in your control

While it is natural to feel anxious and to worry, focusing too much on the things we cannot control can increase our anxiety and helplessness. So the single most useful thing we can do in any type of crisis, is to focus on what is in our control.

Acknowledge thoughts and feelings

Silently and kindly acknowledge whatever is showing up inside: thoughts, feelings, emotions, memories, sensations, urges.  See if you can be curious about these reactions rather than immediately responding to them, gently observing them with curiosity.

Come back to the body

While observing our inner experiences, see if it is possible to bring attention to what is happening inside the body, physically.  See if you can bring attention to these things without attempting to change them:

  • the physical sensations of your feet on the floor
  • the sensations at the points of contact your body is making with the chair
  • the sensations of sitting in your posture, areas of tension
  • the physical sensations of the breath as you breathe in and out. Perhaps following the breath from the tip of the nose, all the way in through the mouth and down, all the way to where the in-breath ends; and then following it all the way out again.

Engage in the present

Get a sense of where you are and refocus your attention on your surroundings in this moment.  You could try these tips to help you do this:

  • notice 5 things you can see around you
  • notice 3-4 things you can hear
  • notice what you can taste in your mouth
  • notice any smells around you
  • notice the physical movements in your body as you continue with the tasks you are doing in hand

Committed Action

Doing things that matter most to us can maintain our moods and bring about a sense of wellbeing.   Are there things you have been meaning to do for some time, but you haven’t had the time to get around to?  Now could be that time – re-engage in things you used to enjoy, learn a new skill, have a sort out, or simply refocus on your wellbeing.

What simple ways can you look after yourself, those you live with, and anyone you can realistically help?

Throughout the day, ask yourself, “what small step (no matter how small) could I take to look after myself,  others around me?” and then engage in that activity fully and with all of your focus.

Opening up

Make room for difficult emotions that are around you and be kind to yourself when they show up. These times are anxiety provoking and stressful for many of us and this comes out in different ways, such as anger, sadness, loneliness, guilt, confusion, fear and many more.

We can’t stop uncomfortable emotions from showing up, so instead of squashing them down, see if it possible to allow yourself to experience a little more of them than you might normally, even though they are difficult.

Treating ourselves and others with kindness and with an understanding that these times are difficult and we are doing our best to cope, is really important for our wellbeing. Self-kindness is important in caregiving to others.  If you have travelled by plane you’ll be familiar with the advice to put our own oxygen mask on before we can help others.

Values

Taking committed action in line with our values has been scientifically proven to boost wellbeing. Some of your values may include humour, respect, honesty, caring, love, compassion, patience, kindness. 

What sort of person do you want to be as you go through this crisis?  What do you stand for in the face of this? How do you want to treat others, your neighbours, yourself? 

What are the kind, caring ways you can treat yourself, your family, neighbours, community.  When you look back on this crisis, how would you like to be able to describe your actions?

Identify Resources

Identify resources for help and assistance, support and advice. Who can you speak to in your friends, family, neighbours and health professionals or emergency services. 

Make sure you have a list of emergency helpline numbers, including psychological help, that you or others can access easily if needed.

Can you be a resource for others?  If so, let them know.

Disinfect and Distance physically

Of course, wash your hands! And keep 2 meters apart from anyone when leaving the house.  These simple steps save lives.

Acknowledgements: Dr Russ Harris, The Happiness Trap & CNWL

An interesting article published in the Guardian by Daniel Freeman and Jason Freeman

“Everybody has won and all must have prizes,” declared the dodo in Alice in Wonderland when asked to judge the winner of a race around a lake. As judgements go, it is admirably even-handed and optimistic. But in the world of mental health the dodo’s decision has come to symbolise a bitter dispute that strikes at the very heart of psychotherapy.

The “Dodo Bird Verdict”, first suggested in the 1930s by the American psychologist Saul Rosenzweig, proposes that the many and various forms of psychological therapy are all equally effective. It makes no difference whether, for example, a person is being treated with techniques drawn from psychoanalysis, neurolinguistic programming, or cognitive behaviour therapy (CBT). What really helps a patient to recover are straightforward factors such as the opportunity to discuss their worries with a skilled and sympathetic therapist or the degree to which they are prepared to engage with the treatment.

Understandably, the Dodo Bird Verdict has ruffled many feathers within the profession, and provoked a slew of studies aiming to corroborate or disprove the idea. Are some types of psychotherapy really more effective than others for particular conditions? There is plentiful data to suggest that the answer to that question – contrary to Rosenzweig’s theory – is “yes”. But that data tends to come from research conducted by proponents of the ostensibly superior therapy, leaving sceptics to conclude that their conclusions are not impartial.

This makes the results of a study of treatments for the eating disorder bulimia nervosa, published this month in the American Journal of Psychiatry, all the more convincing. Bulimia is characterised by binge eating, followed by attempts to compensate by making oneself vomit, taking laxatives or diuretics (water tablets), fasting, and/or exercising frantically. Underlying this behaviour is an intense concern – an obsession, even – with body shape and weight.

Bulimia is relatively common. One large US study, for instance, found that almost 1% of adolescents aged 13-18 had experienced the condition at some point in their life. Many of these teenagers reported that their illness made it very difficult for them to have a normal life, and it damaged their relationships with family and friends. The study also found that adolescents with bulimia were more likely to consider, or even attempt, suicide.
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Given bulimia’s prevalence and potentially disastrous consequences, it is clearly important that we understand what treatments work best, which is why researchers at the University of Copenhagen recently compared the efficacy of two popular psychotherapies: CBT and psychoanalysis. The results were remarkable.

In the study, 70 patients with bulimia nervosa were randomly assigned either to two years of weekly psychoanalytic therapy or 20 sessions of CBT spread over five months. At the core of the psychoanalytic approach is the idea that bulimic behaviour represents an attempt to control problematic feelings and desires. The therapist helps the client to talk about these buried feelings and to understand how they are related to the bulimia. And when the individual has learned to accept and manage their deepest desires, the theory goes, the distress disappears and with it the symptoms of bulimia.

CBT, on the other hand, is targeted at the symptoms themselves: the aim is to stop the binge eating as quickly as possible. For CBT practitioners, bulimia is driven by the belief that one’s self worth is determined by one’s eating habits, shape and weight. Therapists show the individual how to identify and challenge such beliefs, explain the cycle of binge eating, and promote regular eating patterns and a more flexible and realistic set of dietary guidelines. They work with the patient to devise plans to deal with times when binge eating becomes more likely, and to minimise the likelihood of a relapse.

Even though the participants in the Danish trial received vastly unequal amounts of treatment over an extended timespan – with those given psychoanalysis seeing their therapist far more than those allocated CBT – it was CBT that proved more effective. After five months, 42% of the CBT group had stopped binge eating and purging; for those receiving psychoanalysis the figure was just 6%. After two years, the proportion of the psychoanalysis group who were free from bulimia had risen to 15%. But this was still a long way short of the success of the CBT group after two years (44%), despite the fact that by then it was 19 months since the end of their course of treatment.

The Danish trial gives real grounds for hope: CBT, it seems, can bring about major improvements for many people with bulimia. But the significance of the study goes further, because its leaders, Stig Poulsen and Susanne Lunn, are not CBT specialists but highly experienced psychoanalysts. Indeed, not only was the research conducted at a clinic devoted to psychoanalysis, the course of treatment was developed by Poulsen and Lunn themselves.

Even more remarkably, though the CBT therapists received two days of special training and regular supervision from a world leader in CBT for eating disorders, they were less experienced than those responsible for the psychoanalytic treatment.

Despite all this, CBT easily came out on top. As an editorial in the American Journal of Psychiatry commented: “we applaud the candor of the lead investigators for being so forthright in their presentation of the findings. This cannot have been what they hoped to find and indeed was not what they hypothesised.”

So when it comes to psychotherapy, it seems the dodo was wrong. While short-term treatments may produce similar results for some illnesses, such as depression, we shouldn’t assume that the kind of therapy patients receive is essentially inconsequential. Instead we must recognise that some are better for certain conditions than others, redouble our efforts to identify these and improve them, and ensure that the most effective therapies are available to all who need them.

Daniel Freeman is a professor of clinical psychology and a Medical Research Council senior clinical fellow in the department of psychiatry, University of Oxford. Jason Freeman is a psychology writer.

Time and time again, as I help people tackle lifelong issues with procrastination, I find the same thing: the first five minutes of anything is the hardest part. People who often put things off until the last minute… or worse, have the most difficulty with getting started. About 4 out of 5 people who procrastinate find that just working on this one piece of the puzzle solves the majority of their procrastination problems.

Procrastinating in some way is a natural tendency. We avoid doing what we anticipate will be unpleasant. Avoidance provides a sense of relief from what we don’t want to experience. The more relief we feel, the more often we avoid. Ultimately, this can lead to a strategy in which avoidance is the sole component, which can be very problematic. Moreover, the longer we avoid a specific task, the more anxious we feel about continuing to put it off. The more anxious we feel about it, the greater the urge to avoid. It’s a negative feedback loop that for many people, can easily spiral out of control. Increasing the ease with which you start a task can do some serious damage to this procrastinating cycle. Enter the 5-minute rule.

The 5-minute rule is a cognitive behavioral therapy technique for procrastination in which you set a goal of doing whatever it is you would otherwise avoid, but only do it for five minutes. If after five minutes it’s so horrible that you have to stop, you are free to do so. Mission accomplished. Done. However, what most people find is that after five minutes of doing something, it’s easy to continue until the task is done. Setting the intention and starting is usually the hardest part. By thinking about the task as something that may take only 5 minutes, it feels much less overwhelming and a lot more doable. Consequently, there’s little reason to procrastinate.

Katherine Burkinshaw will soon be opening a new CBT Therapy and Counselling Clinic in Hythe, Kent.

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