Independence, Interrupted
by Deborah J. Cohan, Ph.D.
 https://www.psychologytoday.com/us/articles/202007/together-again
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COLLEGE, ESSENTIALLY, is all about individuating from one’s family of origin and forging a new path. How is that going now that most students are trying to do college far away from campus? For many, not very well.

“When you think of college you don’t think of sitting at home with your family all day,” my student Eliza* tells me. “There is no freedom. I have all the same rules and restrictions I had before. I went from being independent right back to high school.”

It’s not that life at home is necessarily bad, although it certainly can be for students with a difficult relationship with their parents. It’s that this is not how it was supposed to be. Students had made the transition to adulthood and put their childhood behind them. Now it’s in their face, along with the awkward reality that their parents may have begun to move on from those days as well. “I feel as if I don’t belong,” Eliza says. “The bedroom that was once mine is now decorated as a beachy guest room. It makes me sad when I reminisce about the days when I was in high school and had pink walls and glitter lamps and postcards and Polaroids decorating the whole room.”
College is supposed to be about educating a new citizenry and socializing for, and toward, hope. A sixty-something friend and fellow academic, Kathryn Feltey of the University of Akron, recently posted a photo of her 18-year-old self online with the caption, “I am leaving my childhood behind as I search for my life and who I will be.”

This is a generation of students now blocked from taking those steps. The various crises in which they have come of age have never made it easy. Toddlers in 2001, they have been largely over parented in a culture of fear in which worries have ranged from terrorism to school shootings. Conversations about safety and protection dominated their childhood. They emerged from it all more tethered, less comfortable with solitude, and by all accounts lonelier. After growing up hyper scheduled, they demonstrate less ease with creative risk-taking and unstructured assignments.

They want to live out Feltey’s ethos but also feel rigidly confined. The generation that might have the most to gain from firmly breaking away from their families of origin have been driven right back, where they are likely experiencing a resurgence of surveillance.
College students returning home may have expected that their parents would acknowledge a changed dynamic and respect their privacy, but for many, the reality has been disappointing. Eliza tells me that her mother has been scrutinizing her every move, from whom she texts to what she eats to what she watches on Netflix.

Some parents who grew used to monitoring their children’s academics seem to forget that their kids have been doing it on their own for quite a while; others, relieved to be unburdened of responsibility for their children’s grades, have become distractions. “My parents do not fully understand the quiet I need to write a paper or take a quiz,” Tess* says. “I was working on a project, and my mom walked in the room in the middle of an interview. I even explained to her what I was doing and asked her not to bother me, but she still proceeded with the conversation.”
 
If the dynamics of sheltering in place are awkward, though, students have to bear some of the blame. Specifically, a childhood spent allowing their parents to do everything for them is coming back to haunt some. “When I come home for school breaks, I’m used to not doing anything productive and letting my mother do everything for me,” Eliza admits, “from making my bed to making my coffee and doing my laundry.” Now, her mother questions why she drinks so much coffee and sleeps so much.

Even those who may appreciate the comforts of home overwhelmingly strive to recover the freedom they’ve worked hard to achieve. “I love being with my family, but I can’t do this every day. I feel trapped and irritable,” Faith* says. “I actually miss the uncertainties of my college life. I had something to look forward to every day.”

“It feels like I’ve reverted back to high school,” says Sydney Ocampo, 20. In December, she came home to West Suffield, Connecticut, from New York University Shanghai to spend holiday break with her parents, George and Karey. When conditions ruled out a return to China, she was able to shift to NYU’s Manhattan campus. After six weeks, she returned home to finish the semester remotely. “I'm technically independent here, but I can’t go anywhere. My mom says that when I was at college I talked to her more than I do now. I was calling her once a day or every other day, mostly just to complain. Now there’s obviously a lot to complain about, but there’s not much to update her about. Without the structure of class, I’m really just not doing much.”

Untenable Situations
Some family situations pose sterner challenges: Megan*, for example, discloses that between her hypercritical mother, who slams her appearance and tells her she needs to lose weight, and the presence of her alcoholic stepfather, she feels trapped, insecure, and depressed at home.

Other students can’t even go home. Having grown up in an abusive family where he sometimes fantasized about death as a route to happiness, David* successfully petitioned to remain in his dorm, but he knows that’s only a temporary fix. “I have been thrust into an unknown world before I was prepared for it,” he says. “I have no money, no job, and my housing situation is not sustainable.”

Despite a loving but now long-distance relationship with Faith, David says, “Daily life is unrecognizable. I have lost hope, drive, and motivation. I go to bed in the early hours of the morning, sleep until noon, wake up, eat, and climb back into bed, only to emerge a few hours later to eat again. I feel my mental health is deteriorating.”

I identify with his fears; had I been forced to return home because of a pandemic while I was a student, I would have been terrified of witnessing my parents’ blowout fights; the stress of their marriage became even more apparent to me once I left for school. Going to college, for me and so many others, has been a ticket to a new life, a new place, and a new self.

Campus becomes not just a new home, but an oasis where we can grow intellectually, emotionally, politically, sexually, and creatively. The forced return to families of origin, Eliza says, “stifles the newly discovered parts of us. Those of us who have been kicked off campus and have smothering parents are forced to hide what we have discovered with higher education.” For David, “College gave me a sense of self-expression, freedom, and independence from the constant fear that had shackled me my entire life.”

How parents handle this sensitive moment—ideally by allowing their children to do the serious work of becoming an adult—will have a tremendous effect on how a generation is able to move forward whenever campus life resumes. College is a dwelling of, for, and about hope. Conversations with my students tell me that overall, the kids are all right. But they’ll be much better off when they can truly fly back toward that structure of hope.

​A 30-Minute Morning Routine that Will Clear your Mind and Banish Stress   
What you do the moment you open your eyes has more impact than you may think on setting the tone for the day.

By Nicole Spector
Better by Today
​https://www.nbcnews.com/better/health/30-minute-morning-routine-will-clear-your-mind-banish-stress-ncna911146

Morning routines can be a struggle even for those who are naturally “morning people.” If you’re facing a busy schedule and/or managing a family, the impetus to get up and get going stat can be extreme — but for an optimal day of productivity and positivity, it’s best that we take some time to ground ourselves and start the day on a good note.

How much time? While it does depend on how early you rise and what sort of relaxation methods you prefer, we’ve determined, through conversing with mental health experts and life coaches, that a half-hour should do the trick.

We’ve broken this 30-minute routine into two, five- and 10-minute intervals. Here’s what to do, starting with the moment you open your eyes to get your day on the best possible track. You can do this all before a workout, shower and breakfast, or build these activities around those essentials.

First two minutes: Positive thoughts and no phone
Many of us (myself included) use our phones as our alarms. That’s fine — so long as you can resist the urge to read any missed messages or emails once you’re awake. If not, get an old-school alarm and keep your phone elsewhere. It’s critical that you’re not distracted at all during this routine.

“That split second when you wake up counts the most, because right then and there you can set the tone of your new day for how you want it to be,” says Jacqueline Pirtle, an energy healer, mindfulness-happiness coach, and author of “365 Days of Happiness: Because happiness is a piece of cake”. “Your first thought should be something like, ‘this will be and is already the best day ever,’ or ‘I am healthy, abundant, successful and happy,’ or ‘life loves me,’ and so on.”

These thoughts may not come automatically to you in the morning, so try rehearsing them while falling asleep the night before.

Next five minutes: Mindfulness techniques and deep breathing   
Next, implement some mindfulness techniques to clear your mind. This can be in the form of meditation, prayer or affirmations of gratitude.

“I recommend that all my patients engage in some sort of meditation or prayer first thing in the morning,” says Dr. Nicole Bernard Washington, a board certified psychiatrist and the chief medical officer at Elocin Psychiatric Services. “The benefit is to clear your thoughts and allow you to start the day with a clear mind.”

“Gratitude affirmations are a great way to start the day as well,” Washington says. “By starting the day making gratitude statements you allow yourself to focus on the positive things in your life. In a world that tends to highlight the negative, starting your day off on a positive note can have positive effects on your mood.”  You can also incorporate breathing exercises to help achieve clarity.

“While laying in bed, breath in through your nose, hold it for five seconds and then release the air through your mouth,” instructs Dr. Erlanger ‘Earl’ Turner, a licensed clinical psychologist and assistant professor of psychology at the University of Houston-Downtown. “Repeat these steps several times. It should help to relax the mind and body.”

Spend five minutes journaling, which can also be done in bed.  The urge to pick up your phone or laptop is probably powerful now, but hold off for just another five minutes and instead take to pen and paper (ideally you should keep a journal on your nightstand).

Christie Tcharkhoutian, M.A., MFT, a licensed marriage and family therapist finds “writing upon waking” to be beneficial.
Writing continues that creative flow from your dream life into your day as opposed to automatically waking up and looking at your phone, which can put a creative block and interfere with your ability to stay present.

“Some brain research suggests that this practice is helpful for brain integration because it helps to integrate parts of the brain that involve linguistic and creative capabilities, setting a tone of creativity and balance for the rest of the day,” she says. “Writing something positive — such as three things you are grateful for or a positive intention for the day — can help to improve mood throughout the day. Our dream life and subconscious work overtime in our sleep and channeling that stream of consciousness as soon as you wake up into writing helps to feel more connected and mindful throughout your day. Writing continues that creative flow from your dream life into your day as opposed to automatically waking up and looking at your phone, reading and consuming information which can put a creative block and interfere with your ability to stay present throughout the day.”

If journaling isn’t your thing, listen to positive messages you recorded Journaling may be a practice you’re not into, or prefer to do at night. If either is the case, consider making a recording of yourself reading daily affirmations aloud and listen to them instead.
“To implement daily affirmations into your morning and set an intention by reading them aloud to yourself, or listening to a recording of yourself reading them every morning,” says Tcharkhoutian. “If positive statements about your identity are replaying like a broken record, they will combat the negative beliefs that can creep in and sabotage your day.”

Spend 5 minutes writing down the essential tasks for the day.  Once you do the aforementioned practices, you can get down to the business of the day — but before your mind starts buzzing with to-dos, use these five minutes to itemize, prioritize and be super specific with what you want to achieve today in list form.

“Don’t just [write] ‘check emails.’ Write down, ‘check 20 emails in 30 minutes from x to x time,” says Stephanie Lincoln, a licensed mental health counselor, certified fitness trainer and the Founder/CEO of Fire Team Whiskey. “We all have hundreds of items on our to-do lists, and this helps us prioritize just five essentials for that day to not feel so overwhelmed.”

“Make sure your essential tasks are focused on your current priorities,” adds Lincoln. “We all suffer from ‘shiny object syndrome’; the thing that is the loudest and most flashy is the thing we will focus our attention on, but step back and ask yourself, ‘Is this really a priority, or is it just the most appealing one I want to work on because its shiny?' Identify the one task you are dreading the most and make that #1 on your list. Get that done first because most likely, the most dreaded task is usually the most important one.”
Check off each item as you go through the day so that later you, you can relish the accomplishments.

Ten minutes: Time with family (including pets)
You’ve now devoted 17 minutes to grounding yourself, meaning you have 12 minutes left. Now is the time to enjoy quality time with family.

“Set aside ten minutes for family,” advises Forrest Talley, Ph.D, a clinical psychologist. “Parents with young children will find this challenging in that they are busy getting them into their school clothes, organizing school lunch bags, etc. But for those with teens, or empty nesters, this can be a great time to connect before the business and stress of the day take on a momentum of their own.”
If you have pets, make them a part of this time.

“The bond between [pet] owners and their pets is often very strong, and a source of significant happiness,” says Talley. “Including a little quality time in the morning insures this bond is not neglected.”

What to do with those two extra minutes? You shouldn’t have a problem using them now that you can get your phone back.

It was five o’clock on a lazy Sunday afternoon two weeks into pandemic lockdown in Oakland, California, and Keeley Mooneyhan was binge-watching movies in the family room with her daughter, newly COVID-furloughed from college. Mooneyhan herself was semi-quarantined, having recently returned from a trip to Africa. Suddenly, her husband appeared in the doorway, looking lost in his own home. Even the words he issued seemed to come from a distant place: “My sister’s gone,” he said. “She’s dead. We don’t know what happened. That’s all I know.”
Raw and shocking, the news drew the three into a long, emotional embrace that dissolved only when Mooneyhan moved to lay some groundwork for grieving. There were just so many layers of loss; the woman who died so suddenly was not only her husband’s sister and her daughter’s aunt but also her own best friend from college, the one who had introduced her to her husband in the first place. Every one of those now-ruptured links was exposing the normally unimaginable fragility of life.
Mooneyhan, who runs a boutique mergers and acquisitions consultancy, first had to face the challenge of getting to the funeral, across the country in South Carolina. It took days to reach the difficult decision that gathering with extended family could be more curse than consolation, possibly compounding the loss, certainly adding to upset by potentially exposing all to the novel coronavirus during travel and transfers. Even if Mooneyhan’s family took the risk, there was no guarantee that they could get back home; California was set to impose restrictions on movement. A service in South Carolina was planned to be conveyed by camera from the funeral home, but it was not interactive. Mourners could observe the event from afar, but not share memories or musings.


Unable to assemble with others pained by the loss, struggling to understand the sudden death, feeling the acute awkwardness of asking disquieting questions from afar, Mooneyhan and her family settled into an uncomfortable state of estrangement from events. All the anomalousness shrouded the death in disbelief. “What you’re trying to do is get some human understanding here,” says Mooneyhan. “Having so many unanswered questions and the filter of distance make the death feel like a bad dream. It could just be that we’re in a prolonged nightmare together.” She is certain that the death will become more real when they eventually gather with her husband’s family. “Then we can have the kinds of conversations that allow you to heal together.”
Grief has always been a difficult emotion in America, disenfranchised in a culture fixated on happiness and positivity. But the COVID crisis has thrown into bold relief what happens when grief has literally nowhere to go, when for any reason at all it is deprived of expression—especially now, when the public good discourages even small gatherings and condemns companionship, that most human of antidotes to raw absence.
The pandemic has also forced into the open the awareness that there are a multitude of losses that garner no memorial placard yet beg for acknowledgment and attention—from the extraordinarily abstract loss of certainty and security to the more concrete loss of a business or a job, without which so many also lose that most ethereal but essential of things, their identity. Then, too, there are feelings of sadness or slowness that are not even recognized as grief, because disruptions of life can disorient anyone, and there is nothing specific to pin that mood on. Nor are there rituals or routines through which to channel grief for such losses. And so, for many, grief itself goes underground, where the pain of loss cannot be ameliorated or probed for meaning, as it must, and, too often, lurks in the shadows as a sense of alienation.


Pathways of PredictabilityAny loss presents a big challenge, affirms psychiatrist Wendy Dean. The compound losses occurring now add to that. “We don’t do a good job tolerating loss or discomfort of any kind,” observes Dean, who runs the organization Moral Injury in Healthcare. “We tend to look away from it. It’s hard to sit with it and process it. Our everyday rushing leaves us no time to assess what we really want, and now we are all being asked to reassess our priorities and values. How do we relate to loved ones versus material possessions? What are the things we value most?”
With two sons on the cusp of adulthood, Dean is particularly concerned about the many young people who have been deprived of the experience of graduation ceremonies this year. According to the National Center for Education Statistics, that’s approximately 1 million candidates for an associate’s degree, 2 million for a bachelor’s degree, and just over a million for an advanced degree. “You graduate to a job, to getting an apartment,” observes Dean. “These students are not just missing out on a ceremony. They’re losing a predictable pathway to finding a future.” The loss of predictability may be one of the most unsettling experiences of all.
In addition to the collegians, there are the 3.7 million who were scheduled to graduate from high school this year. Max K. is one of them. He was happy at the prospect of leaving home in Michigan for college. But before he found out that he was accepted at every place he applied, graduation disinvited him. No ceremony. No celebration. No pranks. And of course, no prom. He felt sad, he says, about not having a formal graduation—but then he stops, and after a long moment, he adds that he feels guilty for saying so because so many people have died from coronavirus infection.
There’s plenty of reason to feel personal privation over the absence of graduation ceremonies. After all, they’re an emblem of achievement, an opportunity for accolades, an occasion for pride. Life needs such events under all circumstances. Also they’re a milestone of maturity, and taking the time to acknowledge them as such works as a kind of push-off to the challenges ahead. The future feels less certain, more rocky, without the landmarks.  
Of course, Max knows that his life will go forward, that he has a future, if with a little less clarity for a while, because he did what loss forces us all to do. It compels us to reflect on what is meaningful so that we can emerge with a perspective on life that more closely fits the new realities created by the loss.
Name the PainFor the first time in the lifetimes of so many, the entire world is in communal grief. “We all lost what we thought our life would be on a day-to-day basis,” says New York psychologist Susan Birne-Stone. “There’s so much devastation right now that you just have to take a moment to acknowledge your own pain: I’m allowed to feel what I feel. Then it’s necessary to understand what’s lost and to name it.” Yet, like other psychotherapists around the country, she finds that clients are experiencing such a pile-up of losses that it is hard for them to identify and articulate all that is missing.
But once they do, they are able to know what’s required to make life feel whole again. Or to take any number of measures, from deep-breathing to writing, to self-regulate their feelings. What makes the abstract losses so challenging is that it’s difficult to know what action to take. But only then, says Birne-Stone, can anyone move on to thinking about what’s ahead. Of course, life can never be whole again the same way. “It might even be better,” she notes. “But at least you know what your life needs.”
When orders to shelter in place were enacted in urban areas, a client of hers became one of the many who were able to maintain their job and their income by working from home. Yet the man found himself increasingly unhappy. It took a couple of conversations to recognize that he was missing his daily commute. He lived alone, and his regular trips to and from work were important points of socialization.
It might mean nothing to someone else or even be an annoyance to others, says Birne-Stone, “but if a commute is your only social event of the day, it can be a significant loss.” It’s that identification, the understanding of exactly what is lost, that allows replacement in a fulfilling way—rather than with food, or drugs, or work. While loss is universal, grief is always individualized and idiosyncratic, even with the death of a loved one. There’s no formula determining which facet of an event or person is missed the most. Each life fits itself to experience in its own way.


Pain vs. SufferingTo deny the feelings of loss that suffuse so many lives right now, or to deny the validity of those feelings, she observes, risks turning pain into suffering. Pain is an unavoidable signal of distress that gives the lie to the mind-body divide: It’s an inextricable mixture of biological and psychological sensations in response to harm, and the perception of pain is influenced as much by cognitive and cultural factors as by purely neurological ones.
Suffering, on the other hand, is solely psychological, a product of the existential meaning we give to the experience of pain. As the Japanese writer Haruki Murakami succinctly puts it: “Pain is inevitable. Suffering is optional.” Unless acknowledged, says Birne-Stone, the pain of loss just festers within and, absent conscious awareness, subverts decision-making and every other element of functioning.
Grief gives us a job, says George Bonanno. It’s a command to slow down, to turn inward, and to recalibrate living in a world without—without our partner, without our friend, without our plans, whatever it is that’s gone. “You can feel grief for anything that is part of your identity,” says Bonanno, a professor of psychology at Columbia University Teachers College, where, as the head of the Loss, Trauma, and Emotion Lab, he studies how humans cope with loss and extreme life events.
Another distinguishing feature of the ongoing pandemic is that there is no way to know what will be permanently lost. New York psychotherapist Esther Perel sees an “invisible current of dread” running through lives right now. “We want to know: Will we ever be back to normal? When can I see my friends again? When will it be safe to open my business?”
That so much is in flux makes any loss even harder to bear, Bonanno says. “You have both the fear that your loss of livelihood is permanent and the anxiety from the continuing stress of the loss. There are so many ways people are just stuck.”
And yet, Bonanno is certain that the vast majority of people—probably 90 percent—will come to terms with what’s gone and resolve their loss, sooner rather than later. “We’ve documented how resilient most people are. Unfortunately, there is a percentage of people—around 10 percent—who don’t get over loss, at least for a couple of years.”


Waves, Not Stages“Grief is undeniably difficult,” Bonanno writes in The Other Side of Sadness: What the New Science of Bereavement Tells Us About Life After Loss, but contrary to common belief, it is not always overwhelming. For sure, grief knocks us sideways, takes us out of the normal path of functioning for a while, but it rarely flattens us. For too long, he says, grief has been understood only through a clinical lens, narrowly focusing on the people who couldn’t get over a loss. That has become the norm for the grief response.
I am no stranger to loss. Some time ago, my husband died. We’d been close for 23 years. I remember one moment more than six months later when I wondered whether there would ever be a day when I didn’t cry multiple times. The pain was most acute each time I saw something or resumed an activity we had enjoyed together—going to the theater or the ballet or a concert, driving to our summer spot in Maine, seeing a whole roster of friends. Each resumption promised pleasures, but each was also a fresh reminder of what was missing.
The first time I traveled to a distant conference and retired to my hotel room for the night, I opened the door and just crumpled. There was no good-night message blinking from afar; I was blindsided by its absence. I felt completely untethered from the universe. But six days after the death, I had kept a longstanding lunch date with the publisher and publicist who were shepherding my next book into print. I told them not to mind, that I’d be fully present, but that there’d be moments when tears suddenly moved in like a squall in the rainforest, and just as quickly the sun would come out. For a long time, I told no one about this meeting or others I had in the weeks following the death. I was afraid of being thought uncaring. But when I recounted them to Bonanno, he smiled acceptingly.
Forget the idea that grief comes in more-or-less predictable stages that you move through over an extended period of time. Bonanno’s studies of the bereaved shift the paradigm. They show that “we have these profound emotional experiences that come in oscillations, or waves. In a book about his wife’s death, C.S. Lewis likened it to an airplane bombing—a big plane circles around, drops its load, takes quite a long time to come back, then bombs again.” Grief doesn’t take forever, Bonanno says: “The meat of the process occurs pretty quickly.” Turning to me, he adds, “You already went through something to get to the point that you could meet with your publisher in six days.”
The brain is a predictive organ, he explains. When we’re so deeply attached to someone that the attachment is part of our identity, our brain is geared toward predicting interactions with that person and relying on those interactions, even though most of the time we may not actually be in his or her presence. When somebody dies, or after the breakup of a significant relationship, our brain has the task of recalibrating the relationship.
The person is no longer physically in the world but is still in our head; we carry a mental representation of the person as part of our cognitive currency. “Your brain has to recalibrate what it means to never see the person again—without completely erasing the image within,” Bonanno says. “I just saw something that he would love. Or I want to tell her about what just happened.” The mind keeps rubbing up against the absence, and the reminder of the loss is sad and painful. The mental resetting is not an easy job, and in the first days after the loss occurs, it is hard to believe.
The sadness serves an important function. It takes the focus of our attention away from the world around us so that we can begin the mental reset. The sadness seems to slow the world down. And it sharpens our cognitive capability. A whole body of research demonstrates that sadness makes our appraisals of the world and of ourselves more accurate than usual.
Most of us have a desire to take away the pain of others, but some pain after loss is particularly useful, Bonanno points out, and many of the behaviors and rituals cultures have built around death are intended to augment the deep processes of adjustment. Funerals, for example, encourage a good cry in the presence of supportive friends. People come together to honor the dead person, which not only fosters acceptance of the death but also helps in the creation of an idealized internal image of the deceased, one in which the rough edges of everyday life have been smoothed over. Further, it connects everyone who knew the person and reaffirms social bonds in spite of the loss: He’s dead, or she’s dead, but you are still connected to us.



AdaptationIn his studies, Bonanno reports, people who are resilient cry when asked to talk about the loss early on, but they haven’t lost their ability to laugh. In fact, minutes later, the majority are able to laugh, and he knows that the laughter is genuine because his team video monitors the conversations and analyzes facial muscle movement to identify Duchenne, or real, smiling.
For all the research, don’t expect a handbook on resilience in the face of loss. “There’s no Do this or Do that and you’ll be resilient,” says Bonanno. Yet, he has identified a mindset that characterizes those who adapt to the loss without drowning in despair. They’re optimistic. They display a so-called challenge appraisal, which enables them to think, Okay, I didn’t want this to happen. It hurts like hell. But what do I need to do to get beyond it? They have a repertoire of self-regulatory strategies at their disposal that they deploy with a certain amount of flexibility. And elements of that flexibility show up as a distinct neural signature on brain scans.
But first, before everything else, they engage with the stressful event that occurred. It’s happened to me. What do I need to do? That involves optimism, challenge appraisal, confidence in coping. All are things that Bonanno and his colleagues can and do measure. And he uses the term “flexibility mindset” to sum up the process.
With sensitivity to context, those who adapt to the loss can call on a repertoire of strategies for managing distress. What do I need to do? What am I able to do? At one point it might mean leaning in to the emotional intensity of the loss, at another time and place it could mean distracting themselves. Each time, they are monitoring and evaluating the effectiveness and appropriateness of each strategy and adjusting their behavior to ease the emotional pain. Does this help me get through the day? Maybe it helps in the morning but not all day. Or I’m going to try talking to people more online. They are flexible in the self-regulatory strategies they muster and choose.
Brain imaging studies of people who are profoundly grieving show considerable activation of the corpus striatum, a major component of the reward circuit. “This is the desire part, I want this person,” says Bonanno. The activation occurs even when they’re not looking at images of the deceased or while they are doing a task that requires attention. They’re getting interfering thoughts; activation of the striatum is the brain marker.
Those who recover from grief also show that same brain signature of thinking about the person. However, they also show activity in the dorsolateral prefrontal cortex, the region of the brain that exerts executive control over memory and attention networks. It’s the region that brokers cognitive flexibility. But when researchers asked the bereaved study subjects about their experience, they reported that they weren’t thinking about the person. “It’s not that they don’t have thoughts about the person. The mind is going to go there a lot. But they’re able to put the thoughts aside. They’re able to shift attention away from those interfering thoughts,” explains Bonanno.
Acceptance of death turns out to be one of the predictors of successful outcome. People who are strongly dependent on the relationship for their identity have difficulty grieving the loss because too much is lost with the death. Bonanno points to the story I told him about my publishing meeting days after my husband’s death. “It indicates that you have other aspects of your identity so that you can still go on. It’s as if you’re saying, A piece of me is gone with this loss, but I’m still here because I’m still a writer who writes books.”
Bonanno finds himself in the curious position of trying to persuade people that they have mental resources that can get them through loss. “It’s a message that people are suspicious of,” he says. Mental health clinicians “may overestimate the prevalence of unresolved loss because they are around people who are hurting all the time.”
Psychologist Daniel Gilbert’s work on affective forecasting offers a reason why nonclinical people may be resistant to the idea of their own resilience. Bonanno, elaborating on Gilbert’s conclusions, explains, “When you feel pain, it’s hard to believe that you won’t always feel pain.” Moreover, he says, “One of the things that people hate when they’re grieving is for a person in their life to tell them that they’ll be OK. What do you mean, OK? I hurt like crazy. How can you tell me I’m going to be OK?”
But Bonanno tells them anyway. There’s definitely a period of adapting to loss, whatever the nature of the loss. “It’s all about getting engaged with the stressor,” he says. “When something happens to us, we need to think about it a little bit. That’s imperative. It’s an unusual situation. It’s dangerous. We need to actually talk to ourselves a little bit about it. What’s happening? What’s happening now? How do I deal with this? What do I do? We can answer those questions. We’re capable of it. I’m making the case that, hey, you’re not this basket case of grief. You’re resilient.”
As the pandemic grinds on and losses of all kinds mount, we can, and must, allow time for the anguish and sadness to course through us and to identify what is missing. We also have the opportunity to consider the bigger questions that get buried in the rush of everyday life: How can we move forward, honoring the losses we have sustained?

Life as we know it has changed. This past weekend I attended a socially distant cookout complete with masked grilling, BYOB, plastic wrapped utensils, and chairs spread around the yard. Coronavirus cases are climbing in many parts of the United States. Most people I know are taking more risks than they have in the last couple of months, yet everyone I talk to is on a different page. Some are seeing family, some are seeing neighbors, others are seeing anyone who will see them. Still others have hardly left their houses since March and aren’t seeing people outside of their immediate family.


Now that summer is in full swing, people are testing the waters to find out if their friends are willing to see them and with what precautions. This article is about the social risks and benefits of seeing friends. My expertise is in communication. I am not an infectious disease expert. Other articles discuss the health and safety concerns of seeing friends.


According to CNBC, new standards for social etiquette are being set in real time and range from requiring friends to get a COVID-19 test before seeing them, taking party guests’ temperatures, or wearing masks while hanging out. When new social rules are made before our eyes, they can be hard to navigate. Below, I explain why conversations to determine how we will hang out with friends are difficult to have, what you should keep in mind if you are planning to hang out with friends, and what you should do if you and your friends are not on the same page when it comes to seeing one another in the new social world in which we live.


Why are conversations about gathering with friends during social distancing orders difficult to have?
These conversations are difficult in part because they are directly tied to our values. Some people are upholding strict precautions including not seeing friends at all, seeing them only outdoors and 6 feet apart while wearing masks, or seeing only certain people while avoiding all others. On the other end of the spectrum, people have resumed something close to pre-corona life, holding and attending crowded social events with no regard for social distancing or sanitation. Others fall somewhere in between. Our choices about the precautions we take and the way we see others reveal our values in regard to health, safety, and privilege.


A mismatch in values can challenge a friendship. Friendships are built on similarities in backgrounds, interests, and values. When people perceive a mismatch in values, they may question the fit of the friendship. Friends may judge one another for having less stringent values when it comes to coronavirus safety or for being too strict or unreasonable in their safety precautions. Friends may feel the need to explain their decisions for being strict or less strict which could involve disclosures they did not want to make about hidden health concerns.


How should people discuss seeing others during a time when exposure to friends/family should be limited?
Only do what you are comfortable with and recognize that those who are good friends will understand and respect your decisions. That said, there is a cost to continuing to avoid or limit exposure to your social network.


Friends who are spending time together are maintaining and growing their relationship while friends who are opting out are missing out. They may be doing the “right” and “responsible” thing, but they are losing out on something else. Take for example a large group of friends who all have kids the same age/grade in school. Those who are willing to hang out have just started up their in-person monthly trivia game again. They are learning about one another, spending quality time, and deepening their relationships. One couple has chosen not to participate due to coronavirus concerns. This couple will be included again in the future but conventional wisdom warns that those who do not show up, stop getting asked to attend over time.


Social network support is critically important during stressful and uncertain times such as the ones we are living in. If you are continuing to stay home and limit your exposure, be sure to keep up the virtual chats and game nights with friends to keep your sense of belonging and support intact. 


What if my desire to see others differs from the people in my social network?
Find friends who are on your page and spend time with them. For those who are not, be willing to be the only person wearing a mask at a gathering or wear a mask to make a friend who is wearing one feel more comfortable. A good rule of thumb is to adopt the standards of the most health-conscious or strict person in the group. If one person wants to stay 6 feet away from others and wear a mask, it will be easier for that person to uphold their guidelines and they will feel respected if everyone at the gathering does the same. These types of behaviors will likely strengthen a friendship as people tend to appreciate when others are willing to make sacrifices for them.


My advice for navigating unknown boundaries? If you’ve set up a friend hang, err on the side of caution: Start by wearing a mask when entering another person’s space. If the default is wearing the mask, you’ll be all set if your friend turns up wearing a mask as well. You can then have a conversation about your comfort levels. If you show up sans mask and they are wearing one, you risk making them uncomfortable and put them at risk.

​https://www.psychologytoday.com/us/blog/conscious-communication/202006/navigating-social-interaction-in-world-covid-19

Post-Traumatic Growth During a Pandemic: Is That a Thing?
Can you grow your resilience while we face COVID-19? Should you try?
By Melanie Greenberg Ph.D. 
https://www.psychologytoday.com/us/blog/the-mindful-self-express/202005/post-traumatic-growth-during-pandemic-is-thing

We are living in the midst of the worst pandemic in modern history. COVID-19 has infected more than 4 million people and caused almost 300,000 deaths worldwide. In the U.S. alone, we are close to 80,000 cases. As a result of its life-threatening potential, high levels of contagiousness, and spread throughout the world, this novel coronavirus has severely disrupted life as we know it. As journalist Ed Young writes in The Atlantic about COVID-19: 

​It has crashed economies and broken health-care systems, filled hospitals and emptied public spaces. It has separated people from their workplaces and their friends. It has disrupted modern society on a scale that most living people have never witnessed."

COVID-19 is a threat to our mental health 
The mental health effects of the pandemic are yet to be fully determined. The lack of personal protective equipment for health care workers and other essential workers, the fact that COVID-19 disproportionally attacks the elderly, minorities, and other vulnerable groups, as well as the big pre-existing economic gap between rich and poor exacerbates its damaging psychological effects. Journalist Mike Levine, writing for ABC News reported that: "Last month the 'Disaster Distress Helpline' at the Substance Abuse and Mental Health Services Administration (SAMHSA) saw an 891% increase in call volume compared with March 2019, according to a spokesman for the agency."

What is post-traumatic growth?
Psychological theories have long suggested that while prolonged traumas can cause untold psychological damage, there is a portion of people who report psychological growth in the face of trauma. 
Tedeschi and Calhoun (2004) define post-traumatic growth as “positive psychological change experienced as a result of the struggle with highly challenging life circumstances” (p. 1). 
Post-traumatic growth has five facets that survivors report experiencing:

• a greater appreciation for life,
• closer social relationships,
• enhanced feelings of personal strength,
• spiritual growth, and
• the recognition of new possibilities for their lives.

The development of post-traumatic growth is theorized to lead to a sense of wisdom about the world, and, potentially, over time to greater satisfaction with life. Post-traumatic growth is seen as not only an outcome, but also as the process of coming to terms with trauma and changing your life in a more meaningful or positive direction. Tedeschi and Calhoun argue that post-traumatic growth is likely to occur later on in the process of adjusting to trauma, and it may or may or may not provide a sense of comfort or relief in the short-term. It can also co-exist with negative consequences of trauma, such as the strain placed on the mind and body by prolonged stress.

In the U.S., we are still in the initial stages of dealing with COVID-19 and so there may not be all that much opportunity for growth yet. When the crisis is over and we finally feel safe enough to process what has happened, post-traumatic growth is more likely. If the economy recovers and people are able to get jobs, they may feel stronger because of mental shifts they made or social support they received that helped them endure. When you don’t have a job and don’t know how to put food on the table, or when you have to risk your life every day in a production line, growth may be the furthest thing from your mind and that is OK.

How to promote post-traumatic growth and resilience in your own life
For those of us who are not in the front lines, or who feel they are out of the most acute danger, it may be useful to think about how we can consciously promote post-traumatic growth in our lives. Below are some strategies for each of the five facets: a greater appreciation for life, closer social relationships, enhanced feelings of personal strength, spiritual growth, and the recognition of new life possibilities.

Greater appreciation for life
Realizing that your life and health are not guaranteed can help you appreciate each day a little bit more. Thinking about people who are worse off than you may help you feel gratitude for being able to work from home, for having a job, or for receiving a loan from the government. Reflect on the support of your colleagues, or of your family and friends, or the resources you find on social media or on podcasts or YouTube. Think about the leadership and hard work of your state’s governor and the protection that has provided you, about the wise guidance of health officials, or the courage of journalists who tell you the truth.

Closer social relationships
This facet of post-traumatic growth may be more challenging because of social distancing guidelines or stay at home orders. Nevertheless, you may begin to feel closer to neighbors, friends, or family who regularly check up on you or whom you are able to help. Working from home may give you a bit more time to talk to friends and family members via the phone or internet. You may spend more time playing and eating with your kids or talking to your teenager.

More personal strength
When you face a difficult challenge that you eventually manage to master or even just survive, you may feel psychologically stronger as a result. Perhaps you didn’t think you could stay at home for so long or face the daily fear of getting infected if you are an essential worker. Doctors or nurses may not have realized their own inner strength to keep trying to save lives in the midst of chaos and crisis. Or you may get up each day and take care of your family despite feelings of depression or severe anxiety.
As Bob Marley said, "You never know how strong you are until being strong is your only choice."

Spiritual growth
Stay-at-home orders present challenges to meeting with your spiritual or religious group in person, although Zoom can provide you with a piece of what you would normally get. If you are staying home, this could be a good opportunity to start a meditation practice, to do some spiritually oriented yoga, or to read books and listen to talks and podcasts that enhance your spiritual awareness. Perhaps you could take some time to reflect on the universe, on your sense of a higher power, or on the spiritual values that make your life meaningful. Acts of service like helping feed the hungry, making masks, getting groceries for your elderly neighbor, or helping your child can also deepen your spiritual wellbeing.

New possibilities
Facing a societal crisis like COVID-19 often facilitates a focus on what is most meaningful in our lives and what is less important. Reflecting on how you spend your time might help you realize that you are not making the most of life’s opportunities. You may decide you want to live a healthier lifestyle or be more present with your children. If you are struggling to survive, this may make thinking of new possibilities more challenging and so it may be something that you put off for when things are more stable.
“Although life is full of the experience of suffering, it is also full of the overcoming of it.” —Helen Keller

The internet is full of memes about gaining weight during the COVID-19 pandemic. It’s no surprise: Being stuck at home without normal activities and constant access to food can easily lead to overeating. On top of boredom and proximity to food, the worries and stress that accompany a global pandemic can easily lead to emotional eating.
In fact, there is an entire body of evidence on how our emotions influence our eating behaviors. Researchers have learned that emotional eating is more complex than they once believed, and depends on a wide range of variables that can be difficult to measure.
One of the most important things researchers have learned is that emotional eating is complicated. An early systematic review established that each individual’s specific emotions and food choices are important elements in understanding emotional eating, and that secrecy surrounding eating is also a factor.
The review found evidence that emotional eating is tied to obesity. Specifically, when obese study participants experienced negative emotions, such as anger, loneliness, boredom, and depression, they ate more than normal-weight individuals and reported that the eating reduced the underlying experience of those feelings. Now researchers believe this may be a learned behavior, according to a more recent review, published last year in Current Directions in Psychological Science. This review found that people may learn to associate eating with specific emotions and social situations.
Another recent review, published in 2017, underscores the complexities in studying emotional eating. The authors found that positive emotions and social situations are also associated with eating. (Think about celebrating an accomplishment with a dinner out or a special dessert.)
They also found that a broad range of negative emotions – stress, depression and sadness, shame and aggression, and anger – were associated with emotional eating and specifically binge eating. Additionally, they found that these negative emotions were more likely to lead to unhealthy food choices. This type of emotional eating over time is what eventually leads to sustained weight gain.
This all makes the COVID-19 pandemic seem like a perfect storm for emotional eating. But while that may be true, research shows there are steps you can take to avoid emotional and binge eating, especially when experiencing negative emotions.
In a recent study from the Netherlands, researchers measured whether elements of meditation could lead to less emotional or binge eating. They found that a specific component of meditation – acting with awareness – leads to less emotional eating. This means paying closer attention to your emotional state and making conscious food choices when you experience a negative emotion. A 2014 systematic review supported the study’s conclusions: Focusing on mindfulness is an effective way to prevent emotional eating.
Finally, a review article published in 2017 evaluated treatments and interventions that target emotional eating. It found that specific types of therapy – including Acceptance and Commitment Therapy (ACT), Cognitive Behavior Therapy (CBT) and Dialectical Behavior Therapy (DBT) – show promise for helping people to stop or avoid emotional eating. The review found a lack of research comparing these types of therapy, and found that more research would help determine which types of therapy were best for specific situations.
The take-home message: Yes, emotional eating is a real phenomenon that is especially prevalent when you feel stressed, depressed, or bored. But there are steps you can take to avoid it: Pay attention to your feelings; when you feel upset, consciously make healthy food choices; and, as always, if you think you are experiencing a more serious problem, contact a care provider for additional support.

​https://www.psychologytoday.com/us/blog/evidence-based-living/202005/what-weve-learned-about-emotional-eating

From Psychology Today
By Dr. Tammy Schultz and Dr. Adam Dell
https://www.psychologytoday.com/us/blog/hope-resilience/202003/domestic-violence-when-you-cant-leave-home
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As COVID-19 continues to spread across the globe, the concept of social distancing has rapidly become a common practice for massive numbers of individuals.

However, home is not a safe place for everyone. Numerous studies have revealed that there is a relationship between natural disasters and increased rates of intimate partner violence (IPV) (Chew & Ramdas, 2005; Gearhart et al., 2018; Parkinson & Zara, 2013).

IPV is defined as “behaviour by an intimate partner or ex-partner that causes physical, sexual or psychological harm, including physical aggression, sexual coercion, psychological abuse and controlling behaviours” (World Health Organization, 2017). The Centers for Disease Control and Prevention (CDC) indicate that approximately one in four women and one in ten men have experienced IPV by an intimate partner during their lifetime.

For some, the workplace environment was previously an opportunity for respite from controlling partners. However, the call for all individuals to engage in social distancing and the transition to working at home or unemployment have meant elevated medical concerns, 24/7 proximity, diminished community support, heightened levels of distress, and an increased vulnerability to IPV. Moreover, social distancing can be used by partners as a coercive controlling technique to impede opportunities for support and safety.

Individuals who are vulnerable to IPV are often overlooked when it comes to safety planning and coping with natural disasters and infectious disease pandemic, like COVID-19. Thus, here are some considerations:

Tips for Survivors of IPV

• Limit exposure to social media and news sources. Continuous reading and watching about COVID-19-related news can increase stress.
• Self-care can be difficult for many people to practice, especially when individuals feel they are not worthy of love. Learning to entertain thoughts, feelings, and behaviors that promote physical, emotional, social, and spiritual well-being is not “self-centered care.” Rather, self-care involves the wise stewarding of our bodies and resources.
• Develop a safety plan or a series of steps you can take to minimize the risk of harm by a partner who abuses. While no room in your home may feel safe, identify the “safest room” where there are no weapons and your ability to leave through a door or window is possible.
• Because isolation is a common aspect of abusive relationships, developing practices to increase connection with others is important. It can be helpful to identify two individuals who you can communicate with using a “code word” to let them know if you are in trouble. Plan in advance what they should do if you send them the code word.
• Although scores of schools and offices are closed, IPV shelters remain open. However, since shelters may have more limited availability due to COVID-19, consider if you have a trusted friend or relative who you could stay with in case of danger.  
• The implementation of faith practices can be particularly helpful for individuals who value faith-based practices such as journaling prayers. Research has demonstrated that writing down thoughts and feelings can reduce both stress and anxiety. Physically writing (as opposed to typing) has been proven to have better results.
• The National Domestic Violence Hotline is available via text or by calling 1-800-799-7233 to discreetly talk with a professional. However, for many individuals, accessing support online may be safer than calling for support as individuals who abuse will not overhear the conversation. Thus, survivors can log onto thehotline.org.
• In an emergency, call 911.

Ways to Assist IPV Survivors During COVID-19

• Check in with someone who you are personally worried about. If making a phone call to someone you know is in a violent relationship, always assume that the perpetrator could be listening.
• If applicable, offer your phone or computer as available resources so that tracing technology is prevented.
• If possible, offer to do errands together while maintaining safe distances (e.g., grocery shopping).
• Some IPV survivors may turn to spiritual leaders for wisdom and support before secular mental health providers. Thus, it is important that clergy are educated regarding IPV so that they can develop safe and effective response teams and provide referrals to IPV experts.

If possible, clergy can offer financial support to survivors facing financial distress or unemployment. Schneider et al. (2016) found that unemployment and economic hardship were positively correlated with IPV during the last recession. If individual intervention is impossible, consider ways your local church might champion the payment of bills, provision of food, or supply of necessary toiletry and clothing items for at-risk families in the community.

From Psychology Today
By William Hwang Psy.D.
https://www.psychologytoday.com/us/blog/flex-your-feelings/202004/how-stop-wasting-time-during-covid-19
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Like many other people, you might have suddenly found yourself with infinitely more time on your hands since the COVID-19 pandemic began.1 Numerous factors may be providing you with more time: You may have been unexpectedly laid off and now spend the 8 to 12 hours a day you would have kept yourself distracted now thinking about your professional loss. Or maybe you have a job you can, fortunately, do from home.

In any case, perhaps it has been more time than you know what to do with. And boy, is it boring. After all, sitting and doing nothing is painfully boring. In fact, so painful that people can and will administer electric shocks to themselves rather than sit alone in a room for 6 to 15 minutes just thinking quietly.

Thankfully, there are endless YouTube videos, Instagram posts, video games, Netflix TV shows, Netflix movies, Netflix documentaries... and blog posts to fill your days in order to kill time and keep yourself busy. However, perhaps therein lies the problem in the way we structure our language around time. Why would we ever want to kill time? Or stay busy just for the sake of staying busy? 

There are several reasons why we do this, not just during COVID-19, but in any "free" time.

1. Avoidance. We "kill time" while waiting at the DMV, waiting for our flight to board, or waiting for any scheduled event to happen. During unoccupied time, our attention tends to wander toward sensations of discomfort that we label as boredom, impatience, loneliness, anxiety, depression, you name it. If we would rather not experience these feelings, it makes logical sense that we would want to kill time.

2. A culture of productivity. And then there is "staying busy." The concept of staying busy takes many shapes and forms, but it generally implies any behavior primarily serving the function of avoiding the discomfort of not doing anything. There is discomfort that arises in the feelings of guilt and unease that show up when we are not actively doing something. Our thoughts tell us we are lazy, unproductive, and worthless in a way that reflects our societal pressure to be squeeze productivity out of every waking second.
This is naturally very stressful, so we scroll through Instagram to take our mind off of these negative thoughts. This goes well until we see a post of someone who has created a DIY rock garden out of recyclable materials, leading us to feel even more lazy, unproductive, and worthless for still being in our pajamas at 2 p.m. So we scroll through another post, and another one to avoid feeling bad about ourselves while seeing more and more posts that make use feel bad about ourselves.

3. Too many choices. We are bombarded with so many choices for how we can spend our time that we often default to doing what we have tended to do in the past out of habit or doing nothing at all. This phenomenon is called choice paralysis, demonstrated most famously in a study in which researchers found that customers in a store were 10 times less likely to buy jam when they saw 24 choices of jam than when they saw only 6 choices.

This dovetails with Barry Schwartz's idea of people falling into two categories: satisficers and maximizers.3 When making decisions, satisficers tend to settle on choices that are good enough while maximizers push themselves to make the best choice. Studies have shown that though maximizers may have better outcomes, they are actually less happy with them. These same principles affect us in the drawn-out time of COVID-19 when the process of even picking which movie to watch can be a source of distress.
The question is, is all of this busyness getting us anywhere? After COVID-19 recedes, will we be satisfied with the choices we made for how we spent our time? We are working against a natural tendency to avoid feelings like guilt and anxiety, which bring us discomfort, a culture that stresses being productive, and a deluge of choices that make it hard to know the best way to spend your time. 

Here are three cognitive strategies you can use to spend your time more wisely during (and after) quarantine:

1. Treat time like money.
With this new abundance of time, we don't have a good sense of how valuable it is. Imagine you have $10,000 in your bank account right now. How concerned are you about spending $100 on a purchase? Now imagine you have $100 in your bank account. How concerned are you about spending $100 now? You are much more likely to blow money when you suddenly find yourself with a lot (like on payday) than when you are pinching pennies at the end of the month. This is the way time tends to work as well. The more time we think we have, the more we take it for granted, and the easier it gets to accidentally waste it.

To avoid this pitfall, budget your time by writing down a schedule and giving yourself artificial deadlines. This will help you create a sense of scarcity, which will help you be more mindful of how you use your time. Just schedule one day at a time if you need to and see how much time you can save by working with 24 hours in your bank account rather than 10,000.  

2. Change your relationship with time. 
Instead of thinking of time like something that you kill when you have too much of it, treat time like your own commodity that you want to protect. Continuing with the metaphor of time as money, imagine that other people, screens, and substances are like advertisements telling us how we should spend our time. These things tell us it is a great use of our time to spend it and they do it in a very subconscious, convincing nature. We might be lulled into spending our time or money on something we did not really want to. Be mindful.

Also, practice gratitude for the time you have. This goes along with the idea of treating our time like it is a scarce resource, just like money. Do a thought exercise and imagine you have a year left to live. Imagine you had two weeks left to live. How would you spend your time? Here's another one: Imagine that in old age you are looking back on your memories of COVID-19. How do you want to reflect on this time and how you spent it? What is the story you want to tell that will reflect the type of person you want to be remembered as?

Your answers to these questions can help change your relationship to time in a way that allows you to prioritize and budget time in a more meaningful, intentional way. Every moment can be an opportunity to be grateful. See this TED Talk by monk David Steindl-Rast for more on that perspective.

3. Practice Saying "Good Enough." 
It is easy to get caught up in procrastination and perfectionism during COVID-19. We may not be aware of how our actions might be driven by choice paralysis and a maximizer mindset in which we feel like we either have to do something perfectly or we don't do it at all. Perfectionism and procrastination are really two sides of the same coin. Practice being a satisficer. Practice telling yourself that this choice is good enough. Imagine that spending too much time trying to make a choice is the same as spending too much money on buying a product. Ask yourself what you really want to have spent your time on when you look back on it all. Practice looking at yourself and saying "good enough."

Staying busy can be an effective way to keep the monster of "I"m not good enough" at bay for a short period of time, but this monster tends to come back out when we can't keep ourselves busy, like right before we try to fall asleep. Instead of running from the monster, slow down, stop, turn around, and face the monster to say, "Hello there. I'm good enough. And I'm not going to be spending any more of my time on this discussion."

COVID-19: Coping in Isolation with an Eating DisorderFrom Psychology Today 
​By Jake Linardon Ph.D.
​https://www.psychologytoday.com/us/blog/break-binge-eating/202004/covid-19-coping-in-isolation-eating-disorder

​

Containment efforts for the COVID-19 pandemic, including social distancing policies and “stay-at-home” orders, have the potential to greatly affect those with—or at risk of—an eating disorder. 

The disruption of face-to-face treatment delivery services that comes as a result of COVID-19 will exacerbate the already alarming figure that fewer than 25 percent of people with an eating disorder receive care. Further, the pandemic will likely worsen the mental health of people with an eating disorder, adding further urgency to ensure that appropriate care is received during this time. 
If you’re struggling with an eating disorder, then the ability to access accurate tips on how to cope during this pandemic is crucial.
Why Eating Disorders May Worsen As someone specializing in the treatment of eating disorders, I want to provide some simple and effective self-help strategies to help you through this time. But, first, I want to outline the reasons why eating disorders may worsen during this pandemic. 

1. Eating Away Stress
Most of us are currently experiencing more stress than usual. Whether it’s listening to the daily news reports of new infections or frantically trying to your homeschool your children, we’re all facing the pressure. Stress can increase eating disorder behaviors due to biological and psychological factors. 

Biologically, stress contributes to increased secretion of the hormone cortisol, and elevated levels of cortisol are linked to an increased appetite and craving for sugary, salty, and fatty foods. This elevated cortisol secretion is, at times, enough to cause bouts of binge eating. 

Psychologically, stress isn’t pleasant to experience, and many of us end up turning to food for comfort or as a way to escape this unpleasantness. Though some stress-induced eating may be helpful, the problem arises when people who gorge on comfort foods end up feeling worse than they did to begin with. 

2. The Fight to Afford Food
For many, COVID-19 is just as much an economic crisis as it is a health crisis. The COVID-19 pandemic may worsen eating disorder behaviors due to increased economic strain and resulting food insecurity, which refers to limited access to food due to economic hardship. 

Evidence shows that, even after statistically controlling for demographic differences, people who reported low food security are more likely to have an eating disorder than people who don’t report low food security. There are a couple of explanations for this. 
First, people who lack adequate resources to regularly purchase enough food to meet their nutritional needs undergo periods of food restriction. Such periods of food restriction may increase the risk of binge eating via food cravings or the biological effects of starvation. Second, those whose families suffer from a limited food supply may experience a sense of shame about their appetite, feel guilty for taking food from their family, and consequently restrict their eating.

3. Social Isolation Equals More Social Media 
Social media usage will have increased as a result of this pandemic. On top of stress-induced eating and food insecurity, greater social media usage creates the perfect storm for eating disorders, as the amount of time spent on social media sites is linearly associated with eating disorder severity.

Why does social media increase eating disorder risk?
First, images on social media play a role in how one seeks validation, often finding our worth by the number of “likes” we receive. When the desired number of “likes” isn’t received, there’s an impaired sense of self-worth that is often directed towards physical appearance. Second, the assumption floating around social media is that if you want to be accepted, then you ought to look a certain way. Women should look thin; men should look muscular. People with eating disorders naturally “buy into” this belief, leaving them feeling ashamed with their body when they realize they don’t meet these unrealistic expectations. 

Tips for Dealing with COVID-19
These five simple, yet effective self-strategies can protect you during this time.

1. Maintain Consistency in Your Eating 
Establishing a pattern of consistent eating throughout this pandemic is the most important thing you could be doing to address or prevent the onset of eating disorder behaviors.  
What I mean by “consistent eating” is eating at least three meals and at least three snacks each day, ensuring that you leave no more than four hours between each eating episode. No skipping meals, no intermittent fasting, and no restricting after dinner. 
The reason for eating regularly is to prevent the onset of extreme hunger as well as feelings of physiological and psychological deprivation. And if we’re feeling satiated throughout the day, then we are much less likely to turn to comfort foods when we’re feeling overwhelmed with stress or ashamed with our body. 
To execute this, you need to come up with a schedule—a schedule that provides guidance on what times you’re going to eat your planned meals and snacks. Create this schedule and stick it on your fridge so that you know exactly what times to prepare and eat your meals and snacks. 

2. Stay Present and Focused 
article continues after advertisementEmerging evidence shows that practicing mindfulness can reduce eating disorder behaviors.
Mindfulness is a way of paying attention that is taught through the practice of meditation or body scans, in which people learn to regulate their attention by focusing nonjudgmentally on stimuli such as thoughts, emotions, and physical sensations. 
During mindfulness, we learn to observe these stimuli without evaluating their truth or importance, and without trying to escape, avoid, or change them. And because mindfulness is thought to result in increased self-awareness and an enhanced ability to respond appropriately to negative situations, these exercises are optimally suited to stop any emotional-induced eating disorder behaviors. 
So, whenever you experience a sudden shift in mood, an overwhelming sense of stress, or shame about your body, opt for some mindfulness practice—it will bring forth clarity, acceptance, and minimize the likelihood of you acting impulsively on these experiences. 

3. Take Up a New Hobby 
Now is the perfect time to take up that hobby you’ve always wanted to. Whether it’s learning an instrument, perfecting your cooking skills, or researching your family history, immersing yourself in a new hobby is an excellent strategy for improving your mental wellbeing and eating behaviors. 

The reason why taking up a new hobby is so important is because it takes away most of the factors that trigger eating disorder behaviors. More specifically, a new hobby relaxes you, gives you purpose, builds your self-esteem, and ultimately reduces the importance you place on eating, shape, and weight. Therefore, whenever we encounter an adverse situation, encounter, or event, instead of resorting to food or eating as your coping mechanism, you’ll quickly learn to fall back on your hobby to help you through the difficult experience. 

4. Modify Your Social Media Usage 
I’m not going to tell you to never go on social media. In times like these, social media is excellent for helping us stay connected to friends, family, and work colleagues. However, we do know that social media usage is associated with an increase in eating disorder symptoms. 
There are a couple of easy modifications you can make to your social media usage to help through this time: 

• Limit the total amount of time spent on social media per day. 
• Unfollow accounts that reinforce unattainable appearance ideals or that don’t make you feel good about yourself. 
• Follow accounts that promote feel-good content, like body positivity or cute animals. 

5. Limit Excessive Alcohol Consumption
Alcohol and eating disorders don’t mix well. There’s good quality evidence to suggest that excess alcohol consumption increases the risk of eating disorder behaviors. The reason for this is twofold. First, alcohol is a direct cause of anxiety, stress, and depression  among some people. We’ve already learned that eating disorder behaviors can worsen when these emotions are experienced. Second, alcohol impairs our judgment and inhibits our ability to carefully consider the consequences of our actions. Therefore, when under the influence, you’ll find it extremely difficult to resist the urge to binge on your favorite foods. 
So, it’s a good idea to limit your consumption of alcohol—particularly during periods of social distancing—if you’re struggling with an eating disorder.
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If you're finding it difficult to control your eating, these 5 proven steps to stop binge eating from my website may help you to get into a better space.