I don’t know about you, but I’ve been experiencing a roller coaster of emotions lately. Each day presents new challenges, and my mind and body rarely feel still. I find myself bouncing between calm and confident, then a chicken with its head cut off. And, the more I talk to friends and family, I find I am not alone in this wide range of emotions. I wanted to get some solid advice on how to manage these feelings, and prepare for the future, post-coronavirus. So, I reached out to a friend who is a licensed Psychotherapist. Aubree is also a mother, so I knew she could relate to many of my fears. I hope you will find this information helpful. If you have a friend or family member you think would benefit from Aubree’s advice, please share it with them.

1) What tools do you suggest for managing the stress and anxiety that so many are experiencing?

I have been getting a lot of my anxiety management tools, especially related to COVID-19 anxiety, from podcasts while I am driving to work. This is my favorite part of the day because I get to learn about different strategies that experts are using, and practice them myself. MindBodyGreen has been my go-to. There are some great interviews, including a recent one with Dr. Ellen Vora on “How to Deal with COVID-induced anxiety.” Other apps that are helpful with meditation and breathing are Calm and Headspace. 

2) Are there daily practices that you recommend, or use yourself?

Shelly Harrell, PhD recommends 4 core strategies to manage anxiety on a daily basis. I’ve been using these strategies with my patients, and they find them very helpful to stop the anxiety loop from happening. 

1. F.A.C.T.: Foundational Attention Centering Techniques. When we shift our focus from anxiety to activities like meditation and deep breathing, we are grounding ourselves so we can feel safe and calm in our own body.

2. Expressive Creative: When we take the time to be creative, we are finding an outlet for our anxiety. Dancing, drawing, crocheting and cooking help move the energy through the body, so it doesn’t get stuck and build up over time.

3. Reflection Exploration Strategies: It’s so important to take time out of our day to reflect on our experiences and become an observer of our own thoughts so we can learn about ourselves. We can do this by journaling, talking to a therapist or writing a blog!

4. Healthy Lifestyle and Values Congruent with Self Care: Our bodies are so sensitive to how we treat them so making sure we are getting the right amount of vegetables in our diet, drinking enough water, and exercising is very important. Also, we often forget our values when we are anxious so it’s essential to connect with what is important to us daily, for example prayer, talking to our family, talking to a close friend, spending quality time with our children.

3) Do you recommend limiting our intake of information? 

Every person is so different in terms of how they respond to stressful events. For some individuals, watching the news or social media helps them feel in control whereas others become more anxious. If you are unsure, get curious about how you feel emotionally and physically after watching the news. If you notice that you have a headache, feel tension in your body, or feel overwhelmed, for example, you should probably set scheduled times to get information and then return to a strategy to reduce anxiety. 

4) How would you recommend talking about the crisis with children?

My heart is heavy for all the parents out there who are trying to manage their own anxiety while caring for their kiddos. First, just know that you are doing the best that you can, take a deep breath, and give yourself a break. Kids can feel our anxiety, so it’s important to manage our stress the best we can and reassure them that we will keep them safe. Second, find out what your child knows first. Our kids get information from a lot of different sources like school, neighborhood friends, and siblings. We can help them sort out what is true. Here are some helpful age appropriate talking points about COVID-19 from the National Association of School Psychologists:

• Early elementary school children need brief, simple information that should balance COVID-19 facts with appropriate reassurances that their schools and homes are safe and that adults are there to help keep them healthy and to take care of them if they do get sick. Give simple examples of the steps people take every day to stop germs and stay healthy, such as washing hands. Use language such as “adults are working hard to keep you safe.”

• Upper elementary and early middle school children will be more vocal in asking questions about whether they truly are safe, and what will happen if COVID-19 comes to their school or community. They may need assistance separating reality from rumor and fantasy. Discuss efforts of school and community leaders to prevent germs from spreading.

• Upper middle school and high school students are able to discuss the issue in a more in-depth (adult-like) fashion and can be referred directly to appropriate sources of COVID-19 facts. Provide honest, accurate, and factual information about the current status of COVID-19. Having such knowledge can help them feel a sense of control. 

5) What steps should we take immediately if we start to feel overwhelmed or anxious?

I love using the DBT STOP skill when we notice an uncomfortable emotion such as anxiety or frustration. 

S-Stop what you are doing and notice what you are feeling.

T-Take a step back and breathe. Breathe in through the nose for the count of 4 and out through the mouth for the count of 7. I suggest doing this for about 3-5 minutes.

O-Observe your thoughts and feelings. Notice what is happening before you take action. 

P-Proceed mindfully. Will my next actions be helpful or unhelpful to me?

6) What therapy resources are currently available, given the many shelter-in-place orders?

Many therapists are now offering teletherapy and continuing to see their patients in the office because therapy is considered an essential healthcare service. Contact your insurance provider for a referral to a local therapist or utilize teletherapy options such as Talk Space and Better Help. 

7) How can we maintain a healthy mindset, post-COVID crisis?

I’m so glad that you asked this question. At this point, the mental health field is preparing for universal Post Traumatic Stress Disorder. When this is all over, it will be a while before many of us stop viewing the world through a lens of trauma. What this looks like is when we go to shake someone’s hand, we might second guess ourselves. So the main question, really, is how do we manage or decrease the impact of the traumatic event. We do this by engaging our body from “fight/flight/freeze” mode to calm mode as much as possible, it’s all about the nervous system (this is where the science comes in!). We do this by experiencing micro-joys all day long; for example, deep breathing, talking to friends, expressing gratitude, sending groceries to immune compromised people. The more we engage in joyful activities, the more our body remembers what joy feels like instead of anxiety and threat. 

In addition to Aubree’s thoughtful and helpful advice, I have also received a link to a comprehensive guide on online therapy, from ConsumersAdvocate.org. These are excellent tools in helping to find the right fit for your needs. Don’t be afraid to ask for help. There are countless resources available, and many of them provide new and creative ways to access therapy during these unprecedented times. Be well, everyone.

Aubree Vance Tovrea is a Psychotherapist with over 10 years of experience working with adults struggling with mental health and substance use disorders in the mental health field. She is a mom to a 9 month old boy and wife to a Sonoma native. She currently works at Siyan Clinical Corporation in Santa Rosa, CA as a psychotherapist for individuals suffering from anxiety and depression. She is also a therapist for the Project Hope-Medication Assisted Treatment (MAT) program working with individuals recovering from opioid dependence. 

Aubree utilizes a client-centered approach focusing on every individual’s unique needs and strengths with an emphasis on somatic processes to relieve trauma symptoms. Aubree is experienced in different modalities to help individuals reach their goals including Cognitive Behavior Therapy, Dialectical Behavior Therapy, Solution Focused Therapy, Narrative Therapy, and Motivational Interviewing.

Aubree received her Bachelor of Arts in Psychology from Vanguard University of Southern California and her Masters in Social Work from the University of Southern California (USC).