Mental Health Recommendations, COVID-19

Dear Parent,

March 15, 2020

What a challenging time for us as we try to balance working from home, being with our kids and self-care!   In the midst of all this, children are probably feeling at least some degree of confusion, and possibly even worry or anxiety.  To help you buffer some of those concerns amid current circumstances, I'd like to offer you some recommendations.

1- Talk with your child about covid-19— be open; keep it simple.

As parents we want to protect our kids, understandably so - we have a protective instinct! So, it might seem like avoiding the topic as much as possible could be the best approach. At the same time, kids are very perceptive and pick up on a lot more than we realize. The trouble with avoiding the issue is that, when kids don’t have adequate information, they fill in the gaps using their imagination. Faulty conclusions easily lead to disproportionate fears and worry.

First, take your own emotional temperature-   if you are feeling on edge, wait until you feel calm to have this conversation.  Keep in mind that when we try to conceal anxiety from our kids, they easily notice this through our non-verbal cues (e.g. body language, tone of voice, etc).   Your intention is, of course, to establish a sense of reassurance, so be mindful that how you present the information matters just as much as the content.  Start out by asking-  what does he or she already know about the situation surrounding coronavirus?  Do they have specific questions about it? Try to respond honestly and to the point—  be open, but try to keep it simple.  Don't provide unsolicited detail; no need to elaborate beyond what your child is specifically inquiring about.  Communicate in a way that's developmentally appropriate as well as easy for your child to digest and understand.   Answer questions when you can.  However, when you don’t know the answer to the question, let your child know that, as you find out new things, you will share the new information.

Over the days or weeks to come, I recommend that you maintain open communication with your child about what you know regarding the virus.  It is appropriate to keep conversations going for as long as they seem productive and helpful. If you notice that the conversation is becoming overly long, or that your child keeps asking similar questions over and over, you'll naturally think "hmm, this isn’t really getting us anywhere." This type of persistent questioning may be an anxiety or worry-driven behavior.  If this happens, you will want to focus on ways to keep your child’s worry in-check. 

2- Keep worry in-check.

You can explain that sometimes our brain tricks us into thinking that worrying about a situation will help.  But, if we've done everything that must or can be done, continuing to worry actually does not help - it only makes us feel badly for no good reason.  To help contain worry, you can tell your child that you'd like to set aside “worry time,” which is a specific, brief period of time of the day when he tells you all about what's been 'bugging' his mind; say for example, from 9 to 9:20 in the morning and/or 5 to 5:20 in the afternoon.  Tell your child you'll set a timer and only worry during those time frames.  Anytime you notice 'worry' starting to emerge, reassure your child that you'll get to talk all about those things during "worry time".   For now, though, you wonder if you can use that extra energy toward something more helpful than worrying.  Perhaps it is a good time for taking a walk, or going on a bike ride.  It may also be a good time for drawing, stretching, doing some jumping jacks, baking some cookies, taking some deep calming breaths, tossing a ball outside or anything else your child might find fun or entertaining.

Play is important!  Kids naturally deal with things that happen through play.  So allowing time each day during which their creativity and imagination can roam freely will be extra important over the next few days and weeks.

3- Acknowledge your child’s feelings – validate the (unpleasant) feeling, but don't magnify it.

Again, our protective instinct may result in inadvertently doing what we can to shield our child from having any unpleasant or strong emotions. But learning about emotions and how to manage them is a very important developmental task for all kids.   So let your child be disappointed, frustrated, nervous— whatever he or she may be feeling.  It may be the most natural response to the many adjustments and changes they are coping with.  Only after you’ve helped your child feel connected, heard, and understood, will it be time to move into helping them find ways to feel better.  Try to brainstorm a few possible solutions.  Maybe together you can come up with a feasible alternative plan.  Can you think of anything good or positive in the current situation?  Try to encourage your child to find that silver lining.  

Keep in mind that we are not seeking to completely eliminate the unpleasant emotion. Let’s say, for example, that they are feeling disappointment.  That may be perfectly appropiate under the circumstances, and perhaps they should feel disappointment.  But we do want to find ways to diminish the intensity of the emotion to make it as manageable and tolerable as possible.  Ideally, you want your child to learn that our emotions certainly matter-   they convey important information and can help us respond to a situation.  It is just as important for your child to learn that emotions must be modulated and expressed adaptively; otherwise, they stop being helpful and can actually get in the way of our ability to think clearly and to carry out daily tasks.  In summary, try to emphasize to your child those things that you can do to problem-solve, without negating the disappointment or other emotion.

4- Emphasize what you can control.

For the most part, our current circumstances are out of our control.  Rather than succumbing to a sense of helplessness, accentuate what you are actively doing. For example, you might emphasize that your family is doing its part in helping to stop the virus by staying home, washing our hands thoroughly; maybe even offering the elderly neighbor assistance if they need something from the grocery store.  If you can emphasize that sense of community and of doing what we can to look out for one another, you will build your child's sense of worth, security, and connectedness.  What are other things that you can be intentional about?  Scheduling.  It can be grounding to establish a mini schedule to create some structure to your day.  Reviewing the schedule together can be a great way to start the day.  Be sure to keep it simple and flexible! The idea is to emphasize how many things you still have control over, not that you have "so many things to do."  Of course, you'll want to incorporate those things you think matter most, and which must be done.  A great way to end the day might be for you and your child to think of three things you accomplished, or three positive things that happened and that you are grateful for. 

5- Be a role-model:  Parents have emotions too! Show your child adaptive ways in which you cope.

This can be a great time to model to your child that experiencing feelings is normal, and that you experience really challenging emotions yourself.  For example, if you are feeling disappointed about a plan cancellation, be sure to label the feeling so that your child can see that a) you are experiencing that emotion and b) there are adaptive ways to express it.  Can you model how to manage or modulate that feeling?

6- Maintain Routines - Especially Mealtimes and Bedtimes.

Routines are very important because they offer predictability and a sense of normality.  In particular, try to maintain regular mealtimes and bedtimes. If you can, sit down for meals as a family!  Add built-in time for creativity and play during your day.   It really is crucial to let kids play, especially in times of increased changes, uncertainty and stress.  Remember, much of the structured time they had built into their day has been swept out from under them.  Help them keep that balance.

7-  Be Mindful & Intentional about Self-Care

In trying times, it is especially important to be extra kind and gentle with yourself.  Please monitor your own self-talk (that internal monologue).  Try to look out for those times when you might inadvertently become overly critical or impatient with yourself.  Any time you notice that 'mental chatter' becoming harsh, take a moment to re-group.  Remind yourself how hard you are working to juggle working from home, homeschooling, cooking, cleaning, not catching (or spreading) a virus, keeping up with the latest emergency order, staying in touch with family and friends, and taking care of yourself - all in the midst of a pandemic and hightened financial uncertainty.  Cut yourself some slack!   Please don't forget to put on your own oxygen mask before attempting to help others.  Make it a point to limit your news and other media consumption and find ways to re-charge your batteries.  As much as you can,  give yourself a few minutes of daily restorative time alone, movement, and/or fresh air.  When we mindfully practice self-care, our children benefit every bit as much as we do.  After all, to assist and support our kids well, we must first be well ourselves.  

Take care,

Dr. Tani