By Jessica Houser, PhD

Maintaining wellness during the COVID-19 pandemic can be challenging. Below are guidance and a framework that may help.
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The overall theme is to aim for balance. Honor your negative thoughts and feelings and try to learn from them. Balance them when possible; seek help when necessary. Use what feels hard or negative to identify and navigate what it is that you’re needing in that particular moment.

• Balance the helplessness associated with COVID-19 by helping where you can (e.g., remind yourself of altruistic reasons for staying in, buy a gift card from a struggling business).
• Balance the lack of control associated with COVID-19 by controlling the heck out of something (e.g. clean something you’ve been meaning to get to).
• Balance the uncertainty associated with COVID-19 by identifying places of certainty in your life (e.g. pets, a living situation, a steady ritual or routine).
• Balance the heaviness associated with COVID-19 by looking for lightness/humor where you can (e.g., have a sense of humor about how you look in a mask).
• Balance the boredom associated with COVID-19 by finding engagement (e.g., invest in learning a new skill).
• Balance the isolation associated with COVID-19 by getting creative about connection (e.g., remote movie watching, game nights, home workout competitions with friends).

In addition to these approaches, consider the following dialectics:

• Adjust expectations for yourself, your kids, your partner, your productivity, your work, etc.

               Balance with prioritizing safety, health, attachment, flexibility

• Connect mindfully when possible (i.e. take breaks from working from home to engage with those in your care)

                Balance with embracing the compression of identities into one space by multitasking (e.g. blow bubbles for kids to chase while you’re doing a home workout)

• Establish routines (new ones, if necessary) for self-care, eating, work, sleep, dressing

                Balance with setting aside unstructured time

• Get out when possible and safe

                Balance with creating a safe retreat inside (a cozy space) and helping those you care for to create safe retreats

• Stay informed enough to feel connected and safe

                Balance with practicing a media/COVID diet (e.g. limit the time or amount that you will engage with media or COVID topics)

• Segment quarantine time into smaller chunks (e.g. one week at a time)

               Balance with thinking and daydreaming long-term to remind yourself that this is temporary

Some other helpful approaches my include:

• Address stress through: diet, exercise, hydration, sleep, sensory toolkits
• Decide who you want to be and how you want this to go and integrate that into the stories you tell yourself (E.g.: I was getting caught up on debt before COVID; COVID derailed my finances; I want to emerge from the pandemic with new financial know-how and a plan to address my financial needs)
• Connect with help (mental health, medical help, wellness websites and apps, etc.)

Balance does not mean the absence of negative reactions; rather, it means acknowledging those reactions, working to understand them (they are often adaptive!), and augmenting with other reactions. If you have been feeling a prolonged sense of imbalance that is interfering with your ability to function in some way that is significant to you, however, it may be time to seek assistance. In addition to many other local mental health resources, the clinicians at Mansfield Psychotherapy Associates have responded to the COVID-19 pandemic by offering remote psychotherapy, consultation, and/or assessment. If you are in need of assistance or referrals, please contact us at 802.863.9079.

By Elizabeth Goldstein, PhD

Quite some time ago, I was inspired to write a blog post about the pros and cons of using technology for psychotherapy. Suddenly, in the midst of social distancing for Covid-19, I’m motivated to put finger to keypad.  So many people are wondering about how using various forms of technology is going to help or hinder psychotherapy while around the world we are all implementing a global pandemic protocol.  Pre-pandemic, my thesis was going to be, “the use of technology has its challenges, but whether it’s therapeutic has a lot to do with the function being served by its use.”  To me, the effect of technology wasn’t so much about the technology itself, but rather, the psychology of the humans using the technology.  I was going to write about how interacting with others via electronic media can serve an avoidant function for some, or be akin to an addiction, or, alternatively, increase intimacy, or, open up new possibilities in creative ways.  Those points were all based on individuals choosing to introduce various technological methods into their lives.  Whereas now, we are all doing it as a starting point.  

Well, I suppose, as a starting point, it’s good to remember that there is a choice to be made.  In these uncertain times when it feels that so many choices are out of our control, whether to engage in psychotherapy via electronic media remains a choice, for the client and for the therapist.  There are risks associated with the choices that affect access to care on the patient end, and ability to provide care on the therapist end.  Still, a choice is to be made, even if it feels that telemedicine is the only reasonable choice.  As the immediate urgency of the Covid-19 threat ebbs and becomes more ambiguous, the feeling of choice becomes more apparent.  And with it, new opportunities for anxiety.  Ultimately, recognizing that we have choices, even if the correct choice seems obvious, can help us feel more powerful and less helpless.

In the past, I felt gratitude for the convenience of being able to text with patients to confirm appointment times, or meet via video conference while one of us is away.  But now I feel gratitude in new ways.  We are so lucky to be able to find ways to connect with each other in real time during our social isolation. However, I notice that using technology to meet with people is really a mixed experience -  a complex fluctuating combination of excitement, intimate connection, drudgery of machine usage, and feeling satisfied, but, often, not fully satisfied, and sometimes drained.  

As a whole, mental health professionals are lucky that what we do translates to remote settings, unlike other services, which have to be put on hold.  But this also puts us in a more ambiguous position as the recommendations from the Centers for Disease Control and Vermont Department of Health open up a little bit.  

My colleagues and I at Mansfield Psychotherapy Associates have been in consistent conversation as the Covid-19 situation unfolds.  Each of us has our own individual psychotherapy practice and share a common waiting area.  For now, each of us is seeing our patients remotely, some of us even have openings for new patients.  As the recommendations change we will continue to be in dialogue.  Likely, we will develop slightly different strategies based on our unique personal needs and those of our patients.  I realize how vague that sounds.  In these times of uncertainty, it would be lovely to provide some certainty.  What is certain is that decisions will be made thoughtfully, based on weighing potentially competing needs for in-person contact and Covid-19 risk reduction.