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Green Hills with Blue Sky

Online Therapy

 

What is Online Counseling?

Online Counseling is the interaction between you and I through the use of the internet. Counseling is communicated through the use of a confidential messenger/video program like skype, called "Zoom". 

Psychological Advice about the fear of the Novel Coronavirus:  Many people are freaking out and panicking about possibly getting the virus.  Signs of Emotional Distress include

  •  Shallow breathing, high pulse
  •  Feelings of numbness, disbelief, anxiety, or fear, 
  •  Changes in appetite, energy, and activity levels, 
  •  Difficulty concentrating, 
  •  Difficulty sleeping or nightmares and upsetting thoughts and images,
  •  Physical reactions, such as headaches, body pains, stomach problems, and skin rashes,
  •  Worsening of chronic health problems,
  •  Anger or short-temper, 
  •  Increased use of alcohol, tobacco, or other drugs.
  •  Overeating comfort foods 

 There are questions flying in our minds, such as: 

  • What if I get it from someone near me while at work, out shopping for food, or even at home?
  • What if I lose a family member over it?
  • How do I stop feeling angry over people wearing masks or not wearing mask?
  • What if the world as I know it collapses? 

One of the scariest things about this Coronavirus is the UNKNOWN.  That is why all of the "What if..." questions really bug us.  We think we can't answer them.  However, we can with a good degree of certainty.  But, be sure you go to medical and scientific sites to find your answers.  Start at the WHO (World Health Organization) and the CDC (Center for Disease Control).  If you read something on the internet, especially on social media sites, that seems very alarming (such as protests, natural cures & remedies, rules & laws), do your research and make sure it is true before you panic and share it. Remember that social media sites have a strong confirmation bias.  Meaning they program your pages you look at to be similar or alike to your belief system (things you said you liked).  In contrast, most scientific studies look at other ideas and hypotheses, making them more well rounded and less biased.  And because data changes, the scientific advice changes. 

Many people fear getting sick, even without a pandemic to scare them.  If you do show any symptoms, like a cough, sniffles, fever, difficulty breathing, call your regular doctor and ask them if you need to get tested for the Coronavirus.  Otherwise, remind yourself that there are plenty of regular colds and flues going around, most of which you will not make you severely sick.  Remind yourself that you are okay. If anyone around you has a cough, you can ask them to wear a mask to cough into, just as you would do if you had a cough.  If you can't find a mask, make one.**

California and many other places in the world were in "lockdown mode" with "SAFER AT HOME" orders. We needed to flatten the curve of new cases so that people who really needed medical help could get it.  If we got it all at once, hospitals couldn't help us all.  While there is great debate on whether we should wear masks and continue social distancing, it's been shown that this has significantly helped reduce the spread of the killer virus.  A group of researhers at UC Berkeley's Global Policy Laboratory investigated the results of the lockdowns in 6 countries (China, South Korea, Italy, Iran, France, and the United States).  They showed, “The last several months have been extraordinarily difficult, but through our individual sacrifices, people everywhere have each contributed to one of humanity’s greatest collective achievements. I don’t think any human endeavor has ever saved so many lives in such a short period of time. There have been huge personal costs to staying home and canceling events, but the data show that each day made a profound difference in millions of lives saved. By using science and cooperating, we changed the course of history.”       

The effect of large-scale anti-contagion policies on the COVID-19 pandemic

S Hsiang, D Allen, S Annan-Phan, K Bell, I Bolliger, T Chong, H Druckenmiller, LY Huang, A Hultgren, E Krasovich, P Lau, J Lee, E Rolf, J Tseng and T Wu, Nature (2020)

While it is very hard on the economy, wearing a mask and social distancing is imperative for a while. I always said that if you are sick, don't go to work.  If you watch the news on each phase of society opening up businesses, and large gatherings, you will see that about 2 weeks after, that group will have significantly more cases of Covid-19.  It's a fact.  Stay home as long as you can. Be careful and beware of your need to go out and who you let into your home.  Many people got together for Mother's Day, you may have noticed that about 2 weeks later, the cases and deaths peaked all over.  I worry about what will happen after all of the protests recently.  

Many leaders are saying that precautions and the economy can coexist, if we do them safely.  Andy Slavitt says, "So we're going to blame the people who were partying on Memorial Day. We're going to blame people who are protesting, we're going to blame -- there were some political leaders -- but the first place to put the blame is on the virus. Now we can control how we react to it. And I think we've issued a statement -- a website called #opensafely, which indicates things that you should be able to do."

Financial worries are also part of this pandemic.  It is important to find any and all resources to keep a roof over your head and food in your stomach. In California you cannot legally get evicted during this time for not paying rent or a mortgage.  You will have to pay it eventually, but not now.  If you are having trouble paying bills, talk to your bank about postponing or lowering the monthly amounts.  Many utility companies like power and water will work with you during this time.  There is no shame in taking a loan, filing for unemployment, or going to a food bank. A large part of our society is just one paycheck away from being homeless.  If you are fortunate enough to not be in this position, try helping out someone you know who is.   If you can keep your job and are financially solvent, now is a great time to donate to non-profit agencies, shelters, food banks, free clinics, etc.  Be aware of scams, too!  Times like this either bring out the best or the worst in people and there are those who will try to scam you out of your money.  As usual, do not give out your financial or social security information unless you are the one who initiated the call. 

Emotionally, it is a very tough time to be in close proximity with people you do not get along.  Typically families have spats and disagreements, but when we are in close together for a long time, the arguments can get really heated.  It feels like there is no where to go.  I recommend "Emotional Social Distancing." Before you say something you might regret and can't take back, take a deep breath, and walk out of the room.  Ask for some time to yourself.  Yelling, "Leave me alone!" or "Shut up!" can just keep the fire stoked, so try to be gentle, yet firm about it.  Use this time to learn how to be more assertive and set boundaries.  When learning to be more assertive, the family system can feel really awkward.  Just go with it and strive for the middle ground, not extremes of aggressiveness or passiveness.  The biggest part of being assertive is asking for what you want, not demanding it.  Also, accepting "No" as an answer.  Try for a compromise.  

Emotional Social Distancing can mean that you are aware and mindful of your emotions and decide how you want to express them.  You may want to just name them and soothe yourself in some way.  Tune in to yourself.  Say to yourself something like, "I am really frustrated!  But, it is going to be okay.  This is temporary."  You may want to set an emotional boundary.  "I don't want to talk about Donald Trump anymore, okay?  I get too upset and there seems to be no end to it"  is a good way to stop political arguments that go nowhere.  If someone you tell this to continues to talk about the President, you can simply say, "I really don't want to fight about this. Can we talk about what we are going to do with our summer?" or "What do you think you want to change about our house next year?" Fights about chores are super common.  Who is always getting stuck with the dishes?  Suggest a schedule that seems fair.  What to watch on the TV is also a big daily argument.  Perhaps you can have a family meeting where everyone lists their favorite programs and you work out who gets to see what and when.  Above all, be respectful of any ideas toward resolutions.  If you are with someone who is emotionally abusive, or you find yourself being emotionally abusive, ask for help from a professional therapist or agency.  Abuse (where you violate other people's boundaries) tends to get worse rather than better with time.  You must make some change for it to calm down. 

Here is Psychotherapist Esther Perel on how to survive the lockdown together as a couple: https://www.newyorker.com/video/watch/getting-through-quarantine-with-an-intact-relationship 

Take deep, slow breathes to clear your lungs and help your body calm down.  Shallow panicky breathing makes our bodies feel like we are suffocating.  Deep breathing and natural coughing keeps you from getting pneumonia-like lung infections.  Cough into a tissue or your left clothed elbow.  

Try to maintain a schedule if you are self-isolating.  Having structure makes us feel safer.  When there is a lot of change, we have to use a lot of energy to adapt.  Do things you usually do to have life feel predictable and controllable.  Ask yourself what you CAN control right now.  

There is plenty you can control: how you protect yourself, how you think, what you believe, what you learn, how you relax, who you trust, who you listen to, what you want vs what you need, whether you feel gratitude, how you are aware in the moment, how and when you ask for help.  What other things do you feel you can control? 

Focus on the abundance, not on the lack. if you usually get up at a regular time to go to work or school, keep your sleep schedule.  Keep your exercise schedule.  Improvise at home.  Fill in your time with fun and interesting activities online.  You can go to many museums and aquariums online, stream movies and documentaries, take new classes to enhance your career (coursera.org is a great source). 

For you and your kids:  Remember that just because a school building is closed, it doesn't mean school lessons stop.  Keep your kids up on their grades and schoolwork.  This isn't a vacation like a long spring break.  Add in "recess" or breaks to your day where you do something physical. 

Try to stay upbeat in your attitudeSing a happy song--  It regulates your breathing and makes you feel happy. Clap.  Dance.  Get up and move.  Laugh.   Try to have fun while you protect yourself.  Ever thought of wearing a Halloween mask or full costumes at home or out?   If your kids need to go out with you to the grocery store, wash up their old Halloween costume and let them go in it.  If the mask has an opening at the mouth, put a piece of cloth, paper, or panti-liner on the inside to cover it. 

Whether or not you wear a mask seems to be another issue to be in conflict with others.  To reduce conflict, we need to realize our assumptions and remind ourselves we may be incorrect. We may assume who is behind the mask or who is not wearing a mask-- what their world view is, what their beliefs are, what their political affiliation is, that someone is trying to block our pursuit of economic prosperity, liberty, or happiness, or whether they have an invisible chronic illness that puts them at risk. Some people don’t like masks because they panic when wearing one, due to claustrophobia or feeling like it’s hard to breathe; others find masks intolerable because of conditions like autism spectrum disorder and sensory processing issues. Thank you for checking on your assumptions!

**You can make your own individual masks with cotton cloths, toilet paper roll insides, diapers, menstrual pads, rubber bands, and paperbags.  Color them to your liking.  They are not surgically sterile or graded N95, but they are a help in protecting you from breathing other's sneeze & cough droplets. If you are coughing and sneezing, you should wear something to protect others around you.  Have a contest to make the most stylish, the most colorful, the most "you" mask. BE SURE TO MAKE THE MASK BREATHABLE!  No plastic in them. 

 

 

Be a positive force in the world. Don't hoard masks or toilet paper, water, or peanut butter.  If you find you are out of toilet paper, ask if anyone you know would like to barter for something you have that they want.  If you need to DO SOMETHING, clean your own house and ask your elderly or disabled neighbor how you can help them.  Maybe a mom nearby needs childcare so they can go to work at a hospital, restaurant, etc.  Share positive stories on social media about how people are coping.  Just as fear is contagious, so is hope. 

If you find yourself lonely from having to self-isolate because your school or work sent you home, or your family is together more and having more conflicts I can help you all communicate peacefully.  Feel free to make an appointment. 

If you tend to be anxious or depressed anyway, now is a great time to get counseling.  Do not let yourself do deeper into a hole of despair.  Please sign up for an online session.  I am here to help.  Write ([email protected]) or text me (9492291138) to ask for an online appointment.  We will come up with a time that is convenient for both of us and then get online at that time.  Please put "online appt request" in the subject line of the email.  Let me know some good available times for you.  You may also want to set your own appointment on my calendar.  Text me to let me know you set up an appointment.  There is somewhere  you can go for confidentiality.  Most people who want individual counseling in their home where other people reside are doing the counseling in their cars. 

The opportunity for confidential support online can help many people to feel safer and more in control when they communicate about their concerns in life.  It helps a lot of people who are not able to come to my office for one reason or another*, or just wish to stay home and do counseling online.  I've been doing online therapy via email for a long time, being one of the first therapists to do so. 

https://www.facebook.com/156550681030566/videos/1829028240449460/?view_public_for=156550681030566

Online counseling can feel very much like in-office counseling. Once the session starts, and we begin our work, the screen seems to melt away. As a therapist, I am giving you exactly what you would get from me if we were in a room together, and I make every effort on my end to convey that to you during our time together. I recommend taking some time upfront in order to facilitate your own therapeutic environment: Make sure you are in a quiet and private space, make sure you don’t have anything else scheduled for the hour, and you do not have interruptions. These things help ensure that you are having the same experience you would in a my office.

I charge $50 for a half hour and $100 for an hour session. Often your insurance will pay a portion of it.  See here for more information on that.  I can offer discounts for people who require them. 

If you do not like the idea of someone looking at you, Email Counseling, TEXT counseling, and phone counseling works, too!  The process of writing down thoughts and feelings can be particularly powerful. For some, this can help to focus thoughts and concerns. Online interaction also gives you the option to reflect or re read your communication with the counselor.  It is especially helpful to people who find writing easy. 

 

 

*Licensed as a Clinical Psychologist in California (PSY14768), I can help you online if your residence is anywhere in California. 

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