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, called "ZOOM". 

 

 

Psychological Advice about the fear of the Novel Coronavirus:  

"NO, COVID ISN"T OVER."  Sorry, as much as we want this pandemic to end, there are still people dying of it every week. Who dies and who just gets minor cold-like symptoms seems to be related to: 

1. How healthy someone is to begin with (if someone is in a high-risk health situation or not)

2. How much they are around many different people

3. Whether they got fully vaccinated or not.

You might notice that many of these symptoms of distress mimic symptoms of Covid-19 (body aches, difficulty breathing, fatigue, cough/sneezing, worsening of chronic health problems, and sometimes fever and/or rashes).  It is one reason that ER's are seeing a lot of people asking if they have it.  Most likely, they are having a panic attack or some sort of emotional distress, but it is possible it could be Covid-19, so it is very concerning.  Public Health Officials are saying, "Don't go to the ER or Urgent Care.  Be prepared with at-home covid tests, or go to a"test and treat" center. Call your doctor, or a doctor, to ask if you should get tested."  And just because you might get a negative result (meaning you don't have it), it doesn't mean you won't get it the next day, or even the next hour..

 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 a mask?
• What if I lose my job or my income?
• 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  by going to medical and scientific sites to find answers. Keep up to date on the research, too, as the data changes the outcomes of studies.  For instance, at first, the medical boards and politicians were saying don't buy masks to wear at the beginning of this pandemic.  They did that because there weren't enough masks for nurses and doctors.  They told us to stay home instead.  Now the medical personnel have enough protective equipment and they are letting us go out more, so masks are very important for us to wear when we are out in public. 

If you read something on the internet, especially on social media sites, that seems very alarming (such as cures & remedies for Covid-19, rules & laws, political rhetoric), 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 that they program your pages and ads 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. 

Covid-19 is a novel, or new, virus that is ever changing and has new variants that are more contagious. The treatment for it changes as well.  It is important to look at the source of the medical information and how the study was conducted.  Proper studies include double-blind, placebo-controlled, randomized clinical trials, which is generally considered a design that minimizes bias and can support causal inference,  This means that the people in the study and the people conducting the study do not know who is getting the real drug and who is getting a sugar-pill.  That way, no experimenter or subject bias can explain the reason for the changes.  The control group, the one with the placebo sugar pill, is there to see if it is the actual drug that is working or some other thing related to being in the study.  If there was no control group, then it would not be able to show causality, just a correlation or co-relation to the drug.   

Avoidance of and Treatment of Covid-19.  Many people fear getting sick, even without a pandemic to scare them. They are more sensitive to their body's symptoms and tend to catastrophize and think of the worst possible outcome.  They are called "hypochondriacs" or other insensitive names.  People might say "It's all in your head."  Most of the time, they have an anxiety disorder that includes being highly sensitive to their body's symptoms. Sometimes they can be unconsciously influenced to show signs that they read about in an illness or the side effects of a drug. If you do show any symptoms, like a cough, sniffles/sneezing, fever, difficulty breathing, losing taste or smell, or rash, 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 and allergies going around, most of which will not make you severely sick in need of hospitalization.  If you do show any of these life-threatening symptoms, please go to the nearest ER or call 911. 

• Bluish lips or face
• Severe and constant pain or pressure in the chest
• Extreme difficulty breathing (such as gasping for air, being unable to talk without catching their breath, severe wheezing, nostrils flaring)
• New disorientation (acting confused about where you are, what day it is, etc.)
• Unconscious or very difficult to wake up
• Slurred speech or difficulty speaking (new or worsening)
• New or worsening seizures
• Signs of low blood pressure (too weak to stand, dizziness, lightheaded, feeling cold, pale, clammy skin)
• Dehydration (dry lips and mouth, not urinating much, sunken eyes)

Otherwise, remind yourself that you are probably okay.  Get evidence for your subjective thoughts.  For instance if you have a headache and worry it may be a brain tumor, see if taking a Tylenol will get rid of the headache.  If it does, then you probably don't have a tumor.  If you have sneezed and then cough, take a Benedryl and see if it is more likely an allergy.

Perhaps you want to get tested for Covid-19 to rule it out.  Just remember that the test doesn't show if you got the virus after you took the test.  To not worry about it, act as though you are fine, rather than acting as though you are sick.  See if you can talk yourself out of being ill rather than the other way around.  If you can, then it is more in your mind than a real illness.  Your mind can manifest these symptoms in your body.  They can also reduce or get rid of them if they are not caused by a contaminant.

The best way to avoid getting Covid-19 is to avoid being around anyone who may have it.  The latest mutations of the coronavirus are more and more contagious.  But, locking yourself in for lengthy periods of time is not always a healthy way to live.  Before we had vaccines available to us, we had to avoid people as much as possible.  Large gatherings, crowds, sporting events, travelling, and even small family gatherings with people you haven't seen in a while was not advised.  

Getting vaccinated works bed to avoid getting severely sick from it.   Having been fully vaccinated, you only have about a 10% chance of getting it, but the symptoms should be mild compared to people who are unvaccinated.   The unvaccinated have a very high chance of getting it and possibly having to go to the hospital and be put on a ventilator.  They may even die.  Not getting vaccinated should be a choice made by you with your doctor about it's safety for you specifically.  Some people have medical conditions that preclude them from getting vaccinated. The coronavirus doesn't care if you are a republican or democrat, a religious person, or a super healthy individual..  Anyone can get it from 2 to 102. 

At home and hospitalization treatment

The Omicron variant of the coronavirus is causing Covid-19 cases to spike again, with new variants of it, too.

The good news since the last peak is that the US Food and Drug Administration authorized new antiviral pills. Paxlovid  was  given emergency use authorization in late December to treat mild to moderate Covid-19. They interfere (through different pathways) with the virus' ability to replicate -- and they can be taken at home, before someone becomes seriously ill. Paxlovid reduces the rate of hospitalizations by around 90% and is considered safe. In other words, Paxlovid is a bit of an antiviral superstar.

Still the best way to avoid Covid-19 is to get vaccinated and get boosted.

Another way we can avoid getting it or passing it, even if we are vaccinated, is to wear a good mask. At this point, 3 years later, we are all tired of wearing a mask.  But, If anyone around you has a cough, you can politely ask them to wear a mask to cough into, just as you would do if you had a cough.  We used to say, "Cover your cough" when people had a cold, but now it is important to really cover it.  Don't just use your hands to cover it. And actually, it is even more important to cover your nose and sneezes.  Don't go "nose commando" and wear your mask below your nose.  Yes, it is more comfortable, but it is completely useless that way.  The virus grows in the nose. You can find masks now, in almost every store, online, etc. Cloth masks are almost as good as wearing nothing. If you work with the public a lot, or around large groups of people, or work with a group of people in a small room, it would be in your best interest to wear a mask.  Find a mask that is at least 3 layered, non-woven, and fits as close to your face as possible.  if you are outside and can stay 6 feet away from someone, you probably don't need to wear a mask.  If you are inside your home alone or with people you have been around for at least 2 weeks without getting sick, you probably don't need to wear a mask.  It is polite and good sense to wear a mask indoors a public area such as a store or a business.  If you don't want to risk getting sick, you have a right to wear a mask. 

There are steps you can take to help protect yourself, grocery store workers and other shoppers, such as wearing a face covering, practicing social distancing, and using wipes on the handles of the shopping cart or basket.

 Peer pressure can get in the way, too.  Some of their peers are rebelling and saying things like "If you wear a mask, you are living in fear. Don't be a wuss."  It is hard to think beyond this awkward moment and stand up for oneself and their health.  They could memorize this phrase in response, "I'm quite brave and smart, actually, and will not subject myself to foolish behavior."  or simply, 'You do you.  I'll do me."

Perhaps this Covid-19 Pandemic has changed your career goals. Maybe you want to join in a medical career (or avoid one).  Maybe you want to be a teacher or educational administrator.  Or maybe that is now the last thing you want to do. Do you think you may want to major in Political Science, Public Relations, or Broadcasting? One of the best things you can do with your time is take classes to find out what you enjoy doing.  And one of the best classes is on critical thinking skills.  If you are in school, find that course in your college or university.  Or, take it from an entertaining scientist, Neil deGrasse Tyson:  https://www.masterclass.com/classes/neil-degrasse-tyson-teaches-scientific-thinking-and-communication. You will sound so smart when you argue your points.  And you will be able to discern what is truly fake news. 

Emotionally, it is a very tough time to be in close proximity with people whom 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.  Stop.  Close your eyes.  Feel the ground under your feet or a flat wall or door frame.  Scrunch your toes and let go. Touch something soft and comfortable.  (Use your 5 senses to calm yourself.)  Now, ask for some time to yourself.  Say, "I just need 10 minutes, please." 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 telling the other person what to do or demanding it.  Also, accepting "No" as an answer.  Try for a compromise, but if someone you are talking to is not up for a compromise, let it go.  For now. 

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 the emotion 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 ex-President, you can simply say, "I really don't want to fight about this. Can we talk about what we are going to do for fun this weekend?" or "What do you think you want to change about our house next year?", "Do you still like the open-concept layout?" "Do you feel like the house is too cluttered?  How can we re-organize?"

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 living room 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, no matter how small, for it to calm down.  Learn ways to de-escalate conflicts.  You don't have to stuff your feelings, but you can't hurt others feelings either.

Keep your cool. 

There are times when all couples, parents, and children feel that they are out of patience. However, it is always important to find ways to help your family communicate without hurting feelings. Here are a few ways to calm yourself when you feel stressed, before you try to talk.

• Take a few deep breaths very slowly.
• Wait 5 minutes before starting to talk.
• Try to find a word to label what you are feeling (such as "disappointed, annoyed, irritated, angry, upset, lonely, sad"). Say it to yourself and be sure that it is appropriate for you  conversation. 
• Think of a request you would like to make regarding that feeling.  Make the request assertively. 
• Do not hold grudges. Deal only with the present.  Try to avoid saying, "You always..." or "You Never..." 
• Seek professional help if you feel that you have lost control.

Healthy communication with your family and friends is one of the most important and rewarding skills that you can develop. It also makes the tough conversations much easier and more effective.

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 elbow.

Try to maintain a schedule while 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.  If you usually get up at a regular time to go to work or school, keep your sleep schedule.  If you aren't a morning person, adjust your time to a later hour, but keep the schedule. Keep your exercise schedule.  Improvise at home with heavy items to replace weights.  Take breaks during the day where you are doing something physical for about 20 minutes (walking up and down stairs, gardening, cleaning, etc.)

Fill in your time with fun and interesting activities online.  You can go to many museums and aquariums online, stream movies and documentaries get curiositystream.com, take new classes to enhance your career (coursera.org, thegreatcourses.com, and udemy.com are great sources).  Volunteer virtually at https://www.volunteermatch.org/virtual-volunteering 

 

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 type of mask you will wear, etc..  What other things do you feel you can control?  Focus on the abundance, not on the lack.

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. If you are having trouble paying your rent or 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 or grant, filing for unemployment, or going to a food bank. If you feel inclined to want to pay it back, you can always bring food or donate to the foodbank you used after you are financially stable again.  Or pay it forward.   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. 

This year, expressing gratitude seems more essential than ever. It’s been difficult lately not to focus on what we’re missing, the people we’re not seeing, the places we’re not going and the things we’re not doing. Articulating what we’re thankful for is a radical act in the midst of a hard time. Turning our attention to the things we do have rather than what we don’t is a tough task, but a crucial one.

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 go 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 confidentialilty.  Many people who live with others and have  no privacy will do online therapy in their parked cars on the street, at a park, or near a place of business that has guest wifi.

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.