As we all navigate through the uncertain time of COVID-19, frontline workers face a set of particularly unique challenges. What follows is a list of ways that frontline workers are being affected by COVID-19, with some suggested coping techniques. It is my hope that, in creating this list, frontline workers will feel better understood and validated, while those not on the frontline may learn how to better offer their support. 

Isolated from Family/Friends

Being isolated from loved ones is perhaps one of the most challenging aspects frontline workers face. During a time when they may need it most, they may not be able to receive the same love and support from their family that they usually would. Keep in mind that, although frontline workers may have to or choose to isolate themselves from family physically, it doesn’t mean that they have to isolate themselves emotionally. 

Be creative – read bedtime stories over the phone or prop up a phone or tablet with video chat for dinner time. It might still be possible to meet in person, but with a degree of separation like a glass door or window. Also, activities like walks might remain an option, so long as there is physical distancing. Even short, positive, love-affirming texts throughout the day can make a world of difference. 

Direct Interaction with the Disease

Imagine a poisonous snake is living somewhere in your home. Every time you open the refrigerator to get food or hop into bed, you risk being bit. This is the reality that frontline workers are facing. Every person that they interact with and every surface they touch is a risk of contracting this disease. Their stress response is heightened for every moment of their day as they are at risk and may feel they can’t let their guard down. 

Frontline workers may benefit from practicing short-term stress-reduction techniques throughout their day, such as grounding or breathing exercises, as well as practicing long-term techniques like meditation, exercise, or therapy outside of work. Continue to take precautions as necessary to help minimize risk. 

Generally Chaotic Work Environments & Long Hours

Whether its hospitals at capacity or grocery stores swarmed with people, frontline workers are generally working in a chaotic environment at this time. Furthermore, working long hours can also be draining, regardless of the type of work. Imagine being used to going for an evening walk and now suddenly having to be able to run a marathon. The demand for frontline workers continues to grow as confirmed cases of COVID-19 increase, and as there is a need to cover shifts for those that are out sick.  

Try different relaxation techniques before and after shifts and, if possible, create a sanctuary or safe space at work in order to have a place to calm down or take a break quickly. Frontline workers are providing an essential service and are helping their community – use that as a basis to create meaning and satisfaction from work and to help maintain a positive attitude. 

Lack of Equipment/Resources

Some workplaces have been extremely aggressive in trying to keep their workers safe. For example, grocery stores are sanitizing carts, have put up a plastic divider between customers and cashiers, and not accepting paper money. Despite best efforts, however, many places are experiencing a shortage of personal protective equipment (PPE), such as face masks. This significantly changes how frontline workers interact with people and how they do their jobs, and it can also lead to a general sense of uneasiness or not feeling safe. Furthermore, the added layer of PPE also affects the patient relationship by way of creating an extra barrier. 

Just today, Prime Minister Trudeau has pledged $2B to buy personal protective equipment, in which Canadian companies are being enlisted to provide critical medical supplies like ventilators, surgical masks, and test kits. Until then, however, continue to focus on things that can be controlled rather than dwelling on things that can’t, and continue to remain positive and practice self-affirmations. Don’t repress worry or stress, however, but give proper times to process and handle those concerns. 

Increased Risk for Mental Health Issues

Many frontline workers are reporting an increase in depressive symptoms, anxiety, insomnia, distress, and trauma-related disorders. Through direct contact with patients, as well as through vicarious trauma of other frontline workers’ experiences with COVID-19, and witnessing illness and death around them all the time, frontline healthcare workers are at significant risk of developing post-traumatic stress disorder, as well as increased suicidal thoughts and/or behaviors. Some could also turn to unhealthy coping mechanisms and even addiction to help get them through this time of overwhelming anxiety, confusion, instability, and loss. Despite these growing mental health concerns, many still have to continue working and treating the ill. 

It is important to remember that there can also be post-traumatic growth, not just distress during these times. There are important resiliency factors that could help buffer against developing any of the above-mentioned mental health disorders. These factors include, but are not limited to: not avoiding the situation and self-disclosure of distress or trauma to loved ones; having social support available to you and being connected with others (practicing safe physical distancing); spirituality, or having a sense of community or belonging; having an identity as a survivor, and finding hope and optimism wherever you can; helping others, and finding a positive meaning in the trauma.

Frontline workers should know that they are valued and appreciated for all that they are doing and sacrificing for the better of their community. I am offering pro bono services (1-5 sessions) for frontline healthcare workers in Ontario (through the Ontario COVID-19 Mental Health Network), and reduced cost services for other frontline workers. Please reach out if you need support – we are all in this together. 

Dr. Brianna Jaris, C.Psych. is a clinical psychologist at CFIR. She has extensive experience in psychological assessment and diagnosis and the treatment of a wide range of psychological issues, including trauma, depression, anxiety. She is currently the head of CFIR’s Trauma and PTSD service. 

Today, I scooped myself a bowl of ice cream. This is no different from countless other times I’ve done the same thing, save for one fact: I didn’t add chocolate chips. Now, let me back up for a second. I’ve been putting chocolate chips in my ice cream since I was a small boy. (somewhere out there in internet land, there is a mention of me eating too much ice cream-it’s true!).

Vanilla ice cream? Add some chocolate chips. Chocolate? Add chocolate chips. Cookie dough brownie with fudge? You guessed it, that’s going to get some chocolate chips too. So why didn’t I add them tonight? The answer: the global pandemic.

By now, I’m sure we’re all sick of reading about and talking about and hearing about the COVID-19 pandemic. So, I won’t belabour that. However, one side effect of the situation is that it’s caused almost all of us to re-think our routines. I didn’t add chocolate chips because when I went to grab another package at the grocery store earlier this week, they were all out (we really do seem to modulate our emotions with baked goods). That made me change a tiny part of my daily routine in a way I haven’t done for probably 20 years.

I’m betting that you, dear reader, might have had something similar happen to you in your week. Maybe you made that meal that you’ve been planning on for months. Maybe you cleaned the baseboards. Maybe you finally reached out and actually called your mother, or your grandmother (or their male counterparts!). Whatever it was, I’m betting that it felt weird at first, but that you felt better after doing it.

See, massive societal changes don’t just change things on the macro (read: big picture) level; they change on the micro, too.

Brent Mulrooney, M.A.S.P. | Therapist

See, massive societal changes don’t just change things on the macro (read: big picture) level; they change it on the micro, too. For 20 years, I have consistently thought that ice cream just wasn’t right without chocolate chips, so I consistently added them to every bowl I’ve ever eaten. Today, because of a situation entirely out of my control, I changed my habit. But here’s the thing: I liked it better. I tried it and I liked it better.

That got me to thinking. How often do we recognize that there’s something happening in our lives that just doesn’t sit right with us? Maybe you don’t call your friends because you think you’re going to bother them? Maybe you want to say hello to someone in an elevator, but you get shy because you’ve never done it before and …don’t weird people do that? (I say hello quite often, so make of that what you will). Maybe you want to start going to the gym, but you haven’t found the right day, or the right time, or the right gym outfit.

Yet, when we actually try something new, those tales we tell ourselves don’t often hold water. Sometimes they’re just not true. Sometimes, the ice cream is better without the chocolate chips.

Looking to start a journey towards change and your life? Mental health professionals at CFIR can help you navigate where you’re coming from and support you in developing healthy strategies to build an emotionally healthy future.

Brent Mulrooney, Ph.D., is a therapist at the Centre for Interpersonal Relationships. He works with individuals and families to improve mood, anxiety, relationships, work, and school. He also works to alleviate problems associated with substance use, learning difficulties (including ADHD and Learning Disabilities), bullying, trauma, violence, grief and loss, transitions in life, self-esteem, gender identity, sexuality, and intimate relationships.

During times of crisis and panic, many people can feel as though their current mental health issues are on overdrive. Everyday activities that were once employed to help alleviate depression and anxiety, such as face-to-face encounters and related activities, have been put on pause in light of social distancing measures and self-isolation. Stress and uncertainty surrounding COVID-19 have many feeling overwhelmed by potential financial, social, and health implications. With the additional strain on our mental health, some of us may feel like we’re regressing into old habits that we deem as ‘unhealthy.’ These practices may include excessive drinking, emotional eating, insomnia or oversleeping, and even over-exercising. It’s easy to start turning to old behaviours.  

There are countless social media posts about ways to achieve new goals, and become uber-productive now that we ‘have the time’; this can intensify feelings of isolation in our struggles. With social distancing in play, it’s even more important to stay connected and share what might be challenging for you right now, because chances are, others are struggling too. 

Remember…this is not an easy time. It’s okay if you are not okay right now, and most importantly, you are not alone in this.

• Be kind to yourself. Some days are going to be better than others, both in mood and motivation. Remind yourself that these are hard times, and everyone has moments of struggling in both similar and different ways. 
• If you do engage in old habits, try to see this as a signal of emotional pain and a need for something that stimulates or soothes you. Try different types of care and activities until you find something that meets your emotional needs.
• Try moving your body regularly, and walk outside (even across the street or around the block) once a day. This practice can help, especially when you feel restless or have low energy.
• Build motivation by making a daily routine and planning things to look forward to in your week, but try not to look too far into the future. There is an ending to all of this, even if it feels far away at the moment. 
• Be realistic. You don’t have to finish a novel or establish a side business by the end of the pandemic. For example, finding a new hobby or activity that you enjoy (even if you’re “bad” at it) is good enough. 
• Connect! Strike a balance between scheduling virtual hangouts, phone calls, or facetime dates, and spontaneously connecting with others throughout your week. When you start to feel lonely and disconnected, call a friend or family member. 
• Disconnect from social media and news intermittently. Many of us are glued to our phones, scrolling through Instagram or Facebook, and catching up on a constant stream of COVID-19 articles. Set boundaries and limits with these things and try to give yourself some breaks in your day to connect to yourself and your needs.  
• Breathe. It may seem simple, but it has a profound impact on our nervous systems. In moments where you feel overwhelmed with anxiety and fear, take a few deep breaths and remind yourself that this will pass.  

If you feel alone and overwhelmed, clinicians at CFIR are ready to offer support. Psychologists, psychotherapists, and counsellors from CFIR Ottawa and Toronto are providing secure, confidential therapy online or by phone. 

Whitney Reinhart, R.P. (Qualifying) is a qualifying registered psychotherapist, at the Centre for Interpersonal Relationships (CFIR) in Toronto. She supports adult and couple clients with a wide range of difficulties related to depression, anxiety, traumatic experiences, and interpersonal conflict.

Almost two years ago, the worst thing in the world happened: my precious, loving, silly, joyful, brilliant, freshly two-year-old son was unexpectedly diagnosed with cancer. Despite putting him through every treatment available, nine months after that, he suddenly began to decline, and one day, he came to die in my arms. 

For the past two years, I have been living every parent’s absolute worst nightmare, every single moment of every single day. 

And yet, for the past two years, I have also maintained a thriving psychotherapy practice; expanded my skills and hobbies and personal culture; developed a deeper practice of self-compassion; cultivated a stronger sense of connection with others both close and far and across different life domains; and immersed in a strong sense of meaning and purpose, more than I could have ever imagined at any point in my life before losing my son… 

This era that the world has been ushered into so suddenly and most unexpectedly, by the novel coronavirus and COVID-19, reminds me in so many important ways of the life of a cancer parent:

• One day, you and I each woke up to a whole new world. Nothing was as we expected it to be anymore. All of the mainstays of our day-to-day lives, everything we had come to count and rely on, everything that made us feel like our normal selves—our daily routines, our goods and services, our relationships with others, all the sights and sounds we had grown accustomed to—had seemingly ceased to exist. Our sense of normality, sense of safety and security, hopes and dreams for the future—all of these and more were shaken to their very core, one day, oh-so-unexpectedly. And this new world had no roadmap. We felt lost and disoriented and scared.
• As we took in the intensity and severity of what was happening around us, we lost the luxury of ever forgetting, even for a second, how fragile life really is. Without a moment’s notice, everything can change, even for the worst, despite our best efforts and wishful thinking. Our shared experiences, like confinement to our homes, financial strain, social isolation, perceived scarcity, and a sense of helplessness, all combine to worsen the impacts of the situation further, while also failing to make it better. 
• We learned, in an undeniable way, once and for all, that we are all vulnerable—that even we are impermanent.

When our basic sense of normal is so shaken up—when we understand that we are vulnerable to this disease, that it can get and take us or our loved ones, or at least, our financial means and other things that mean so much to us, this is such a massive weight that becomes piled onto our shoulders. 

“…even when the worst thing imaginable happens, we can still be okay.”

Reesa Packard, M.A., Ph.D., R.P. 

Notice that in calm times, to feel free and peaceful and relatively unburdened, the fragility of life and our inherent vulnerability is not always at the forefront of our thoughts—it simply cannot be. To feel okay enough in the present moment, we cannot also be so terribly consumed with what might happen in the next moment, or tomorrow, or next month or year.

The burden is so heavy that we cannot sustain carrying it so much all of the time. Sometimes we have to put it away and change our focus to something else—ideally something uplifting, something that deeply soothes and nourishes, whatever that is for you (nature? connection with self or other? a sense of something bigger than yourself? something creative? something fun?). 

COVID-19 and its consequences are still going to be there when you return to thinking about it, and your time away will not change anything significant, so we can surely all afford a good, well-deserved, full break from it every now and then.  

The helplessness of all of this is a common theme that I am hearing people struggle with the most. We want to protect ourselves; we want to fix it, and we want to be safe. To this, I offer some food for thought:   

1. There is only so much that we can control. If we trouble ourselves with trying to control it all, all we end up with is despair. Learn, through credible sources, what we best understand for now as being some ways to protect yourself and your loved ones, and take these actions, and then speak to yourself directly to remind yourself: “I have done everything I can.” 
2. Because we cannot control everything, there will be things that upset or stress us, that we cannot directly do anything about. In moments when these feelings strike, try to embrace them, and try to embrace yourself as you experience them. Speak to yourself again, this time to remind yourself: “this is hard—really, really hard—and we have to get through it. This will come to be okay, somehow, someday. It will pass because nothing has ever lasted forever, so nor will this”. 
3. There is a harsh reality that none of us can truly ignore right now: even though we have done all we could, and coped as well as we could, sometimes, things still go wrong or not as planned. Sometimes all that we can do is not enough, and the worst happens anyway… And even as we work to accept this harsh reality, I am here to tell you—because I now absolutely know this to be true—that even when the worst thing imaginable happens, we can still be okay. We still get to wake up the next morning, coax ourselves out of bed, and choose to find or create the meaning and purpose that keeps us going. We can make it through, and we will make it through. 

Suffering is relative. Many of you have already survived so much. Some other hard thing you lived through before this might have already felt like “the hardest thing ever.” This, right now, may or may not be harder. 

Remember that you are strong and resourceful and have a lot, already inside of you that can help get you through this. You have come this far, and you will keep trekking forth. 

Remember that you are not alone and that we are globally in this together through our common humanity and shared experience. 

Remember that we can choose to approach this current crisis with the goal of simply trying to make the most it that we can while trying to minimize negative impacts as best we can. 

Remember that the brain and the body respond to the demands that we place on them. Whether or not you can imagine this, you can and will grow in incredible ways as you live this extreme experience that is capable of stretching you, far beyond the confines of your previous self that didn’t yet have to deal with all of this. 

Remember that we can and that we will. 

Take good care. 

Reesa Packard, M.A., Ph.D., R.P. is an Associate and registered psychotherapist at CFIR (Ottawa). She has a doctoral degree from the Saint Paul School of Psychotherapy & Spirituality and works in private practice as a registered psychotherapist. She works with clients hoping to develop a more integrated sense of self as a means to well-being and meaningful, lasting transformation. Reesa is also involved in the teaching and supervision of psychotherapists-in-training and advanced knowledge through research in her specialty fields.

With the outbreak of COVID-19, the whole world changed rapidly and drastically, which can invoke feelings of fear as well as uncertainty. A particularly crucial yet psychologically difficult element associated with COVID-19 is the worldwide efforts of socially distancing to limit the spread of the virus. As human beings, we have a fundamental need and drive for interpersonal connections and relationships. During social distancing, it can be common to feel loneliness and disconnection from others. However, with modern technology, we can build and nurture new and existing relationships that have evidence-based findings to improve our mental health and overall wellbeing. Healthy relationships are linked to reduced production of stress hormones such as cortisol, a greater sense of purpose, and healthy coping behaviours.

During times like this, it is crucial to utilize the psychological benefits of social relationships by:

• Scheduling times to connect via FaceTime, Skype, or virtual platforms. This activity can serve as a wonderful substitution for face to face interaction. 
• Sharing our thoughts, feelings, concerns, and experiences with friends and family. Doing so allows us to feel heard, understood, and increasingly connected to others.
• Create time for individual hobbies and self-care; however, include scheduled time for family activities such as game nights or think of some creative ideas on date nights you can create with your partner at home.
• Reconnecting with friends or relatives that we haven’t had much time or opportunity to connect with as frequently in the past.
• Keeping in touch with colleagues or employees during these uncertain times and offering support.

Clinicians at CFIR are offering confidential, secure video therapy or teletherapy therapy, which can help support you with maintaining social relationships during COVID-19 as well as working through feelings of loneliness, loss, or uncertainty, amongst others.

Edgar Prudcoi, B.A. is a therapist at the Centre for Interpersonal Relationships (CFIR) in Toronto and is near completion of his Masters degree in Clinical Psychology at the Adler Graduate Professional School. He supports individual adults and couples to deal with difficulties related to emotion (e.g., depression, anxiety, anger), the effects of trauma, loss and grief, conflict resolution, and relationship functioning.

Stress, anxiety, and low mood are frequent problems, especially now in times of social distancing and socioeconomic uncertainty. Because of recent social distancing measures, few people are now able to use or access traditional face-to-face psychological services. The research shows that while equally effective as traditional face-to-face therapy, few people access teletherapy due to novelty alone and because they perceive it as less effective than face-to-face services. In the last decades, hundreds of meta-analyses, systematic reviews and robust clinical trials have supported the effectiveness of teletherapy (e.g., Andrews et al., 2018; Newby et al., 2016; Hedman et al., 2014; Hedman et al., 2013; Hedman et al., 2013; Mewton, Wong & Andrews, 2012; Metwon, Smith, Rossouw, & Andrews, 2014; Olthuis et al., 2016; Primer & Talbot, 2013; Williams & Andrews, 2013; Titov et al., 2018). 

Rather than having you sort through hundreds of meta-analyses and clinical trials, let me summarize some of this research for you. This extensive research conveys four important messages:

1. Teletherapy services increase access to mental health services. Compared to face-to-face therapy, teletherapy offers greater flexibility in terms of scheduling, requires no travel, and can connect those living in rural with a therapist from urban centres.
   • Teletherapy ensures effective care and treatment despite social distancing measures.
   • Canada, Australia, Denmark, Norway, the United Kingdom, and Sweden have all successfully implemented teletherapy services. These teletherapy clinics have allowed people to connect and receive treatment services regardless of location and requiring no travel. 
     1. The most notable example is the Mind Spot Clinic, located in Sydney, Australia, which had served more than 33,990 Australians from all across the country as of 2016. 
     2. Another example closer to home is the Online Therapy Unit located in Regina, Saskatchewan, which has helped connect people all across the province to receive mental health care, even those located in rural and remote areas. As of January 2020, 5,503 clients had been enrolled for treatment services with the Online Therapy Unit.
2. Telepsychotherapy is safe and confidential 
   • Technological advancements in the last 20 years now allow clinicians to offer teletherapy that is both safe and confidential. 
   • Therapists can monitor and ensure a client’s progress even from a distance, whether through online questionnaires or frequent clinical contact. 
   • New video conferencing technologies ensure that information transmitted virtually remains private and confidential. 
3. Teletherapy is as effective as face-to-face therapy
   • Research on teletherapy has shown that it’s as effective as face-to-face therapy for treating issues such as depression and mood disorders, generalized anxiety, social anxiety, panic attacks, OCD, PTSD, chronic pain, sexual functioning, grief and loss, substance use as well as overall wellbeing, and interpersonal functioning. 
   • When offered as video sessions, teletherapy has also been shown to be as effective as face-to-face therapy for dealing with couples and families.  
4. Assessments services can be done via teletherapy
   • Just like for therapy, teletherapy research has supported its efficacy in providing assessment services. 
   • For example, the MindSpot Clinic mentioned had provided assessment services to 25,469 Australians. 
   • Video sessions and questionnaires administered online allow clinicians to assess clients just like face-to-face sessions.

When to Seek Help

In this period of social distancing, stress, low mood, loneliness, anxiety, and scarcity have been increasingly challenging to manage. If you find that recent events have heightened the intensity of difficult feelings and thoughts or that they have been present for more than two weeks, seeking help can be your very courageous next step. 

The Centre for Interpersonal Relationships offers teletherapy services. Secure, confidential, and compassionate clinical services with registered psychologists and psychotherapists are accessible by video or phone from home. We’re staying connected! Visit www.cfir.ca to learn more.

Dr. Miguel Robichaud, C.Psych. is a psychologist (Supervised Practice) at CFIR Toronto’s location.  During his graduate studies, Dr. Robichaud’s work involved establishing the Telepsychotherapy Unit founded in 2016 and located at the Université de Moncton in New Brunswick, www.etherapies.ca. The Telepsychoptherapy Unit develops, studies, and implements self-guided online therapy programs to help adults deal with low to moderate symptoms of anxiety and depression.  His work at CFIR is supervised by Dr. Rylie Moore, C.Psych. and Dr. Dino Zuccarini, C.Psych. 

As cases of coronavirus disease (COVID-19) continue to rise, society is faced with a new reality that few have ever encountered. In an unpreceded move to ‘flatten the curve’ and avoid further spread of the disease, government agencies have enforced stringent travel restriction policies and implemented ‘social distancing’ protocols. Undoubtedly, this isolation will have an impact on how we feel about ourselves, our relationships, and the larger world. Though this separation is likely to affect mental health, there are several ways to make the best of this forced retreat. Here are helpful tips to help you through this social isolation:

Limit News Intake: While it is essential to stay up to date on the current news regarding coronavirus disease – but moderation is crucial. Try to set a routine as to when you’ll check for updates or choose only to read critical news releases. Staying connected to 24-hour news channels will only increase anxiety and limit your ability to engage in other pleasurable tasks.

Reach Out to Others: Though you may not be able to connect live in-person, technology allows us to communicate in many new and unique ways. FaceTime, the Houseparty app, or Skype are fantastic services for connecting. If someone you know isn’t able to access these technologies, phone calls are still a viable way to reach out.

Create Boundaries on COVID-19 Discussions with Friends: During difficult times it’s essential to relate and share with others. However, if you don’t put boundaries on discussing your anxiety with others, the conversation can spiral quickly. Be mindful of your communications and ask yourself, “…is this helping me feel better or making me more stressed?” If it’s making you stressed, try changing the topic to something else. Try to strike a balance between exploring your feelings and discussing more positive issues.

Create a Flexible Routine (with breaks!): Humans crave some routine. Although it doesn’t need to be structured, try to stick to a basic regimen for your day that includes when you will eat, sleep, and work. This routine will need flexibility given the current situation, however, it’s still good to have a general plan.

Enjoy Nature: If you can, take a walk in a park, your backyard, or some other natural space (just remember to keep 6 feet of distance!). Connecting with nature helps reduce stress and anxiety.

Take Time Alone: Remember to take time alone if you are in isolation with others (especially partners). We often still need quiet time when isolated. Just be sure to have a conversation with your partner/family/roommate, so they know it isn’t a personal sight, and that you need space.

Limit Time on Social Media: It can be easy to get caught up on social media. Though it can be a great way to connect – it also has many downfalls. Avoid reading to many fearmongering or non-credible articles. Remember to avoid comparing yourself to others and what they are doing in isolation. It’s OK to relax and rest.

Get Physical: Going to the gym might be out of the question; however, you can still stay active! Many gyms are offering free online programing that requires little or no equipment. Research tells us that one of the best ways to combat stress and anxiety is to stay active.

Don’t Expect Perfection: It’s impossible to expect yourself to be able to operate at full capacity during a crisis. Practice self-compassion when things don’t go the way you’d like them to and extend this compassion to those around you.

Society has come together like never before to eradicate the coronavirus. We all have our part to play in trying to reduce its spread and keep those around us both physically and mentally safe. Following these tips can help to nurture your mental health during these difficult times. If you are feeling alone and in need of help, skilled clinicians at CFIR can help you better understand your experiences and support you during this difficult period. Secure and confidential video and telephone sessions are available.

Joshua Peters, M.A., R.P., is a Registered Psychotherapist at CFIR. In his clinical practice, he works with individual and couple clients who are experiencing a diverse range of emotional, self, identity, and relationship struggles. With appropriate guidance in therapy, he can help you to get at the emotional roots of your distress as well as help you to become in touch with the concerns, goals, and needs that underlie your experiences.

The COVID-19 pandemic has had a drastic impact on all of our daily lives. While many can stay at home with their partners, other couples are separated indefinitely while restrictions on travel are in effect, or as a means to prevent transmitting the virus to a partner who is especially vulnerable to developing a critical illness. It can feel especially isolating to be apart from a partner at a time like this when we most need support from loved ones, especially when the duration of the separation is unknown. Here are some tips for managing this difficult situation:

1. Find ways to maintain your connection while you are apart

Some things to consider:

– Technology now offers a variety of ways to engage with someone remotely. In addition to phone calls and video chats, consider multiplayer online games as an option. These are not limited to traditional video games. Some of these games allow you to simulate playing a board game or completing a puzzle together!), or websites that will enable you to stream the same video together. 

– Rituals can feel grounding at a time like this; consider having a shared mealtime or coffee over video chat, or making a point to wish one another good morning and good night each day. 

– If possible, consider having some of your partner’s favourite snacks or other things they enjoy delivered to them.

– Discuss what each of you needs when it comes to communication. What works best for each of you in terms of scheduling and other commitments? Having a conversation together helps to mitigate the chances of misunderstandings and hurt feelings in this stressful time.

2. Take things one day at a time

It is natural to worry about how long it will be before you can see your partner again, or what the worst-case scenario could be. Still, these worries often contribute to high levels of stress while not helping us to adapt to the situation at hand, especially as it has been rapidly evolving. What can you and your partner do to keep yourselves safe while staying connected today and in the near future? What are the things you can be grateful for, even in these challenging times?

3. Take time to speak about your concerns about the pandemic and how it will impact you or others

Understand that your partner may have very different concerns from your own, as this pandemic is having a range of impacts on people. Some may be worried about their health or the health of loved ones, others may be struggling with lost work or other financial difficulties, and still, others may be distressed about missing important events. Be sure to take time to talk about these concerns so that you can support and validate one another.

4. Take time to speak about literally anything else

While it can be challenging to maintain a sense of normalcy and to maintain your connection as a couple, it’s also important to talk about things other than the pandemic: different aspects of your daily lives, your hobbies, and interests, your hopes and wishes, etc. Consider whether there may be opportunities to talk more deeply about some of these things than you might typically, given the extended time apart and disruptions to your routines and way of life. While you may not be able to avoid a painful time away from your partner, are there ways you can use this time to develop your relationship in a new way?

5. If you live alone, identify others around you who can provide help if you need it (for example, if you are ill or otherwise self-isolating and need someone to run essential errands for you)

Our partners often take on these tasks for us, and it can be anxiety-provoking to be without them at a time when we may need such help; neighbours, extended family, friends, or coworkers may be able to help if asked. If you do not have a robust social network in your area, look into community resources that may be able to help those in need. If you are healthy, also consider whether you might be able to volunteer to provide help for others in your community.

The pandemic has spun the world into a challenging time, and it’s okay not to feel okay being away from your partner right now. In addition to these tips, be sure to take care of yourself and reach out for (and provide, as you are able) support from others in your life, to help cope with this difficult time.

Clinicians at CFIR can work with you to collaboratively set treatment goals to ensure that you or you and your partner’s concerns and needs are adequately addressed. Secure and confidential video and phone treatment options are available. Contact us today.

Dr. Tracy Clouthier, C.Psych. (Supervised Practice) is currently practicing under the supervision of Drs. Dino Zuccarini, C.Psych. and Aleks Milosevic, C.Psych at CFIR (Ottawa) provide psychological treatment and assessment services in both English and French to adult clients facing a variety of difficulties, including depression, anxiety, relationship challenges, concerns related to self-esteem and identity, difficulties with emotion regulation, trauma, and challenges adjusting to life transitions and other stresses.

These are challenging times for all of us, and for those of us with children, it can be especially daunting to face the coming weeks. Schools have been closed and are unlikely to resume any time soon. Managing elementary and middle-school aged children can be quite a task for parents trying to juggle working from home and engaging in full-time childcare at the same time. This is one time where perhaps the usual gripes about reticent high school teenagers can pivot to feelings of gratitude about their self-sufficiency! For the parents of younger children, though, there can be additional feelings of guilt and anxiety regarding making sure that they are doing home-schooling “right.” This concern can result in a top-down approach to structure, where rules can be established rigidly, in an attempt to mimic the structure of the school day. 

Attempting to ensure that, every day, your child: 

– studies math, 

– reads a certain number of pages, 

– gets physical exercise, 

– engages in arts and craft, 

– practices music, 

– learns new things in science and social studies, 

– keeps up with the school-at-home websites, and after that, 

– talks to family and friends, 

– engages in game and leisure time, 

– eats, 

– sleeps, 

– bathes and brushes on time…

… will only ensure the outcome of a frayed, fraught and frazzled parent!

All of the activities, as mentioned above, are useful in themselves; however, desperate times do not necessarily call for extreme measures. A ground-up approach to provide structure would be more useful in such challenging times. Moving smoothly between structured and unstructured activities will help your child to regulate their emotions related to the significant changes to their daily school routines. Rather than structuring the whole day with a gamut of activities, it might help to structure the next hour or two with an activity or two and leaving enough room for unstructured time. A more inductive approach to tasks and achievement during this time of crisis would help the child process and express their emotions in healthier ways. 

There is significant research on the positive benefits of unstructured activities for younger children. Now might be a good time to allow those benefits to be obtained, as we can creatively and compassionately weave those in with the scheduled activities. It would help parents to realistically manage their own expectations (and that of their children) and for the time being.

If your child seems to be struggling with adjusting to the new routine of life or is experiencing negative emotions related to the pandemic, psychologists, and therapists at CFIR are here to help! We are offering telepsychotherapy (e.g., video, telephone) sessions that are private and safe. 

Dr. Ashwin Mehra, C.Psych. is a psychologist at CFIR (Toronto). He provides psychological assessment and treatment services to a wide range of clients. Dr. Mehra supports them to understand and overcome a wide range of difficulties related to anxiety and mood disorders, traumatic experiences, substance use and addictions, and interpersonal challenges.

The coronavirus pandemic has evoked a sense of living in an eerie, uncertain, and unpredictable dream. We all need to do our part to carry out public health recommendations to reduce the spread of COVID-19 (i.e., keeping a safe distance from others, practicing proper hand-washing and hygiene techniques, staying at home). But for those who struggle with an eating disorder, the isolation, stockpiling of food, empty grocery store shelves, along with a general sense of heightened stress and anxiety, can be a living nightmare. Indeed, eating disorders tend to develop insidiously in hiding, as a person becomes more isolated with their illness. Concerns about food scarcity and stockpiling food can create enough tension and anxiety to lead to binge and/or purge urges, while guilt about eating limited food may trigger restriction urges. For those in treatment with a prescribed meal plan, having limited access to their regular foods can create confusion, fear, and panic about what to eat. Disruption to our routines, including our food, eating, and activity routines, can threaten our sense of security. On top of all this, social media memes about weight gain and the ‘quarantine 15’, along with the plentiful messages about ‘staying fit at home,’ can bring upon intense body image distress and/or compulsive exercise urges. This combination can be a perfect storm for ED to rear its head.  

Although this can be a challenging time for those who struggle with an eating disorder, there are strategies to help ease, cope with, and tolerate the distress:

Maintain a (flexible) schedule and plan

Having a structure to our days can be hugely beneficial to our sense of security and stability. Maintaining regular meal and snack times can offer grounding anchor points throughout the day. Further, having a meal plan can reduce anxiety during this time when food-buying patterns are shifting. Building flexibility into that schedule and plan, however, can help to reduce the likelihood that rigidity and perfectionism flare, both of which may trigger eating disorder symptoms. For example, this might mean creating a meal plan with multiple options for meals and snacks, so that limited food available at the grocery store is less likely to create panic and distress. 

Connect with your physical self outside of exercise

Physical activity can be soothing and regulating. For those with compulsive exercise urges, however, connecting to our physical self in forms outside of exertive training might help to limit these urges. For example, stretching, deep breathing, or body-based guided meditations and mindfulness exercises can help to feel a greater connection to our body.  

Engage in tactile and sensory activities to cope with and manage eating disorder urges (e.g., crafting, drawing, playing an instrument, doing a puzzle).

Much of an eating disorder exists inside our internal worlds – doing something external by engaging our senses can help to shift our focus away from eating disorder thoughts and urges. 

Limit time on social media

Being inundated with overwhelming and conflicting messages on social media can contribute to heightened anxiety, depression, and unhelpful social comparison. Putting boundaries on scrolling through social media can help to prevent this spiral.

Seek connection and support

Although many in-person support groups have closed, online support groups may be available. Further, many clinicians are continuing to offer assistance through video and/or phone therapy sessions. The National Eating Disorder Information Centre (nedic.ca) runs a helpline and instant chat for those needing support. Hours are available on their website. Connecting in with loved ones and talking about our struggles can also help to soothe the distress associated with an eating disorder. Asking a loved one to help out with grocery shopping or meal prep may reduce the related stress, while also offering opportunities to feel connected to and supported by others.

And finally,

Be compassionate towards yourself

Eating disorders are notoriously harsh and critical. Gently approaching yourself with moments of self-compassion and kindness, acknowledging that this is a difficult time, and validating the struggle you are experiencing, can be a quietly powerful way to help weather this perfect storm. 

Clinicians at CFIR can support you in working with issues of weight and emotional eating.

Dr. Jean Kim, Ph.D., C.Psych. is a clinical psychologist at CFIR’s Toronto location. Over the past eight years, Dr. Kim has had the opportunity to work alongside people as they develop a greater understanding of themselves and their relationships. She has specific interests and training in working with people who struggle with disordered eating, weight, body image concerns, as well as those who are experiencing the challenges of integrating their cultural identity.