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.

Were you already feeling lonely before physical distancing became mandated? Now in response to the novel Coronavirus Pandemic, The World Health Organization (WHO) recommends “physical distancing” as it is vital to slowing the spread of COVID-19. It is difficult to fully grasp the idea of limiting physical human connection as it is essential for promoting wellness in our lives. But we are being told this vital connection could potentially harm us. 

But I Was Already Lonely…

Unfortunately, COVID-19 is not the only public health concern we should be worrying about as we start to see the countering effects of social isolation and loneliness. According to new research by Statistics Canada, the number of people living alone in Canada more than doubled over the last 35 years. Also, there is some evidence that individuals who live alone are more likely to report social isolation or loneliness than those who live with others. For many of us, especially those who live alone, being deprived of social connection for an uncertain amount of time could exacerbate current feelings of loneliness and other mental or physical illnesses.

We were already living through an epidemic of loneliness, even before the Coronavirus pandemic started. Those who are lonely do not choose to be isolated. Loneliness can be defined as the subjective feeling of being alone and not connected to others, which can still occur when in the company of other people. Those who experience loneliness tend to have higher levels of cortisol, which is an indicator of stress. An accumulation of this stress hormone can suppress your immune system when exposed to pathogens.

Stay Physically Apart But Stick Together

Being told to stay away from one another physically is the opposite of our innate response as humans to seek out and support one another during stress to maximize survival. Humans have lived in groups for thousands of years for this reason.

The new term “social distancing” was intended to stop or slow the spread of the Coronavirus by limiting the number of people you come in contact with while keeping a physical distance from one another. But more recently, The WHO says efforts taken to slow the spread of the Coronavirus should instead encourage strengthening social ties while maintaining that physical distancing. The new term “physical distancing” emphasizes the need to be physically apart, but socially we still need to work together. 

Why is Social Connectedness so Important?

There are decades of research that support the importance of social connection and love and belonging. According to Abraham Maslow, humans possess an innate desire for a sense of belonging and acceptance. These needs are met through pleasing and fulfilling relationships with others.

From the beginning of our lives, we are wired to connect. This fact is evident from our early days as a newborn. When an infant cries, oxytocin is released. The cry serves as a signal for the mother to bond with their child. Also, there is evidence that this bonding hormone is released when we engage in positive social interactions.

Here are some ways to engage in positive social interactions while halting the spread of COVID-19 and turn social distancing into distant socializing:

Be in Nature – Cultivates interconnectedness of others and reminds us that we are just a small part of the greater whole. 

• Go for a walk at least once a day – each person you pass say hello and smile at them
• Go for a hike or bike ride

Use Technology in Socially Healthy Ways Set reminders to connect with others 

• Social Technology Connections 
  • Use Facetime, Zoom, House Party or Marco Polo 
• Watch Netflix in Party Mode stream together with a chat function at Netflixparty.com
• Virtual Exercise Classes

Media and News Exposure

• Limit exposure to media related to COVID-19 ten minutes in the morning and ten at night 
• Use consistent and credible news sources for your information 

Slow Down and Reflect

• Create a new normal at home with structure and consistency 
• Reflect on a past positive event 
• Look at old pictures or videos- by seeing, hearing, or thinking of loved ones can recreate old attachment bonds. 
• Embrace little connections; they can be meaningful
• Comfort food – reminds us of being safe and cared for 

Be Present and Mindful

• Engage in interactions requiring eye contact with both people and pets 
• Pet and play with your furry companion

Help Yourself and Others

• Talk about your feelings of loneliness with others. It may not rid you of your loneliness entirely but lets you know you are not alone in that feeling.
• Give support to others – helping others will help them, but it makes us feel connected as well, which can help us see our shared humanness. We are all in this together.

The correlation between social connection and overall health is clear. Social interaction and connectedness can be used as treatment and prevention for feelings of loneliness and isolation.

At this point, it is safe to say that connecting with others during this period of isolation and using technology in socially healthy ways can increase pleasure and continue to release the oxytocin we need to thrive and survive. This can, in turn, reduce stress and increase happiness. Physical distancing may protect us from the Coronavirus, but it may deprive us of our innate need for social connectedness and belonging.

When we are isolated from others with limited social connection and deprived of oxytocin, life can feel cold and empty. For many, loneliness and even depression follow. Right now, our clinicians at CFIR are offering secure video and teletherapy sessions to new and existing clients. Please feel free to reach out if you would like to connect for a confidential therapy session from the comfort of your own home.

Laura Moore, B.Sc. (Honours) is a therapist at the Centre For Interpersonal Relationships (CFIR) in Toronto. She is completing her Masters degree in Clinical Psychology at the Adler Graduate Professional School in Toronto. Laura works with adults and couples in therapy, to support them to overcome challenges related to depression, stress, grief and loss, trauma, and relationship conflicts. Her current research focuses on cultivating spousal attunement following traumatic experiences.

There is no doubt the COVID-19 pandemic has already become a time of significant uncertainty, concerns, and instability. For many individuals, this chaos may negatively impact general well-being and functioning and may provoke increased levels of stress, sleep disturbances, and lower mood. Try one or all of the following tips to help maintain a certain level of normalcy in your daily regimen:

1. Follow recommendations and take actions

When possible, participating in measures and advice can help us feel connected to our community and increase our sense of internal control. For example, by practicing social distancing, we can feel solidarity and know we are taking a concrete measure to limit the spread of the virus. By encouraging local businesses, we know we are participating in the local economy. By connecting with the vulnerable individuals around us, we minimize their isolation. In this uncertain global climate, taking ownership of our actions can help mitigate our sense of helplessness.

2. Stay connected

Social distancing can tangibly and positively impact the pandemic, but the practice can also leave us feeling lonely. Communicating with friends, family, and colleagues through different means of technology can give us a sense of connection – which is such an essential part of our regular functioning and well-being. Share a meal or a board game session over video chat, play online games with friends, write a letter or send an e-card, or call and message your loved ones.

3. Maintain your routine

When our daily routine is completely changed, it is vital to maintain some key elements, so it is not too difficult when we return to full normalcy. Try practicing your same eating and sleeping habits, get up and maintain your regular wake up time, go for a walk or do some stretches when you would usually take a break during the day, etc. It will go a long way! 

4. Participate in self-care activities

Your self-care remains essential, and we can be creative with that exercise. Many cultural events, physical training programs, and interesting classes are now shared online for free. You may wish to revisit past activities that make you feel good such as playing games, taking a bath, doing a meditation exercise, reading, watching a movie, organizing or decluttering your house, cooking, sorting through pictures, etc.

5. Seeking help and support when needed

Throughout this challenging time, you may feel an increasing need for emotional support. Do not hesitate to rely on your support system, call a distress line, or consult a mental health professional. CFIR is offering secure teletherapy to individuals in need of services, and we are here to help! 

Like all things in life, this chaos will eventually pass. By focusing on our needs and staying connected, we will all get through this together. 

Dr. Karine Côté, D.Psy., C.Psych. is a psychologist at the Centre for Interpersonal Relationships (CFIR). Dr. Côté provides psychological services to individual adults and couples experiencing a wide range of psychological and relationship difficulties related to mood and anxiety disorders, trauma, eating disorders, sleep disruptions, and interpersonal betrayal. She works from a humanistic approach and integrates therapeutic techniques from gestalt and object relations psychotherapies, emotion-focused therapy (EFT), and cognitive-behavioral therapy (CBT).

For most of us, the social distancing process has been accompanied by many questions, concerns, and uncertainty, leaving us feeling overwhelmed, confused, and anxious. These feelings are common, as we are trying to navigate an unprecedented situation that left us needing to adapt rapidly to a new reality.

There are many useful ways to help us adapt during this time, such as setting boundaries. Boundaries are an integral part of self-care and will be essential to feel psychologically well.

Boundaries with yourself related to pandemic can look like the following:

• Limit your media or information intake
• Rely only on two or three trusted resources
• Maintain good sleep hygiene practices
• Check-in regularly with yourself to increase self-awareness of internal experiences
• Eat regular meals (even though anxiety can make it hard to feel hunger cues)
• Limit your caffeine intake as this can induce anxiety symptoms
• Say no to hanging out with friends, even if it is at home
• Find safe ways to breathe in some fresh air and move your body every day

Boundaries while working from home can look like the following:

• Set the alarm in the morning
• Get dressed
• Schedule breaks
• Set your phone aside or use mobile applications to block distractions (e.g., self-control)
• Create a designated, comfortable workspace
• Schedule specific times for social interactions
• Check emails during the workday only
• Focus on one task at a time

Remember that you are not alone in what you are experiencing. It is ok to feel all your feelings. If you had mental health difficulties before the pandemic, this might be a more triggering time for you. Again, you are not alone. I hope that you take good care of yourself by honoring your mind and your body. I also hope you stay connected to your community and your loved ones by reaching out via video chat, texts, and teletherapy. We are all in this together.

Mathilde Theriault, B.A. Hons., is a clinical psychology resident at the Centre for Interpersonal Relationships (CFIR) in Toronto and a candidate in the Doctor of Psychology program (Psy.D.) at the Universite de Moncton in New Brunswick. She provides psychological treatment and assessment services to individual adults and couples in the areas of depression, anxiety and stress, trauma, personality disorders, and relationship difficulties.

Many of us are still coming to grips with the surreal experience of living through a pandemic. Yet, here we all are grappling with many of the same questions and concerns, from basic ones, “Are we going to be able to find toilet paper?” to more existential ones, “What is life going to look like in three (or six or nine) months from now?”

Over the past week, a recurrent conversation I have had with friends, family, and colleagues is how we plan to use this time as an opportunity for growth. Whether it be chipping away at our ever-expanding reading list or reconnecting (or connecting more deeply) with loved ones, how will we expand? For couples whose relationships were strained before the implementation of social distancing measures, this may be a fork-in-the-road moment. One path takes the couple down further disconnection that will make salvaging the relationship more difficult; the other road offers opportunities for couples to build a stronger relationship in potentially profound ways.

This blog will focus on two broad opportunities associated with taking the latter path:

1. The first is for couples to learn/re-learn how to work together effectively as a team. This moment in history has brought one thing into crystal clear focus: we all rely and depend on each other. Indeed, the effectiveness of my efforts in socially distancing depends on whether those around me do the same. Often, as couples become disconnected over time, their ability to work as a team is compromised. Differences in how to load the dishwasher, for example, become a place of further division and alienation. As social distancing measures continue to be in effect, and some of us are forced into close quarters with our partners, problem-solving and finding solutions that work for the couple is critical. Problems that will naturally arise include: Who is going to get groceries? How many hours of screen time for the children is acceptable? What are the meal plans going to look like? To effectively address all these questions and more, couples have no choice but to keep the lines of communication open. Relying on assumptions and hiding from your partner is no longer an option for the time being.

Here are some tips for couples trying to work together:

• Be flexible, do not nitpick. It is okay to have standards, but you are sharing a smaller, more contained, world with someone, so your ability to compromise is essential. Your place may be messier than usual. Permit yourselves to relax those standards.
• Pause heated conversations and make a plan to return to them at a later time. Set aside time consistently to review any issues or concerns that need to be addressed.
• If you are upset, refrain from criticizing your partner or making “always” or “never” statements (e.g., “You never help out” or “You always do it wrong”). Focus on the challenge right in front of you. Avoid “kitchen sinking” each problem by referring to all your past conflicts.

2. Another opportunity for couples during the pandemic is to reconnect through openness and curiosity about each other’s experiences. Couple partners presenting to treatment often struggle to be open and curious about their partner’s experience because they can assume that they’re going to hear something critical or something that implicates wrongdoing on their part. In this situation, partners will often become angry or withdraw from each other, creating a self-perpetuating cycle that leaves all parties feeling frustrated and invalidated.

Questions you could ask your partner might include:

• What is this like for you?
• What are you scared/hopeful about?
• How effective do you think the government response has been?

If you feel that your partner is open and curious about your experience, you will be more likely to feel validated and understood. This is important because the process of feeling heard by someone is a salve for our emotional distress and helps to build intimacy and connection. This might inject goodwill into the cycle mentioned above that strengthens the foundation of the relationship for other changes to take hold.

Taking these steps to improve the relationship will no doubt present some challenges. Psychologists and therapists at CFIR that work with couples are here to help you and your partner implement these necessary changes and to process and work through any issues that might arise. During the pandemic, we offer telepsychotherapy services (e.g., video, telephone) to support you and your partner to overcome challenges and build intimacy and connection.

Dr. Sela Kleiman, C.Psych. is a psychologist in supervised practice at CFIR’s Toronto office. He has provided clinical and assessment services in a variety of settings such as the Centre for Addiction and Mental Health, the McGill Psychoeducational and Counselling Clinic, and the Health and Wellness Centre within the University of Toronto. He has also completed his Ph.D. in clinical and counselling psychology at the University of Toronto. In individual therapy, he help adults struggling with depression, anxiety, grief, as well as those trying to cope with the effects of past and/or current verbal, emotional, physical, and sexual abuse.

Within the past few weeks, so many of our realities have entirely changed. With the COVID-19 pandemic, many of us are working from home and choosing to practice social distancing. This new realm may have interfered with your weekly or biweekly therapy sessions. For others, you may be finding yourself struggling with new or familiar troublesome thoughts, feelings, and memories. 

Right now may be a time when you are looking for support.

Right now is when video and telephone therapy are great options to explore. 

Some of the benefits of video and telephone therapy include:

Accessibility

ideo and telephone therapy is easily accessible to everyone that has a phone, computer, or tablet and an internet connection.  

Comfort

You can have sessions from the comfort of your own home which may make you feel more comfortable because you will be in a familiar setting

Flexibility

There is more flexibility in terms of scheduling your sessions

Consistency

These sessions work much in the same way that face-to-face meetings do. If you are used to coming into your therapist’s office, there will be minimal difference when switching to video or telephone sessions. 

Clinicians at CFIR are offering secure video and teletherapy sessions during this time, to ensure continuity of care. Reach out if you would like to have safe, confidential therapy sessions from the comfort of your own home.

Natalie Alexov, B.Sc. is a counsellor at the Centre for Interpersonal Relationships (CFIR) under the supervision of Dr. Aleks Milosevic, C.Psych., and a Masters of Education with a concentration in Counselling Psychology at the University of Ottawa. She supports individual clients to overcome a broad range of difficulties, including depression, anxiety and stress, the impact of traumatic experiences, and relationship problems.