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Meaning Making in Times of COVID

Written by Carly Chodosh, LSW | JFCS Social Worker / Care Manager

We’re all looking for it – and under the current circumstances, it seems elusive to many. The world we live in is unfamiliar, the rules seem to change on a weekly, if not daily basis. Too many people we see are in pain and we feel it directly or residually. This is particularly true for the workers on the frontlines of this “Brave New World,” who may desire some return to ‘normalcy’ (whatever that means), and fear the next steps to come.

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Meaning making is the desire to find value, or inherent truth in a challenge or arena in one’s life. According to Victor Frankl, it was how he survived living in Auschwitz for 4 years. But according to Frankl, in his memoir Survival in Auschwitz, it wasn’t grand scale meaning that kept him waking up each day – it was finding the small moments of laughter, connection, and value that enabled him to face day after day.

And we’ve seen it throughout this pandemic as well. From funny memes about how many times a cat can take on the persona of zoom bomber, to that woman who turned herself into a potato in a Microsoft Teams meeting, we’re finding ways to connect amongst the chaos. But there is no place that this holds true more than in the meaning our healthcare workers are finding for their patients, for themselves, and for their communities during this time.

From Jimmy Fallon’s “Safety Dance” with frontline workers to endless story after story about last rites rituals and last-moments Facetime sessions with loved ones, nurses, doctors, respiratory therapists, and other frontline workers are doing everything they can to change the narrative from dire and hopeless to full of love and, well, meaning. Providing these opportunities for connection during the most vulnerable moments of one’s life is something that cannot be measured, and it is that part of the narrative that I am hopeful will carry throughout time.

But as our frontline workers carry that tremendous load of responsibility, how can we support them in the search for meaning throughout the murky waters? The reality is that it is a challenge, and there are no clear cut steps. However, there are areas where it may be possible to focus on the way that meaning happens, rather than the way that it’s nowhere to be found.

Mindfulness
Mindfulness is a tool that provides opportunity for curious reflection, without judgment, of feelings, behaviors, and thoughts. Utilizing this during your time on-and-off the floor will allow for moments of humor, sadness, kindness, and value to trickle in.

Self-Compassion
We are all experiencing a collective trauma – and one that we cannot expect to recover from overnight. Just as bones and muscles need care and tending to in order to recover, so do our brains and hearts as we realize the gravity of our experiences. Facing yourself with compassion and kindness will allow the small victories or “silver linings” to shine rather than the moments we may wish to forget.

Help Seeking
Every single person has limits, and it should not be taboo to ask for help before we reach our own. While stigmas and structural barriers exist in many communities when it comes to treating our own mental health, there are many opportunities available to speak with a professional when it is necessary. This is not true only in the peak of this epidemic – but will remain true for however long the recovery period is afterwards, as well.

Connection
When possible, focus on physical distancing, and not social distancing. Utilize time off to do something that you really LOVE, whether it’s time with your family/loved ones (over zoom or skype), cooking and eating your favorite foods, or spending time in nature – whatever makes your heart sing should be a priority to give you an opportunity to turn off your brain and be in the moment.

Sometimes, the answer is to simply stop looking for an answer, and start looking for a reason to put one foot in front of the other. Usually, meaning will provide those steps. And with our search for a shared meaning, we will get to the end of this pandemic, no matter what the world looks like on the other side.

For support during this time, please call our Care Navigation Line at 1-866-JFCS-NOW or go to www.jfcsphilly.org/sfhp
The National Suicide Prevention Lifeline phone number is 1-800-273-8255
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How to Soothe Yourself in Stressful Times

Written by Lilliam Rozin, LCSW | JFCS Older Adult Mobile Mental Health Therapist

It has been an incredibly challenging time for all of us lately. We have been required to change almost everything about our lifestyles, schedules and plans. We are cooped up either completely alone, or with our families and we are tired of it! Many of us are worried about being able to care for our families and pay our bills; we all wonder what our futures will be. And we all have to learn to live with uncertainty.

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One of the deepest lessons we are learning at this time is that we often cannot count on our external environment to bring us comfort and peace. So how do you find peace, calm and ease during such a challenging time?

Here are some suggestions to help you navigate this time with as much grace as you can!

  • Always do your best, but let go of perfection.
    Juan-Miguel Ruiz in his wonderful book,” The Four Agreements”, encourages us to let go of getting things exactly right! Whether you are a front-line worker or a parent with young children, this is a time to be kind to yourself and realize that you can only do what you can right now. So remember, you can’t fix or control everything. Just do your best each day. Because each day is different, and each day we may feel different!
  • Take time for yourself, any way you can.
    If you have kids and are working from home, this may seem impossible. But teach your family that you need 5, 10 or even 30 minutes of time for you. If there is no other place, go to the bathroom and lock the door! Take a few minutes to just breathe, do a guided meditation, put on your headphones, or take a cleansing shower. Everyone needs some down time to function at their best. Plus you are teaching your kids that even moms and dads need downtime…
  • Talk about how you are feeling with others who can listen and share.
    When we don’t try to handle everything ourselves, we at least feel less alone and realize that everyone else is in a similar boat. This is truly a difficult and unprecedented time for all of us. We need each other more now than ever!
  • Do something mindful for yourself at least once a day (if not more).
    Count backwards from 20 as you exhale or listen to a guided meditation on youtube. Take an online yoga class or just sit quietly and repeat everything for which you feel grateful. If you can stop every hour or so and even just stretch or take one deep breath, that would be great. The more you do these small gestures, the more they become healthy habits, and the more they will help you manage the anxiety you may be feeling with all the unknowns.
  • Find some ritual that helps you create a separation between work and home time.
    These days our workspace is our home. So teach your brain that work time is done for the day by mindfully putting your work in a folder, writing notes for tomorrow so you don’t worry about it all night, tidying up, and even putting things on a shelf or closing a drawer. This helps the mind understand that your focus will shift elsewhere for now. If you can, walk outside and physically make a break between your workday and family time. Sounds small, but it helps train the brain to focus where we want it to.
  • Do something unrelated to work that captures your attention in a one-pointed way.
    For instance, Sudoku or a crossword puzzle; watching a great movie; playing a card game, doing a craft project. It is really hard to be stressed if your mind is focused intently. Multitasking is overrated! In order to calm the mind, we can’t be doing 3 things at once.
  • Finally, remind yourself regularly that self-care is not a luxury, it is a necessity!
    If you don’t take care of your needs, you will become more anxious, depressed, angry and less able to adapt to change. We all handle our stress differently, and we can’t expect others to know what we need. So tune in to your own body and once you know what you need, let your family and friends know how they can be supportive. You are also modeling for your kids and others when you take care of yourself!

As you try any or all of these suggestions, be kind to yourself! It is harder to change and learn when our systems are under stress. So remember: all you can do is your best today. And tomorrow’s best will be different…

If I could pick out just one emotional skill I wish everyone could have, it would be to self-soothe. I find in general that people have not learned to do this for themselves, whether because they were over-protected as children, or had to survive trauma and just figure out the best they could for themselves. Mostly, when we become triggered, we revert to either numbing in some way, escaping, ignoring or self-harming. All if these survival strategies have their value at some point; but are they really getting you through the crisis/ problem or just pushing it to the side (or on to someone else!).

After working with a lot of clients over time, I have noticed that people will call me in a crisis, I talk them off the ledge, and then the next time there is a crisis, they call me again. I usually repeat the very same thing I have said before, and often, even they can recognize this pattern. How nice would it feel to be able to do that for yourself, instead of depending on another for your wellbeing?

With that in mind, we have put together a few tools on http://www.jfcsphilly.org/supportforhealthcareprofessionals you can use to identify and help you remember what you need to gracefully move through challenging times.

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Saying Good-Bye When You Cannot Be at Bedside

Written by Rabbi Tsurah August | JFCS Chaplain

The voice on the phone said: “There is a family whose father is dying in the ICU. They would like you to help them.”

The call came to me from a fellow hospital chaplain, because I work with dying patients and their families, helping them cope with and help make their final hours with their loved ones more comforting, and meaningful.

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3 months ago, I would have quickly gotten the room number and made an appointment to meet the family there. But this was 2 weeks ago, and that scenario was already impossible. No visitors – no family and no chaplain!
Our “visit” was made entirely by phone, without the family or chaplain present at their father’s bedside. And it was moving and beautiful!

Saying our final Good-bye to a loved-one is hard enough. Not being able to say Good-bye at all can be agonizing.

This time of Covid-19 has prevented one of the most important natural human yearnings from being expressed: Being with and saying good-bye to a dying loved-one.

What can we do to have a “Loving Good-bye” with our loved ones when we cannot be with them?

Over the years, I’ve received many phone calls like the one I shared at the beginning of this article. And, much as I would have liked to rush to a patient’s bedside, this was not always possible, so I guided their family members by phone in saying good-bye. Now, without a chaplain available, you can still make this a meaningful and comforting time for your loved one and family.

Here are some practices that have worked for me by phone, when extenuating circumstances prevented me and the family from being physically present.

In advance of the “visit”, invite your family members to join you in this “loving good-bye” and set the means (Zoom, FaceTime, etc.) and time frame. Cap the time at 20-40 minutes, depending on how many people will be on the call.

(BTW, this definitely can work with only the family members on the call. However, there may be a nurse or other staff able to help you connect the patient to the call. Even unconscious patients can hear. I recently had a doctor set up a FaceTime call. The Pastoral Care Office may be able to help you in this.)

You may want to begin the call by having everyone light a candle in their own homes or having a photo of your loved one in front of you. Feel free to be creative! Do whatever makes this feel like a special moment.

If your family has a connection to a spiritual or religious path, you may consider beginning and ending the “visit” with a prayer or blessing.

There are 5 categories of “good-bye gifts” that end-of-life professionals consider to be helpful. They can be said out loud by whomever wants to speak, or held silently.

The first is an expression Gratitude.
Gratitude for how the patient has enhanced your life. This can include general or specific acts or words, such as “I am grateful for how hard you worked to support us”, “I am grateful for your unconditional love”. Or “ I am grateful for the time you….”.

The second is to assure them that They Are Not Alone.
This may seem strange, since they are physically alone. However, this lets them know you all are thinking of them and that your love is with them.

The third is Forgiveness.
This can be a challenging one. Throughout our lives there are moments when we may act or speak in ways that are painful to others. A sharp word, a teen-age acting out, a fib, etc. Even the kindest of people have these moments. This is the time to ask for and offer forgiveness, even if the patient cannot initiate or respond.

However, there are situations where asking or giving forgiveness is not authentic, because the pain is too deep or unresolved. In this situation, I recommend simply saying “We have done the best we could”.

The fourth is We Want the Best For You.
We Will Take Care of Each Other the Best We Can. This can be very comforting to the dying person who will no longer be able to take care of you. It can also help deepen the family bond and reassure frail and vulnerable survivors.

(Many End-Of-Life counselors suggest saying something in the order of “You can let go now, we will be OK”. )

The fifth, and final, is You Will Be Loved and Remembered.
This speaks for itself.

Now take time to share memories! Laugh, cry!

I hope these suggestions help you find a way to say “Good-bye” that is right for your family. No matter how near or far you are from each other and your loved one, your care and love transcend time and space. No matter what!

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Tips for Coping and Stress Reduction

Written by Robin Axelrod Sabag, LCSW | JFCS Assistant Director, Counseling and Therapeutic Services

Times are uncertain. We are experiencing a worldwide pandemic. Countries and borders are shutting down. Some of us are in areas that are hot spots for coronavirus. Many of us stay glued to the news, wondering, “what will happen next?” This is not easy to embrace. Humans do not like uncertainty.

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With so much unknown, it is normal to feel stressed. While this reaction is understandable, it can wreak havoc when there is a sense of uncertainty and conflicting information around us. None of us was prepared to simultaneously juggle zoom calls, parent quarantined kids, change diapers or help children to log into online learning all while finding the time to cook three meals and several snacks per day. Parents were also ill – prepared to support their kids who formerly were over-scheduled but now have to navigate endless down time, screen time and no real-time friendships. People were not prepared to dodge the disease, worry about leaving the house, and then return from grocery shopping only to wash their hands incessantly and disinfect the bags in which the food was packaged.

With stressors such as these, our overall well-being is likely to suffer, without us even being aware it is happening. Some of us may feel more anxious, on edge, depressed, and frustrated. Those with underlying mental health issues will feel this even more intensely.

During this precarious time, it is important to gain perspective and to know that we are not helpless. We can arm ourselves with tools and choices. Here are some things we can do to take care of our mental health in the face of uncertainty:

Accept That it’s Normal to be Stressed Out Right Now. Don’t Judge Yourself For How You’re Feeling
One of the first steps to coping with anxiety and uncertainty is to recognize that it is a normal and reasonable response. Symptoms of stress, like elevated heart rate and racing thoughts, evolved as the body’s way of signaling to your brain that it is in danger. This is what is commonly knows “flight or fight” and is a basic human instinct. Keep in mind that stress tells us that something is off and that we need to adjust. We cannot simply do away with stress; we have to find ways to manage and cope with it.

Separate What Is in Your Control From What is Not
There are things you can do, and it’s helpful to focus on those, not on what you cannot control. Stay home. Wash your hands. Remind others to wash theirs. Take your medicines and supplements. Limit your consumption of news to certain times per day and only from reliable sources. Take care of yourself.

Stick With a Routine
Having a daily routine in place can help you to feel grounded. Try to: wake up at the same time every day; eat regular meals; do an at-home workout; get your work done; plan for enjoyable activities etc.

Get Outside in Nature
Get outside; you can still walk through nature while keeping a safe distance from others. Take several walks a day. Get your dose of vitamin D; don’t stay inside all day. Exercise also helps both your physical and mental health.

Challenge Yourself to Stay in the Present
You may not only be worrying about current events, but also projecting into the future. You might be concerned about the state of the economy, whether you will have a job next week, whether your sister will be able to have her wedding this spring, or whether your aging parents will be able to survive without catching this virus. These are real concerns. Some you can prepare for; others you have no control over. When you find yourself worrying about something that hasn’t happened, gently bring yourself back to the present. Engaging in mindfulness activities is one way to stay grounded when things feel beyond your control.

Stay Connected—Even When Physically Isolated:
Humans are social animals, hard-wired for connection. Social distancing comes with risks. Staying in isolation can cause depression. Prioritize connections. Do what you can to schedule daily check-ins with friends and family. Join an online support group. Utilize social media to stay connected to your community. Remember, you are not in this alone.

Prioritize Exercise and Proper Nutrition
This is always good advice, but it’s worth emphasizing during times of uncertainty. Since you cannot get to a gym, there are many online at-home workouts available. Anxiety increases the stress hormones – adrenaline and cortisol. Physical exercise reduces the levels of these hormones and stimulates the production of endorphins, which serve to elevate mood and well-being. Although it is tempting to seek comfort in food, sticking to a healthy diet is also important and can also help improve your outlook. A recent study found that a Mediterranean-style diet, rich in fruits and vegetables, whole grains and lean protein help reduce the symptoms of depression and anxiety among a group of young adults.

Don’t Let Coronavirus Be the Center of All Your Conversations
Keep in mind, there was a life before coronavirus. There are other topics of conversations. When connecting with others, try to take a break from the stress. Remember to laugh and try to find ways to enjoy the company of others, apart from this misfortune.

Seek Professional Help
If your mental health is being impacted by the stress of the coronavirus, then you may want to seek professional help. A licensed mental health professional can help you to manage your fears while also empowering you to make the best decisions for you and your family. Most, if not all mental health professionals, are practicing Tele Mental Health now and can provide support during this stressful time. You do not have to be alone with your worry, and it is okay to ask for help from a professional.

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Building Empathy in Our Children

Written by Paula Goldstein, President and CEO

The past week has been agonizing for Americans. After bearing witness to the tragic killing of George Floyd, and evoking a sense of anger and outrage, our country is not where it should be in terms of racial division and equality. Peaceful protests and demonstrations nationwide followed, exercising our freedom of speech, and characterizing one of the privileges of being an American citizen. While the majority of protesters expressed their understandable anger and despair in a peaceful manner, others chose destruction and theft, leaving parts of our cities destroyed and George Floyd’s family and many civic, religious and community leaders saying this is not the way to achieve justice, and not what George Floyd would have wanted.

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Our children have been watching or experiencing the narrative of racism, social inequality, injustice, and personal safety unfold, and as if parents did not feel enough anxiety already, they are now searching for ways to talk to their children about these recent events. How do parents create a safe space for discussions about race, privilege, and injustice with the goal of educating our kids, helping them reflect on their world and cultivate empathy for others, and embrace anti-racist values, standing up to hate?

I remember when my kids were growing up, our most significant conversations took place in the car when I was driving, and they were in the backseat and did not have to make eye contact with me. Now in the pandemic, families are with each other 24/7 with little personal space and a lot of stress. Having these conversations now is critical and finding the optimal location and time is a challenge indeed.

If parents were to think of moments like the ones over the past week, when people are scared, confused, uncomfortable, and angry, as opportunities for tremendous growth and learning then perhaps the intense feelings of despair and anxiety can be redirected towards self-reflection, awareness, and change for both the adult and the child.

To begin conversations with kids it is imperative to know yourself and your own feelings about some big topics. Self-Awareness is a must! What are the values that you live by, how you do you feel about your own ethnicity and heritage, and how does your own life experience inform your beliefs about social justice, social action, inequality, discrimination, diversity, and inclusion? If you have a partner or spouse, talking to each other about your feelings and creating a loving and encouraging space where these difficult conversations can take place and will benefit children in the long run. Engendering a comfort level between partners enables healthy discussion with kids where self-expression is honored.

Finding the appropriate language by which you express your values and beliefs based on kids’ ages and developmental stages can help to engage your children in meaningful conversations. Looking for cues that they bring forth to start a discussion will also show your ability to be responsive when they want to talk. When you are asked questions about events such as last week’s, respond thoughtfully and honestly. Use “I” messages in explaining your feelings, like “I feel sad that George Floyd died;” “I feel like it is not fair;” “I know some very caring police;” or “I feel like people should be free to express themselves peacefully.”

You can also frame a conversation about protests in front of the White House, or at the Philadelphia Art Museum as an important way to express oneself when a person doesn’t agree with something that has happened or the way that someone has behaved. When talking with teenagers it may be more appropriate to hear what they think and why, as opposed to finding opportunities to share your own views. Asking questions about their ideas or what they think is needed (even if it isn’t well thought-out) might get them thinking and open the door for future conversations. No one needs to have all the answers—everyone just needs to care.

The relationship between the parent and child is key for discussions that tap into kids’ sense of belonging, safety, and responsibility for themselves and others. If the parent is overly anxious and stressed, kids most likely will be too. If the parent can listen and acknowledge all feelings, more and more discussion will naturally occur.

It seems that all roads in talking to kids about the unrest in our country lead to the cultivation of empathy and this is something that a parent must first model themselves. Empathy is the ability to understand and share the feelings of another. We want our children to experience deep empathy in times like these so that they evolve and lead the next generation with a sense of hope, compassion, and responsibility. Now is the time. Developing empathy in children is the most hopeful way to cope with the cruelty and chaos our country is now experiencing, with the goal of changing the future.

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More Articles and Information

New York Time Series on Resilience

Comprehensive List of Mindfulness and Compassion Resources

Minimizing Relationship Tension at Home During COVID-10 Crisis
University of Houston

How Mindfulness Can Help During COVID-19
by Child Mind Institute

Boost your mental and physical health during the pandemic by volunteering virtually
CNN

Managing Stress: Tips for Coping with the Stress of COVID – 1 9
Massachusetts General Hospital

Parenting in a Pandemic
A Conversation with Dr. Alan Kazdin at Yale University

Little House Calls Website

Parenting While Human Blog

25 Science Based Practices for Parenting During COVID-19

The Postpartum Stress Center
A great resource and also offers support groups

CNN/Sesame Street Coronavirus Town Hall
Dr. Leana Wen answers questions from children all over the world about what the coronavirus is and how they can stay safe.

CNN/Sesame Street Racism Town Hall
CNN’s Van Jones and Erica Hill partner with “Sesame Street” for Coming Together: Standing Up to Racism, a town hall for kids and families. 

This Is #MyJewish. It Matters.
Tablet Magazine

You Don’t Have to Choose Between Black Lives Matter and Israel
The Forward


For support during this time, please call our Care Navigation line at 866.JFCS.NOW (866.532.7669)

The National Suicide Prevention Lifeline phone number is 800.273.8255.

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