Living Well Integrative Health Center

2176 Windsor Street, Halifax, Nova Scotia, Canada. (902) 406-1500

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A short survival guide to COVID-19 Published April 1, 2020. It's no joke we need to take care !


A short survival guide to COVID-19

Maria Patriquin, MD CCFP FCFP

There is much to be grateful for as we enter a new week with so much fear, confusion and vulnerability. Gratitude may be harder to access than social media would suggest or imply so I am going to help guide you through that if you wish.

The desired goal is to hold our shared vulnerability with gentleness, generosity and compassion. This is our shared humanity and we are all together in this. May we be creative and grateful for each and every moment we have and when struggling to access this try and connect to someone remotely to help you see it.

It indeed is a scary unpredictable time but together we fare this better. We must enjoy, tolerate, endure, rejoice, relax and accept this. Regardless of what it feels to us in a given moment, we must understand that to stay inside and isolate physically is the only way we will reduce the human toll. Find some way to embrace it or connect to others that can help you do this

Consider this...

1. Make a schedule. Humans thrive on routine. The predictable in a time of unpredictability gives a greater sense of normal and we don't just want this we need it.

2. Restrict, limit and define your exposure to the news. By “define” I mean be clear about why you are tuning in. Checking once or twice a day will suffice, the latter of which should not fall at bedtime. Choose a reputable source as fake news is also in circulation. The most important use of your news time is to remain current on local numbers, measures, laws and available resources. When it comes to news please consider that children and teenagers do not need to hear more than the critical messages like what the virus is and why the concern. They need to grasp the importance of physically distancing while remaining socially and emotionally connected, They need to know that we can also do things to stay healthyphysically and mentally at this time. Teenagers are often attributed more capacity to deal with the difficult and fearful than they are able to. Don’t assume, please ask what they need. People often say younger children aren't listening or don't understand. They do so please just trust me on this one and contain your covid conversations and ensure they are age appropriate. Decide how much of your shared family time will be spent on open discussion and then move on to other topics of interest. This keeps conversations and relationships balanced.

3. Ensure you do all the self-care things you thought or said last month you didn’t have time for. Sleep enough, eat well, exercise, socialize (phone or through social media), pray, make something, listen to music, get fresh air. In essence all that you feel will feed your mind, body and soul! Remember that self-care is not a luxury but a necessity and helps foster health and resilience in the face of stress.

4. Meditate. Use guided to begin. See my website page under mindfulness, the UCLA site or YouTube for many options and variations of a seated meditation or body scan. This helps center the mind and calm the nervous system. If a meditation or body scan doesn't feel accessible or safe to you, just breathe. Count your breaths or say in, out. The exhalation should be longer than the inhalation thereby activating the parasympathetic nervous system. For children try blowing bubbles, using a pinwheel or a balloon to help facilitate deep breathing.

5. Name three things a day you are grateful for and they can’t repeat. This is my trick to ensure we don't put the practice on autopilot. We do gratitude as grace at dinner. It is also a great way to begin and end the day. Feel free to surpass the three. Also consider doing what we call in our house "blahtitude or failitude”, you know giving voice to the difficult feelings, thoughts or perceptions of failure. They count too and need to be shared not held inside. Just ensure to follow them with some gesture of gentleness or gratitude. That may be hard but we need it. Make it small, I mean micro. For example I might be grateful that the sun was warm on my front step when I ventured outside. I saw a blue jay or a random stranger walking down the street said “Hi” while walking their dog. Write these down as journaling works. Keep a small booklet or create a gratitude jar (clear) so you can see the gratitude piling up. This will serve as an external reminder each time you pass by. I use a little pocket sized notebook that can be easily accessed in a moment of deep discouragement or darkness. It's pretty hard to believe those thoughts as facts when you read through all that you felt grateful for in the preceding month. External reminders work, write them on your mirror and windows, or post a picture of a peaceful place or loved one around your home.

6. Let yourself feel. You are human. You are going to have intense feelings at this time. Fear, anger, sadness, frustration, grief, loss, confusion are all normal. These emotions and the thoughts that accompany them are telling you something. Fighting, distracting, numbing or detaching from them enhances and intensifies strong feelings. Breathe, soothe, move and know this too shall pass. I suggest pairing the moment with something soothing, grounding or positive that normally gives you some sense of comfort or pleasure. I call this "positive piggy-backing" and it is the principle of using our conditioned positive response to something to color a not so positive state. When we revisit, remember, recollect we are actually physiologically re-experiencing. The re-experiencing can help us lean into and soften our response to the current more negative or intense thought or feeling. This will help you move through the feelings and thoughts in a healthy and reasonable time and manner, making them more tolerable and manageable. Use the feelings you have to inform your day of what activities will be of most help. To do this you must be mindful, listening to how it is you feel, think and sense. If it isn't meditation, then don't meditate, do jumping jacks! If you choose Netflix, chose a positive, inspiring show or movie. This isn't the best time for a downer drama or horror movie. Stay safe and healthy emotionally and cognitively.

7. Think optimistically. So when it doesn't go how you wish or someone or something disappoints you, rather than lashing out at someone or in at yourself, consider that it is just something that happens. Give yourself and others the latitude to be human. That means stuff happens, we fail, we fall and everyone experiences and feels this way sometimes. The acknowledgment of our pain and understanding of our imperfection is at the heart of self-compassion. Envision a different outcome understanding that regret differs from guilt (which holds hands with shame and blame) and from that place we can choose differently next time, holding our experiences with more self-compassion and a shared sense of humanity.

8. Do something kind for someone else. "Be kind on purpose" is my trademark, motto, mantra and motivation. Yeah we know you can’t leave your home! Call, draw a picture and text it. Sing out loud to your neighbors, text them and perhaps sing together. I texted some moms and got kids to go outside and a block away they exchanged bird calls. Draw a picture or a message on the sidewalk for all to see. Need more ideas just ask and keep tuned to our website and Living Well Fb page

9. Remember that we are the only species that can think about how we think. This translates to being able to hold something in our conscious minds and we then see things differently, as if through that lens. So choose a word that reflects a quality or attitude that you want to embrace at this time. It needs to align with your value system. For example I might choose brave, thoughtful, kind, compassionate courage, strong, resilient. Each time I do something with intention I repeat that word to myself and I see and experience that intentional act through that lens. The more I do it, the stronger it becomes and more powerful in transforming my experience into one that embodies that quality as well. The key lies in repetition.

10. There is good evidence supporting the understanding we have that not only can we be "resilient", we can actually grow and surpass where we may have landed if there had not been some major challenge/trauma/crisis. This is called post traumatic growth and it means that the ways you develop right now to cope and manage have the potential to enable this growth or hinder it. You may not think these measures or suggestions work, but they do. You don't need to buy in (although that does help strengthen the practices), you have to just do them! Whatever we do repetitively we get better at.

11. I have always said it's not what happens that's most important but the attitude we take towards what happens that matters. Deciding who you want to be in the face of this challenging time and crisis is singularly the most important decision you can make. So take some intentional time to think and jot down your personal values, who you are. Then be you, do you. Be authentic, be in wonder, empathetic and empowered by making healthy choices like the ones we just read. I call this being "In AWE".

We are in isolation, we are alone in some sense....and we are in this together. We need to stay socially connected while remaining physically distanced. It is from this social and emotional connectedness that we remain motivated to continue to do not just for ourselves but for each other and the common good. Now more than ever we can create a sense of community as collaboration truly does cultivate community.

With hope, Maria

Dr. Maria Patriquin has worked as a family physician for 22 years and is the founder of Living Well Integrative Health Center in Halifax She is recognized for her work on collaborative models of primary care with special expertise in prevention and management of stress, mental health, PTSD, RN and physician health. She is physician lead for family medicine based innovative group medical visits, psycho-education and group psychotherapy in Nova Scotia. She represents the CFPC on several national mental health working groups, committees, task forces and is the 2020 co-chair of the Canadian Collaborative Mental Health Care Conference. Dr, Patriquin sits on the Editorial Board of the CFP and is currently an assistant professor in the department of family medicine at Dalhousie University. 


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