Category Archives: Covid-19 Crisis

Parenting Tips for Homeschooling

As homeschooling seems to stretch endlessly for many families, certainly school districts try to provide guidance and curriculum. These are some tips offered by my offices to ease the course. And even make it enjoyable.

Establish structure
The success of homeschooling depends on your willingness to commit to a structure and a schedule and your willingness to be on top of it. I have families maintain a large calendar, or even whiteboard, that has all the family activities on it, to be able to see them at a single glance. This includes outdoor activities, family time, special events, social commitments, downtime (described below), class time, and, of course, homework. Homeschooling is not just about schoolwork.

Use available resources

  • KhanAcademy.org has also added new features and functionality as a result of the pandemic, including daily learning schedules for children ages 2 to 18.
  • thinkwell.com offers classes for homeschoolers taught by acclaimed professors in subjects ranging from high school and Advanced Placement mathematics and science to American Government, Economics, History and even public speaking.
  • audible.com has free books for kids.
  • math-drills.com has free math sheets for kids

Model the value of dealing with uncertainty.
At Embolden, we call this emotion coaching. The pandemic, so often referred to as unprecedented times, really is. Mental flexibility is a hallmark of executive functioning, and incredibly valuable as a life tool. Teaching and discussing as a family how to deal with not knowing is invaluable.

Change your expectations.
Things are not the same. Expecting a similar level, duration, or output of work is unrealistic. Set the kids up to enjoy the experience. Before worrying that you or your child are underperforming, remember that having and maintaining close emotional connections with kids during this time is a priority.

Play
Free time, is an incredible stress reducer for children, and so is outdoor time. One family I know it takes a family walk most evenings of the week. Parents have told me that kids really open up to them on these outings. Another option is quiet time, an hour away everyone has to entertain themselves, whether they choose to read, play games, or even text with friends.

Encourage fun chores
Homeschooling is not just about school. I have many of the kids I work with plan a menu or recipe, make the grocery list, and make a meal for the family once a week. Other kids and teens I work with enjoy working in the garden with parents or family, or taking care of indoor plants. Start with less demanding tasks, and reinforce the importance of a family home and all its members.

Be easy on yourself. And them.
It’s important to remember that homeschooling isn’t going to be perfect. It’s a stressful time for both you and your child. Teachers, parents, and students have all noted in studies, that it can be hard, and even tiring. So if you need to put on a movie to get through the afternoon, or call it quits for the day, that’s okay.

Movement
Stretching, walking around, playing with a furry family companion, and even going outside for short breaks have all been shown to increase concentration. 

On pandemic and homeschooling

Several of my local school systems as well as private schools in my work in Maryland, Virginia, and Washington DC have made it known that they are going to have a very limited schedule or no in vivo teaching this fall.

I work with many parents and educators. It’s been an incredibly difficult process, since March, to parent, work from home, do home schooling, manage health concerns, and still try to have quality of life and self care.

I have the deepest respect for the challenges involved. But it’s essential to help children feel safe, keep healthy routines, manage their behavior and build resilience.

Here are some tips to help your children feel safe.
– Address children’s fears directly
Children rely on their parents for safety, both physical and emotional. Reassure your children that you are there for them and that your family will get through this together.

-Answer questions about the pandemic simply & honestly. Talk with children about any frightening news they hear or see. It is OK to say people are getting sick or passing, but say following rules like hand washing and staying home will help your family stay healthy. Explain to them why they may not be able to see their friends easily in a calm fashion. Making things seem like they are falsely positive it’s not helpful for children, because they will know that there is something wrong

-Recognize your child’s feelings. Calmly say, for example, “I can see that you are upset because you can’t have your friends over.” Guiding questions can help older children and teens work through issues. (“I know it is disappointing not to be able to hang with your friends easily right now. How do you think you can stay in touch with them?”)

-Keep in touch with loved ones, friends, and family. Children may also worry about a grandparent or family member who is living alone or a relative or friend with an increased risk of getting COVID-19. Video chats can help ease their anxiety

-Model how to manage feelings. Dr. Siddique calls this emotion coaching. Just like a coach can help you be a better athlete or student, emotions also require practice, feedback, and implementation.

Talk through how you are managing your own feelings. (“I am worried about Grandma or Auntie, since I can’t go visit her. The best I can do is to check in with her more often by phone. I will put a reminder on my phone to call her in the morning and the afternoon until this outbreak ends.”

-Acknowledge compromises. Yes, working from home is hard. I have to make a lot of adjustments. I know mommy is in the study all the time. It’s like being at the office but now it’s here at home. Sometimes when I’m here in the house, I can’t always talk to you. But we will have our time later.

-Tell your child before you leave the house for work or essential errands. In a calm and reassuring voice, tell them where you are going, how long you will be gone, when you will return, and that you are taking steps to stay safe. More than ever, communication matters.

-Look forward with realistic optimism. Tell them that scientists are working hard to figure out how to help people who get ill, and that things will get better.

-Offer extra hugs and say “I love you” more often. Being affectionate matters.

-Keep healthy routines
During the pandemic, it is more important than ever to maintain bedtime and other routines. They create a sense of order to the day that offers reassurance in a very uncertain time. All children, including teens, benefit from routines that are predictable yet flexible enough to meet individual needs. go to bed within a certain time range and wake up at the same time. Model that unfortunate times do not have to create chaos.

-Structure. With the usual routines thrown off, establish new daily schedules. Break up schoolwork and chores when possible. Older children and teens can help with schedules, but they should follow a general order, such as:
Wake-up routines, getting dressed, breakfast and some active play in the morning, followed by quiet play and snack to transition into schoolwork.
Lunch, chores, exercise, some online social time with friends, and then homework in the afternoon.

-As recommended by Dr. Siddique: Fun, food, and family time before bed.
Chat, play, read, or watch a great show. How you complete the day sets the stage for the next one.

-Avoid any physical punishment. Per pediatric research: Spanking, hitting, and other forms of physical or “corporal” punishment risks injury and isn’t effective in any scientific study. Physical punishment can increase aggression in children over time, fails to teach them to behave or practice self-control, and can even interfere with normal brain development. Corporal punishment may take away a child’s sense of safety and security at home, which are especially needed now. They can also manifest and difficult or unhealthy relationships in the future, because people who love you can hurt you.

-Neuropsychology research: Embolden reminds parents and caregivers never to shake or jerk a child, which could cause permanent injuries and disabilities and even result in death.

-Self care. Caregivers also should be sure to take care of themselves physically: eat healthy, exercise, and get enough sleep. Find ways to decompress and take breaks. If more than one parent is home, take turns watching the children, if possible.

Reopening: Community Mental Health Clinic

Dear Friends:

This week, I reopened the community mental health clinic I’ve been running for over 18 years, started by my previous beloved mentor, Dr. Neil Schiff. We have been closed since March for safety reasons. I am indebted to the community in Washington DC and Maryland for giving me the trust that they have all of these years. As we maintain extreme precautions, I am also grateful for again seeing the local community that I care for deeply.

While gratitude helps me through each day, my gratitude is tempered with outrage. Longstanding and deeply rooted health care inequities—based on race, ethnicity, and income—have been thrown into relief by the COVID-19 pandemic that cannot be minimized. Everyone is suffering, but communities of color are suffering more. The shortcomings of our system with respect to caring for the elderly are painfully visible. The risks associated with incarceration are vivid. While none of these problems originated with this pandemic, the crisis has exacerbated these injustices in devastating and tragic ways.

I am striving in joining with others to do the urgent work needed to dismantle the barriers to health that persist for so many. As you know, while this has been a long-term focus of mine, this crisis presents an opportunity to design and demand real change. These barriers threaten all of us, not just those who face them directly. COVID-19 has indubitably demonstrated that fact. None of us are untouchable.

6 Big Takeaways Regarding the Restaurant and Bar Industry

This morning I had the pleasure of meeting with government officials from the DC Department of Health and the DC Council. We discussed anxiety and coping strategies for the many service Industry employees heading back to work. Also included were local restaurant leadership/owners, business leaders, and legal experts. It was very informative, and more info to come.

Virginia is starting phase 2, Maryland is 1.5, and DC is taking a slower and more measured approach, even though throngs of protesters certainly make that a challenge.

6 Big Takeaways Regarding the Restaurant and Bar Industry

1. You can and should call in sick if you need to. You cannot be penalized or retaliated against by employers.

2. Similarly, if there are health practices in your business establishment that make you uncomfortable, you are protected as a whistle blower.

3. My point: Restaurant leadership needs to inform patrons about the procedures and protocols. Often, people who seem to have bad behavior, simply don’t know what they are supposed to be doing and not doing. Information needs to be readily available on websites and in restaurants.
People are excited to go back to restaurants, but this is not a one-sided deal. Respect those who feed you. 

4. The biggest concerns that front line restaurant and bar workers expressed to me:
–  The trade-off between potential financial hardship and risking your life and your family’s on a daily basis to do your job. Remember, that patrons do not wear masks while eating, talking, and drinking. There is inherent risk.
–  The complete uncertainty of what’s going to happen next. There could be another shut down in the near future, and there is no way to predict what’s going to happen. Business is certainly going to proceed at a lowered capacity.
–  The porous lines between Virginia, Maryland, and DC. Workers and patrons going back-and-forth, making it harder to control safety regulations. 
– The pivot. 20% of restaurant jobs, and likely restaurants that are privately owned, will be gone. How does one transfer the considerable skills that restaurant folks have to other fields?
– The importance of communication and feeling heard. I suggested that every restaurant have a team of people that are assigned to work with front of the house and back of the house workers as emotional coaches.

5. Mental health is just as important as physical health. During the pandemic, clinical depression hit the highest national average recorded, in May 2020. That month, 50% of Americans met the criteria for major depression. ( US Census Bureau)

6. Self-care is crucial. In the best of times, the industry is one of the highest for levels of stress. Sleep well, eat healthy, exercise, meditate or follow personal spiritual practices, rest, and have a strong social support network.

Seek therapy or teletherapy when needed. Resources are available.

Ten strategies to cope with anxiety about COVID-19

In my upcoming book, Fight/Flight/Flow, I discuss the importance of anxiety. Anxiety is a natural human reaction that involves mind and body. It serves an important basic survival function: Anxiety is an alarm system that is activated whenever a person perceives danger or threat. Anxiety is both in the mind, or cognitive; and in the body, in the form of physical symptoms.

When the body and mind react to danger or threat, a person feels physical sensations of anxiety — things like a faster heartbeat and breathing, insomnia, tense muscles, sweaty palms, a queasy stomach, and trembling hands or legs. These sensations are part of the body’s fight-flight response. The fight response can make us angry and irritable. The flight response can make us avoidant and isolated. These are caused by a rush of adrenaline, cortisol, and other chemicals that prepare the body to make a quick getaway from danger. They can be mild or extreme.

My psychotherapy for anxiety involves what I call the flow response. It’s hunkering in place, but not in a passive way. It’s observing, holding, and waiting. It’s like floating in water. You’re still in it, but you’re not thrashing about.

The fight-flight response happens instantly when a person senses a threat. It takes a few seconds longer for the thinking part of the brain (the prefrontal cortex) to process the situation and evaluate whether the threat is real, and if so, how to handle it. If the cortex sends the all-clear signal, the fight-flight response is deactivated and the nervous system can start to relax. If the mind reasons that a threat might last, feelings of anxiety might linger, keeping the person alert. Physical sensations such as rapid, shallow breathing; a pounding heart; tense muscles; insomnia; gastrointestinal problems; choking sensation; trembling; and sweaty palms might continue, too. Lastly, anxiety is curvilinear. A little bit of it can motivate us to problem solve and take action. A lot can immobilize and sicken us.

Tips to manage anxiety during these challenging times:

1. Sense of community.
Being there for and with others lessens our solitary load. From virtual exercise classes, virtual classrooms, volunteering, and zoom cocktail hours, feeling connected decreases anxiety. We are social creatures, and separating has been very difficult for many.

2. The spiritual life.
From meditation and yoga, to a peaceful walk in nature, a personal home altar, or faith based activities, these pastimes help reduce our panic and sense of fear.

3. The foundations of self-care.
Keeping to good sleep hygiene habits, nutritious meals, and daily exercise. All three of these are potent medicine.

4. Reflect don’t react.
There are many choices within our control even when we feel out of control. Dr. Victor Frankl, who was incarcerated in a concentration camp and wrote “Man’s Search for Meaning,” stated everything can be taken from a man but one thing, the last of the human freedoms, to choose one’s attitude in any given set of circumstances, to choose one’s own way of being.

5. Place stones across the river.
This is my method that I teach to patients, that consists of piecing together the small moments that make each day meaningful and significant. Speaking with a great friend, playing or cuddling with your companion animal, enjoying the beauty of the spring time, having the perfect cup of coffee, taking a moment to connect with others online, listening to your favorite music. These seemingly insignificant things become a powerful gestalt when they are pieced together, and help make our brains create hopeful pathways.

6. You are not your day.
If you have a day where nothing feels hopeful, or an even an hour of despair, it does not define you. It will pass. Remind yourself of the times that you persevered through catastrophic times. Reboot. You can even make self statement index cards and read them to yourself. Remind yourself that this too shall pass.

7. Disconnect.
Sleep, rest your body, turn off the screens, don’t read the news. We can stay in formed but we can also inundate our brain with information and misinformation.

8. Question.
Not everything you read in the news or the Internet is accurate. Similarly, when we are having anxiety or depression, our brain is a trickster that tells us misinformation. We can learn to refute it.

9. Schedule.
Keep to a routine as much as possible. This should include the aforementioned exercises, meal prep and planning, sleep, work, outdoor time, social media time, and downtime.

10. Breath-work and grounding.
Strategies that I teach individuals with anxiety disorders can be used by anyone, you can take them with you anywhere. Using the power of your breathing, close your eyes, take a deep breath in through your nose, and exhale slowly through your mouth. Repeat. And again. Similarly, you can ground your body by progressive muscle relaxation, this is a series of moments of tightening and releasing your muscles starting at your feet and working all the way up to the top of your head. For example, clench your feet hold for five seconds, and release. Continue to your legs, and so on. There are many guided strategies on the Calm App or HeadSpace, on Apple and android, that can help you practice these methods.

If you feel that anxiety is trying to take over your life, please seek professional support. Embolden offices are now offering free 30 minute sessions to first responders.

On talking to the kiddos and executive functioning

It’s hard for many people to put the coronavirus global crisis into perspective. It’s even harder to explain it to children. But understanding the big picture can often help us make sense of what’s happening around us.

Some kids—and adults—have a hard time seeing the bigger context in situations. (It’s common with kids who have trouble with executive function.) That’s not necessarily a bad thing, especially for kids who get more nervous the more they hear and know.

But for other kids, not understanding what’s going on makes it harder for them to cope. It raises their anxiety level because they don’t always recognize that people are doing things to reduce the threat. 

To help them get a broader idea of what’s happening and be less anxious, start with what they know, says Ellen Braaten, PhD, director of the Learning and Emotional Assessment Program (LEAP) and co-director of the Clay Center for Young Healthy Minds at Massachusetts General Hospital.

“Correct their misconceptions and then help them organize their thinking on the topic,” Braaten says. “Emotions tend to ‘de-organize thoughts,’ so you need to keep things real.

“You could say things like: ‘Scientists predict that this kind of virus can spread quickly. But it can’t spread as much when people stay apart for a while. That’s why you’ll be home from school for a while,’” she says.

It’s important to talk about what you’ll do during the time off. Share how you’ll continue to do things to stay healthy, like washing hands and getting enough sleep. Explain that doctors, nurses, and other health care workers are working very hard to understand how to help people, and they’re doing a good job at it. Emphasize the importance of having a routine.

“To do this, you need to be informed yourself,” says Braaten. “You also need to be able to discuss this in a fairly non-emotional way.”

(Stats from the Centers for Disease Control (CDC) and the American Academy of Pediatrics).

8 Ways to Support Others During Tough Times

Life is vulnerable; uncertainty is the only certainty. Pema Chodron has written a great book about this, the places that scare you, that I highly recommend. At one time or another, we will all go through a difficult time, whether we deal with financial hardship, health problems, death of a loved one, catastrophe, crisis, or relational breakdown. In psychology, we have a list of psychosocial stressors that include bereavement, breakups, housing problems or transitions, health problems, financial troubles, loss of work identity, and domestic or other abuse. Often people may experience more than one area of hardship simultaneously.

In those times, we need each other more than ever, but it’s not just enough to be surrounded by people. We, as supporters, need to be educated in the best way to love our friends and family through tough times.

How do we reach out to others? In tough times, circling the wagons and looking out for yourself and your immediate family becomes instinctual for many people. However, more than ever, we actually need each other. Often people don’t know what to do. They may even cause great harm by saying do not cry or just get over it.

1. Silence speaks louder than words misspoken.
Don’t ignore them. Plain and simple. If you don’t know what to say, don’t avoid them. Say something. Ninety nine percent of what you could say is better than saying nothing at all. I tell my clients to speak as close to the truth as possible. Which means sharing process. You could say, I don’t know what to say, but I really love you and I just want you to know that.

2. Don’t make them ask you for help.
Do they need help? Absolutely. Do they want to ask? Absolutely not. There is nothing more humbling than having to admit that you don’t have your life under control, and for all the people pleasers out there, asking people for something as simple as meals or free babysitting is something we’d rather avoid. We’d rather tough it out than beg.
Instead, offer your help, and offer specific ways that you would like to help.

3. Don’t rush them through their pain.
Saying things like “I know exactly how you feel” or telling me a story of your cousin’s boyfriend’s aunt’s struggle and how she made it through. While we may say things with good intentions, it can also serve to minimize their issues and urge them to stifle their pain. Yes, what they are going through has probably been faced before. Yes, people do survive. Yes, things might get better. Yes, to all the things. People need to know that the pain they feel is real and they need to move through it. They need to get a little messy and be a little more honest and feel a little more, because if they move through it too quickly or try to avoid their feelings, they might not heal just the right way.

A doctor doesn’t just give a sling with no cast to someone who has severely broken their arm. The doctor gives a cast. The doctor prescribes time for healing, because they know that if the healing is rushed, the bone may also not heal properly. In the same way, we need to give time for others to move through their pain rather than rush them. Instead, sit with them. Listen. Let them be honest when life is hard. Let them be angry. Let them be whatever they need to be, and resist the urge to fix them, heal them, or placate them. Just be with them.

4. Don’t give unsolicited advice.
Even if you have been in the situation before, support, but don’t preach. This includes all cliche and trite phrases and platitudes. You may have heard them said before, but that doesn’t mean they are helpful. Instead, listen, love, give. Give time, energy, resources… give yourself. Just don’t give advice when they haven’t asked.

5. Don’t give them magic formulas.
If they stand on their head, count to 30, twice and backwards, confess everything they have ever done, change their past mistakes, then this tough situation would no longer be happening to them. There is no magic formula. Life is hard and messy and it doesn’t negate the goodness in this world, but it does assign blame and guilt to the situation, one of the last things that someone who is suffering needs is to be shamed. Instead, let them know you are thinking of them, praying for them, loving them, and cheering them on.

6. Don’t make it about yourself.
Essentially, don’t complain about how your friend’s tough time makes you feel. If you are close, you will be affected, but if they are closer to the problem than you, then they are not the person to whom you should vent. Instead, you should offer them support. Check on them. Love them. Let someone else support you to stay on track.

7. Don’t forget the person.
With all of the above tips, don’t just follow them in a rote fashion. The beauty in each of us is that we are unique individuals with different backgrounds, personalities, experiences, and circumstances. Instead, consider the recipient. Some people want hugs. Some people aren’t touchy-feely. Some people want company. Some people prefer to sit alone. Some people want you to do things without asking, some people want you to run it past them first. Some people want someone to cry with and talk to, some people reserve that trust for a select few. Consider who they are before you act, and support them accordingly.

8. There is no timeline for grief and loss.
People may return to a place where loss feels fresh again. It’s not linear. Let people have whatever time they need. There’s no time limits or quotas.

Say a little less. Love a little more.
Life is messy, but with love, we can help each other survive even the toughest times.
#SpiralUp

Parenting and homeschooling, during COVID-19

It’s been a frequent question, how to handle the current situation with regard to kids. In Washington DC, the school systems are closed for at least a month, and I’m thinking longer. This is what I’m telling my patients and families:

1. Establish a routine. This needs to include online schoolwork, chores, exercise, scheduled not random downtime with a preferred activity, and very regular bedtimes and morning routines. You do not get to sleep till 11.

2. This is not a snow day. We can’t live on Doritos, ice cream, and junk food. I am asking all kids nine and above, to help plan and prepare a meal at least once a week for the entire family. This can actually be fun. We all need to cook.

3. Developmentally appropriate information needs to be discussed. From social media to television, we hear bits and pieces that can be very scary. No kid needs to be terrified.

4. Get some outdoor time. It’s spring, and it’s beautiful. Just because we can’t interact, touch or hug, doesn’t mean we don’t get to embrace the sun.

5. Find one cool new hobby or interest to explore. You’ve never had time like this to do that.

6. Don’t forget to check on others. Lack of social contact is one thing, but we have neighbors, relatives, elders, who need our support.

6. Last time, probably most importantly, give each other space. We are used to being at school, the office, sports, activities. Now we are stuck with each other. Annoyance happens.
Find some alone time, for each family member.

Embolden Psychology
Embolden

Embolden offers the ADOS-2, the gold standard assessment for kids on the spectrum.

Combined with psychoeducational testing, it helps provide comprehensive information and recommendations to help children and teens six and up.

Thank you for contacting us.