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Becoming more virus-resilient: tips on dealing with the COVID-19 coronavirus situation - Professor Hugh Koch

07/08/2020 UPDATE: Remembering what we CAN do

One of my loyal American readers in Los Angeles responded to last week’s blog by telling me how, during the pandemic, he had actually been having ‘the best time of (his) life’! Various positive superlatives were used to describe his current work and personal life. He suggested I might write about the positive effects of the pandemic. He felt it was bringing people closer to one another and making us more satisfied with the simpler things in life.

I think we all have this challenge to balance our distress and pessimism in both our work and personal contexts (including our health) with the positive effects which we can have, depending on our circumstances. It is likely that we all have both the positive and negative to cope with.

It is likely, I think, that we use our pre-existing resilience to address our current pandemic-related circumstances, and consider what researchers in North Carolina call ‘Post-Traumatic Growth’ and how we can draw on our past experiences and coping strategies to deal with social distancing, mask wearing and sensible unlocking of restrictions.

In the process, we need to remember to: -

· Enjoy expressing kindness and positivity to others

· Be mindful and satisfied with being in the here-and-now and our awareness of the simple things in life

· Sharing our happiness with small or large life, family or work experiences

At the same time, try and benefit from: -

· Being logical and balanced about pandemic problems (e.g. wearing masks, continues social distancing, and maintaining hand washing)

· Talking to friends for reassurance about these difficulties

· Be optimistic and hopeful about using our resilience to manage as many of these difficulties as possible

‘Living Thru Lockdown (and beyond)’ is a challenge we are all battling with. The key strategy is to keep yourself safe and healthy while you manage your work and leisure activities.

Best wishes,

Hugh Koch

Ref: If you have time, look for a series of podcasts called ‘Living Thru Lockdown’.

31/07/2020 UPDATE: Can being resilient mask our underlying anxiety?

We all get anxious in different ways and to different extents. This strange few months has touched all of us, mentally, socially and economically. Since the easing of lockdown and distancing restrictions, we have experienced more freedom but, simultaneously, felt varying levels of anxiety as a result.

Finding an equilibrium between this “freedom and anxiety” has been a difficult adjustment because:

a) It’s been a long slog over 5 months so far with inevitable adjustment-related fatigue

b) The road continues in front with new concerns cropping up, but at the same time…

c) We want and expect to get back to ‘normal life’

One specific task facing us … literally … has been how to cope with our nervousness wearing a mask – these are now part of our everyday lives especially given the risk of a second wave. Tolerating this requires us to:

· Understand our face mask anxiety and its claustrophobic ‘feel’

· Tell ourselves masks are safe and protective

· Challenge negative ‘I don’t want to do this’ thoughts

· Focus on our breathing

· Stay ‘in the present’ and not be fearful of mask wearing discomfort

· Build up mask wearing tolerance by practice

· Personalise your mask, or look for the best mask on others. Even add some scent!

Take control over your mood by reacting logically to this threat by enhancing your self-belief and confidence in sensible social distancing, mask wearing and hand washing – you can do it.

Imagine your mask has magical powers!!

Take care and have a safe week.

Professor Hugh Koch

24/07/2020 UPDATE: Build your strength for ‘living beyond lockdown’

Feedback I have received for last week’s blog varies from “yes, I know most of this” to “it’s even more difficult than you describe”. Most of us, I think, are somewhere in the middle, being buffeted by what we hear from the government and also from friends who are in really difficult circumstances.

Lockdown is clearly being eased to some extent and this gives us the opportunity to reflect on our own feelings and anxieties about some sort of ‘normal behaviour’ like going to the shops (? mask wearing), travelling on public transport (? is it safe), meeting friends (? oops, I want to hug them) or returning to the office (? have we got adequate PPE). Whatever our own particular circumstances, we now need to get mentally, emotionally fit for whatever comes next and build up our post-lockdown resilience and confidence. This entails anxiety management and recognising our strengths.

Anxiety management

Returning to normality or near-normality makes us feel uneasy - is public transport risky? are the crowded shops safe? how likely is the second wave? is my job safe?

This transition stage needs managing – it will take time and we need to manage our anxiety and nervousness by physically relaxing, mentally being logical about these various crucial issues and getting reassurance from our friends about what’s best. Feeling anxious is inevitable so we need to take time, relax, find ways to de-stress – be sensible and don’t over-criticise.

Recognise your strengths

Like many problematic changes in our lives, dealing with such difficult events like COVID-19 draws on our personality – understanding our strengths and ensuring we appreciate each hour and each day – optimism, maintaining self-esteem, and acceptance are all crucial.

It is interesting and, at times, frustrating that our confidence with undertaking and completing small everyday tasks can be affected when we go through this type of crisis – a simple phone call or negotiation over a problem can seem much greater and potentially more problematic. Remember you are resourceful and well able to sort things out.

There are many aspects of COVID-19 that we don’t know and can’t plan for – the duration of the virus is unknown; we don’t know when it will end. We need to accept this random unfairness and tolerate the uncertainty – it’s difficult to do, but possible. Focus on aspects of your life you can control – what can you influence? Your daily routine, your regular contact with friends and relatives, your questions about how others are coping and so on.

Friendship is central to our mental health – this partly is indicated by the number of friends we have but also the quality of these friendships – are they based on genuine interest and kindness – are they kept going by efforts to make face-to-face contact. We need to see and talk to our friends on a regular basis to get the mental health and resilient-related benefits.

In addition to anxiety management and recognising our strengths, active monitoring of our friendships, especially of those of our friends who are vulnerable, more than we are is a valuable aim for this week.

Good luck over the next week.

Hugh Koch

17/07/2020 UPDATE:

Sitting in the sunshine, Sunday morning, thinking about this week’s blog, I turn the radio on and hear the soundtrack to “The Great Escape”! This seems to be prescient, in some ways, although we still have a way, maybe a long way, to go.

The easing of lockdown restrictions on families, schools (partly) and businesses raises new sets of dilemmas for us all, in different ways, in trying to reconnect with pre-COVID lifestyles and stabilities.

The two themes that caught my attention are:

  • The stress of the past 100 days

  • Choosing between family and health

Listening to those who have lost loved ones, at home, in hospital or in a care home, listening to those who have offered their care, service and love looking after these individuals, has highlighted the many experiences of stress, during this trauma (peri-traumatic) and following these awful events (post-traumatic).

Trauma occurs in many different ways which fortunately many do not experience – the sleep disturbance, the nightmares and flashbacks to vivid images of very upsetting events – the difficulty coping with the distressing feelings that these traumatic events have sparked in ourselves – fear, loss and grief. It is part of our complex and amazing human condition that we try to avoid and protect ourselves from these feelings, which then can affect our relationship with those dear to us.

Throughout this complex experience, those affected by trauma and traumatic stress find that their lives are very badly disrupted both at home, at work and in their relationships.

Whether you, the reader, or those you know have been, in some way affected by COVID-related stress, you can support those who have been affected by your understanding and empathy as well as encouraging them to seek some sort of professional support if necessary.

My second theme this week is the dilemma facing many family members about how grandparents and their grandchildren can now be more reunited and rejuvenate the crucial grandparent bond, a normality that all grandparents have been yearning for. This isolation has been harrowing for many older people and for families with recently born babies, the enforced separation has been acute – it is difficult to make up for lost time, lost cuddles and lost play time. Helping out with school drop-offs, pick-ups, swimming lessons and babysitting is gradually returning. Celebrating this occurs but without hugs and kisses as caution and distancing is urged – this may well continue for several months. Grandparents will and do adapt and find creative ways to stay close to their loved little ones, for example, postcards, presents in the post and remote calling. Grandparents are, by definition, resilient people who have age-related experience coping with stresses – COVID separation is yet another stress for them to bear with characteristic fortitude.

Please tell yourself, these very tough times will pass.

Whether you have (or someone near you has) experienced the very sharp end of COVID-related trauma or whether you are (or know) a grandparent who is coping with separation from loved ones, continue to be resilient in ways which help you, appreciate, along the way, the things that are going well – small or large, and try to use this appreciation and good feeling to get you through a minute, hour or day, rather than taking these potentially healing and positive experiences for granted.

Best wishes for the next week.

Hugh Koch

06/07/20 UPDATE: Meeting Again

Many of us will have noticed some nervousness or trepidation about leaving our house or flat now that lockdown, in most places, has been eased a bit. The noise, and increasing hustle and bustle, with negotiating crossing roads, for example, makes us more cautious and vigilant. This is, I think, how most of us feel to some extent. Those with a pre-existing health condition, whether mild or severe, have the extra fear of catching the virus and significantly exacerbating symptoms we already have, either from a physical point of view or purely the psychological effects of leaving the house.

Despite the change in shielding guidance, many just do not feel safe going out until a vaccine or some effective treatment is discovered. Added to this group, there will be some who have new illnesses diagnosed during this lockdown period and they will have double anxiety – anxiety about their new diagnosis plus COVID-19 related anxieties – it’s a difficult time.

One of the therapeutic techniques often used by psychologists to help clients with fears and phobias is, what is called, “gradual desensitization” – this is a very practical and sensible approach to reduce a specific fear or anxiety and associated avoidance. This can be applied in a common sense way to our COVID-19 related re-entry anxiety:

1. Identifying a small, next Active Step in overcoming your fear e.g., leave the house and walk 100 metres and then go home.

2. Identifying the next steps (e.g., walk to the nearest park; walk for 30 minutes; drive to town; walk past a row of shops; stop for a take-out drink; and so on).

3. With each step, practicing relaxing your shoulders, other parts of your body, and taking deep breaths.

4. Practice positive thoughts about your ability to cope with each step, and tell yourself “I’m doing well”.

5. Keep practicing each step regularly, and increase the complexity of each step.

Different challenges evoke different levels of anxiety in different people – what’s small to one person, feels like a ‘mountain to climb’ to another. Set your own ‘next Active Steps’ for this week, tell your nearest and dearest what you plan and then dip your proverbial toe into the ‘re-entry’ water – it will work and you will be pleased you tried.

For those who don’t have anxieties, help someone who does – there are lots of us around.

Best of luck,

Hugh Koch

29/06/20 UPDATE: Dealing with re-entry anxiety and uncertainty

Three months after the emergence of the COVID-19 pandemic, the ‘trajectory of the pandemic’, according to the King’s Fund, is still unclear suggesting a long haul.

Our understanding of psychological transition is that with most stressful periods we pass through three stages:

  1. Ending, losing and letting go of normal activity

  2. Neutral limbo where old reality has gone and new reality is not yet formed and

  3. The new beginning which reflects change in practices on many fronts.

We have passed through the first stage , and are currently ‘Living thru lockdown’.Things have definitely changed both at work, school, college and home. Most of us have escaped serious illness, some have not .We are all now vacillating between the ‘neutral zone’ of lockdown, home working and studying and the ‘new beginning’ where ‘living beyond lockdown’ involves loosening and reduction of restrictions is happening. Working practices in many sectors are being resumed in a modified way and school and hospitality re entry is beginning to happen.

Throughout these three stages, we have all, in our own ways, been battling with anxiety and uncertainty, not only about our personal health and risk of infection , but also the changes which can and do affect our psychological, social and economic circumstances.

We know that logically the way forward is to be positive in all the myriad ways that we have discussed in previous posts. However, many readers have responded by telling me:

  1. It’s difficult to be positive all the time or even some of the time

  2. Anger and resentment gets in the way of being realistic, logical and positive

  3. Feeling anxious and angry makes one’s inbuilt generosity of spirit to others difficult to maintain.

So......what are some helpful Active Steps to address these three difficulties?

A) try and keep relatively busy with helpful routines ,keeping occupied and having a focus and direction to your day.

B) use physical and mental relaxation and mindfulness exercise to give you occasional (2-3minutes) time to focus on your body and non anxious thoughts. Your problems will still be waiting for you but linking the anxiety to feelings of calmness help.

C) pick one person who you know will be a sympathetic ear and contact them (text, email, phone). Despite your own preoccupations, ask them how they are feeling.....I promise you they will return the compliment.

D) write a short paragraph on paper, phone or iPad, about how you are feeling right now. Five things. Suggest to yourself a helpful strategy for know yourself best and are your best therapist.

Psychological uncertainty and the associated loneliness is not pleasant. Use your insight about resilience and coping to ward of your difficult feelings and return to your underlying compassion and kindness to yourself and others. Pool your good feelings and self esteem and move into the ‘new beginning’ with fortitude and a very deep breath....I will if you will!

Best wishes
Professor Hugh Koch

17/06/2020 UPDATE: Practice your positive thinking

Listening and talking to many people over the past few weeks since COVID-19 landed, it would appear that we are divided into three substantive groups (at least), the ‘trusting’, the ‘dissenting’ and the ‘frustrated’. At times, we all vacillate between these groups, depending on the prevailing issue. An Ipsos MORI survey indicated 38% in each of the first two groups and 24% in the last, the frustrated group.

The membership of each group is obviously partly predicted by political persuasion, by Brexit-allegiance (sorry to swear!) but also, in my opinion, predicted by the level of positivity and optimistic perspective that we manage to maintain.

There are so many issues that we can hold a view on, many relating to how we think the government has handled the crisis e.g. PPE, testing, employment, financial support, maintaining lockdown, releasing lockdown and so on.

It would seem that a large percentage (90%+) went into lockdown unified and in support of the measures taken but are now more divided as we emerge into the post-lockdown world with recurring uncertainty.

Despite macro-political, and socio-economic factors that affect all of us differently depending on pre-existing and current circumstances, it is important to keep our underlying personal thinking strategies as positive and resilient as we can. Remember these 6 active steps help:

1. Repetitive positive thinking helps our own physical, and cognitive functioning, encouraging positive mood and reduced levels of anxiety.

2. Daily early morning positive perspectives predict success in achieving our daily, manageable goals.

3. Regular reminders to relax whether sitting or walking around.

4. Maintaining patience and perseverance by having realistic goals and keeping our self-esteem higher not lower helps to keep going during the day and

5. Recognising what tasks have been achieved at the end of the day makes us feel worthwhile and as happy as our macro-circumstances allow.

6. Frequent use of active steps 1-5 above will help to reduce self-criticism or negative judgements of others.

I was reminded this week of how this type of resilience needs to be applied to those we love with (partner; flatmate; parents) or work with or spend time with (close colleagues; friends).

We all cope with the strange and reclusive nature of lockdown differently – some have reassuring routines, others don’t; some maintain their self-esteem with small rituals, others find this hard and often feel low as a result. Some families have major pre-existing stresses with mental and/or physical disability issues. Whatever your circumstances, try and apply the mini-cognitive prescription above to your day today, weekend or week ahead.

Many reading this will be grappling with severe economic problems linked to your ability to operate your business or manage your household finances. This is so difficult in, for example, the Hospitality industry with bars, clubs and restaurants all battling with social distancing, financial margins, and space utilisation issues. Despite no easy answers, keep hopeful and proactive with whatever your plans are.

I have had a lot of positive responses to these various blogs for which I am grateful. Many helpful strategies seem, on paper, to be simple – whether this is true or not, these are practical active steps that can work – it helps to remind ourselves of the power of thinking positively. If it is simple, you will be applying it already. The next step is to apply it more often in more challenging circumstances and let others know.

Good luck with today and tomorrow.

Professor Hugh Koch

12/06/20 UPDATE: Dream about the virus going

Many are reporting that their sleeping pattern has changed during COVID-19, some sleeping more, some less, some reporting a ‘change in dreaming’. As a frequent ‘dreamer’ since childhood I am intrigued by how we describe and interpret this phenomenon.

· Do dreams generally mean something?

· Do they increase and/or decrease in occurrence or is it our recall that changes?

· Can we learn from the content and our emotional response to dreams?

Dreams are stories and images that our minds create while we sleep, typically at stage 5 of the sleep cycle where there is rapid eye movement (REM). They can be entertaining and fun, but typically are confusing, frightening and often bizarre. Most of us dream each night but only some remember their dreams. This dreaming state of consciousness is characterised by sensory, thinking and emotional aspects e.g., thrashing and physically in bed, touching partner (sensory); anxious, claustrophobic imagery (thinking); panic or fears of being hurt (feelings).

Dreaming can be explained as random signals from the brain and body during sleep, and processing information gathered during the day. I emphasise the word ‘random’ as our dream recall produces amazing and ‘fantastic’ (literally) imagery which initially defies logic such as, interesting examples like resisting capture, teeth falling out, an attack by a swarm of bees, being sent on a space ship to Mars.

Sometimes, a dream will involve behavioural acting out. For example: -

· Passing a piece of jagged glass to one’s partner in bed

· Standing by the bedroom wall naked ‘painting the wall’

Covid-19 specific dreams which have been reported include: -

· Calling an Uber taxi and a hearse arriving

· Receiving an unexpected huge invoice (£70k) for immediate payment

· Dying from the virus and coming back to life

· Masked man entering a Zoom meeting (my favourite!)

· Young family of four mysteriously being added to by two stranger teenagers

· Continuous, never ending supermarket shopping arriving on doorstep (“magic porridge pot”)

Reports of dreams are often full of vivid experiences that contain themes and concerns which correspond closely to waking life. This week I saw my grandchild and then dreamt about her the next night. Distressing dreams, described as nightmares because of the upset felt on waking, will frequently occur following unpleasant recent day time experiences. The themes in our dreams may reflect reality e.g., real people and events in our lives but also not reflect reality. Also there can be a dream lag in between a daytime experience and a night tine dream sequence.

So, what positives can be obtained from dreaming?

a) To reduce the scary nature of unpleasant dreams and nightmares, practice sleep hygiene in the 60-90 minutes before sleeping – feeling relaxed before ‘lights out’ is helpful and the final thoughts of a loved one or a happy event (today/tomorrow) set the scene for a good night’s sleep less disturbed by strange events.

b) To discover meaning don’t try and interpret the dream at face value – a bizarre dream is more likely to be due to tasty cheese, excessive alcohol than childhood dramas. However, what you can do in discussion with someone who will listen (many partners will switch off!), is to free associate, starting with the dream, and see where the conversation consciously goes. For example, ‘my dream about fighting a friend reminds me of how I get angry with people who don’t listen’, and see where the conversation and understanding goes to.

Remember, dreams and their recall illustrate how random this phenomenon is. High recallers may be more insecure, more intelligent, more talkative or just eat more cheese – as a repeat offender, I find this fascinating. Goodnight, sleep well.

Professor Hugh Koch

05/06/2020 UPDATE: Living through lockdown and beyond

There are many ways to cope with lockdown, some positive and some involving distress and anxiety – there is no one way of managing these.

In the past month or two, I have spoken to several friends, colleagues and clients, who have expressed their own concerns and difficulties – these have included:

· Nervousness with the whole uncertainty of COVID-19

· Over-eating and alcohol misuse due to enforced social isolation

· Concern over social distancing for grandparents, parents and grandchildren

· Worry over work and school viability in many different forms

· Increased frustration with partner due to greater time together

· Poor sleep and vivid dreams

In contrast, some friends have been aware of several positive experiences including extra quiet time with partner or children, more relaxed day-time timetable, opportunity for exercise, ‘how are you’ texts resulting in greater kindness and friendship, and listening to calming or energising music.

However, as we move towards a partial releasing of lockdown, many are experiencing and voicing their anxiety about leaving their house or flat as they schedule short visits to shops, hospital, clinic, workplace, schools and neighbours. This ‘re-entry syndrome’ of feeling nervous and a bit on-edge about returning from social isolation to ‘new normal’ activity and expectations need to be self-managed by positive thinking, nervousness-calming and reinforced by mutual support to and from each other, which involves gradually getting closer to people you know again.

Small active steps we can consider at this time include:

· Give yourself positive self-messages about your confidence and resilience to copy with ‘living through lockdown’.

· Take small steps to widen your exposure to the ‘outside world’ e.g., short journey (pedestrian, car), small shopping list for a 15-minute shop.

· Reinforce your efforts – a pat on the back is OK and helps. We all need that. Tick off when you have completed a job.

· Keep a positive perspective for how today and the rest of your week is going to go.

· Schedule small, relatively easy day-time trips away from the house.

· Use distraction with favourite music or engrossing book or article.

· Put a small card with a calming word like ‘relax’ where you can see it.

Key phrases like ‘bit by bit’, ‘one active step at a time’, value what you do do, minimise guilt over tasks not done, and generally have a ‘bias for action, both psychological and practical’. It’s been and still is a hard road but we can get there. We will eventually “wash our hands” of this pernicious virus.

Professor Hugh Koch

01/06/20 UPDATE: It’s still going, on and on... how can we keep our motivation and routines going?

As we enter the next phase of battling this pandemic, we need to keep our proverbial eye on the ball.

We need to maintain our purpose in terms of social distancing and not doing anything which risks increased infection or infection rate.

  1. We need to maintain our sensible routines which have helped to stabilise infection so far.

  2. We need to maintain our positivity and connectedness within our family and social circle.

  3. We need to keep optimistic about our work or study situation and prospects, planning our finances and potential borrowing requirements.

  4. We must be vigilant about any physical symptoms, virus-related or not.

  5. We must take care of our mood variability and anxieties, again virus - related or otherwise.

Each one of us will experience and interpret these six objectives in different ways, with differing degrees of confidence and positivity.

According to Carlos Castaneda (Perdue, 2020), the trick to maintaining positivity is “in what one emphasizes. We either make ourselves miserable, or we make ourselves strong. The amount of work is the same”. Many may say this is easier said than done, but an optimistic outlook and perspective each morning as one starts the day is very helpful and energizing.

I am aware of friends and colleagues around me who are struggling with health issues, business and financial issues and generally trying to keep their mood and wellbeing on an even keel...we all have difficulties in some aspect of our pandemic-related lives. Remember giving or receiving a kind word, text or call, does wonders for keeping a strong feeling going.

I rarely get a large postbag of emails about anything, but I have been aware in the last week of a significant level of frustration with recent political events. Trust, credibility and transparency in all we do is crucial. If I say or suggest one thing to others, I must try to ensure I do likewise. If I want to do something that might be construed as inappropriate by others, I need to consider and reconsider my potential actions before I make them. Maintaining trust is linked to maintaining positivity and social cohesion. As we start the next phase of virus management, we need to be able to trust each other. According to the stoic Epictetus (remember him?) in 50AD, “your actions should correspond to the person you want to be”.

Professor Hugh Koch

22/05/2020 UPDATE:
“My background trained me to cope” – feel confident (and happy) during the pandemic

Coping with all the effects of this pandemic has been and continues to be a tall order – whatever our age or pre-existing health. We have never been involved in anything like this before. However, we all have prior experience of dealing with difficult events and these strategies are available to us now and over the next few or many months.

Coping with uncertainty

Our first challenge since February/March, has been how to cope with the uncertainty that COVID-19 has brought – looking for information and guidance has helped reduce this primary human motivation. My colleague and friend Nick Carleton (Regina University, Canada) found a clear link between uncertainty and our ability to manage anxiety and frustration – research indicates that even having certainty about what we don’t know (yet) helps our self-esteem. A good example of this being when and how a vaccine maybe found and produced – knowing that we cannot know when, yet, can be reassuring in a paradoxical way. Alternatively, the pessimistic information that a vaccine may not be available until January 2021, provides more certainty, albeit not what we want to hear.

How can we make our uncertainty more tolerable?

1. Practice relaxation and mindful meditation/thinking when you are aware of ‘uncertain’ feelings.

2. Seek better and better (reliable) information from specific, trusted sources.

3. Maintain positive attitudes and ways of reacting – ‘how’ we react is achievable (Linda Blair)

Highlight your own virtues

Florence Nightingales 200th Anniversary was remembered for her unique contribution to caring for the sick – ask yourself, how am I like her? You/we all have some of her virtues of discipline/organisation, empathy and compassion, and mindful attention to others and ourselves. It may seem difficult to be self-aware, especially of positive aspects of our behaviour, but its more important than ever to focus on our positivity and bolster up our self-esteem. This increases our motivation, creativity and problem-solving abilities, as we work out how to cope now and later in the year with virus-related issues.

We all have different circumstances as a result of COVID-19 but/and it’s OK to allow yourself to be happy and positive even when we or others are ill or out of work.

Changing our approach to psychological problems

Notwithstanding the support, reassurance and benefit many get from being prescribed antidepressant and anti-anxiety drugs, many believe that the answer to many of our emotional struggles lies in non-medical solutions. Anxiety and variable mood are often an understandable response to a crisis. We see this in ourselves and others in this COVID-19 circumstance. Positive resilient behaviour, whether this be our thinking, stress management, or our social collaboration and empathy, has many practical and day-to-day benefits – we are not ‘broken’, or ‘needing fixing’. We are in this strange temporary world together and can share the emotional load and learn helpful strategies from each other.

So, what?

So, this week’s prescription is the following: -

1. Proactive relaxation and mindful thinking.

2. Continue getting reliable information about COVID-19.

3. Keep thinking in a positive way.

4. Appreciate your own ‘virtues’ – i.e., your positive and kind actions.

5. Talk with others about what your wellbeing and resilience is based on: positive thinking, relaxation and calmness, organisation and focus, and kind communication with others.

Remember, just like Boots organise repeat prescriptions for medical conditions, you can provide your own ‘repeat prescription’ for enhancing your own resilience in these difficult times. Each week, remind yourself to update these Active Steps.

If you want to contribute to next week’s blog which follows on from last week’s blog on information reliability and accuracy, please write to me (This email address is being protected from spambots. You need JavaScript enabled to view it. ).

Keep going,

Hugh Koch

Links to other websites

1) Expert Witness: -

2) Hugh Koch Associates: -

3) Links pending to and


15/05/20 UPDATE: Active Steps to getting accurate information

COVID-19 and our response to it is an all-consuming event. It is unprecedented, causing massive uncertainty about how it is transmitted and controlled, if that is possible. Remember ‘the flu’ is managed but not prevented. We all need personal and organisational resilience plus access to expertise and information from government, public health and scientific disciplines (e.g. epidemiology and global health) and the incisive questioning of the media holding the government to account.

General and public health messaging is crucial – to be effective it has to reach 80% of the population – both the Government and the media are critical for achieving this goal (Lang and Drobac, Public Health Experts, Oxford University).

The constructive dynamic between the Government’s information and that coming from the media and the research and expert scientific community is paramount. The Government needs to be listened to and understood then the decisions need to be put into context, explained and debated.

At some time or another, we have all been critical of the Government’s response to the pandemic e.g., lack of anticipation; variable assessment of risk; lack of preparation and action once identified. We need to encourage government, the scientific community and the media, to combine their significant skills, collaborate in investigating what is happening and provide information which is reliable, valid and empowering. Over the next week or so, this will centre on infection mode and rate, balancing health need with economic need, and its implications for our behaviour (e.g. social distancing; returning to workplace; use of public transport; enhancing limited extra family contact).

We need the encouragement to be as responsible ourselves as we can in many matters, coming from a sense of trust in those providing this encouragement, feeling that they are genuine, credible and empathic of the varied difficulties facing us.

We need to experience a balance between what our personal resources (e.g., compliance with social distancing) can produce and the resources we need from outside ourselves (e.g., furlough funds; PPE; testing). We need to constantly strive from the latter to the former, relying less on the State, when possible. As we achieve this outcome, bit by bit, we need to feel rewarded and valued, and our achievements appraised positively. In return we need to respect and reinforce those giving us information and suggestions, even when imperfect.

Similarly, where we rely on parliament and media for their efforts to report reliably and accurately, we need to provide constructive positive appraisal of their efforts. Neither function, governing or reporting, is an easy one given the cognitive and social diversity inherent in the macro tasks involved (e.g., social behaviour management, PPE, vaccination and testing), and balancing more liberal and less liberal approaches.

To digress momentarily, my day to day work in the civil justice system places me in a situation where the adversarial system(lawyers, barristers, experts on two ‘opposing sides’) encourages argument , often heated, and constructive criticism, and results in a process of logical summary and resolution, as best as the evidence allows, via the good offices of the judge and everyone’s conflict resolution skills. Throughout this process there is an underlying desire for professional rigour and duty to the court. How might these various behaviours apply to, and be extrapolated to, the pandemic issues?

Taking our current environment for learning on a day to day basis what’s going on and what we should do in COVID-19 land, we need to:

  1. Manage what IS under our control and comply as best we can.

  2. Obtain reliable information from the government/parliament, as well as various media outlets.

  3. Recognise positive encouragement to comply e.g. social distancing; phased return to work

  4. Seek and get access to resources to help us work, educate our children, look after our elderly parents.

  5. Respond to government and media with positive communication skills and reactions including:

    • Allow them to be wrong and survive!

    • Give them credit for what they DO do

    • Allow them to say ‘I don’t know’

    • Be constructively critical of specific points, comments, plans

    • Allow the media to hold the government to account

    • Tolerate different points of view

6. Have positive expectations of leaders (political and media) and their behavioural and cognitive traits expecting good attention span, impulse control, management of cognitive and information deficits. We should manage our frustration and anger, by constructive, patient and specific criticism.

7. Be active in questioning the government by, for example, communicating with your MP, participating on public broadcast, Q & A programmes and online discussion boards and social media comments.

We need to encourage a ‘bias for action’ amongst ourselves and our leaders to address lockdown and, when safe, its gradual release, phased return to work and the whole testing strategy in a constructive way. Consultation across the UK and across all communities (England, Scotland, Wales and N. Ireland) must optimise the ‘Stay Alert’ strategy and prevent a second spike. As in my civil justice analogy, impartial and balanced information, informing action, is key to our resilient approach. It is important to question government about the strategy it is pursuing of virus suppression and as opposed to collective immunity, and the degree to which its advice (e.g. use of face masks) is based on science.

Professor Hugh Koch

08/05/20 UPDATE: Effects of COVID-19 on pre-existing problems

It sounds like a truism but most, if not all, psychological and physical problems are affected by stress. This past two months is no exception. This pandemic will have added to all our stress.

I am not going to go through all the possible disorders which could be affected but most of us have: -

a) Minor or moderate symptoms of aches, pains, anxiety and variable mood.

b) Some have severe symptoms. Clinicians use a diagnostic label to identify them and provide the most effective treatment.

The stress of the COVID-19 pandemic will affect us whether our experience is mainly in category a) or b) above. Pre-existing pain, specific physical symptoms and/or anxiety or depression may all ‘feel’ worse during this pandemic due to our ruminating, worrying and being less able to distract ourselves in the usual ways.

Any symptom that is of a muscular nature e.g. Parkinson’s; Motor Neurone Disease; Multiple Sclerosis will be adversely affected by the muscular tension inherent in feeling anxious. It is also linked to an increased susceptibility to infectious diseases.

Risks of symptoms of asthma, chronic obstructive pulmonary disease (COPD) and other respiratory illnesses are likely to make individuals more likely to experience COVID-19 complications as are diabetes and heart disease alongside any illnesses linked to underlying lung disease.

People with psychological and psychiatric disorders, such as anxiety- and stress-related disorders such as agoraphobia, claustrophobia, generalised anxiety and post-traumatic stress symptoms are vulnerable to an exacerbation of their pre-existing symptoms during this pandemic. The social isolation and its eventual withdrawal, social distancing and pre-occupation with health- and cleanliness-related imperatives can all increase anxiety and rumination. This, in turn, can exacerbate low mood and depression.

Many mental health issues often coincide with challenges that make it difficult for people to access the most basic necessities such as food, medications, housing and healthcare.

Substance use can be adversely affected – alcohol consumption can increase due to excessive downtime at home or exacerbated stress and preoccupation.

Look after your mental well-being

So … we know it’s a difficult time for us all and any pre-existing symptoms may be or may feel exacerbated/made worse during the pandemic. We need to look after our psychological wellbeing using practical ‘Active Steps’ which involves

(1) our thinking and logical perspective;

· Try and approach each day with a positive perspective

· Set small goals to start the day and get you out of bed and going

· When you complete a task, however mundane, give yourself a proverbial “pat on the back”

(2) our ability to relax and feel physically calm(er);

· Every few minutes (yes, that often) take a deep breath and relax your shoulders and arms

· Use the word “relax” in your head to prompt a quick, calming feeling

· Try putting the word “Relax” on a card and put it on your desk or bedside table

(3) our positive and compassionate contact with others;

· Monitor your language when talking to others and use positive and kind words

· Tell others when you can that you appreciate what they’ve done – a simple Thank You is good

(4) our ability to manage both home and work pressures and demands;

· Be organised about what tasks are on your today-to do list

· Set a realistic list of tasks and feel good when you achieve them

· Tell yourself you are coping well

We have all entered this pandemic with pre-existing strengths and weaknesses – be kind to yourself, feed your strengths, and manage the rest with sensible Active Steps.

Professor Hugh Koch

01/05/20 UPDATE:
Managing our Loneliness

We know that being alone can often make us anxious and then painfully lonely – loneliness is near, if not top, of the list of mental pain.

At the moment, we all exist in some sort of time warp – we look out of our window or go for our daily walk and roads are eerily empty, especially at night, we see a single figure in the distance with or without a dog on a lead, silhouetted in the street light.

Being in lockdown makes the part of us which is lonely, isolated and sad, even more so. We feel that there is “nothing to love or link with” (Philip Larkin).

This internalised psychological experience is reflected outwardly in our social world at home or nearby in our dealings with our children, our nieces or nephews, and our elderly parents – we worry about helping them remain active, occupied, healthy and well. We frequently feel helpless and then hopeless about our own family microcosm.

We can feel less isolated by a routine, a human touch, a digital connection, or in the case of one of my grandchildren touching a family photo on the fridge door. If you live alongside someone else, then a hug is invaluable. If living alone, hugs are possible “virtually” by digital and verbal connections.

Not everything in life has been permanently cancelled since March – events will be rescheduled, shops, bars and restaurants will eventually re-open, contact with temporarily estranged family will start again.

Paradoxically, the shutdown can be construed as helpful in that it may result in the lonely part of us reaching out when we see people walking or delivering post and provisions to our doorstep. We and they can mutually reach out, if only to share “hello”, “how are you”, “keep safe” and “see you next week”.

Alongside recognising and being kind to the lonely part of ourselves it’s good to be forward-looking, active with our planning and harness our hope and anticipation that we will get through this, one way or another. We will.

Professor Hugh Koch

24/04/20 UPDATE:Becoming more virus-resilient during social isolation

Most of us will have been enduring a very unusual state of affairs over the past four weeks, with partial or total lockdown. However enjoyable being at home is at the weekend , days off or on holiday , being at home full time is a different kettle of goujons.

At each of the main psychological levels- thinking, feeling ,practical organising and social- we are all having to adjust to this extra time and space being within our four walls at home.

My daughter reminded me recently that we all have different ways of coping with life at the moment and there is “no one strategy fits all”, flexibility is the key. It reminds me of the debate about whether a tidy ,clear desk beats a cluttered ‘I know where everything is’ desk.........I’m not sure about either example. I think that some tools and steps work better than others, albeit some of the time, perhaps not all.

Organising one’s home work space takes careful planning and execution. Consideration of one’s partner’s needs and space requirements is crucial to prevent milk or blood being spilt. The partnership which you love as you walk out the door each pre- virus morning needs nurturing in a different way now that you are tripping over each other’s papers ,mobile, laptop and tea cup.

Thinking for an eight extra hours under the same roof means your positive or negative thoughts may coincide or clash in ways that rarely occurred when the family routine was the pre-virus one. While you are calm with your own positive, optimistic plan, your partner may be suffocating under thoughts of dread and helplessness . At any one time, one of you may need more support and understanding than the other.

Feeling calm and relaxed is a transient ,and rarely continuous state. While he/she has found solace in some completed tasks plus a reassuring ,validating phone call, you may be feeling alone, getting uptight and tense over task overload, disrupted wifi signal and request for domestic assistance.

A partnership consists of many social relationships, some overlapping, some independent. The mélange of daily social events involving chats with each other,texts, calls, work and domestic topics, requires mutual communication , tolerance and kindness. At the very least , the ability to show compassion and 50/50% listening to each other are paramount, plus clarity of expectation whether this be not forgetting to order the carrots or showing undying affection.

So while you think about whether positive thoughts, calming techniques, an ordered or ‘everything on show’ desk, remember that you and your partner see the world at home in different ways at different times. However, telling him/her you understand this and love him/her is a good way of managing this difference in personality. The lockdown will pass and you can then share how much you miss this extra time together.

Good luck with everything you have to deal with this week.

Prof. Hugh Koch

17/04/2020 UPDATE:Maintaining our collective momentum

4-5 weeks in and, for most of us, there is a sort of stable equilibrium in our daily existence – we are either at home socially isolating, social distancing outside or essential working and being very careful. For a very small number, things are immeasurably worse with significant virus symptoms and hospitalisations. My very best wishes to this group and their families.

How can we maintain our collective equilibrium?

a) Understanding the virus more

We need to remain educated as to how social isolation and herd immunity, vaccination or other testing will be of benefit as we move into weeks 5-8. A significant problem is our uncertainty. The dilemma between returning to work and staying socially isolated is going to continue to be hard. Some level of anxiety in this situation is to be expected and normal. When confronted with uncertainty, surround yourself in facts, not rhetoric and follow best practices. Recognise that, with time, uncertainty will ultimately give way to clarity (from Prof. David DeMatteo, in Philadelphia).

b) Keeping our vigilance, compliance and healthy practices going

Whether at home or at work, we must maintain our handwashing, surface cleaning and avoidance, and social distancing from visitors, colleagues, friends and others. We must also listen to available Government and scientific advice and both understand their responsibilities and pressures, but also hold them logically to account.

c) Coping with lock down

Day 7 at home and the dog is looking at me like “See? This is why I chew the furniture!” (from Prof. Helene Hilger, Charlotte, North Carolina).

Cope with this very unusual and ongoing situation by using positive self-talk about the day ahead, physical activity routine and, don’t forget, humour and enjoy being at home, learning new skills (from Prof. Bruce Leckart, in L.A.).

Despite ‘lockdown’, it’s fun to have family together, whether extra time with a partner, play time with very young children or cooperative time with older children. If living alone, maximise digital connections and relax/meditate/eat well (from Elizabeth Seay, Wall St. Journal) – being homebound is important right now so enjoy and value co-existing more closely, and be patient.

d) Have faith in your beliefs

Amid all the anxiety, helplessness and grief, we also need to keep in touch and develop our own faith and belief. Despite our day-to-day investment in our home, our work and our finances, our belief deep down is in ourselves and those around us – even though we are physically separated from many of those we love, our spiritual or existential belief can help us feel optimistic, resilient and focus on our future – there is and must be a ‘connectivity in isolation’. Have faith in each other, however difficult the sacrifices we have to make at the moment. Tell someone you love and care for them.

e) Replace criticism with praise

We don’t learn by being told what not to do by those close to us. Whenever you feel the urge to criticise another family member or friend, pause… once you can come up with something helpful, positive and constructive that they can try, suggest that instead (from Linda Blair, London).

Also many thanks to those in the UK and USA who have contributed to this and also those who I have referenced here.

Prof. Hugh Koch

Links to other websites

Links to other websites

1) Expert Witness: -

2) Hugh Koch Associates: -

3) Links pending to and


09/04/20 UPDATE: 'We'll meet again'

On 5/4/2020, the Queen commented on the challenging and disruptive time we are all currently in, and pointed to our spirit, self-discipline and pride as being predictors of our common endeavour to succeed and see ‘better days returning’. At a time when it is likely that the peak in infection has not yet been reached, and the full economic and health deficits have not as yet materialised, this is a very difficult ‘ask’ - to be positive about our futures. We regularly hear about “transmission”, “new cases”, “flatter curve”, hospital admissions and worse.

However, part of being resilient both personally and organisationally, is the ability to bounce back from adversity. But what does this actually mean? Can we do this now before more ‘green shoots’ appear?

1. Acknowledge and share our helplessness and hopelessness

Before we can move on and upwards, we need to feel that our low feelings of sadness, loss and anxiety are out in the open and have been shared and acknowledged by those close to us. Martin Seligman, an American psychologist, often talks about stress and adversity being accompanied by thinking in a pessimistic way, and feeling hopeless and unable to see the light at the end of the proverbial tunnel. We need to share this before we can move on to “find the light”.

2. Predicting a time when this will be over

Whether you use scientific/medical concepts or a ‘finger in the air’, it is possible to make a prediction of when the major effects of this virus will be over. This prediction, of course, may not be borne out by facts but it’s a start to our forward-pointing thinking and planning. I can predict July (2020) but I don’t know.

3. Visualising what will be required

Thinking about your own particular circumstances when things start to improve, it is possible and important to do the following: -

a) Think about some of the first next ‘Active Steps’ you will want or need to take to climb your own particular ladder.

b) Discuss these steps with at least one other person (e.g. partner, colleague, friend, advisor).

c) Use logical brainstorming to generate these Active Steps in practical detail with time scales (even though these timings will inevitably be incorrect).

d) Consider financial advice to help with business interruption.

e) Consider sensible ways to support and encourage your childrens’ wellbeing and education while “school is out”.

f) Be positive about steps a) to e) above and don’t let this virus-period define you. You can move on.

4. Pool intelligence

Continue to be rational, logical and comply with the ‘best fit’ advice we are being given. Cognitive diversity, the ability to think in a variety of ways about what is happening, is important. The dynamic debate between “herd immunity” and “social isolation and avoiding infection” is one such example of this diversity. We need to pool our collective intelligence to tackle this huge challenge. This means talk about what’s best with each other. We will emerge from this in a more collaborative and interconnected way.

Many aspects of this current period are very sad and distressing but, returning to the words of Vera Lynn, echoed by the Queen, we can start to ‘meet again’. This means continuing to manage our social behaviour positively, getting beyond the infection peak, compliance with guidance, and starting to plan for bouncing back when and as soon as is possible. Start that ‘back of the envelope’ plan today.

Links to other websites

1) Expert Witness: -

2) Hugh Koch Associates: -

3) Commentary and Guidance on the Legal and Commercial Effects of Covid-19 by Members of Kings Chambers: -

4) Coronavirus (COVID-19) updates from APIL: -

03/04/20 UPDATE:
Managing Your Anxiety

We are doing well and most of us are becoming more and more informed about COVID-19.

We are not alone; we are working hard to feel informed, optimistic and up to date on all the issues we care about. However, the widespread information and media coverage can make us anxious. How can we deal with this?

1. Keep logical:

Have an analytical approach when reading and listening to news and media reports. Verify information with family and friends, GP and others. Continuously improve your understanding in the light of new evidence.

2. Keep things in perspective

Contracting COVID-19 will result in, typically, mild symptoms for most people. Vulnerable people, those with underlying health conditions or the older age group, must take extra precaution and be helped by the rest of us. It helps to be positive in a constructive and hopeful way.

3. Communicate and connect clearly

Honest and age-appropriate information must be given and listened to, discussed and adhered to. Maintain connection without increasing anxiety. Isolation and distancing isn’t fun but its necessary and will be time limited.

4. Continue to use pre-existing coping strategies

The COVID-19 has added stress and anxiety to those with pre-existing problems – use the coping strategies you had before this outbreak, practice and share tips that work for you.

5. Remember Anxiety is viral too!

These are very worrying times but manage your own mental health sensibly and positively. Understand and appraise the government’s responses but don’t ruminate over-critically. Now is not the time for that. We all need to reassure ourselves and be proactive. Think and talk rationally.

Many, if not most of us, are living and/or working at home – we need to follow simple rules to remain involved and productive both socially and work-related. Sensible use of social media, digital connectivity, emails, postcards and WhatsApp groups are invaluable. Workers need to plan for now, the next 2-3 months and the following 3-6 months, during which time we all hope to see improvements in handling COVID-19 and virus outcomes, and the slowing and suppressing of this outbreak.

6. Compliance with advice

Compliance with advice given is crucial and most are doing this – outside spaces are empty and social distancing is being adopted, with predominant self-isolation. A small proportion of the population are not acting rationally – they fail to grasp the bigger picture, ignoring the scale and the reality. They have misconceptions about the risks, quoting sensationalism and “crying wolf”, and they display “learned helplessness” where they may just give up and not heed the advice given. Unfortunately, one person refusing to socially distance or isolate may influence two or three others to do the same – transmitting psychological as well as infectious error.

Look after yourself, your family and friends, and your colleagues, by showing small acts of kindness – follow advice, comply with social distance and isolation, and connect positively as frequently as you can. This complex situation will get better – repeatedly tell yourself this. Please keep safe.

27/03/20 UPDATE: 
“Feeling connected but staying apart”

The Government and its experts stressed the importance of shielding ourselves. They focus especially on the most vulnerable in our communities, the 1.5 million who need to stay at home for various health reasons. ‘Shielding’ now however applies to us all. We must have a “can do” attitude and get our heads around this directive. The following tips must be reinforced:

1. Listen to advice given and keep to it to reduce the need for Government to impose greater legal restrictions on us. This means doing things differently.

2. Balance safe ‘social distancing’ with increasing remote and digital communication (i.e., WhatsApp, email, telephone and other digital platforms). Local street-specific WhatsApp groups are easy to set up and very reassuring. Whether for social or work-related reasons, home-based digital communication is essential, how long for? We don’t know.

3. Show your family, friends and neighbours your kind and compassionate actions and availability. Try and spread reassurance and confidence rather than sharing anxieties – a difficult ask, but possible. Be clear and helpful, not critical.

4. Combine getting ‘fresh air’ from pleasant walking with ‘social distancing’ from those you see on your walks – keep over 2 metres away. You can smile at them! Attractive outdoor spaces must not be crowded.

5. Whatever financial or employment advice you need, there are people who can provide this at relatively low, modest cost – reduce your worry by being well-informed.

6. Take all the advice about hand washing, surface cleaning, modest shopping routines and minimal travelling – they all make sense and will help to keep you and others virus-free.

7. To young(ish) Mums and Dads:

Families who have both school-age children and elderly parents to worry about are feeling the strain inevitably. This so called ‘sandwich generation’ are now into ‘extreme juggling’ looking after both children and elderly relatives while keeping them far apart. Coping with Mother’s Day has been a difficult task.

Mums and Dads, you will need all your organisational skills plus a huge dose of ‘taking a deep breath’, managing your anxiety about the ‘best things to do’ and telling each other that you are a good team.

8. Young student who cannot be at school, college or university, step up and keep occupied in whatever way you can. Some home-based study, some leisure hobby time and some helping your family with household tasks. Keep in touch with your teachers and advisors.

9. Unfortunately, things are likely to get worse so accept this and prepare for this. But look forward to the near future (July?, October?, December?) when we are in happier and more controllable times.

  1. Available research indicated that the vast majority of us, if we develop the virus, will survive it. Try and see the Government advice as largely a force for stability and calm. Keep positive and reassure yourself and those around you that you are doing a good job.

20/03/20 UPDATE.
 We are now one further week into the Coronavirus outbreak and all of us are being affected in some way, socially, occupationally, psychologically and to an extent, medically.

Some are being advised to isolate ourselves at home to reduce the ever-present risk of contracting the virus.

What can we add to our current strategy for coping?

a) Socially: - maintain separate-ness from most other people. Follow the guidance of self, couple or family isolation at home as appropriate. Despite isolation measures, use your phone and email to keep in contact with loved ones, friends and colleagues – you need them: they need you.

b) Occupationally: - we are still in the transition stage of some working in normal, or amended ways, and some working at home already. Make sure you have a plan now for how your working routine may/will change. Talk to colleagues and those you’re with and discuss options. Remember, although we have different work routines, we all need to support each other as best we can in this very difficult situation.

c) Psychologically: - the main feeling I pick up from colleagues and friends is their anxiety – hardly surprising. We have never, in our lifetime, been in such a stressful circumstance. To manage this: -

· Reduce your uncertainty by getting quality information from media sources so you are abreast of latest public health and government thinking, but … know when to switch off so you don’t feel overwhelmed or frightened.

· Be cautious, if not, over cautious, in your prevention strategies – short-term isolation and restricted activity is better especially it works and you don’t get the virus.

· Don’t hold on to negative information and dwell on it.

· Be positive about your own immediate future and have confidence in what you are doing.

We cannot, at the moment, control the pandemic, but we must try and control how we mentally respond to it.

I will keep you updated weekly via PIBULJ.

Key risk factors are clearly proximity to infected individuals but our own personal resilience can enhance our protection to becoming unwell... but what does this mean?

It means:

  1. Remembering and prompting self, family and colleagues to hand wash regularly and avoid shaking hands, kissing and touching.
  2. Maintain a positive attitude about one’s own personal risk of becoming infected, or one’s ability to manage the infection.
  3. Obtaining and understanding the available information about risk, severity and symptoms of Coronavirus, and being realistic and logical about these.
  4. Looking out for each other ,especially those already feeling unwell, those getting unwell or those mature in age.....self isolating can be a lonely process even though it’s needed.
  5. It’s looking like this stressful situation will last 3-4 months, at least. So it’s going to be a long haul. Use your email contacting to keep in touch with people, your loved ones, friends and those that are vulnerable.

Clearly we are in a very stressful situation that is likely to last several months. Our personal positive resilience coupled with supporting each other as best we can will help.

Professor Hugh Koch
Clinical Psychologist

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