PI Brief Update

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

16/07/21 UPDATE:

Well, can we say our COVID-19 hibernation is nearing an end? I hope so and I hope you agree. Despite recent statistics, we are hopefully getting on top of the overall infection rate.

Since March 2020, and even a bit earlier than that, we have felt very uncertain about our safety, the risk of infection and adverse effects, and our psychological, social and economic wellbeing. This uncertainty has been very worrying and caused significant changes in our self-esteem and confidence.

On a weekly basis, the news about changes in infection rates, hospitalisations and very sadly, deaths have reminded us and worried us about what is happening across the UK. Although still a problem, these adverse statistics need to be seen in the context of increased vaccination and, hopefully, greater immunological protection.

The ‘protection’ to our self-esteem and wellbeing given to us by having friends, some close, is an ever-present contributor to our resilience – not everyone has this social comfort. Perhaps this last two years has helped us to see how important our acquaintances, neighbours and friends really are. Our ability to be empathic to those around is crucial to our ability to understand what others are going through and also help us feel human. We all feel differently about things, and we need each other to listen and take on board our most difficult feelings, don’t we?

Those of us who are working and have an office, away from home, will have been debating how and when to return to this. The general move back to office working is helping to reflect further normality and will continue to do so.

Reading newspapers, magazines and listening to media reports each week has helped me understand what people are thinking, feeling and issues they are battling with – this source of information plus replies and emails from my readers have been a constant source of stimulation for me writing this weekly blog – I hope my blogs have both reflected your moods to some extent and also provided, at times, practical ideas to use from day to day. I wanted to share some positive comments from one of the blog’s readers:

“Thank you so much for all your efforts over the months. I have said previously, you seem to ‘have hit the nail on the head’ so often. I understand that it is now probably time to come to an end.

It has been a difficult time. I am still concerned that personal responsibility will be excused by some thus the danger of things getting worse again. Like you I will continue with the mask when appropriate and will avoid crowds.”

My resilience throughout this pandemic has been helped by the belief and positive thoughts that we can ‘bounce back’ with each other’s help and support. I would like to sign off this weekly blog by thanking you for reading and responding, wishing you all the very best for managing your health and wellbeing over the next few months. I am reminded of a quote from Tedros Adhanom Ghebreyesus, WHO Director General, who said “Be safe, be smart, be kind”.

I wish you well and thank you for reading this blog.

Kind regards,

Hugh

09/07/21 UPDATE:

As I watch Wimbledon, the Tour de France and Euro2020, I am getting some feeling of normality creeping into my daily routines. I have always felt responsible for my behaviour at home, at work and outside throughout the pandemic, guided by government advice. Since Monday night’s PM audience, I am even more confident of my own personal initiatives and responsibilities. I will continue to wear a face mask in crowded and enclosed spaces, keep space between me and others, and wash my hands after any touching (surfaces etc). I will remain part of a social group of colleagues and family who are careful about what symptoms they experience and the need for testing as appropriate. The next few months will be tricky managing the dynamic between freedom to mix, and social distance vigilance. We should be able to make an increasingly more ‘informed’ choice.

Some families have experienced significant loss and bereavement. We should all sympathise with them. It’s been a terrible time for them, and I would not like to have been in their predicament. Fortunately, vaccination has now broken the link between disease and death. I know this doesn’t, in any way, help those families who have already been so badly affected.

The pandemic is, in its urgency and high infection rate, waning but will continue to be something that we need to protect ourselves via repeated vaccination and sensible behaviour. How does that leave you/us/me feeling? It’s been a long and anxiety- producing 16–18-month period, hasn’t it? Now is the time to embrace the lifting of lockdown, take the advice and be careful. Schools need to be open as do GP surgeries for normal duties. Even though some of us get covid or get flu this winter (and next), we must avoid anxiety and panic.

This will be my penultimate blog as we have reached or are about to reach some form of homeostasis. Thank you for continuing to accept (subscribe), read and, on occasion, reply to this weekly blog. Let me have any thoughts on reflection about how you have or are experiencing the pandemic and how you see the future.

Thanks so much for your support.

Kind regards

Hugh

02/07/21 UPDATE:

Up until relatively recently, our young children have been significantly protected from the virus and its social and psychological consequences. However, more recently, discussion and debate has focused on education, vaccinations (of young people) and particularly on the emotional effects that the pandemic has had on them.

However much we, as adults, feel we have got to grips with COVID-19 and its many facets, our children have suffered the toll of stop-start education and childcare, nursery and playgroup attendance, plus inevitably they have consciously or subconsciously experienced their parents anxieties along the way.

Studies and articles are inevitably being discussed about the observable effects of all this on our children in terms of anxiety, panicky feelings and general social anxiety and variable self-esteem.

Pre-existing variability in young people’s self-confidence and separation anxiety will undoubtedly have been exacerbated by COVID-19 and attempts by them and their parents to understand and be positive will have been used to help children desensitize themselves to the unknown, uncertain and unpredictable. It seems very strange to think that for some very young children, a significant amount of their lives will have been spent in lockdown.

As with most psychological or social trauma or adverse events, an individual’s reaction can result in positive ‘growth’ and greater adaptability or, of course, can result in the alternative increase in worrying traits and tendency to helplessness.

Our (adult) ability to stay calm, sit and talk with our young children and reassure them are key components of helping them build up social confidence and self-esteem, and manage their own individual responses in areas such as getting to sleep, going on play dates, learning to swim, and starting or returning to some form of schooling.

Children have had a tough time and as Sally Baker (“The Getting of Resilience” and Tanith Carey (Telegraph/”Locked in Trauma”) both described, “our children are canaries in the coal mine” and are central to our continuing awareness and experience of pandemic-related issues.

Keep safe,

Hugh

25/06/21 UPDATE:

Chronic home fatigue? In many ways, it has been lovely being at home over the past few months whether by choice, by necessity or a mixture of both. We have been able to spend more time with our children (any age), our partner, pets and having time to reflect on what we enjoy at home and in our leisure time.

However, now that special feeling has begun to wear off for some of us, as have the benefits of watching TV, cooking (yet again), staying in the house, excessive eating/snacking/drinking, lazy morning rising (or not rising) and being away from the workplace.

Re-entry behaviour has involved managing our anxiety after lockdown – COVID-catching fear has reduced alongside vaccinations and reduced infection rates, although some anxiety still remains about touching surfaces, being in enclosed populated spaces and travelling on public transport. Paradoxically, despite this ongoing infection-related anxiety, we also are dealing with a fear that regulations could be put back in place at any time, which would be very disappointing and have further unwanted adverse effects.

We need to stay hopeful and optimistic, as well as leaving a space for some anxiety which is normal. Gradual re-exposure – dipping our toes – into some of our normal activities is the way forward, allowing ourselves to desensitize ourselves to a ‘re-entry’ to everyday normality, increasing our comfort zone, by pacing ourselves.

We do this by building healthy habits proactively with our sleeping habits, eating and drinking, and, as always, exercise and physical and mental routines. While doing these, in our own ways, we also need to practice calming and relaxation techniques which can become, yet again, an important and ever-present part of our daily experience.

As you finish reading this, take one deep breath, hold it in for 5 seconds and let it go. Give yourself a reminder every 15 minutes to do this – it helps.

Thanks for reading.

Kind regards,

Hugh

18/06/21 UPDATE:

Socialising in general has been a key issue over the past 16 months with debates over whether communication is digital, telephone or face-to-face.

Throughout this difficult period, most, if not all of us, have been thinking about our ‘best friends’ and how we and they have nurtured these relationships and how these have sustained us and our wellbeing.

Close friendships mean the world to most of us but what defines a ‘close friendship’ and isn’t it different for each of us? Having 4-6 close friends apparently is the optimum number and also the number that one can sustain – they are characterised by one or more of the following: -

· Being available in a small crisis (cup of sugar, bottle of wine, loose change for parking) or a large crisis (you name it!)

· Accepting and enjoying each other’s dysfunctions and foibles

· Listening and providing emotional support as and when asked for it

· Laughing and enjoying each other’s company

· Spending regular or irregular time together in some joyful pursuit (walk, talk, drink)

· Having the ability to ‘carry on’ with this relationship where you left off whenever you’re in contact to catch up

· Replying to our messages before the day is out!

Friends are not necessarily geographically close – they may be a ‘cup of sugar neighbour opposite’ or a ‘great friend living on another continent’.

As you read this, why not play a game of asking yourself:

· Who are your 4-6 close friends (as of today; they can change!)

· Send each a short text or email to say (in your own words) how much you appreciate their friendship or how you have been thinking about them and wanted to say ‘hi’.

Close friendships reflect our own individual way of being socially intimate – we have different ways of doing this – some of us ‘collect souls’, some of us are generally gregarious and enjoy being warm and empathetic, some of us have friends to offload our burdens onto. Whatever the dynamic, these friendships need working at and ‘watering’ like plants by paying attention and time to.

During the pandemic, close friends have never been more important – many have said how their close friendships have sustained them during the dark and uncertain times – mine certainly have.

Thanks for listening.

Best wishes,

Hugh

11/06/2021 UPDATE:

A week away from my office, desk and papers is very welcome and valuable, but news and discussions about vaccination uptake, virus variants, holiday risks and long-term safety still impinge on my everyday consciousness. I feel somewhat lulled into a low-level calmness punctuated by an occasional need for a family covid test and viability debate of a booked European flight.

Other life events and issues are intruding more and more into my weekly agenda and, in many ways, virus-land is settling into the background of my life, rather than disappearing. I wonder if this is what is going to happen? We will continue to use masks, social distancing and hand washing, continue to be safety conscious but, despite this, we will continue our daily routines more and more.

Fairly obvious musings...I intend to increase my ‘new normal’ routines and, for me, the next step is to focus on the safety of more public transport.

Keep pushing your own particular envelope and keep safe.

Kind regards

Hugh

04/06/21 UPDATE:

Pandemic-related stress has affected many people in terms of night-time wakefulness and sleeping problems. Pre-existing variability in getting a ‘good night’s sleep’ has, in many, been exacerbated. Whether COVID-related or a pre-pandemic vulnerability, disturbed sleep where we spend a significant period of the night awake is debilitating and very wearing. It can easily result in a vicious circle of daytime fatigue, low energy and nervousness about ‘turning the light out’ the next night.

We all have our own strategies that we have read about and practiced over the past 16 months and before – these include regular bedtimes and getting-up times, restful bedrooms, healthy early morning routines and occasional strategic use of light sleeping potions.

As with many other distressing aspects of our daily lives, the techniques within cognitive-behavioural therapy and psychology are useful and well worth building into our ‘getting ready for sleep’ routines. CBT-i (insomnia-related) helps to identify negative or unhelpful thoughts about sleep e.g., I’m worried I’m not getting enough sleep; I won’t get back to sleep. It helps us to identify and practice positive and optimistic thoughts either before we try to go to sleep or if and when we wake up in the night or about our day ahead tomorrow. It is crucial to not turn sleeplessness into a worry that itself prevents you sleeping.

Clearly if you have significant problems in your life at this time, then all of this sleep positivity is hard to implement – I appreciate this and daytime talking and/or therapy maybe a short-term necessity.

Sleeplessness can, should and usually is, a temporary situation and increasing positive and logical thoughts reduces this. Remember you can try one or more of these techniques:

1. Read before you go to sleep.

2. Enjoy relaxing physically – find the technique that works for you.

3. Monitor and increase the positivity of your pre-sleep thinking.

4. As you close your eyes, think of someone or something nice and

5. Think of something you plan to do ‘tomorrow’ which makes you feel good and worthwhile.

As I often say to myself and my family, “goodnight and sleep well” – you will do, if you think you will do!

Kind regards

Hugh

28/05/21 UPDATE:

Is it behind us? Oh yes, it is! Oh no, it isn’t!

15 months on from the emergence of COVID-19 we are sensing and seeing a lot of recovery – lower infections and, thank goodness, lower death rates from COVID-19-related illness, high rates of vaccinations and some easing of the social and economic lockdown conditions.

However, we still need to practice mask wearing, social distancing and hand cleanliness, and act carefully for the foreseeable future. This has significant impact, still, on primary, secondary and tertiary education and also the additional activities we so dearly want for our younger children out-of-school hours, like sports, swimming classes and other crucial self-esteem and skill building activities which are still adversely affected.

We all need a further period of ‘dipping toes in water’ and further gradual re-exposure to normal activities that we happily did pre-pandemic.

As we all move forward with our easing of personal, social and economic lockdown, we need to remember the key techniques of:

· Gradual step-by-step re-exposure (‘doing it bit by bit’).

· Rewarding ourselves, each other, and especially our younger children for their valiant attempts to ‘try something again’ – it just hasn’t been easy for many.

Despite the stresses and duration of COVID-19, we have done really well and need to continue our efforts to push back the barriers caused by the pandemic. The more we can keep pro-active, smiling and positive, the more, month-by-month, we will see progress and greater freedom for each of us and especially our children.

Keep safe,

Hugh

21/05/21 UPDATE:

Firstly, thank you to all those kind readers who sent in positive replies to recent blogs – it’s always very reinforcing.

Uncertainty and fear is now gradually being replaced by experimentation and re-exposure (tempered by ongoing masks, distancing and hand washing).

The last 16 months or so has helped all of us look at our daily lives and consider what really matters to us – our way of thinking, our contact with others and our perspectives on so many aspects of our everyday life, all in the context of keeping ourselves and our loved ones safe.

Our ability to cope since last March (2020) has been, in my view, predicted by how we coped pre-pandemic – this doesn’t really help one way or the other as we have to cope ‘today’ irrespective of our pre-pandemic history and experience. However, nevertheless, this is logical, I think.

We have all had to react to social circumstances, our way of thinking about safety and our reaction to political decisions and pronouncements. Putting these together, I am picking up many ‘spring-time’ indications of ‘lockdown relief’ as evidenced by more connections, more contacts, more mutual invitations to see each other somehow.

So how can we ‘flourish’ post-lockdown?

· Arrange to meet a ‘new’ friend for coffee and slowly expand your connections with others.

· Write down new things you would like to start or revisit.

· Practice making your thoughts ‘a little more’ positive every morning when you wake up.

· Enjoy day-to-day experiences, small or large.

This pandemic was not of our making but most of us have coped so well with the necessary restrictions and safety habits – let’s keep going “a little longer” – I hope it’s a little!

If you have any poignant, humorous or gentle anecdotes to share, please let me have them and I will collate them next week – a refreshing alternative from musings by me!

Keep safe

Hugh

14/05/21 UPDATE:

After a tumultuous fifteen months, we are all experiencing the effects of lockdown being eased – vaccinations, getting out more, meeting up with relatives and friends, all helped by our continued efforts wearing masks, keeping hands washed and sensible social distancing – well done, all of us!

“Spontaneity” … remember that word, remember being that? The pandemic has reduced, if not stopped, our freedom to express pleasure spontaneously. It has been really missed. We can only really be spontaneous when we feel safe which we are beginning to feel now – we can now feel less on guard and less fearful.

Feeling self-assured is linked with spontaneity, pleasure, curiosity and a sense of humour – it makes us more energetic, open-minded and helps us to face the normal everyday challenges. To increase the re-introduction of spontaneity, try these ideas: -

1. Change your routine and do different things and do things differently or in a different order.

2. Make quick decisions and let others make decisions for you – go somewhere new for coffee, somewhere different perhaps.

3. Change your TV viewing choices tonight, watch something different.

Continue to visualise happy things you can do and think in a positive, happy and ‘it’s going to be ok’ mindset. Things will continue to be different than what they were prior to March 2020 but we are getting there. Practicing spontaneous, playful behaviour and thinking will help us along this road.

Keep safe.

Hugh

07/05/21 UPDATE:

They say that birdsong is one of the best antidotes to stress (Moss, 2021). Waking up to the first chirps of the robin or cuckoo give a sense of comfort that they and us have slept through another night and have a good day to look forward to.

Listening to https://www.youtube.com/watch?v=Qm846KdZN_c helps us to connect to the natural world and get closer to nature. Researchers at Surrey University found a correlation between hearing birdsong and reduction in stress and refocusing our concentration. The tweet of the day every weekday morning on Radio 4 helps to bridge the gap between night-time and waking/getting up.

Whether it is territorial or trying to attract a mate, the bird and its tunefulness is a joy to hear whether it be a dawn chorus or response to finding today’s worm(s). Birds have had their own reaction to the pandemic, or the reduction in environmental and social ‘noise’ during lockdown – some have sung differently and more quietly or ‘softly’, and at different frequencies, possibly due to females’ greater interest in wider bandwidths of potential males’ songs. Paradoxically, due to the reduction of ambient noise, birdsong has, for some, appeared to sound louder. Birdsong has also, for some, dug up memories of childhood and family experiences, prompting calmness and happy thoughts and images.

But why does nature, in general, and birdsong, in particular, have a healing effect on us? Hearing bird song signals life is present around us and implies safety. Birdsong is a pleasant thing to focus on, giving us a break from other cognitive or social challenges, and elicits a sense of curiosity and wonder in the world.

So, how can our feathered friends help us as we manage easing of lockdown?

· Notice and appreciate the sight of sounds of birds around us, in our garden, or in the sky.

· Encourage interaction by making flowers, plants, seeds and worms available.

· Talk to the robin who comes to visit.

· Be mindfully aware of a bird’s presence if only for 30 seconds.

· Listen to their songs and intermittent tweets naturally or digitally.

Birds symbolise, for many, feelings of life, peace and hope – if you occasionally wake up at 3am to early morning chirping, pause to appreciate your joint experience of starting another day, and join in with this dawn chorus. Remember, that it’s possible that birds, like us, may sing just for the joy of it (Maclear, 2016).

Keep safe,

Hugh

- Maclear K and Turnham C (2016) The Wish Tree. Chronicle.

- Moss S (2021) Natural high: why birdsong is the best antidote to our stressful lives. The Guardian (29.4.21).

30/04/21 UPDATE:

Many are reporting that as lockdown eases, and our freedom to return bit-by-bit to pre-pandemic routines, they are feeling exhausted. We, of course, know that in ‘normal times’ our energy and fatigue levels fluctuate and often do so with our prevailing mood and interest in our daily life. However, it would appear that, following the huge efforts we have made to cope during lockdown, we now perhaps are experiencing a reaction as we emerge from lockdown of variable tiredness and associated down-beat feelings like sleep disturbance and lack of motivation. This reflects the tension we have been through in the last 12-14 months.

Most of us have some hesitancy about opening up our activities, travelling and socialising – it is as if we are reluctant to leave pandemic-related lockdown behind. Managing a busy schedule of family and work commitments, living a full life, is conflicting with our keenness to retain a quieter home and social life – but we need to overcome this, don’t we? Whatever our age we need, if we can, to regain our self-confidence and feel less vulnerable – we need to start socialising more, travel safely and fill up our diaries once again – the COVID-19 mindset neds to be replaced by ‘Flourishing 21’.

In all probability, this is the languishing period between lockdown ‘inertia’ and post-lockdown ‘flourishing’, maintained by uncertainty about dipping toes in the new normal (Professor Van Tam, are you listening…’dipping toes’).

So, what can we do to address our internal emotional clock?

· Maintain a regular sleeping pattern and include 15–20-minute power nap, mid-afternoon.

· Monitor caffeine and alcohol intake especially early evening.

· Exercise will increase your energy levels and decrease chronic tiredness – light exercise, pleasant walk, low intensity yoga or pilates, stairs not lifts.

· Manage your stress levels by meeting up with friends, relax regularly, remember the things you enjoy doing. Set post-pandemic goals that reflect pre-pandemic calmness and energy.

We need and can take socialising slowly. Social reticence will gradually change. Ask yourself ‘what small steps feel manageable?’. Self-consciousness will change with gentle practice. The question ‘how was your lockdown?’ needs to be handled sensitively. Prioritise one goal to help you see one friend for a little while – whatever you can manage.

Heard it all before? Yes, me too, but it helps, I’m told, to be reminded of healthy, energy-promoting ideas. We are getting there, bit-by-bit.

Keep safe,

Hugh

19/04/21 UPDATE:

The sun is out, the sky is blue (ignore the snow and chill wind). Lockdown has eased a bit and outside hospitality venues are opening. The spring is in our proverbial step(s) is slowly returning.

Many thanks for your feedback on coping strategies, especially the emphasis on planning for trips, local and UK-wide – visualisation of ‘next steps’ seems a really good idea – it leads to conversations, inspecting diaries and looking forward to ‘un-locking up’ – the opposite of ‘lock-down’!

Two issues raised themselves in my digital post bag this week: “worry about my next Astra Zeneca jab” and “dealing with panic anxiety post-lockdown”. I thought I would address both this week.

Worry about my next Astra Zeneca jab

Many have received a text from the NHS informing them it’s time for their second COVID jab (Astra Zeneca). Research to date reveals a very small statistical risk of blood clots, described as ‘very rare’, and to date, not conclusively linked to this vaccine as yet.

Despite this risk-to-benefit ratio, under 30s are being advised to consider an alternative vaccine. However, Britain’s regulator endorsed the benefits outweigh the risks for the majority of people and we should continue with the second Astra Zeneca jab, if we have had the first. I include me in the ‘we’. The risk is incredibly small. I personally feel reassured by available information, including information about low second jab side effects. I’m looking forward to increasing my immunity.

How to deal with panic anxiety post-conclusion

When lockdown occurred last March (2020), many described themselves as very nervous (Office for National Statistics), some reaching the level of acute anxiety and panic. With lockdown being eased, there may well be, for some, an increase in this nervousness, especially for those already prone to anxiety. The most effective intervention is a cognitive and behavioural approach to our thinking (rational and positive thinking) and our behaviour (relaxing, calmness and calm routines).

It is important to monitor and interpret the thoughts which keep our anxiety going – try not to avoid anxiety, but instead meet it bit by bit with relaxation-inducing activities such as calm breathing, changing our thoughts to positive coping ‘I can do this’ thinking. Nervousness often subsides over minutes. It is normal and understandably to feel nervous or uneasy as lockdown eases – take small steps towards easing yourself out of lockdown.

Share this with a friend and start a reassuring conversation with them about feeling more confident about this week’s plans – push your own particular boat out stroke by stroke – another metaphor to consider!

Best wishes

Hugh

09/04/21 UPDATE:

We are hearing further hopeful news about opening up hospitality in part, increasing social contact alongside ongoing vaccination volumes. As this blog enters its second year (month 14), I wanted to mention some of the feedback I have received over the past few months. I am very grateful for those of you who have taken the time to say you’ve enjoyed reading the blog but more importantly, many of you have described how you have been coping yourselves:

1) The ‘simplicity' of the messages or suggestions

2) Encouraged to relax at different times of the day

3) Pushing oneself to do things, rather than ‘just sitting’

4) Positive responding to one’s partner, relatives and friends

5) Supporting each other as you wait for your first (and second) jab

6) Remembering pastime memories including childhood books

7) Visualising safe therapy places

8) Sense of increased friendliness

9) Looking forward to eating out, and seeing friends soon

10) Managing the long drawn-out nature of COVID-19

11) Appreciating little things including the weather, and sunny, blue sky days

It is very reassuring to know that some of the ideas I have been discussing have hit the right buttons. One respondent has been reading particular blogs several times.

Going back to the ‘old days’ (pre-pandemic) or going forwards to the ‘new normal’ is teaching us all lessons. We are all tired and weary. We shall have to wear masks and socially distance. There is no valid reason to refuse. Many of us are worried or nervous about meeting up with others, in small or not-so-small groups.

So... let’s all take a deep breath in month 14 and plough on, practically taking safe strategies and enjoyable allowed activities. If you are finding re-entry nerves are affecting you a lot, find someone who you can share this with and use that conversation to put your understandable nervousness into perspective, so it is easier to manage. If you don’t have this re-entry anxiety, I bet one of your friends will, so support them if and when you can.

If you would like to send me an email with your top tips for coping, I’d be glad to pass these on next week.

Keep Safe.

Hugh

01/04/21 UPDATE:

There is more hopefulness in the air with jabs getting nearer, socialising easing up a little, and a road map (literally) becoming more evident as we and the clocks “spring forwards”. However, we are also hearing about longer term delay of access to holidays, annual winter booster jabs and the absence of a tidy ‘that’s it – sorted’ feeling.

That’s why I think many of us are still feeling ‘blue’, despite the positives and despite spring approaching. It’s strange that the steps forward are also, paradoxically, making us feel a bit helpless and potentially disappointed about the time taken – we have yet to fully regain our confidence.

Perhaps we can capitalise on the new shoots of pandemic spring and get in touch with some ‘hopeful’ energy. It’s difficult when there is still so much uncertainty around – however when the shoots of spring do appear, enjoy and appreciate them for what they are – getting a jab, getting out a bit more and planning a more energetic and social routine are all things that are worth appreciating – this enjoyment and freedom will feed on itself more and more during the next few months. If this is also reinforced by returning to more active work and employment, then that will be great.

What are you worrying about at this moment? It’s normal to be worried (a bit). Hardly surprising at the moment. Anxiety is uncomfortable but it needs to be tolerated rather than avoided or numbed. It’s good to understand how our mind works, replacing bad anxiety habit loops with healthy ones, so Dr Brewer (psychiatrist) suggests by:

· Writing down your worry or telling someone, and voicing what you are doing to cope with it.

· Taking one deep breath now, let it go and relax.

· Doing something calming now (next few minutes) – don’t worry about the next 24 hours for now.

· Doing something kind (for yourself) and kind (to someone else) – does it feel good?

Try practising the positive loops of calmness and kindness today. If you can, then sit in the sunshine and enjoy the moment. Your list of jobs can wait 15 minutes.

Take care,

Hugh

26/03/21 UPDATE: Another day, another mask!

Despite the ongoing vaccination programme successfully rolling out, it does feel as if the end of the tunnel is twisting and turning ahead of us, not necessarily getting nearer or further away. At the moment, given the world-wide perspective about the virulence of COVID-19, we are preparing ourselves for a long haul, with maybe, like the flu virus, an ongoing need to protect ourselves.

My current thoughts this week centre on what positive effect the ongoing pandemic could be having on us and how we can use our social skills to manage our uncertainty.

COVID-19 can make us stronger

Of course the pandemic has had devasting effects on some families, especially those who have lost loved ones, have had significant illness and/or suffered huge economic hardship. However, we also know from other trauma-situations that people can emerge with better coping strategies, feeling stronger and more resilient from awful situations. Coping with COVID-19 is no different. It has made us consider how we cope on an everyday basis – many of us have been more expressive emotionally, showing our anxiety, upset feelings and talking about coping/not coping. For many, this has resulted in real signs of better psychological functioning, including re-evaluating our current (and future ways of coping). We have found more ways to be grateful especially for everyday things and also being hopeful and see ourselves as positive survivors. Our social activity is a key aspect of post-pandemic growth.

Getting used to people again

Shane Watson’s recent article ‘Pick how you mix’ eloquently talked about how the gradual unlocking of restrictions has been making us all a bit nervous, and we need to support each other in getting used to being with each other again.

Routines over the past few months has consisted of alone-ness, early nights and social distancing. We are now becoming a bit more free – how can we cope with this?

· Increase your mental non-verbal ‘hellos’ – waves, smiles, small ‘how are you?’ comments – no need for long discussions to start with.

· Focus, in conversation, about the positives of your and their day/week.

· Choose your social ventures sensibly and carefully. Avoiding over-populated situations and times.

· Ease yourself into socialising gently. Don’t feel pressurised to be in large groups or spend long times with others.

Some socialising may feel awkward and uncomfortable. We may find some of our acquaintances more difficult to be with at the moment. Their views and your views may be temporarily divergent or different. That’s ok. We tend to migrate toward those we like or those who we have an outlook perceived as similar to our own. This may be a temporary feeling or not – just try not to have entrenched or fixed opinions at the moment, and avoid conflict discussions.

If you want to practice tolerance, look to the aspects of others that you like or can relate to, ignoring for now the things that irritate you. Practicing empathy, seeing things from the other person’s point of view creates an atmosphere of likeability and understanding.

Remember your routine (in your head), your mask (in your pocket) and your hopefulness (in your heart).

Take care.

Hugh

References:

“Pick how you mix” Shane Watson, Telegraph. https://digitaleditions.telegraph.co.uk/data/545/reader/reader.html?#!preferred/0/package/545/pub/545/page/77/article/153673

19/03/2021 UPDATE:

Lockdown easing is helping our young children to return to their schooling, both primary and secondary. However, those of you with school age children are expressing their mixed feelings about this major and important step. Parents are on the one hand delighted to see their children return to socialising, mixing and playing with their friends and getting back to crucial learning. But, at the same time, they voice their concerns both for their children and themselves about how they will deal with nervousness about this return after so many weeks of home-based activity.

So, what can parents do to bolster their own confidence and that of their children? Here are some useful tips to discuss and consider.

Back to school tips (Primary)

Talk about this before they go back, or as soon as possible, after their return.

Prepare their uniform, pack their school bag.

Reassure that study confidence will return.

Reassure that earlier friendships will return.

Encourage them not to be overwhelmed by the size and loudness of school.

Listen to your child and their concerns.

Reassure them about separation anxiety.

Ask them to tell you about their day.

Use breathing and relaxation – show them how.

Don’t worry – it gets easier for them (and you)

Help them to relax, sit still and concentrate.

Back to school tips (Secondary)

Talk about ‘facing the challenge’ and share solutions.

Arrange to meet a friend to walk to school.

Reassure about COVID mask and testing.

Reassure about catching up – it will happen.

Manage screen-time sensibly – not too little, not too much.

Discuss sensible bedtimes.

It may well be that you are reading this after your child’s first week or two has been and gone. See how these tips tie up with your own experience in the past two weeks. Relaxing, talking and reassurance work at any time in your child’s development, so good luck. I’m sure you’re doing a good job helping your child/children re-adjust.

Best wishes, Hugh

12/03/2021 UPDATE:

Back to university, college and work

Whether you are a mature student returning to university or college or a member of staff, issues of re-entry anxiety will, no doubt, apply to you all.

Lockdown routines have been very different since March last year – we have become, to an extent, a nation of home-based hermits, fearful of leaving the house. Even now, that the threat of COVID is reducing, we are still nervous in some ways, being accustomed as we are, to staying apart. We have, in part, become deskilled at socialising and the return to being with our peers in college and university in making some of us nervous – we are out of practice.

For all of us, friendships and relationships are vital and too many Zooms or ‘Teams’ hugs may have a significant impact on us. We need to remember, as we emerge from lockdown, our ability to share, laugh, hug and make more and more contact with each other. Loneliness or alone-ness needs to be gradually replaced by the other side of the coin, friendship – we don’t cope well with extended isolation. Happy friendships raise our mood and increase our wellbeing.

Specific concerns raised to us about returning to work and learning environment include the following: -

1. Organising caring responsibilities at home.

Concern about arranging care and support for elderly or clinically vulnerable family members and very young pre-school children.

Concern about leaving pets who find separation stressful.

2. Transport anxiety.

Anxieties about catching trains and buses.

Dealing with crowds at bus stops and platforms (“sardine trains”).

Practicality of shortened transport timetables.

3. Return-to-work environmental safety and hygiene.

Concern about ‘hot-desking’ and poor health and hygiene including desk cleanliness and adequate ventilation.

Reduced efficiency due to physical meetings and reduced organisation.

Unsure about blended way of working being effective.

Availability of adequate lunch at work and time for dinner at home.

Adjusting to working in a room with others.

4. General increase in going out ‘anywhere’.

Generalised anxiety about going out of the house ‘anywhere’.

High levels of dread, panic and nervousness.

Tips for re-entry

1. Gradual build-up.

Do a little more each day if this is possible. Discuss this with colleagues or supervisors.

2. Be positive about your plans.

We are all different. Don’t compare yourself unfavourably with those around you. Be focused about what works for you.

3. Touch base with friends and colleagues.

Get support from your friends and colleagues by staying in touch with them both at work at when you’re at home.

4. Maintain an enjoyable hobby.

Don’t make the day ‘all work’ or ‘all study’ – have a pastime that you can enjoy for 5-30 minutes each day either at work (e.g., ten minutes relaxation and coffee) or at home.

5. Show interest in colleagues.

Avoid dwelling on yourself by shifting your attention onto others and finding out how they are.

6. Read earlier blog tips.

Read the previous 12 months blog for useful tips.

Getting back to work and college is yet another step towards returning to normality. Good luck with how this affects you over the next few weeks.

Kind regards,

Hugh

05/03/2021 UPDATE:

For the hospitality sector since February 2020, their ‘world’ has been a nightmare – minimal income, ongoing costs of space, consumables and staffing. Key brief easing of restrictions have caused more grief than opportunity. They are now approaching a timetable for opening ‘outside space’ and then inside, followed by easing of hours for opening for mixed music/eating/drinking venues. What a nightmare it must have been (and still is until the dust settles).

What people in hospitality have wanted more than anything is clarity – planning is how restaurant owners and catering staff operate – in good times they plan how the space will look, will operate, how dishes, wines and cocktails will taste, how staff will serve and how to ensure the customers enjoy their time.

So, they need a clear plan and need our support once they’ve opened. We must make sure they are a priority – hospitality is not just some fun appendage to our busy lives, they are a cornerstone of our daytime and evening culture and are a direct and indirect employer of many, many people.

The Government’s plan needs to be clear, thorough, and sustainable. Al-fresco dining, as an initial step, needs to be planned for. In the longer term, distancing measures and reasonable limits on covers is important alongside a business rate holiday for as long as there are restrictions.

Hospitality entrepreneurs are creative, positive and hopeful people. What can we do to help and support them during the coming weeks to show we care for this hugely important part of our cultural fabric?

Your local hospitality venues will continue to face ongoing disruption, change and uncertainty for a while, at least the remainder of the year, even once easing has occurred. So here are 10 things we can do to help these venues, especially the ones that you love and don’t want to see disappear

1. Write a positive review

After a great meal and good service, share this information online and give ‘your’ venue and its staff a lovely morale boost – there are several sites, just write on one.

2. Like, comment and share posts

Interact with the social posts from your local venue – this will help get the word out and encourage more customers to visit – doesn’t cost any money just a minute of your time, and it builds up valuable solidarity. This includes posts of a recent great meal, tagging the venue.

3. Buy a gift voucher or bar tab

If available, show support for your local venue, buy a voucher to use now or later.

4. Be kind, compassionate and loyal

A few kind, positive words to your venue’s staff or on social media goes a long way to make them feel they are contributing to your community – an additional gesture of kindness is well worth the effort.

5. Schedule venue-visits

Working from home for many of us will have shifted how, when and how often we spend on restaurant food. Do your bit for local hospitality venues and plan a regular visit – you will enjoy the break, and they will enjoy your visiting.

6. Book and honour the booking

Booking systems are very reassuring to the venue, giving them predictability and confidence, and helpful to the customer who feels organised and expectant of a good time. If you book, try and keep to it, but if something forces you to cancel, give the venue sufficient notice. Realise cancelling too near the time, has a negative impact on the venue, especially a small one, that is unnecessary.

7. Understand price difference between supermarkets and hospitality venues

The cost of your favourite pint includes fixed costs – supermarkets have ways of incorporating these plus high-volume pricing which disadvantages the venue – be loyal to your venue, taking your well-earned cash there.

8. Book a DIY box or drink

Many venues have created DIY recipe boxes so that diners can continue to savour their favourite dishes or drinks. These add a little excitement to your weekly recipe rota. This may extend to a takeaway – enjoy this once every so often to help support a small venue going though rough times.

9. Buy restaurant merchandise

If your venue offers any sort of merchandise, buy some – it all helps – whether it’s a mug or t-shirt.

10. Value ‘your’ local venue

Restaurants, especially independent ones, are resilient and flexible. They want to survive and emerge from the pandemic nightmare – to do this, they and you, the loyal customer, need to collaborate making the local neighbourhood venue community thrive and mutually empowered. Value your local venue, now you understand them a bit more.

Professor Hugh Koch

Reference: Squaremeal: 11 ways to support your local venue during COVID-19

26/02/21 UPDATE:

This week, Boris Johnson set out his timetable for easing lockdown in schools, businesses and hospitality as well as keeping the rest of us on track with vaccinations and social distancing. Along with the opportunities this brings to see friends, play sports, resume contact with friends or plan to get back to work or college, these anticipated changes can be difficult for our mental health and be a worry, especially for those more vulnerable. The end of lockdown may have as many difficulties as the start did, at least to begin with.

Everyone is facing uncertainty and challenges with fear and anxiety perhaps being most common as we approach the release from lockdown, changing some familiarity or unfamiliarity, feeling uncertain or scared. This will involve returning to routines which we had forgotten about, finding that some things had changed during the pandemic e.g., one-way systems, queuing, travelling a little. These feelings are reasonable and to be expected – we now have to rebuild our tolerance to work through these anxieties. Remember that any everyday nervousness we had pre-pandemic will perhaps re-emerge post-pandemic to a lesser or greater effect.

Here are seven strategies to help cope with lockdown-easing anxieties:

1. Control what can be controlled

Although you can’t control the timetable or vaccine roll-out, there are things you can manage and plan for. Make sure you keep your vaccination date, once you get one (or two).

2. Pace yourself

Push yourself at your own rate, not other peoples. Discuss your concerns with your friends and pace yourself especially with reconnecting safely outside your home, when rules allow, and the time is right for you.

3. Vary your routines

Vary your routines so you contact different people in different situations at different times. Try alternative shops or supermarkets and at less busy times. Organise a different walk at quieter times.

4. Build up tolerance

Gradually changing your routines will increase your tolerance and manage the anxiety you have with easing lockdown behaviour. Appreciate what you achieve and note things you enjoy.

5. Look after your general wellbeing

Eat healthily (still), manage and limit alcohol, exercise regularly and remember sleep hygiene tips that calm you at night. Continue to read, practice mindfulness and spend time on hobbies and getting outdoors – all these activities have a positive effect on wellbeing.

6. Focus on positives

As always, resilience is based on positive thinking – take pleasure from the small positive changes and opportunities you have with this easing of lockdown. Focus on positives in your behaviour, others’ actions and general things you see, hear or feel.

7. Looking after our children and older family members

Managing the changes in family support and closeness is crucial as lockdown eases. With schools soon to re-open, parents need to manage and plan how their time is scheduled, assisting with school work, covering part-time childcare and other responsibilities across the working week. Some of us older people will be feeling anxious about how to stay safe, especially those with long-term conditions who are still reluctant to go to the health centre or leave the house more often. Many are still worried about contracting COVID-19, despite the positive changes in risk. Many older people aren’t connected digitally, so telephones are an essential way of keeping in contact by them or by you.

It is important to acknowledge that worries about lockdown easing are reasonable and understandable despite the positive direction we are going in. We need to build up our confidence and tolerance to get through these worries and keep on target.

Keep safe, well and positive.

Professor Hugh Koch

 

19/02/21 UPDATE:

For the past 12 months, we have all been having pandemic-relationships of varying sorts – these have been with friends (old and new), partners and/or colleagues. The ‘relationship barometer’ in all these will have varied, but the feedback I get suggests that most relationships have fared reasonably well despite the inevitable pressures. Being in lockdown with its many social, economic, health and wellbeing problems has made us, at times, socially frustrated and short tempered, testing our skills and patience with each other. Chronic stress, like that which we are all experiencing one way or another now, can result in significant exhaustion. This is characterised by feeling physically and mentally overwhelmed, which reduces our tolerance of relationships, and makes us feel ineffective and inadequate. So, what are the secrets of successful relationships during the pandemic (and beyond)?

Kindness in small ways

Doing something kind for another person is endearing and shows thoughtfulness which can warm the other person in surprising ways – an unsolicited cup of tea or offer of a snack, opening a door, letting someone go before you, waiting an extra 5 seconds at the zebra crossing (as driver or pedestrian). These are all examples.

Appreciation of other’s actions

When someone has done something kind, recognising and acknowledging this is worth a lot, even if the other person feels altruistic and not in need of being thanked. Respecting and valuing each other’s actions gives out a warm feeling.

Non-critical and non-judgmental comments

When we get on well with someone, whether in the capacity of a friend, partner or colleague, there are few open arguments. Comments are less critical or judgmental. Criticism, when it does occur, is specific and couched in affectionate and valuing language, avoiding phrases which upset or offend. Effective communication takes responsibility for how they feel and how they make others feel. They understand that relationships need ‘looking after’.

Humour is very important in communication and relationships, superficial or close. Not taking oneself too seriously is an important point of connection. Light teasing adds something and encourages feelings of normality and safety.

Avoid social perfectionism

We all want and like to excel and do things well, but the reality is that being a perfectionist creates stress especially if it is not acknowledged. ‘Adaptive perfectionism’ with setting high goals, looking to improve and having high standards is good. However, perfectionism becomes harmful if it involves being flawless, having extremely high and ever-present standards. Socially, this displays itself in self criticism and criticism of others, all-or-none thinking (e.g., perfect or worthless) and having an inner fear of failure if a mistake is made. Once we recognise this, it is helpful to: -

· Look at the benefit of 75% standards

· Allow yourself to make a mistake and be ‘less than perfect’

· Shift your high expectations down a little, allowing for some trial and error

In conclusion, the more we can try and be a flexible, kind and compassionate friend, partner or colleague, the better our self-esteem and self-confidence becomes. Try some of these ideas out today and watch how your relationships benefit – let me know what works.

Have a good week.

Professor Hugh Koch

 

12/02/21 UPDATE:

In Enid Blyton’s well-loved book ‘Faraway Tree’, the imaginary Lands at the top of the tree change frequently.

Example lands include Dreams, Spells, Toys and ‘Do-as-you-please’ but one of the more relevant ones for me, in the context of COVID-19, was the Land of Topsy Turvy – homes are upside down as are trees with roots in the air and people walk upside down too.

Our Pandemic Land is a bit like this, isn’t it? – our personal and working life is topsy-turvy and, at worst, very upsetting, distressing and worrying. Over the past 11 months, we have been fearful of getting infected by COVID-19, having a serious respiratory (or worse) condition or succumbing to the illness.

We have been worried about and frustrated with our economic circumstances with reduction in working hours, viability of businesses, loss of jobs and/or lack of financial security.

Socially, we have been managing isolation, alone-ness, and loneliness.

At home, we have been getting to grips with significant changes in our daytime routines.

All these anxieties and associated variable mood have been a real challenge to us all and continues to be so.

The ‘light at the end of the tunnel’ is there with emergence of vaccines and jab appointments being scheduled for many of the older, and more vulnerable groups. However, concerns remain about efficacy of vaccines, double-jab interactions plus longer-term vaccine effectiveness.

Like Enid Blyton’s Lands and life itself, this pandemic-land is always changing. There is no enduring security, currently. However, recognising and accepting the ever-changing nature of this last year can bring a sense of partial security to us all.

I would like to add a small idea which we can all use to help us manage our own Faraway Tree Land of Topsy Turvy – this involves finding our own sense of calmness or ‘sanctuary’ from time-to-time despite the anxiety and distress.

Discovering ‘sanctuary’ is a very positive technique, lasting 5 seconds to a long time. Visualising sanctuary uses one’s own experience from the past to visualise a safe and happy place where one can go in one’s imagination – a sunny beach, a babbling stream, a childhood room, an affectionate friend. Every ‘sanctuary image’ is unique. One can always return and enjoy its calm, beauty and peacefulness.

This visualisation can be accompanied by a physical, physiological and mental relaxation response from sitting still, turning your phone to silent, wearing comfy clothes and focusing on your steady breathing while picturing your sanctuary image and relaxing.

How long do you do this for? Ten seconds is good; 1 minute is a great start; ten minutes is a big achievement. There is no pressure to take a long time doing it. Be in control of how long you take.

As you find this pleasurable experience makes you feel good, apply it and practise it every day including when you are out and about.

Our worries and concerns do not evaporate, we still have them, but we all deserve occasional sanctuary of calmness and peace.

Take care of yourself and your family.

Professor Hugh Koch

 

05/02/2021 UPDATE: A new month, new hopes

four helpful ideas to help us all continue our resilient journey through this pandemic, towards the light at the end of the tunnel. You may have noticed that I tend to file good ideas under one of four ‘psychological’ or ‘self-help’ factors: our behaviour, our social connectedness, our thinking, and our health and wellbeing. Here are my foursome for this week.

1. Early morning vitality and a routine

This third lockdown is having a difficult effect on our energy levels, and feelings of vitality. De-motivation has adversely affected our daily routines. What can we do?

Try not to spend extra time in bed, awake or asleep. We don’t need additional sleep – keep to your natural bed routine. Long lie-ins make us more lethargic not less. Make sure you get appropriate hydration when getting up in the morning.

Have daily routines to get you through long empty days, setting yourself plenty (or enough) to do each day. This requires more creativity, thinking ahead, scheduling activity or hobbies or social contacting.

Low-grade moods are helped by getting up and getting outside, exposing ourselves as much as we can do natural daylight and starting our routines. This wards off general fatigue. Take a few steps every half-hour, even walking around your office, to break up endless sitting.

2. Training your mind for positivity

Whatever your usual mindset, challenge yourself to move it one notch along the positivity dimension, by looking at your patience, positivity and self-kindness: -

· At night, list 2-3 things that you’re grateful for or have achieved

· In the morning, list 2-3 things you are looking forward to today

· Go outside in the morning for a burst of natural light, fresh air and movement (any amount will help)

· Smile to yourself or someone near you (irrespective of a reason to smile)

· Do something helpful

· Practice new phrases that are positive

· Be patient, calm and enjoy your here-and-now experience

3. Start, continue and maintain connections

Social connections and mood are linked. We all need ways of keeping socially engaged by:

Schedule into your routine some ‘social engagements’, social connecting and knowing there’s a group of people to touch base with can be energising in itself. An extra advantage of the ‘Zoom/Teams’ revolution is it then encourages us all to dress … properly/tidily/normally or … just dress! And stay well grounded.

· Say hello, smile as you pass a stranger on your walk

· Start a phone call or email with a happy version of ‘how are you today?’

· Acknowledge emails that landed over the past 12 hours

· Plan your ‘contact routine’ so you regularly communicate with someone each day

· Tell yourself you are a social person and this helps others (as well as yourself)

4. Move around, up and down

Exercising and moving around does matter, both physically and mentally. Our lockdown-related sedentary lifestyles are not helping, and adversely affect every organ in the body. The idea of taking activity breaks isn’t new and still is important.

Take breaks and, in each break, address your wellbeing in social, physical, mental, emotional and nutritional ways. This could be brief exercise, meditation/mindfulness, message someone, having a healthy snack, listening to one piece of music, taking a walk – anything that makes you feel better.

Irvin Yalom, a well know psychologist in the USA, talked about what made therapy effective – now this blog is not therapy but some similarities with self-help are obvious and the key ‘Yalom Factor’ I want to leave you with is the importance of instilling hope in ourselves and those around us. We will get through the pandemic, with our own efforts, vaccination and local, national and global good sense. Tell yourself and your loved ones this whenever and as often as you can.

Have a good week.

Professor Hugh Koch

29/01/2021 UPDATE: Making Home Working Healthy

Over the past ten months, many of us have been working from home part-time or full-time. This has largely entailed several hours a day sitting at a desk, doing paperwork or gazing intently at a screen. The long-term physiological effects of this can include an increase in falling molecules in the blood plasma, insulin resistance and increase in LDL ‘bad’ cholesterol. This means the muscles don’t absorb fat and blood sugar levels rise, both contributing to weight gain. In addition, muscles lose their strength and the maximum oxygen we consume falls significantly. All in all, not the healthiest outcome.

In addition to negative physiological and physical bodily effects, many of us have experienced negative effects on our mental health and wellbeing which I have reported on in previous blogs. So what ideas are there to improve our home working situation ergonomically, physically and behaviourally?

1. Posture and seating

Use a chair which supports your back and gives you lumbar support and consider placing a small cushion or rolled up towel in the small of your back. Vary your posture and position – some people sit on a gym ball which encourages an active posture. Make sure your laptop, computer or iPad is at a comfortable height for you. Use household items to prop up your screen if necessary, like files or books. Keep changing your position and move around. Most sitting-related muscular skeletal injuries occur due to prolonged and repetitive movements.

2. Improving eye strain

Rest your eyes every 15-20 minutes and focus on a distant object for about one minute. This helps to relax the eye muscles. Make sure the room is well lit, preferably with natural light. Reduce glare and reflections from the screen. Make sure the font and image size of the screen text is adequate to read without squinting.

It can be hard on your eye muscles if you are looking at a screen for any length of time. Make sure you have the appropriate glasses for this purpose and if required get a ‘refresher’ eye test and correct prescription for glasses.

3. Distraction, breaks and switching off

Keeping a good work-life balance can be hard to organise. Be strict and have a timetable for switching off. This can include switching off your work devices when you finish your work slot.

4. Managing space and family

Find a space for working that is free from distractions and comfortable enough to concentrate in. Some rearranging of your home space may be necessary. Having your own space will immediately help you to focus and get in work-mode. Agree with family members when you are working and unavailable. Dedicate time to uninterrupted work and schedule breaks to spend with others. Stay in touch with friends either using remote technology or telephone contact.

5. Exercise

Frequent movement is important. Every twenty minutes, stand up, shake your body, do some shoulder and neck rolls.

Take a brisk walk each day even if its walking around the home to make a quick coffee.

Walking outside the house is easy and accessible and doesn’t depend on the weather! Fast walking or a short run are good for your cardiovascular system. Pilates is good for working on balance, flexibility and stability.

6. Diet, alcohol and caffeine management

All three contribute to our health and wellbeing so manage a healthy diet, with some healthy snacking even when you’re working. Moderate your alcohol and caffeine intake so you can enjoy a small tipple or cup. Do not be excessive in your intake. Don’t visit the fridge too often.

7. Schedule and routine

Like at the office, manage your workload so it doesn’t overload you and also complete jobs so it makes you feel competent and ‘on top’ of your schedule. Each morning and/or evening, write a short timetable for the next day. Again, this gives you a sense of predictability and control. Give yourself a positive stroke when you get your task completed.

Many of these tips are applicable to when you return to your normal work/pre-pandemic setting. Try them out and share them with friends – they will appreciate your thinking of them.

Good luck and keep your home working healthy.

Professor Hugh Koch

22/01/2021 UPDATE:

January is usually the time when we encourage ourselves (or others!) to make resolutions that will make us healthier, happier and improve our general wellbeing. These resolutions need to be sensible, practical and achievable – some of us find a black-and-white aim like a ‘dry’ January easier to start with, others find an incremental ’10 minutes fast walking in January; 20 minutes in February’ easier to go with. Whatever your favoured implementation strategy, here are some tips to consider on your “2021 List of Resolutions”, which can help you take control of your daily activity.

1. Write down a routine for your spare time

Once work, if you’re working, or family/childcare has been sorted, if you are left with spare time on your hands, it’s good to have a routine planned to use this time and make you feel relaxed. 15-minute slots can be allocated to reading, having a cup of …, a brisk short walk, sending ‘how are you’ emails and so on.

Establish regular routines for everyday domestic tasks such as showering, dressing, wash up, have a small breakfast, morning ‘coffee’, tidy up before bed, put clothes out for morning, read in bed. These simple routines give reassurance and make you feel in control.

2. Build relaxation into each day

Find 5 minutes in the morning, afternoon and evening, to sit quietly and breathe deeply a few times, holding your breath for 2-3 seconds, and imagine, on your out-breath, that you are letting the air go down through your body and feel it relaxing you and making you calm. Not complicated and only takes 5 minutes. You can even do it on the loo! Just slow your breathing.

3. Accept the idea of mindfulness

Whatever you are doing, practice focusing on that task (washing up, tidying a drawer, folding the drying, laying a table, peeling potatoes and so on) and avoid your mind wandering. Focusing on the task in the here-and-now makes you present-centred and calms your mind.

We all find it hard, from time to time – to remain focused on your daily activities. Our mind wanders a lot. Make a list each day; prioritise which ones are more urgent (unless they are time specific); tick or cross out tasks as you complete them; hone your focus by playing a game (e.g., crossword, sudoku).

The more focused you are on a task, the quicker and better it will get done

4. Fast walking not fast talking

You can find pieces of research to help/hinder almost any activity – however, we are now being told that a daily fast walk of 15-20 minutes which raises your heart rate is very healthy and compared favourably with other activities which take longer and seem more energetic. If you live or work in a tall building, use the steps and stairs to achieve this target and avoid the lift.

5. Connect with others over these resolutions

To give you another reason to share things with family and friends, tell your nearest and dearest about these six resolutions – they may find them interesting and helpful and, also, may, I hope, ask you how you are getting on with them. This will give you support and help you keep motivated.

Feel free to replace these by other resolutions – these are only ideas! Let me know how they go.

Professor Hugh Koch

15/01/2021 UPDATE:

Happy New Year, 2021. I hope you and yours are safe and well. Has the virus gone yet? – No. Have you had your vaccination? Probably not.

Will you get your vaccination soon? Yes. Will this, plus sensible personal behaviour, make the virus go? Probably.

It’s been a long 10 months since March, last year. But we have learnt a lot over this time on how to manage our risk. Lessons reinforced by the Government initiatives.

We know the importance of social distancing and shielding, cleanliness including handwashing and mask wearing, and protecting wherever possible those older and more vulnerable individuals.

We have had to adapt to changing work practices and routines. Unfortunately, some have not been able to continue working which has brought significant economic and mental health costs. Those of us who are still working have adapted to remote methods of communicating, for example, interviewing, teaching, communicating with colleagues and customers. Some have been furloughed and had disrupted working scheduled and practices.

Whether at work or managing the home, we have learnt how to change our routines to help us keep going, keep positive and keep motivated. We all need to be more explicit about our daily routines so inevitable feelings of boredom, demotivation, listlessness and poor mental health are kept, if all possible, to a minimum. Routines include timetable for getting up and going to bed; exercise and walking schedules; healthy eating and drinking; hobbies and pastimes; keeping in contact with family and friends. All these help to fill the day(s) and keep our spirits up.

Depending on our age and circumstances, we know that we will get vaccinated over the next few weeks or months so there is light at the end of the tunnel. Over the next few blogs I will be fleshing out some of these ideas into positive and practical resolutions for 2021.

Professor Hugh Koch

11/12/2020 UPDATE:

Facing the first Christmas since COVID-19 landed is raising many dilemmas about meeting friends and relatives, travelling, and the tension surrounding a planned relaxation of restrictions for a short burst over Christmas. The underlying fear is that this relaxation could lead to a spike in COVID cases, a third wave of the pandemic and a further lockdown in January. This is despite the good news that we now have one vaccine approved and just released.

Over the next 3 to 4 months, infection risks still need to be balanced with our understandable wish to see loved ones, old and young. There have been debates in the media about allowing people the right to make their own decisions – this ‘allowance and responsibility’ has always been present to varying extents, and will continue to be present over the Christmas period – we all need to be careful.

Relaxing indoor mixing rules carries the risk of a rise in infections with its NHS-related implications. The need for balancing various risks and desires continues to be ever present, but here are some steps we all can make over the Christmas period: -

· Practice caution and manage social gatherings sensibly – treat your ‘bubble’ with care.

· If travel is essential, then avoid, if at all possible, busy trains and buses.

· Avoid hugging – it sounds very strange but rehearse this self-instruction and don’t hug!

· If spending Christmas alone, use your phone to stay in touch via calls and texts.

· Use a regular walk, alone or with someone, to get exercise and “see other people” – repeat more than once day.

· Despite how much you love your parents, protect them from the risk of infection over Christmas.

· Don’t put yourself under pressure to make Christmas normal – it’s not. But do things that will make it a cheerful and happy time.

· Make plans for spring/summertime COVID-free activity both home or abroad – your vaccine is on its way.

· Sing when on your own but not near others.

As we approach Christmas, it will be different. Manage the various restrictions responsibly and face the challenges this Christmas brings – we are getting skilled at dealing with all the necessary issues learned during lockdown and have a much greater understanding of the virus and how it can be managed.

I’m sure you are finding this time hard. So are very many other people around us. Kindness and compassion are essential to all of us getting through Christmas and the next few months.

Thanks for reading some of my blogs – I appreciate that very much – I know you know much of what I say if not more.

A final point: with thanks to Dean Russell, MP for Watford, repeated in the Times last week: Keep your fingers crossed that Santa’s helpers keep virus-free and don’t need to elf-isolate.

I wish you the best Christmas possible under the strange circumstances.

Very best and kindest regards,

Hugh
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04/12/2020 UPDATE:

As we start to enter the Christmas period, most of us are thinking and hoping for an effective vaccine to be produced, approved and become available sometime in the new year. Several vaccines are nearing production and their efficacy is being calculated. It is possible that any vaccine will, similar to the flu vaccine, be something that will protect us via a yearly jab.

There are occasionally some side effects or risks attached to a vaccine and it will be very important that scientists can ensure that any COVID-19 vaccine is safe for public use. One of the forefront vaccines has been shown to have minimal side effects, although some mild side effects have been noted in a few participants. However, it will be essential that scientific scrutiny is applied to assess how safe and effective any vaccine used actually is.

It is likely that once approved, vaccine production would be rapid. The UK Government have ordered a large quantity of vaccines ‘leading the field’ and it is anticipated that a large number of people would be able to get treated in the coming months, depending on factors such as the storage temperature. Hopefully access will be straightforward. Access would be based on the benefit of any approved vaccine outweighing the risks. It is unclear at the present what level of immunity any vaccine will guarantee.

Some individuals dislike injections. Some may have a higher risk of experiencing side effects after receiving shots. This might make them nervous or scared of getting an additional shot, needed for full immunity. We need to be reassured that a COVID-19 vaccine would not be approved for use if it carries potentially life-threatening complications.

Side effects are an example of our body working hard to produce a robust immune response. One possible symptom to prepare for is a headache, another sign of the body’s inflammation response alongside mild pain, soreness and drowsiness – common symptoms when being vaccinated at any time against an infection.

Despite our hopes that a vaccine will be produced, approved and become available before too long, with any breakthrough in science, there are also worries – a significant percentage of adults are afraid of needles, and likewise a proportion of children. This needle fear can impact vaccination rates. In Canadian vaccination programmes, scientists created guidelines to reduce vaccination pain and anxiety. Issued in 2015, these guidelines for preparing for and receiving a shot helped.

Interventions included distractions, watching videos or listening to music. Topical anaesthetics help numb the skin at the site of the injection. The usual technique is a kind, happy conversational response from the injection-giver. All these suggested interventions have a common thread – they focus on the pain, fear and any memories of past adverse inoculation events by changing the person’s focus during the injection procedure.

When facing an injection, the best strategy is to have a plan beforehand – discuss the procedure, bring a friend along, use your own distraction (I talk to the nurse about the weather and their hectic schedule and also don’t look!). Some people look at something on the wall with writing on it and count the number of letters – this engages the part of the brain responsible for analysing risk.

If you have children who will be having the inoculation, the best way to help them with any needle-related anxiety is to manage your own vaccine anxiety. You can try tactics of distraction and comforting them and remember, children understand much of what you tell them when stated in a simple, sympathetic and understandable language.

This debate about needle anxiety is good in that it shows the vaccine likelihood is getting nearer and nearer.

Don’t worry – the vaccine, when approved, will be safe; it will be accessible and the momentary discomfort when it is administered is absolutely worth it.

Stopping now so I can draft next week’s letter to Santa.

Have a good week and keep positive as best you can in your own circumstances.

Hugh

24/11/2020 UPDATE:

We know and have talked before in my blogs about the effect that COVID-19 can have on how we felt pre-pandemic – anxiety and worries can become worse, tendencies to be gloomy can be exacerbated.

We also know that concerns about getting COVID-19 or, if we contract COVID-19, can result in us also having psychological problems, such as anxiety, low mood or sleeping problems. I bet we can all relate to some aspect of the above tendencies or vulnerabilities – my own outlook is that I tend to worry more about small ambiguous tasks and I’m more sensitised to feelings of colds, coughs, sore throats and fatigue in case …!

So, with this background of feeling more vulnerable than we used to, both physically and psychologically, what can we do?

This week I have come up with three practical strategies to suggest to us all. These are:

· Focusing on hopeful and ‘good’ news

· Rethink and visualise life post-pandemic

· Enjoy mindful ‘pottering’ about

Focus on good news

Since March and the start of the pandemic in the UK, we have often been bombarded with bad or worrying news. The reports of infection rates, death from COVID-19, understandable restrictions on our activities and so on have meant our own thinking and conversation have predominantly been on negative and down-beat issues. We need a regular antidote to that sinking feeling we get from the TV, newspaper or conversation with each other which inevitably focuses on ‘bad news’. The stress hormones in our bloodstream stick around, and don’t immediately evaporate.

From time to time, we will hear the good news of releasing lockdown, easing social distancing guidelines and progress towards a vaccine. The trouble is that, according to the psychologist Frank Tallis, it’s not just enough to hear good news when our lives aren’t immediately altered. Our expectations tend to veer towards rapid delivery and release from fed-upness.

So, what’s to do?

1) Get support from those around you in your bubble or via Zoom and email and focus on ‘good’ news. This is probably in small doses e.g., a sunny day, a dry day, a fun conversation, an appetising meal, in preparation or consumed, a favourite TV programme, … anything that allows you a mindful appreciation of something positive.

2) Acknowledge, name and share your feelings, whatever they are, with someone nearby; this makes us feel less alone or lonely and makes sadness more manageable.

Listen to these thoughts in a non-judgemental way, as a sympathetic friend would do.

Visualise life post-pandemic

When is post-pandemic? Next spring, July 2021, 12 months from now? We don’t know. But I think we can say that sometime soon we will have a vaccine, the virus will have temporarily dissipated and our lives in general, both social and work, will have been ‘unlocked’.

So, use visualisation and thinking ahead to look forward and seek meaning and purpose – a reason to get up in the morning, talk positively to our relatives, friends and colleagues. Talk more openly about things that lie ahead, demystify the future and, instead, plan for it positively – it is there.

Enjoy pottering

For many, time has altered in terms of how we experience it. Despite the best intentions with jobs at home or adapting to work at home or in an altered workplace, we still often have time (unfilled) on our hands.

We need to celebrate the technique of mindful pottering – a combination of precise focus and vague idleness. This involves the small, practical everyday tasks that can feel satisfying and relaxing e.g., rearranging the books/plants/cushions; ordering the shelves and spice racks; preparing clothes for tomorrow. These not-quite-aimless activities are calming, reflective and restorative.

Pottering gives a positive feeling of control for both men and women, and can be employed anywhere, and is a distraction from more solid achievements (which we also need).

COVID-19 can be escaped. In many ways, we ‘battle’ to overcome this immunological adversary. However, according to Frank Tallis, a wise course of action is to try, like the river going around the mountain, to find small ways around the pandemic experience like hopeful news spreading, visualising post-pandemic life and enjoying pottering.

Keep well.

Hugh Koch

13/11/2020 UPDATE:

For some, albeit a small number, the last few months since the pandemic started to have its psychological and social effects, have been among the worst of their lives.

Whether you, the reader of this blog, are one of these people, or know someone who has felt this, I wanted to acknowledge and express my sympathy for how awful things have been.

In previous blogs, I have mentioned how this pandemic may have been made pre-virus problems worse. This is undoubtably true, but also specific effects of COVID-19 may well have been high anxiety or traumatic events in their own right and adversely affected even the most resilient of individuals.

Some have experienced significant loss of income, ability to pay for a modest lifestyle, lost a job and been unable to replace it, the loss of a loved one or been a COVID victim themselves (and survived).

COVID-19 has had a significant and negative effect on the employment market and viability, with the Bank of England worrying that unemployment could rise to a very high level by the end of 2020, with hospitality and retail being among the hardest hit. Lack of childcare availability during the pandemic has forced many mothers to reduce their working hours or losing their jobs. Children and students have had an uncertain time with their studying.

It’s the difficult and painful emotions that come to the surface under these, and other similar conditions, - feelings like sadness, grief, guilt and shame centred on low self-worth and low self-esteem. Upset and fear about the uncertainty ahead increase, and self-confidence is hard to feel more than in a fleeting moment – people dislike feeling ‘scared, isolated and utterly useless’.

All of our situations feel and are similar and different but the first need to get met is being able to share our pain and distress with someone who listens, and is sympathetic, showing understanding.

But what else can we do? We know in the final analysis we can seek professional help – if this is available then some meetings with a therapist or counsellor can be very helpful. But what can we do to get back in touch with our own resilience and self-confidence to help us battle with the practical and emotional aspects of such difficult life events brought about by COVID-19?

· Identify feelings, thoughts, actions and possibilities which are positive and show you the efforts you regularly make and praise yourself for these, whether small or large.

· Accept praise from others and remember them for when you need to reinforce your self-esteem.

· Have some phrases which you keep in your head or even write down and stick to your bathroom mirror to give yourself a daily boost – like brushing your teeth, this needs to be done regularly by all of us.

· Despite possibly low motivation and energy, remind yourself about routines or habits that you usually enjoy and build them into your day – favourite music, comfortable clothes.

· Problem solve your own predicament with someone you trust – resilient planning your next active steps.

· Above all, remember you are not alone – your own adverse life event or events are not personal. You will get through this very difficult and upsetting period.

Refinding our own self-confidence following a dreadful period of distress is not a quick fix – it’s a slow gradual process – you will find your own way to the end of the pandemic tunnel where the light is and where you will feel stronger and more able to cope.

As I write this, I’m aware of slipping between ‘you’ and ‘we’ – whether we have experienced really awful events during COVID-19 or have witnessed and shared other people’s pain, it has been a very difficult time and we all need to recognise this and support each other in small or large ways!

I was reminded this week by Allison Pearson, in her article “The light at the end of the tunnel” of a quote by Emily Dickinson who said:

“Hope is the thing with feathers, that perches in the soul – and sings the tune without words – and never stops at all”.

Our road map for keeping ourselves safe plus an awaited vaccine or vaccines will contribute to this hope.

Kind regards,

Hugh

06/11/20 UPDATE:

Since March this year, many of my blogs, have mentioned the importance of staying connected with friends, family and colleagues in any of many ways. Relatively easy ways have included email, text, telephone, and socially distanced face-to-face meetings. What about our ‘special relationship(s)’? The pandemic continues to place enormous strain on our close relationships with a partner, close friend or regular daily contact. ‘Couple stress’ can occur in many forms: arguments, dis-ease and unhappiness, separation and, in extremis, adverse physical contact or physical distancing.

The pandemic itself can be a source of couple stress with specific areas of concern being a fear of infection, and excessive extra time spent together at home or in the office bubble.

What are the reasons for this stress?

· An imbalance of time spent together rather than spread across several relationships and different social activities.

· Partner’s adverse reaction to each other’s daily routines and leisure interests e.g., reading, listening to music, exercise preferences, listening to each other, ‘catch up’ phone calls.

· Managing views, comments and tension about different activities during lockdown, including political views.

· Incremental boredom arising from the ‘sameness’ of daily activity and routines – exacerbated by the number of hours in each other’s company.

So, what can we do in our “couple bubble”? Compared to feelings of loneliness and isolation that we can all feel when cut off from good friends, having a ‘best’ friend or partner has many advantages for our wellbeing and mental health. Some of the strategies to help us manage our own “couple bubble” includes:

· Appreciating activities together and attempts to inject novelty into these when possible.

· Appreciating activities done separately and the opportunity to share how these went with each other afterwards.

· Keep the simple positive communication skills going and practice these with each other including, listening to each other, looking at each other and smiling during these conversations. I mean an ordinary ‘social smile’ not a Cheshire cat smile!

· Appreciate their concerns, worries and anxieties in a warm and non-judgemental way.

· Offer helpful suggestions if that seems wanted or welcomed.

· Manage disagreement or potential disagreement by recognising that there is more to agree about which makes the tension and conflict less and easier to resolve.

· Be mindful of their efforts and skills – telling them that you appreciate this will make you both feel less stressed.

· When you or they ‘leave’ or ‘come back’ to each other, remember to smile and be affectionate, in the context of what your relationship is.

We are fortunate to be sociable and have good friends – these friendships benefit from being nurtured and reinforced.

‘Who is your best friend’? Show them this blog and thank them for reading it.

See you again soon.

Best wishes,

Hugh

30/10/20 UPDATE:

I can hear the sound of tiny feet .... if you have children, you will know how the pandemic is affecting the little ones in your midst already.

As we walk around the streets and parks, we see young children who are going about their playful experience. Are they aware of what’s going on or oblivious of it.? Whether we have children or grandchildren, they are all around us and being resilient at this time means understanding and responding to them in our own ways. As in any other time, children pick up our concerns and worries, so since the pandemic, they will have been aware, to varying degrees, of our own anxieties.

So what can we do:

1. Keep explaining why there are Covid rules ... if their routine changes, let them help plan new ones.

2. If they show some irritation with everyday alterations, tell them it’s ok to be frustrated, let them label and discuss difficult feelings like disappointment, sadness and frustration.

3. Use a breathing game when they get stressed. Teach them to practice calming strategies including deep breathing and relaxing. Make this fun and useful.

4. Regularly praise their achievements, their efforts and, generally, encourage them, by your comments, to value themselves.

5. Listen to them “actively”, that’s how they learn to listen to you. Keep eye contact with them with language appropriate to their age and language skills.

6. Help them see they can persevere and achieve even if a task feels a bit difficult to them.

7. Teach them gratitude by thanking them for something and getting them to think of someone to thank each evening.

In general, watch out for upset, anxiety, behavioural changes including irritability as possible signs of extra stress that need talking about or comforting.

Anyone who has children should be able to identify with one or more of these situations and practical ideas. Those whose main contact with children is through extended families or friends, can also identify with this positive and comforting approach when in contact with young people...they will appreciate and value your ability to reach out to them at their level.

People who don’t have (young) children can use these ideas and also adapt them to their adult relationships, can’t they? Our skills in communication, empathy and positivity are just as applicable to each other as to the young people around us.

Crosby, Stills, Nash and Young wrote in a 70’s song that we should teach our children well ..... be understanding, non- judgmental and put yourself in a young person’s “shoes”, accept their experience and be pleased they share their feelings with us. I know you know all this but it does no harm to remind ourselves about these straightforward and affectionate and kind reactions to the younger ones around us.

Kind regards

Hugh

23/10/20 UPDATE:

The second wave of the pandemic or the return of the first wave is raising our anxieties and testing our resilience to keep practicing healthy and appropriate action, including hand washing, social distancing, not touching surfaces and mouths/faces. Despite our efforts, we all battle with the psychological fall-out in different ways, depending on our personal social, economic and personal circumstances.

What specific things help us with this ongoing battle? Irrespective of the financial/economic and behavioural/lockdown-related strategies, one underlying and crucial variable is our ability to “empathise” with each other.

Empathy, sympathy, genuine authentic response, honesty – these are all relevant when we think how best to:

· Put ourselves in someone else’s shoes

· See their personal perspective on some issues

· Saying or suggesting something to help them

It would take a long article to list all the different circumstances, people and contexts which are being affected by COVID-19 – people of all age from young pre-school children separating from mum and dad through to people mature of age, who are lonely and isolated, people with work-related problems and unemployed people. Alongside these people there are the rest of the population coping as well as they can day-in, day-out.

Whoever we come into contact with, briefly or consistently, they deserve our kind responsiveness and ability to understand and share their feelings.

It is important to appreciate what it’s not: -

· Not to intellectualise other people’s problems

· Not to be so emotional as a reaction that we cannot help the other person

· Not to focus on self not others

We need the right balance between logic and emotion.

We need to maintain a compassionate balance between reflecting their feelings and being logical or rationale, as appropriate.

Some specific Active Steps for feeling and showing empathy include: -

· Don’t be distracted when someone is telling you their experience

· Be genuinely and honestly ‘curious’ about their story

· Don’t try to immediately ‘solve’ their problem

· Imagine how you would feel in their place

· Ask them questions and nod to acknowledge you’re listening

· Listen more than talk – change the usual 50%/50% conversation into a 10%/90% conversation

· Keep looking at them, don’t get distracted

Being unhappy, uncertain or helpless is a difficult and often lonely experience, use your listening and empathy skills to help them feel more hopeful and confident.

If you’re reading this to the end, I bet you are empathetic and considerate to others – I hope there are one or more people in your world who are empathetic to you, too.

Have a good week and thanks for reading.

Hugh

 

16/10/2020 UPDATE: And so, it goes on!

The government are learning over time to handle the virus but we are still facing more severe restrictions as the second wave of COVID-19 bites, with debates about Test and Trace, opening hours and locations, and how to repay the fortune spent. We need a plan from BJ and his merry band, although we are not and should not ask for miracles. There clearly needs to be a balance between economic and protective health strategies.

As for our own behaviour, whether socialising or travelling, we need to handwash and continue mask wearing and social distancing. Alongside these issues, we also need to cultivate and maintain our tendency to smile, laugh, and on an everyday basis and face each day optimistically. Humour is a coping mechanism when things are not going well.

Humour is a superpower that is under-utilised. As they said at Stanford University recently, ‘Humour is Serious Business’. It feels good, enhances self-confidence and boosts problem solving. Signalling your sense of humour makes a big difference. Colleagues who show a sense of humour – regardless of whether they themselves are actually funny – are seen as more respected, pleasant to work with and friendlier. They are also preferred when being interviewed for jobs.

Optimism is a gift and we need it in spades at the current time. Some say that pessimism can become a masochistic pleasure for some, but it can also reduce our confidence in our own abilities. Having a ‘glass half full’ is a good metaphor and practice – we refill it by our waking mood each day. Optimism is necessary for most of us and a positive humour style is linked to positive health.

When you have the chance, smile and let those around you see your sparkle – this will energise them and make you feel both more human and happier.

Enjoy a good laugh with your friends. Humour cheers one up and puts others at their ease.

Best wishes

Hugh Koch
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09/10/2020 UPDATE: Alternatives to feeling angry and frustrated daily during COVID

The last six months since March have been a rollercoaster of emotions for most of us – we have been experiencing significant changes in our psychological, social, work and economic circumstances – in different ways for different individuals. Anger alongside being fed-up, nervous, worried and lost has been a fairly constant feeling. Much has been written about anger management so I would like to focus on some key causes and some practical strategies for managing anger at this difficult time.

Some readers of this blog are saying that anger is a normal and intermittent feeling which, although it is uncomfortable at the time, is nonetheless an important safety valve for “letting tension out” – I agree with the normality and variability descriptors and I really agree with the link of anger with a build-up of tension. We often get angry and tense when: -

· We feel things are uncertain and uncontrollable.

· We feel helpless and dependant on others for support.

· We feel that support is perhaps unclear or insufficient.

· We are unsure about whether we are doing the right things.

Knock-on effects of this tension can be toxic debates which maintain frustration, cause fallouts, and leave us feeling more ‘at sea’ and ill at ease.

As we have discussed in earlier blogs, we can often get frustrated with the government, the council, our MP, and other macro-agencies. The greater the distance between us as individuals and the apparent object of our anger, the more amorphous, non-specific or magnified it can get – it is a venting without any particular outcome or resolution.

So, what are some useful tips for all of us when we feel this build-up of tension, frustration and irritation.

1. Be specific about the reason for your anger (e.g., specific action, statement, initiative)

2. Avoid “whole person” or “whole organisation” anger (e.g., they/he/she always does this) – try not to exaggerate the information (e.g., “everyone’s forgetting to wear a mask)

3. Identify what effect your anger is having on your relationship with that person

4. Relabel your anger as tension and: -

a. Take a deep breath

b. Relax physically

c. Share your tension with one other(s)

d. Distract yourself with an interesting task, exercise or time-out

5. Watch your email language! Read an ‘angry’ email three times and each time, moderate your language. Eventually consider not even sending it.

6. Manage your self-confidence – the better you feel about yourself, the better you will be at managing frustrations.

A message for my two readers:

Can I ask your help please. Which of these three quotes is most relevant to us all or you in particular? Please tick one or more box and return this to me.

“Holding on to anger is like grasping a hot coal with the intention of throwing it at someone else; you are the one that gets burned”

“When someone points a finger at someone else, remember that four of his fingers are pointing at himself”

“If you speak when angry, you’ll make the best speech you’ll ever regret” – Groucho Marx

Thanks for reading. Best of luck.
Hugh Koch
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02/10/2020 UPDATE:

“Listen – time passes – listen”. This quote by Dylan Thomas in the legendary ‘Under Milk Wood’ is more and more in my mind these days as I talk with many people to hear their own take on COVID-19. From the child (and parent) preparing for school, the student at college, employee going to work or grandparent waiting to give a hug, we all have our concerns and practical strategies for coping.

My focus this week is on the power of listening to each other and using our warmth and empathy to reassure, relatives, friends and colleagues that their feelings are understandable, albeit sometimes different or at variance with our own.

Watching and listening to the Government we judge their response in terms of how they engage with us and communicate the difficult choices they have to make, and how they are managing this crisis. What I hear from people is that they want the prime minister to project authority, to be clear about policy trade-offs and also state that the government cannot entirely control the pandemic, but want to shape the national response to limit the impact of the issues. We want a government we can support.

Listening to children, I hear that they have mild anxiety about either returning to school or starting nursery or school after lengthy periods at home. This is both normal and, in all likelihood, heightened by the effects of the pandemic. They are the future and must be our priority.

Listening to other adults, I hear them battling with their discipline and compliance with ‘Hands/Face/Space’, searching for the resolve coupled with togetherness to carry them through the next few months. To help our resolve, we need concise mental health information and strategies to support our efforts.

We don’t know how long this pandemic will last and have its effects and we now approach the autumn and winter facing variable lockdown without sunshine, juggling home, school, college, work, money and daily routines. We know uncertainty makes us anxious, so let’s understand that the virus will still be around, as will the ‘Hands/Face/Space’ desired strategy. Our vulnerability to aspects of depression and anxiety will be felt by us all – the length of time being enclosed or restricted over a longer period will be hard. So, our positive routines will be more important than ever, to give us pleasure and keep us both healthy and connected. We can take charge of daily life to some extent by appreciating and evaluating our day and what things, usually small, we have achieved. In doing this we help both ourselves, our partners, relatives, friends and colleagues who will respond to our positivity. I heard a British Navy submariner on the radio today talk about the importance of routine and communication when under water for 90 days! A good lesson there from his experience.

Listening to our close friends and relatives is so crucial. One or more of them may be feeling much worse and more uncertain and lost than we are. Our ability to make connections today with them will have more benefit both to them and ourselves than we think.

Sam McBratney, an Irish author of children’s books who recently died (77), popularised the phrase “I love you to the moon and back” in his little bear series. Sam said his stories were ‘somehow true, and describe what people feel’. Phone, text, email or say face-to-face to a close friend some version of the ‘moon’ statement – it is invaluable.

Dylan Thomas set ‘Under Milk Wood’ in the fictitious Welsh village called ‘Llareggub” (which is an anger-venting phrase spelt backwards). My blog today has been set in the fictitious village “Kculdoog”!

As I sit at my desk, I can hear my desk creek, the photocopier whirring, a member of my staff talking to another, and my late-night jazz playing quietly in the background. Only I can hear this exact combination. Like our responses to the pandemic the, ‘what can you hear’ question does not have one answer. A one size approach to our response to the virus does not fit all! We are all different.

So, in summary: -

1. Appreciate your skill and value in listening to others

2. Acknowledge the differences in our experiences

3. Decide what response from you helps the government’s message, when positive, get across

4. Listen to children’s anxieties and encourage their confidence and skills

5. Create your own autumnal ‘sunshine’ with reinforcing routines and connectedness

6. Tell one person (or more) the moon quote!

Best wishes as always

Hugh Koch in ‘Kculdoog’

25/09/2020 UPDATE: Optimism, hope and control: how can these help during a second wave

As we enter the second wave of COVID-19, our different ‘psychologies’ or frames of minds will predict how difficult or manageable it all is. We need as always to have three key strategies mentally: a realistic appraisal of where we are ‘now’, a feeling of optimism despite stress, and a sense of hopefulness despite our helplessness. So, what do these three mental strategies mean and what can we do?

Realistic Appraisal of ‘now’

The latest government/scientific briefing, reminiscent of the daily briefings during the first wave, have brought it home to us that COVID-19 has not gone away and is not yet managed adequately. To try and avoid or reduce further infection rate rises, the Government have introduced further social and economic/work restrictions. Appraising these interventions requires us to understand the need for a ‘bias for action’ at different levels of our/any society. There needs to be action at several levels: Government level, local Council level and employer, street/neighbourhood level and extended family levels. None of these interventions are necessarily “Orwellian” – the “we must do…” motive is to control the infection rate at any/all of these levels, not to make us feel overpowered or ordered about.

“I sometimes feel if a family member advises/tells me to wash my hands that I’m being ordered about … I’m not, they are trying to help – their tone and comments are usually helpful” – the Government need to use tone and context in a similar way

Testing is still a highly beneficial intervention – I have had three extended family examples of testing, two good (i.e., easy access, rapid 2-day response) and one 4-hour return journey after difficulties booking. Testing is a massive venture and the more accessibility and analysis are adequate, the greater confidence we all have in “the system”.

Social distancing is crucial to maintain and associated loneliness and isolation, especially for the vulnerable, needs our awareness and support especially as we enter autumn/winter seasonal greyness.

Optimism despite stress

It is important that our initial concerns, anxieties and feelings of distress can be shared and ventilated without any immediate optimistic statement from the listener. The pandemic ‘pumpkin’ cannot be turned into a ‘royal carriage’ by statement like “we must all be positive”. However, …

While avoiding naïve or immediate positivity, it is still helpful to be compassionate to oneself and others and practice positive thinking when logical and appropriate. The pandemic will pass eventually and/or become more manageable. Our mental health is important and needs careful looking after in terms of our own thinking, our rewarding social contacting and connectedness, and our way of feeling benefit from what we do with our additional time at home.

Hopeful control despite helplessness

Our individual level of action which I alluded to in the second paragraph above means do what we can about our own situation. This gives us a feeling of confidence and control, and involves:

· Being confident about “Hands/Face/Space”. This is a positive, social ‘infection’ which is key to managing this pernicious virus.

· Routine and structure to your day to manage isolation, boredom and loneliness

· Maintain ‘healthy eating, drinking and exercise’

· Project your thinking beyond 3-6 months to include vaccine availability and successful virus management

Final Point

We all have a role to play either at the micro-level (my street; house; extended family) and/or macrolevel (Government; Council; employer). We need to support each other and be constructive with our own and others’ efforts.

Deep breath and good luck.

Hugh Koch

18/09/2020 UPDATE: Battling with a “second spike”

We have all been aware of several helpful strategies for managing the risk of contracting COVID-19 during the months March to September. This has included social distancing, limited group membership, wearing face masks, hand washing, travel restrictions and workplace management.

It is unclear as to whether herd immunity is an underlying context which, unbeknown to us, is happening. It is also unclear as to the ‘power’ or severity of further infection due to COVID-19 which may occur, complicated by the approaching Autumn/Winter implications.

So how do we try to live our lives as normally as we can and feel more in control in the process?

1. It is likely that restrictions and safety precautions will be ongoing for the next few months.

2. The Government need to address and sort out the availability of testing and its analysis locally as a matter of urgency. The public are expected to ‘do their bit’ but we need the reassurance of testing.

3. We need to focus on what we can control in terms of maintaining social distancing, both locally and through the avoidance of unnecessary travelling.

4. We need to continue to handwash regularly both at home and when out.

5. We need to continue to wear masks when in public places. We know most of us dislike this experience, but it helps.

6. We need to plan for the present and avoid medium/long term planning (e.g., holidays; Christmas parties etc.)

7. We need to understand the giving of our contact details when out and about as a safeguard in case of individual infections not as an imposition to be resisted or avoided.

8. These sensible steps are easier to maintain and continue if we continue to show kindness and tolerance to each other and those who are managing this crisis, despite constructive criticism along the way.

One of my valued readers said to avoid suggesting what we shouldn’t do as people resent this. I have tried to take this advice onboard and say what we can do.

Good luck with keeping well and active over the next few months (and beyond).

Hugh Koch

11/09/2020 UPDATE:

From time to time, I am approached by individuals who are feeling either very anxious or very unhappy due to the uncertainty surrounding COVID-19. Although these distressing feelings are a reaction to many different situations, the two most common causes relate to feeling isolated and lonely, and returning-to-work/study related circumstances.

Most of us could relate to this but the people I am referring to are asking themselves “have I got a significant problem and, if so, what should I do?”. Clearly, they are feeling a high level of anxiety or low mood which is starting to disrupt their day-to-day life and be detrimental to their wellbeing:

High levels of anxiety can either be:

1. focused on specific areas like returning to work, going on buses or trains, talking to people, managing work, managing home life with finances.

or

2. generalised to lots of different areas of their life with feelings of panic.

High level of distress, feeling low and fed up can either be:

1. variable and intermittent fed up ness, often made worse by specific conversations or events

or

2. consistent, most of the time, affecting sleep significantly...things generally getting on top of you, feeling over loaded.

The first way of approaching this is to consider some practical steps to address the difficult feelings, before thinking about whether any professional help is needed.

For example:

1. talk to a friend or colleague about one or more aspects of this

2. try and tell yourself things will get better, they usually do.

3. look for a small number of ‘active steps’ to focus on and practice which will help. E.g. text a friend every day, ask them how they are and tell them how you are feeling.

4. focus on the bits of your day/week which goes well and gives you pleasure and confidence.

5. don’t get isolated, keep in touch with people, meet them, text them, phone them.

6. each day relax for 5 mins somewhere quiet and peaceful

7. each day set yourself a target for achieving a small task of some sort to give you confidence.

Any of us at any time may get so overloaded by our emotional difficulties that we feel helpless and a bit hopeless. If these ‘active steps’ above don’t help, it may be worthwhile to see a professional (e.g., GP, Counsellor, CBT Therapist) who can give an independent, expert view of what the person is experiencing. Both self-help and professional help, have a place in deciding what’s best.

None of us want to feel anxious or fed up, especially at the moment in this very difficult period if COVID-19.

Sharing your distress with others can unlock positive answers and getting the reassurance from a professional on occasions can also help.

Don’t feel alone or stuck.

Kind regards

Hugh Koch

07/09/20 UPDATE:

 “I didn’t sleep a wink last night – I got out of the wrong side of the bed this morning – I wish I could go out like a light, hit the sack and sleep like a log.” These are all metaphors about how we sleep (or don’t sleep!).

During this pandemic, many people are complaining that their sleep is disturbed with initial insomnia (difficulties getting off to sleep,) early insomnia (waking up early and failing to get back to sleep) and disturbed sleep (tossing and turning). Whether COVID-19 symptoms adversely affect our sleep or whether day-to-day COVID effects or work, money, social isolation make sleeping difficult, we have all been there – a little or a lot.

Have a look at your daytime, early evening, bedtime and night-time routines and see what small ‘Active Steps’ to sleeping well makes sense to you.

Are you still awake?! I tell my grandchild to close her eyes as I read her a story and in 30 seconds she is in the land of Nod. Try some of these techniques and see if you meet her in Nod!!

Good night

Hugh Koch

28/08/20 UPDATE:

Look around you now – the people you see, speak to or connect with are likely to have different views, opinions and more, significantly, anxieties about COVID-19, and its continuing effects.

I have just asked one staff group of 6 administrators in their twenties what their current concerns are. Here are their three main fears:

· Contracting the virus (still) and being very ill or dying

· Specifically being at risk due to schools opening

· Having to cope with a resurgence of infections with additional or return to lockdown

Becoming very ill

The rate of infection and serious infection is low. We all know of friends who have contracted the virus but who have recovered. In some extreme circumstances, it has been very upsetting where someone has passed away but despite this individual grief and distress, this has been low in number. Following the guidelines in a sensible and rigorous way will have and will continue to have a protective function for our personal and social risks.

Increased risk due to schools opening

We have read about the dynamic between getting children back into school and learning context of school while at the same time protecting them and us (older individuals) from risk of infection. The worry seems less related to the infection rates at school but more the cross infection back at home, our own bubbles and the possibility of bubbles getting, unwittingly, broadened and less secure.

Great care with social distancing outside school, hand washing and hygiene care are going to continue to be crucial to all of us.

Possible return/increase in lockdown isolation

Our own personal resilience, our positive thinking, our daily routines all vary from person to person – some individuals have found initial lockdown very testing – it is not the obvious “we spend too much time together” comments and feelings, but more the lack of changing routines and activities which can make us feel in-occupied, distracted and less valuable than usual. The vicious circle linking lack of distraction, use of alcohol, excessive eating and social isolation have all contributed to variable levels of low mood and anxiety in many of us.

So – today’s suggestions.

Keep talking to each other more about “what works”. Keep rewarding yourself and your nearest and dearest about how diligent you both are with social distancing, hand washing and following directions about safety as best you can.

Whether the “second wave” concept has actual virus-scientific backing or would be, in fact, the outcome of our own lack of sustaining sensible and protective behaviours, we don’t know, but go for the second view (self-protection) as it makes us feel more helpful and hopeful, I think.

It’s a long haul but we will get there.

I hope this helps – please let me know your views, positive or otherwise.

Best wishes

Hugh

21/08/20 UPDATE: Be ‘Present’ and generate positive ‘steps’

Relatives, friends, colleagues and others who we read about in the media are all experiencing the tipsy-turvy world of this pandemic – like the changing lands at the top of Enid Blyton’s Magic Faraway Tree, our daily lives swing from positive, happy and coping to pessimistic, low and feeling helpless. No amount of ‘resilience-speak’ about positivity can alter this variability – once the virus is managed presumably by an effective vaccine, then these swings will settle down to a large extent. In the meantime, we all do our best to use our thinking, actions and connections with others to help us feel as confident and content as we can.

Two techniques that I have found invaluable to help me, my clients and my friends, cope involves finding occasions during the day to be ‘present’ and experience what I am doing in the ‘here-and-now’ - as I write this at 7.55am, the breeze is coming through the window, the morning sun and rays are outside, and my chair is comfortable, supporting my back which so far isn’t hurting. Being mindful means to be present, in the moment. You can do this wherever you are and whenever it is – sitting, walking, brushing your teeth, eating, drinking, being alone, being with others – every day, any experience is an opportunity to apply this awareness.

A good example as we experiment with going out, being near shops, social distancing as we go, is when we are standing in line in/near a shop or bank – be aware and mindful of being in line, your posture while you’re waiting, mindful of how you are breathing, focus on how your body feels – watch yourself checking your watch or your phone for messages, being mindful of distancing from others in line, monitor how your mask feels.

The second technique involves an alternative to worrying about your day and your schedule – as soon as you’re up from your bed in the morning, generate a thought of what you are going to do and can do effectively – thinking about your capabilities and appreciate your ability to cope with small everyday tasks can feel good and put you in touch with your own ‘self-esteem’ land. No one technique changes your world but these two can make you morning start in a good place.

Keep well and safe.

Hugh Koch

14/08/20 UPDATE:

In previous blogs, we have explored how any pre-existing (pre-COVID) issues will, in all probability, have been made worse and exacerbated by the significant stresses we have felt during COVID-19. Continuing this theme, I would like to talk about how our pre-existing anxieties about our health have made us more vulnerable to feeling more worried and distressed when facing risks of COVID infection.

A recent study at the University of Bath found that approximately 25% of a group studied had significantly elevated anxiety and depression, exacerbated by lockdown, isolation and social distancing. Nearly 15% reached significant levels of health anxiety, causing preoccupations and disruption to normal activities.

So, what is Health Anxiety? This is a worry about having a serious medical condition, marked by a high imagination of possible physical symptoms.

During COVID, we have been sensitised to being aware of sore throats, coughs, temperatures and loss of smell or taste. Some or all of these can be misinterpreted when they are minor or normal bodily sensations, despite reassurance by relatives or medical professionals.

Is there a difference, then, between concern for your health and health anxiety?

It’s normal to be concerned about bodily signs. However, when these signs are minor and intermittent and we develop a constant belief that we have a severe illness, this can become irrational and disabling. At these times we need to reassure ourselves (with or without medical support) that we are healthy.

Pre-existing preoccupations with ill health can make coping with these signs difficult. Factors like a poor understanding of bodily sensations, family members who worry excessively about their (and others) health and a tendency to negative worry and rumination all predict a difficulty with coping with these minor signs mentioned above.

So, what’s to do?

We all need to identify our own health anxieties and be aware how these affect our general wellbeing. By doing this we need to learn to cope with our own anxiety and stress and not set up difficult avoidance patterns which are, on careful reflection or discussions, unnecessary or disruptive.

It is possible to reduce our preoccupation with any bodily sensations, especially if they are minor, intermittent or variable.

Be prepared to appreciate when you feel OK and healthy and inject a spring into your step when, actually, you are feeling well. This will prepare you for better awareness of illness if and when it occurs.

Many thanks for over 4000 clicks on this series of short blogs on ‘Becoming more virus resilient’ and also individual email responses.

Have a good week and keep cool.

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’. https://www.buzzsprout.com/1143062

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 each...you 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 200^th 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: -

https://www.expertwitness.co.uk/articles/news/becoming-more-virus-resilient-tips-on-dealing-with-the-covid-19-coronavirus-situation---professor-hugh-koch

2) Hugh Koch Associates: -

Www.hughkochassociates.co.uk

3) Links pending to www.kingschambers.com and www.apil.org.uk

 

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: -

https://www.expertwitness.co.uk/articles/news/becoming-more-virus-resilient-tips-on-dealing-with-the-covid-19-coronavirus-situation---professor-hugh-koch

2) Hugh Koch Associates: -

Www.hughkochassociates.co.uk

3) Links pending to www.kingschambers.com and www.apil.org.uk

 

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: -

https://www.expertwitness.co.uk/articles/news/becoming-more-virus-resilient-tips-on-dealing-with-the-covid-19-coronavirus-situation---professor-hugh-koch

2) Hugh Koch Associates: - Www.hughkochassociates.co.uk

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

https://lawinthetimeofcorona.wordpress.com/2020/04/08/becoming-more-virus-resilient-tips-on-dealing-with-the-covid-19-coronavirus-situation/

4) Coronavirus (COVID-19) updates from APIL: - https://www.apil.org.uk/covid-19

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.

16/03/20. 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
www.hughkochassociates.co.uk

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