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Families Coping With the Coronavirus Health Crisis

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Published on March 20, 2020

Key Takeaways

Psychotherapist and family counselor Jennifer Abraham discusses the impact of the COVID-19 outbreak on mental health and shares some tips to deal with stress and anxiety.

Jennifer, who's also a chronic lymphocytic leukemia patient in active treatment, addresses ways to allay fears in children, stay supportive of elderly family members and maintain daily structure at home. 

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Transcript | Families Coping With the Coronavirus Health Crisis

Recorded on 3/18/2020

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

Esther Schorr:
Hello everybody. This is Esther Schorr. I'm the Co-Founder of Patient Power, and I'm here today to have a conversation about the coronavirus crisis we are all experiencing, and have what I hope will be a great conversation with somebody who can give us some insight. Less about the medical aspects of what's going on, but more about the kinds of things that I think all of us human beings are dealing with right now, in kind of a new normal that we hope isn't going to last too long as our norm.

Our guest today is Jennifer Abraham who is a psychotherapist. So she works with families, with individuals of various ages to help them deal with mental and emotional issues that impact them in daily life. And right now, all of our daily lives have been impacted by a big change in how we go about our day.

So the other thing you should know about Jennifer is that she is a CLL, a chronic lymphocytic leukemia, survivor and thriver as she likes to call herself. And she is also in active treatment. So she is a part of our staff, and she's working every day and definitely a thriver. She's also a single parent. Yay, Jennifer, for all the effort you have to go through. And she also has two teenagers at home who have come home from elsewhere, and their family is dealing with this new normal.

So I think we're going to talk with Jennifer about not only things that may be able to help you in your daily life in trying to figure out how to manage that, but also Jennifer will share some of the things that are going on in her family. So, Jennifer, welcome. We're glad to have you.

Jennifer Abraham:
Thank you, thank you for doing this.

Esther Schorr:
No, absolutely. So maybe you could start by talking to us a little bit about what you're seeing and hearing about the impact of what's going on for individuals and families in this crisis and maybe give some perspective on what you see is a way that people can help center themselves mentally, physically, emotionally.

Jennifer Abraham:
What I'm hearing a lot of from friends, when I'm reading a lot of on Facebook is this void this time now that people are having to stay at home with their children. Some of them have online schools, some of them, it hasn't been set up yet. So this has been the first kind of real week. And the questions are, “What do I do? What do we do? What does this mean? What is our structure? Do they have to get up every day and get…?” These are all great questions. None of us really know.

So the way I'm addressing it, and the way I'm really dealing with it is that first of all, every family is different, and every family has their own dynamic. It's really important that during this time you don't try and become a different family—you don't try and make things happen that maybe have never happened before. I know one person I spoke to said they had a—Monday morning they had a chore list of all the chores that kids needed to be doing all day long, and the kids didn't want to do it. And, of course, they didn't want to do it, because they didn't really do those things before.

So I think there are ways to have conversations with your children, family conversations and kind of discuss how are we going to fill this time? Can you get online, and can you do some work? Can you have some play time? Can you have some rest time, some mealtime? People just really are struggling with—they're panicked about—it's like they think every day is a full 24 hours forgetting that we do sleep.

Esther Schorr:
So, Jennifer, let's see if we can get a little specific too. So when you and I were talking earlier, you had some bullet points of how to take say structured time versus play time. And we talked about it in the context of children, but I think those kind of pointers are the kinds of things that people can use in their own even adult life. When you talk about balance and prioritization. Can you talk a little bit about that of how people can…

Jennifer Abraham:
…yeah. Well, the first thing is balance. So in the way most families work is that everyone gets up early, they get dressed, and they leave the house, and everyone goes their separate ways. I think it's still important to get up at a reasonable hour. I think it's really important to get dressed, put on makeup, do your hair, take a shower. I think lounging around in pajamas all day is not really healthy for anybody.

And just as you would have the week and then the weekend, maybe on the weekend it could be a little more lenient. In terms of what I find is people really focus better in the morning. So maybe if there's work kids need to do, if they can kind of get started after breakfast, adults, they probably have their work they need to do touching at work or get online or whatever it is. And also have some rewards with that. How about, let's all work for a couple of hours, and we'll meet up again, and maybe we'll have a snack. Maybe we'll have—someone I talked to had a dance party. So they had a dance party at 12 o'clock with the family and at 6 o'clock. And I think it was more just to get the kids moving. But I thought it was a great idea.

Esther Schorr:
So you're really talking—let me just be sure I'm clear on this. So you're really talking about, we all have our own personal and family schedules. So you're talking about kind of looking at our days when we get up now set a schedule. There can be some looseness in it, because things change. I talked to somebody who's getting up in the morning, used to going to work. They're getting dressed in some semblance of work clothes. They're having breakfast with their spouse or their kids and going to work rather than taking a break. We're actually doing that.

I got Andrew and my 22-year-old son who's home, I got them to do yoga in the living room the other day and we've kind of gotten in a pattern of around 5 o'clock in the evening, we're doing some kind of exercise, whether together or separately. I heard something that your daughter had some kind of an interesting project that you put around or she came up with?

Jennifer Abraham:
Well, no. So my daughter likes to paint and she said, “Mom, I actually didn't have any canvases at the time. And I went to order them and were going to be in a week, she said, "Can I paint my walls? Can I start painting the walls?" I said, "Sure. Start painting the walls." I can be that mother. It doesn't matter, and it's been great. So she's painting and really keeping busy. I think with that kind of breaks down to though is, let them paint the walls. Nothing is permanent. This is really a trying time.

And I think for kids in particular, I'm so worried about kids, to be honest with you. I'm worrying about them being home. I'm worrying about them having too much free time. I'm worrying about them maybe getting depressed or getting anxious.

Esther Schorr:
So, two questions. How would you suggest we explain these two young kids versus how do we help those older, but young adults, for them to be able to understand it and cope with it? So maybe start with the younger kids who don't understand why Mommy and Daddy or Daddy or Mommy or caregiver are home all the time. What do we say?

Jennifer Abraham:
Well, first of all, young kids especially I think are the most empathic of our entire family system. They feel everything, so they actually probably know what's going on. But the problem with them is they don't have any words, there are no words for them to articulate the feelings. Most likely they're really struggling on some level but don't know how to, might be afraid to ask. So, it's important to give them some information.

With really young kids, you don't need to use words like, pandemic is, I can't stand that word. It makes me crazy, it's a terrible word, outbreak, I mean crisis. I think what's really important for kids or a way to talk to kids about it is to maybe find, I don't know if there's a favorite video game they like, or a movie they like, or a book they like, try and change the story a bit and give them an example.

Esther Schorr:
Meaning? Yeah, give me an example.

Jennifer Abraham:
Meaning, the first thing I'm thinking about, it's been a long time since I've had little kids is Goldilocks and the Three Bears, And Goldilocks is eating out of bowls of porridge, and she doesn't know who fixed them or where they came from. She's in a home where she doesn't know what's been prepared. And you can explain it in that things are happening now where a lot of people have been eating out of or touching things that they don't know who's touched them. And people are getting sick from this now, and we're all just trying to figure it out. And maybe we want to make it a safe place so Goldilocks can go into any little hut she wants to. So until we figure out how to make it safe for Goldilocks, we're all going to maybe stay put for a while.

Esther Schorr:
And don't share food.

Jennifer Abraham:
Don't share food.

Esther Schorr:
If Mommy gives you food. Right.

Jennifer Abraham:
Yeah. And you can say too and the reason we have to stay home from work and the reason that you're not in school is because we just need to make sure that nobody's doing this.

Esther Schorr:
And with young adults, they pick up everything. And I know from watching our young adults that social media is not only filled with good information, but by and large with a lot of bad information, and there's a lot of feeding the fire and the frenzy. So do you have any concrete suggestions for how to help those young people who get that there's something not so great going on, but to help them sort through that or how to put that in perspective?

Jennifer Abraham:
So I'll give you an example. Last week, my daughter's school, she's a sophomore in high school, and in health class they must have said the coronavirus is going to be very dangerous for people who are going through treatment, people with cancer. And that went on in the lecture. Apparently my daughter went to the nurse's office and had a total, a little bit of a panic attack. Started to cry, tell the nurses, "My mother's having chemo, I don't want her to die. I don't want to go back home. What if I have it?" And now I didn't know any of this was happening. The nurse called me and she said, "Everything's okay, but your daughter is really worried about you." And I said, "Why? What's wrong with me?" And it had never occurred to me to actually have a conversation with her. And so she said, "I just want to give you a heads up. She's very, very worried, and she's worried that if she brings it home to you, you'll die." And I thought, "Oh, my God."

Jennifer Abraham:
She got home. I sat down with her. I had the computer in front of me in case she had any questions.

Esther Schorr:
Mm-hmm.

Jennifer Abraham:
I go to the CDC, because I find that it's incredibly reliable.

Esther Schorr:
Right.

Jennifer Abraham:
And I just explained to her that we're going to stay in the house, and this is what's going to happen, and I'm going to be okay. But the point of that story is I never thought to talk to her about it. I just figured she knew what was going on. So it's really important to be proactive and to have a conversation and then to also invite them. To say, "If you have any questions, ask me. And if you read something that you think is totally nuts, I want to hear about it, because most likely it's not true."

Esther Schorr:
No, that's great. So really proactive. Have those conversations. So kids who are old enough to understand, are able to understand it's bad, it's temporary, and we're all together in this. But don't assume that they understand completely what's going on. No, that makes total sense.

Question: What about families or individuals who are concerned about the bailout of senior citizens who are at higher risk? For example, I know that my elderly parents are now in in essentially a lockdown situation. I happen to be in Carlsbad in Southern California. I know you're in the Boston area. Correct?

Jennifer Abraham:
Mm-hmm. Yeah.

Esther Schorr:
So we're talking bi-coastal. They're different situations in different areas. But overall this concern is one we all have. What do you suggest in terms of both interacting with these senior citizens who may be in a lockdown situation, and what is now the normal of maybe not being able to visit them? What can we do to allay our own fears and to try to support them?

Jennifer Abraham:
Well, actually there are two parts of that. I think phone calls are always great. I don't know, some people don't have FaceTime available or Skype available—some of the people that are in nursing homes. But I think it's really important. So I've heard from two people that their kids are panicked about their grandparents, and, of course, they can't go see them.

So I think it's really important if they're still home and able to get online at some point, even if you have to walk them through something, you're going to get to teach them how to FaceTime. It's really important that kids see and talk to their grandparents. It's as important for the grandparents as it is for the kids. In terms of us as adult, my mother's in Florida, and she's all by herself. And it's very scary for me.

But yet we don't want her on an airplane, and we have no way to get to her. So we try and call as much as possible. But we have to have a lot of faith, and also we have to be very active and keep connecting. Just even, and my mother will say, "Please call me back. I just want to talk to somebody." Even if it's for five minutes in between work, it's important to just stay connected.

Esther Schorr:
Connected. Actually that's really interesting, because one of the things that we're talking about doing, and I'm sure we're not the only ones who have thought about this, we're talking with our family about setting a time with her. It's once a week or twice a week or on the weekends to do a family joint FaceTime. Now…

Jennifer Abraham:
Good idea.

Esther Schorr:
…where you can, if you have iPhones that's very easy. I'm suspecting, and we'll talk with some of the younger tech gurus about this, and be able to share it on another program. But I'm guessing that either Google Hangout or Zoom or some of these other apps that people have on phones could facilitate meeting virtually together. Whether it's a group of friends or a group of moms who are tearing their hair out because the kids are at home, that kind of thing. So would you say that that would be a good thing to do as well, just keeping it regularly?

Jennifer Abraham:
Oh, I think it would be a great thing, actually. I think it's a great thing for kids too to have play dates that way. Facebook has something, and I think you can only have nine people on, I'm not sure.

But it's a great way to stay connected. I know I have family chats, text chats, and they can go on and on for hours. And I know yesterday when I connected with you on this, and I got to see your face I said, "Oh, so nice to see…"

Esther Schorr:
…see a real face.

Jennifer Abraham:
Yes and to have a real conversation.

Esther Schorr:
I see your real face.

Jennifer Abraham:
Yes. Now have a real conversation. So it's really, really important.

Esther Schorr:
So, okay. So, Jennifer, there are these general things we can do for ourselves and our families, but are you aware or can you share any resources there are for counseling for people in this new environment? Because I know, for example, I think you shared and some other people shared that there are kids out there especially, and I'm sure there are parents, who really need some counseling like what you do—where they're getting really depressed, or they're super anxious and need to be talked down. Parents can only do so much. Any suggestion of where people can find those resources?

Jennifer Abraham:
Well, I think first of all, if you have a therapist already and you're seeing someone, I think it's very reasonable, and I would be surprised if they wouldn't agree to do a FaceTime or a Skype call. Something I just was on the phone with the pediatrician this morning, because he's getting a lot of reports of kids now with new cases of anxiety and stress. And they do not have a therapist. So one thing we were talking about is maybe collaborating with a couple of therapists and being available for kids on a volunteer basis and for parents and just for someone to touch base with.

Esther Schorr:
So what would somebody at home do now, if I have a kid who is just uber anxious or got their head in the bed with a pillow and the cover over their head not wanting to deal, what would you suggest would be the first thing for parents or loved ones to do?

Jennifer Abraham:
So the first thing I would recommend is you call the pediatrician, give him a little bit of a history about what's happening and ask if they have a recommendation or referral. Referrals from a pediatrician usually always go a lot further than if you just open up a phone book. And then as the parent, I think you get on the phone and you start finding someone and asking for callbacks and you interview them and say," Will you be available? What is your availability? If this goes on for six months, will you be able to do this on the phone?" And some will say yes, and some will say no. But you can proactively find somebody and actually your realm is bigger now, because you don't have to just look in your neighborhood where maybe it would have if you were—you could literally look all over the country for somebody.

Esther Schorr:
Right.

Jennifer Abraham:
There are no resources at this time.

Esther Schorr:
No formal ones.

Jennifer Abraham:
No there aren't.

Esther Schorr:
Yeah. Okay. So I know, Jennifer, that our audience by and large skews to the older population. We do have some young people, but a lot of them are older. And so I'm suspecting that that is a lot of the people who are listening today. What can you suggest to them in terms of if they are now isolated? Whether they're with somebody, if they're with somebody in a community or they are living alone, what are the things that they can do to have their world not feel so small? Obviously it works in the other direction, talk to your family, that kind of thing. But what are some other things that they can do to keep emotionally together?

Jennifer Abraham:
Well, I told my mother to set an alarm on her phone, every hour when it goes off, go walk around the lanai three times and then go back and sit down. Because hours can go by, depending on the age or the physical health, and maybe someone doesn't move. So it's really important to move. It's important to get up and to get dressed and to move. Another thing that I've been thinking about, and I mentioned it to a few people, and it had some good responses. Is that maybe making that recipe or that cake that you've been thinking about, right?

Esther Schorr:
I did that last night.

Jennifer Abraham:
The one with the 75 ingredients that you just never had time to. Or another thing is take out all your old pictures. I know a lot of people say," Oh, I'll put those in a photo album one day." Well, this is the one day.

Esther Schorr:
What about funny movies? How about balancing…

Jennifer Abraham:
…funny movies are great. Funny movies are great. Everyone I talk to seems they're watching Contagion or all these crazy movies and I don't understand why.

Esther Schorr:
Why?

Jennifer Abraham:
Funny movies are great sitcoms, old sitcoms. There was one, Golden Girls. I said to my girls," Let's start from the beginning and watch Golden Girls."

Esther Schorr:
That will take a while.

Jennifer Abraham:
Yeah. Well, we have a while I think. But it's pushing the boundaries a little bit. I think most people, we are pretty conservative in our daily lives and especially as we get older. But I think you just push the boundaries a little bit.

Esther Schorr:
Yeah. We watched a movie called Meet the Millers, or We're the Millers.

Jennifer Abraham:
That's a great movie.

Esther Schorr:
For any family with kids, doesn't matter what age you are, it is a classic. That's a great one. So ones like that, I think you're right.

The other thing is the news right now, there doesn't seem to be any good news. What would you say about the balance between staying informed and being news junkies right now? I know I've toned down what I watch. I watch it once a day, at the end of the day to be sure the world is still there versus being hit all the time in social media. Can you talk a little bit about just the psychology of that and what helps?

Jennifer Abraham:
Well, I'm a news junkie, and it's not healthy. And actually my daughter said," Why are you putting that on again? We know what's happening?" And I said," It's a really good point." But what happened, I head it on the other day, and I actually started to have heart palpitations when they were talking. And I thought, “This is horrible.” So I haven't put it on since. So I think you can stay informed. It's even nicer to read, you can even change some of your settings on your browser that you can have the news come through with your email. I didn't realize, I'm not very tech-savvy, but I didn't even know that was an option. So now I'm choosing to read it, because the tone helps me. I read it in the morning with my coffee. I don't read it before bed. So I've been having trouble sleeping just out of being a little bit anxious. My whole family lives in New York, so I'm away from all the people I really would love to be quarantined with.

Esther Schorr:
What about the role of exercise and nutrition and sleep? You mentioned sleep. Any just general thoughts about, what you tell your clients when they're feeling anxious or overwhelmed? Where do those fit in?

Jennifer Abraham:
Well, I think you have to move. I've been walking the dog and going outside, and the other night my daughter and I put on a yoga video, and we did yoga and with the dogs. But you have to move. You absolutely have to move. And I don't know what the weather's like. We're going to find coming the next month or so, the weather's going to get nicer for everybody. But you have to move as long as you stay away from people, a big enough distance. But exercise is really important. If you have a home gym at home, I mean that's even better. And sleep, it's important to sleep and not—because we can get into bad habits of staying up all night long and then sleeping until 12 in the afternoon, and that's not actually a healthy sleep.

Esther Schorr:
Well and that hearkens back to what you said originally, which is setting a schedule of normalcy or relative normalcy, will help people not fall into a pattern of," I don't know what to do with my time. I'm stuck at home." It sounds a lot like what we all need to do is take a deep breath, look at the things that we haven't had time to do that now we have time to do and not be afraid to reach out to other people virtually. I think that the older generation, and maybe we didn't quite touch on that, but I would think that younger people in your circle can help with the older generation who's not tech-savvy to help them learn. And you can teach virtually how to use an iPhone or how to get on the computer and play cards or even watch a movie if somebody wants to watch one thing on the television, and somebody else wants to watch it on a computer. What about music? What do you think?

Jennifer Abraham:
So…

Esther Schorr:
…about music?

Jennifer Abraham:
Well, I live with two teenage girls now, so it's always on. We did actually have a dance party last night in the middle—we were all folding laundry, and this crazy song came on, and we started to dance. And we laughed and laughed, and it really felt great. All of that, as long as you can move—if you can all dance together and make that something fun, I think it's terrific. I think moving if you have a playground, a yard for the kids, if they can go outside, if you go outside with them, throw a ball. This is happening for a reason. I'm not really sure why it's happening, but if—I'm going to try and take the positive out of it, is that maybe we—it's time for us to do things we have never done before.

Esther Schorr:
Mm-hmm.

Jennifer Abraham:
There are so many opportunities with this.

Esther Schorr:
That's an interesting, because our family has talked about what might be the silver linings in this. Of course, there's—I wouldn't downplay the very clear…

Jennifer Abraham:
Definitely.

Esther Schorr:
…negative and unfortunate things, but perhaps the silver linings are we're all slowing down, we're taking a breath, and I've heard talk that fewer cars on the road—manufacturing, we don't want people to lose jobs, but the net effect is our environment may feel a little bit better and breathe a little bit easier. We may all become more literate. So, yeah, I think that your point is well taken that we also have to look at the positives.

I know we're going to get close to the time to close, but I did want to talk about one other thing, because I know, again, our audience tends to skew a little bit older. I know that we are being told that people with immune system suppression, people with cancer, have been treated, or are in treatment, or people with COPD or lung disease or diabetes, that they're at greater risk.

Jennifer Abraham:
Mm-hmm.

Esther Schorr:
Are there any tips that you have—we're getting it from the medical experts about what they can do. But do you have any commentary on just sort of the emotional outlook that you have in terms of boosting your immune system?

Jennifer Abraham:
Actually, I do. So, for most people that have issues, health issues—excuse me—they've lived with them probably for a long time, so they've developed their own coping mechanisms.

And I think—one of the ways—well, a great suggestion or something that really works for me is that I just always do the best I can. So, now I take two vitamin C's, I—but in terms of—the fear is there, the worry is there, but I think for most of us living with these chronic illnesses, the fear and the worry is there anyway. It exists anyway for us if someone gives us—I don't know—if someone gives us a cold, if we go have a blood test—so, I think people like us are very familiar with the fear and the anxiety of it. And, I guess, my suggestion is that it's not any different.

You stay at home, and you stay away from people. It's actually the same as—and it's the same as what we all live with when we're out there in the world.

Esther Schorr:
It's just the rest of the world is now going to have a deeper understanding.

Jennifer Abraham:
Exactly.

Esther Schorr:
Yeah. Got it. Well, Jennifer, I think we're going to wrap for today. Do you have any parting words for our audience?

Jennifer Abraham:
I just hope everyone stays really healthy, and I do hope if there is some silver lining, that we can all come to it together.

Esther Schorr:
Mm-hmm. I thank you.

Jennifer Abraham:
Thank you. Thank you for doing this.

Esther Schorr:
Yeah. No problem. That is our goal. So, for those of you who are watching, we really invite your comments about what we're doing, your suggestions for other topics, feedback on how we formatted it, and the best way to do that is to write to—you're actually going to be writing to me at comments@patientpower.info.

We're also planning to do more of these sort of half-hour Ask the Experts for specific cancer populations over the next few weeks. We'll also do some additional programs for family issues with tips on how to manage that will certainly complement some of the things that Jennifer has shared with us. 

So, let us know how we're doing. We want everybody to stay safe, stay healthy, and stay positive. And please remember that knowledge can be the very best medicine of all.

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

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