April 2020 (COVID-19) – Blog Post 4: Talking about COVID-19 with Children – The Guildford Psychologist

15.04.20

Once again, I really hope this period is not proving to be too difficult for you and your loved ones. This is the fourth blog of this series and is focused on how to talk about COVID-19 with children. My previous COVID-19 blogs titled ‘Managing Loneliness’, ‘Ways to maintain your Wellbeing’ and ‘Coping with uncertainty and other difficult thoughts and feelings’ can be found on the March 2020 blog posts: https://www.drbenjmead.co.uk/2020/03/. As always, any questions, please do not hesitate to contact me and I’ll be happy to help.

Stay safe,

Ben

 

Talking about CoVID-19 with Children

I’ve received a few queries surrounding how to discuss COVID-19 with children, so I thought I’d offer some tips. I should add that many of the tips in this blog are not mine, rather they come from one of the professional bodies I’m attached to – The British Psychological Society. I’ve added a few of my own, plus some links I think could be helpful too.

 

Tip 1: It is good to talk

Children will have heard about Coronavirus and likely noticed changes around them – such as people wearing face masks, not being allowed out, and (crucially!) not going to school. It is important they feel comfortable talking to you about Coronavirus. As their parent you’ll likely not only be the best source of information but also the best place for reassurance for them. It’s also likely they will talk to their friends or other children. This can lead to misinformation and imaginations going wild. So having the chance to check-in with you is especially helpful.

 

Tip 2. Be truthful but remember your child’s age

Take an honest and accurate approach – give them factual information, but adjust the amount and detail to fit their age. For example, you might say ‘we don’t yet have a vaccination for Coronavirus, but doctors are working very hard on it’ or ‘a lot of people might get sick, but normally it is like a cold or flu and they get better’. Younger children might understand a cartoon or picture better (there’s a great cartoon book that I found here: Coronavirus cartoon.

We also recommend that adults watch news programmes and then filter this information to their child in a developmentally-appropriate way.

 

Tip 3. Allow children to ask questions

It is natural that children will have questions, and likely worries, about Coronavirus. Giving them the space to ask these questions and have answers is a good way to alleviate anxiety. Again, try to be honest in your responses – it is ok to say you don’t know. At the moment, there are questions we don’t have answers to about Coronavirus: you can explain this to your child and add in information about what people are doing to try to answer these questions. Maybe your child has an idea too; let them tell you or draw it.

 

Tip 4. Give practical guidance

Remind your child of the most important things they can do to stay healthy, such as wash their hands regularly, and remember the ‘catch it, bin it, kill it’ advice for coughs and sneezes. Help your child practice and increase their motivation for keeping going – maybe thinking of a song they want to sing while washing their hands.

 

Tip 5. Recognise change can be overwhelming for some children

Humans typically like a sense of control. When we don’t get it, we can get stressed. Also, when lots of changes happen at the same time it can be overwhelming. This can be more so for children, particularly if they are not able to fully understand why the changes are occurring. It’s therefore helpful to normalise this. Discuss with your child that their body may feel nervous at the moment and this is okay; these are strange times. Just let them know that you are there for them if/when they wish to talk.

 

Tip 6. Worries about Coronavirus may manifest in other worries or in frustration

When we’re anxious about something, it’s common to get stressed about lots of things. I know when I’m struggling with something I often get a bit frustrated with the dishwasher, for example: I’m really not a fan of emptying it! The dishwasher hasn’t done anything to deserve this, it just acts as an object towards which I express my stress. The same can occur with children. It’s possible they may start to get more concerned about being alone at night, or worried about something that used to bother them in the past. This is understandable. Just listen, reassure and try to help relax them.

It’s worth adding here that stress can manifest in both anxiety and frustration, via the fight/flight response. Therefore, just like adults, when children are stressed about something it can lead to worries about lots of things, as well as frustration and anger: that adrenalin needs to go somewhere. Again, the same ideas apply. When they’ve calmed down, give them space to talk, or at least let them know you are there if they want to chat.

 

Tip 7. Try to manage your own worries

Finally, children can be quite good at picking up when we’re anxious, so talk to your children about Coronavirus when you feel calm. I wrote some tips in one of my blogs last month (https://www.drbenjmead.co.uk/2020/03/) that I hope will help you if/when you are feeling anxious or worried. It can be so easy to fall into traps of ‘What if (insert your fear about the future)’, particularly at this moment in time. Trying to manage these as best we can is all we can ask of ourselves.

 

I hope all of this helps. As always, just pick up the phone or send me an email if you have any questions.

March 2020 (COVID-19) – Blog Post 3: Managing Loneliness – The Guildford Psychologist

27.03.20

Once again, I hope this period is not proving to be too difficult for you and your loved ones. This is the third blog of this series and is focused on managing loneliness. My previous COVID-19 blogs titled ‘Ways to maintain your Wellbeing’ and ‘Coping with uncertainty and other difficult thoughts and feelings’ can be found below this post. As always, any questions, please do not hesitate to contact me and I’ll be happy to help.

Stay safe,

Ben

Managing Loneliness

Humans are social creatures. Back in caveman/woman times, without each other we’d struggle to survive. There was virtually no way that we’d be able to hunt, cook, fight, make a shelter and our clothes, all on our own. As a result, part of our brain is wired to seek out other people and seek social approval.

Thankfully, in today’s world, we have so much available to us (supermarkets, ovens, houses, online shopping) that it is relatively easy to survive on our own. However, whilst we can survive in the physical sense, it does not mean we will feel good mentally when on our own. This is because there is still that part of our brain that believes we need others to survive. This is why regulations surrounding staying indoors, social distancing and working from home can be tough. If you’re living on your own you may not be able to get the physical human contact that your mind craves. It is therefore natural that your brain is going to react with concern.

Loneliness is the feeling we get when we are not able to achieve the level of social interaction we desire. It can play a significant impact on our mental health and can unfortunately lead us to feel anxious and depressed. I therefore hope these tips help.

 

Tip 1: Think of alternative ways of making contact with others

If you’re unable to go out, try to think of other ways in which you can see people. Phoning, text, WhatsApp and FaceTime / video calls are great ways to stay in contact with friends and family. This can help remind you that there are people around. There are even some great mobile apps to help link up with friends in group video – Houseparty is one of these apps (www.houseparty.com).

 

Tip 2: Talk to people online

If you have a hobby/interest then there’s a high chance that there’s an online forum dedicated to the subject. This’ll enable you to chat to others with similar interests. Tapatalk (www.tapatalk.com) hosts thousands of different forums, where you can chat to others. Dating apps too, and online games can also be great ways to interact with others.

 

Tip 3: Just observe others

Just observing other people outside can be really helpful. So, if you can go out, take some time to do some people-watching. Or if you live near others, sit by your window and watch the world go by. Even waving to someone or saying hello to a neighbour through their window can help us feel a little less lonely.

 

Tip 4: Learn to spend time with you.

This period could be a great time to learn how to make the best of being with yourself and comfortable in your own company. For example, during this period could be a time to learn a new skill, read up on something you’ve always wanted to know more about. It could be cooking, yoga, writing a novel (or just a journal!), or just reading that book that you got for Christmas five years ago that always goes in the ‘I’ll read that after I’ve done (insert mundane task)’ pile.

 

Tip 5: Make plans for the future

We can learn a lot about ourselves in our own company. Some things we may like, some we may not. But recognising these gives us an avenue to make changes to improve, to set goals on how we may go about things differently in the future.

 

Tip 6: Got any pets?

Pets can be a great reliever of loneliness; spending some quality time with them can be a great way to reduce feelings of loneliness.

 

Tip 7: Just for older people….

If you’re one of the 8.5 million older people in this country then this period may hit you the hardest. The length of time you may be asked to self-isolate to keep yourself well could naturally have an effect on your mental health. Understandably, feelings of loneliness could appear. There are people out there though, and AgeUK (www.ageuk.org.uk), Independent Age (www.independantage.org) and The Silver Line (www.thesilverline.org.uk) all can provide further advice as well as their ever popular befriending services.

 

This is just a small list of tips that I thought were more applicable to the current difficult situation we’re in than a typical list (which, naturally, invariably involves meeting up with new people or old friends!).

If loneliness is an ongoing problem for you, there are lots of places out there that can help. There are charities that specialise in helping with loneliness. One of which is Campaign to End Loneliness (https://www.campaigntoendloneliness.org/). On this website you can find links to all sorts of places, including other befriending services and volunteering opportunities. Indeed, once normality returns and we do not need to stay indoors then there are many websites around which can help us meet new, likeminded people – Meetup (www.meetup.com) is a great (non-dating!) site where you can meet new people in your area.

Finally, I just wanted to add that if loneliness has been a long-standing problem for you, then it’s important to recognise the value of small steps to help overcome it. For example, if the idea of volunteering is daunting, then just set your first goal to write the email to enquire, or just have a short phone call. If attending a yoga class is something that interests you but feels overwhelming, then perhaps ring the organiser and ask if you can just watch for a session. I also help many people for whom loneliness is a result of shyness/social anxiety; working on the latter can be a really helpful way of helping with the former, so just ask if you’d like help here. It’s such a common difficulty and I’d be more than happy to help.

 

August 2019 – Common Questions – The Guildford Psychologist

During my 10 years in private practice there have been common questions I’m often asked. I thought it may be helpful sharing some of these. I’m sure there’s lots I’ve missed, so please do not hesitate to contact me if you have any queries.


What’s the process to see you?

After contacting me I’ll immediately let you know if I have a waiting list. If I do, I’ll let you know how long it is likely to be before I could offer you weekly appointments. Sometimes this may be a few weeks, sometimes, unfortunately, a couple of months. Whichever it is, if I have a wait time, I’ll always try to ensure I offer you cancellation appointments in the interim.

If the wait time is okay for you, I’ll then suggest we speak on the phone. This is just to see if you have a difficulty I feel I can help with. I do this, as the last thing I want is for you to make the effort to come to see me only for me to say I’m not the most appropriate practitioner. However, you do not have to have this call if you do not wish. It’s just there if you wish to have it.

If I feel I can help, I’ll then let you know when an appointment (cancellation or weekly) comes available. If you plan to fund through health insurance, I’ll also need a few pieces of information just to confirm treatment with your insurers.


How long is the wait for an appointment?

Unfortunately, my clinic is often full. Therefore, it’s common for there to be a bit of a wait for a weekly appointment. However, prior to a weekly appointment I’ll always try to offer you a couple of appointments that are available due to cancellations. These appointments are generally used to complete an assessment and they also give you a chance to work out if you feel we can work together – without having to wait until a weekly slot comes available to find out. Don’t get me wrong though, in an ideal world, I would be offering everyone weekly appointments from the first week they contact me. I can only apologise if I’m not able to offer this.


How many sessions will I need?

This question is easier for me to answer as the treatment progresses. It is a really common question that I’m asked over the phone or on email. I can completely understand this as it’s natural to want to have an idea on how much of your time may be required, and also your money (!). Unfortunately, the best I’m likely to say over phone or email is 4 – 20 sessions. I know this is often an unhelpful answer, but it is so difficult to ascertain how many sessions could be beneficial from a quick phone call or a brief email description.


I have health insurance, how do I ensure they fund the sessions?

The best thing to do is to speak to them. The most common process with insurers is that they’ll want to see a report from a medical practitioner (a GP / Psychiatrist) that states your need for treatment. Once they have this, they’ll hopefully give you an authorisation number for psychology treatment. We’d then be good to start.


I don’t really know what my thoughts are, I just feel so anxious / low / angry

This is a really common question.  Many people I meet struggle to identify thoughts, and sometimes a client may be really concerned by this. If this is you, you needn’t be concerned. It’s a really common concern. Indeed, Soucy et al (2019), recently identified it of the most common questions asked. We’ll work together on this, and sometimes we may even find that it is not even important to know what the thoughts are.


I’ve had CBT before and it didn’t help – how will you be able to help me?

As much as I wish it did, CBT does not work for everyone. However, CBT had developed so much in the past 20 years. There are now different variations of CBT, each with a great evidence base. For example, there’s Acceptance and Commitment Therapy, Compassion Focused Therapy and Mindfulness-based CBT – all of which I can offer. All fall under the CBT umbrella but are also distinctly different. If you’ve had one type of CBT, it’s possible that another type may be more helpful. We can certainly spend time discussing this. Indeed, whenever I see anyone, I’m trying to think what type of therapy (or what type of CBT) could be most helpful to this person. Although I always aim to, I’d be lying if I said I always get this right. Sometimes we may start with one therapy and then realise it’s not quite achieving what we want so we’ll discuss whether to move to another. If I do not offer the therapy I feel would be the most helpful, I’ll help you to find a practitioner who does.


Do you see children?

I see both adults and children.


Do you work with people who are suicidal?

I’m afraid not. There are a couple of reasons for this. The first is that I’m part-time, and I feel I may not be able to offer the level of support that may be most beneficial. The second is that active suicidal behaviour is not something I’m particularly experienced in. I do know a few practitioners who are though, so do feel free to contact, even if it’s just to ask who I would recommend. Sometimes I recommend the NHS in these situations, simply because, when someone is highly suicidal, you’ll be able to receive support from teams specilised in this area. Those teams have lots of different practitioners (psychologists, psychiatrists, nurses). This can mean the level of support given can far outweigh what a private practitioner may be able to offer, and the support systems will be regularly able to meet to ensure the needs of the person at risk are met.


Will I need to attend regularly?

Therapy is generally considered to be so much more effective when attended regularly. In cognitive behavioural therapy, often a lot of information is learnt and getting into a ‘flow’ can be really helpful. Having a session once a month or every now and then can make things tricky. It’s a bit like physiotherapy exercises – if you do them once in a while they are often not that helpful, but if you’re regular with your exercises then progress can quickly occur.


Do you offer Skype sessions?

I do, but I always try to meet a person face to face first before progressing onto online sessions. Online has it’s pros (no travel, convenience), but sessions sometimes involve writing out things and face to face can be easier for this, and it can feel more personal too.

 

June 2016 – Health anxiety – The Guildford Psychologist

It is quite common for me to be asked to help someone who has excessive anxiety about their present or future physical health. This anxiety can be very distressing can cause someone to regularly have multiple tests to ensure there are no major problems. Each time a test comes back negative a person will feel relieved. However, a few months later the question may return and the doubt sets in. After all, what if something has happened in the preceding months? The cycle then repeats.

Physical and Mental Health Anxiety

Slightly less common and less researched though is when someone has excessive fear and anxiety about their future mental health. Commonly, it is put in the bracket of health anxiety but often studies on health anxiety will focus on those with physical health anxieties. It was therefore interesting to read the other day an article written by Gelinas and Hadjistavropoulos. In the article they gave preliminary evidence that cognitive behavioural techniques for physical health anxiety be efficiently adapted for mental health anxiety.

Intrusive and Unwanted Thoughts

An example of an excessive fear and anxiety about a future mental health problem may be someone who fears that they will ‘become a serial killer’. This is despite having no desire to be one, and exhibiting no behaviours to indicate that they put others at risk. They may though be experiencing intrusive thoughts or images of hurting others in some way.

Interpreting these thoughts and images as a ‘symptom’ of being a future risk then heightens the anxiety. Often these cognitions will then lead someone to perform what we call ‘safety behaviours’. These behaviours make a person think they have ‘saved’ themselves from doing something bad, but have actually just perpetuated the fear. A good example here may be that the “serial killer” may avoid using knives when others are at home. This action lowers the chance that they will attack their loved ones with a knife. However, seeing oneself avoiding knives will then promote doubt in the person’s mind. Why avoid the knives if you are no danger to others?

If someone has a fear like this, I often show them a piece of research by Purdon and Clark. In this study, they asked 293 people (none of who had been diagnosed with a mental health problem) to indicate whether or not they had experienced a particular thought. The results, to many clients, are often surprising. For example, did you know that 34% of men (17% of woman) have a thought of fatally pushing a stranger? Or that 48% of men (18% of woman) have thoughts of hurting a stranger? It’s not just predominantly men either. The study showed that 55% of woman (52% of men) have thoughts of swerving into traffic. Finally, 47% of woman (43% of men) have thoughts of causing a public scene.

Tolerating Uncertainty

However, as with many things in life, there is always a chance, however small, that a negative prediction will become reality. Therefore, generally it is impossible for a therapist to give a 100% guarantee that a negative prediction will not occur. Therefore, much of CBT treatment for health anxiety involves building resources to tolerate uncertainty. Some of this involves helping a person reduce the behaviours that often relieve their anxiety in the short term but perpetuate it in the long term. Examples include: looking for reassurance from family/friends/doctors; checking the internet for what a symptom could mean (I’ve seen some very very inaccurate things written on some sites!); avoiding particular activities to reduce chance that a bad thing will occur (e.g., knives example above); and frequently monitoring and checking current symptoms. For many, this is not easy. So we work on building up resilience to do this.

Treatment also involves exploring a person’s thoughts and testing out particular beliefs that could be maintaining the anxiety. Sometimes I also use an Acceptance and Commitment Therapy approach, exploring a person’s values and helping them to dedicate more resources towards living by these rather than focusing on unwanted thoughts or images. Throughout treatment though, I’ll aim to work with the client and together we’ll work out the best way forward for them.

Please do get in contact if you have any questions about the information I’ve written here, whether it’s just for more information, or if you feel you may be struggling with one of the difficulties discussed. I’d be happy to talk to you.