 to coronavirus and mental health. Today is March 2nd, and we're coming to you from, well, I'm coming to you from Hawaii. And well, today is another day of the pandemic of coronavirus. Now, the cases are plunging and some restrictions are loosening and it's all happening too fast and too slow for most people. The statistics from the New York Times indicate that our numbers are down from over 4,200 last in, well, not last month, but in January. And that was a two-week indication in late January, down to in the 120s from yesterday for our two-week average with the actual count yesterday with only at 117 new cases. So things are changing rapidly and we're gonna talk about that today. And we're also gonna talk about the effects that the developing situation in Ukraine may have on people here in the United States and people around the world. Today, I'm very fortunate to have my good friend and therapist extraordinary, Daniel Lev, and he's gonna tell us what's happening. He's just now come to us from being with a client and after we talk today, he'll be going back to his client load, which is extensive as it has been in the coronavirus era that we've been going through in the last two years. So I'm gonna start off by asking you, Daniel, when you look at your case load for the past two years that the coronavirus has been altering our lives, what changes have you seen in your clients as far as problems and needs and everything and sort of your perspective on the whole coronavirus period? Well, like any other stressful situation, it magnifies what a person's going through. Some people just see me because they're stressed out about coronavirus, but if they had a preexisting anxiety problem, it of course becomes worse because this is yet another issue that is worrying them. So I've definitely seen that and you're right as far as being busy and I'm not the only one, a lot of therapists are noticing that we're having to put people on waiting lists because we're so full. And I see about between 20 and 28 people a week individually, primarily adults. So it's very busy and a lot of problems, yes, have been exhausted. I've noticed compared to the years before this. If we take a look at that to compare it to recent events with the anxiety about Russia and Ukraine and what's happening there, the threat of war that's now transitioned into actual fighting and people dying and lives being upset and great fear spreading across the planet as to how far this war is gonna go. How many people are gonna be involved? Are we gonna be in another war and what kind of war are we going to be in? Now, right now, everybody I'm sure is exhausted from dealing with the coronavirus. This stress for two years that we've been undergoing, all the changes in our lives have been immense. Now, in wartime, that's the same thing happens. Very similar things happen. We get cut off from our family members. We look at the world and see how powerless we can be and how little maybe we can make an impression or an impact on what's going on globally. All these things mount up and now they're coming in right on top of the coronavirus. So it seems like we're doubling down in problems. During the last month, while all of this has been developing, have you seen changes in the last month in your clients as far as anything that's been associated with this developing global crisis? Yeah, I'm just one therapist, but I really haven't seen anything just yet that is any different than before, even the buildup of the Russian troops on the Ukrainian border. And that's fortunate, but I'm sure that over time, as this may affect us economically or otherwise, they may start feeling more of the pinch of this experience. Well, let's talk about war in general, because we just retreated from a forever war being in Afghanistan and in Iraq. And the country is tired and people are tired. It just seems to be with us forever and we seem to be in this crisis mode forever. Now for the last two years, we've been in the same crisis mode only under coronavirus where things go up and they come down and they look better and then they look worse. And war is also like that. The rapid changes and the feelings of hopelessness from a lot of people. Let's go back to our forever war. What did you see when you were dealing with your clients under those war conditions and how do we deal with stuff like that? Well, definitely people had a heightened level of anxiety about when our soldiers coming back and what are we doing there and things of that sort. But if we look at now, the few people that did talk with me about Russia and the Ukraine expressed a sense of relief that we're not going back to the Afghanistan-Iraq situation that actually we're not gonna have to send soldiers there and they felt relieved about that. It wasn't a huge issue on their mind but a few folks that did talk about that did experience that. And as far as during Iraq and in Afghanistan, well, certainly a lot of the people I work with are soldiers. I work with a number of folks who are either veterans or active duty soldiers and absolutely affected them, as you might imagine, in forms of PTSD or other kinds of issues that being in a battle, being in a war zone will create for someone. Yeah, let's talk about that for a second because last night, our president got on television and radio and broadcast to everybody and his agenda seemed to have radically changed in the last couple of days. From his, you know, things that he was interpreting before, you know, money for the, you know, for the environment, for causes that we need to deal with here in the country. And all of a sudden he's talking a lot about Russia and, you know, the Ukraine. And so things are happening at such a rapid rate that even those of us who think, well, we're so far away from this, you know, it can't affect us. Well, we've been through that before. We tried that sort of in World War II and then all of a sudden Pearl Harbor came to Hawaii and we who thought we could stay back from all this were not. All of a sudden we were right in the middle of things. And if this spreads out to other countries in Europe, especially those with NATO, this is gonna change again rapidly. And every day seems to bring more pressures to bear on us. Actually, one of the things he talked about which very much bears on this with some of my clients is the concern about democracy and how there are larger groups which used to be more on the fringe that would create a January 6th insurrection kind of situation. So I find some of my clients were kind of insecure about how solid will this democracy be? I think right now, at least after hearing the State of the Union and seeing Republicans and Democrats clapping that may have given people some hope that there will be some level of unity because the split amongst these various populations liberal, conservative and others was perceived by a number of my clients and myself included as a dangerous lean back to what happened in the 30s. And so I've worked with them again to help them deal with the anxiety, deal with the depression and not overly focus on these things. But it's hard when it's in the news and it's there all the time. Let's talk about that split for a minute because what we're seeing is when all those coronavirus positives come down and the hospital admissions are going down and even our death rate here in Hawaii is now down, we expect people to feel a lot better than they are. And right now I still see a lot of division. I see if like with the loosening of our restrictions as far as where we can eat when we have to mask and our vaccinations and the governor is gonna be ruling on the 25th of this month on our safe travel health restrictions. So these are things that's gonna make great changes here in Hawaii, but for many people this is going way too fast. And we're saying, you're jumping on the bandwagon here and this still may be dangerous. And I'm not comfortable with this loosening going so fast. Other people are saying it's way than way too slow that people are dragging their heels. It's all these people who are paranoid, et cetera who's keeping us back. We should be full on open about this so I kind of make and get back to it's healthy self. And like you're saying, there are still groups of people even here in Hawaii that are saying, no, no, this is not the way to go. And our government is not leading us in the right direction. So the splits is very real and people still seem to be angry and they still seem to be afraid and unsure of what's gonna happen. And are those some of the things you're also seeing in your clients? Yeah, well, people I see are like everybody else. They have certain problems they wanna work with me on but so I see the polarization there too. There are some that think the vaccination is dangerous or various conspiracy ideas. Other people were angry at the previous president and government for not taking COVID as seriously as they felt it should have been taken. So there's definitely a bifurcation of these approaches. Again, when I'm working with them, yeah, they may express some of these things. I can see some of these things when you try to work on helping lower the stress that comes from them, okay? Because that's part of the problem, a good deal of the problem is people can think about certain issues that happened but the stress level goes up and then whatever psychological problem they've been dealing with, that becomes exacerbated. So even though they're two groups, so to speak, I treat them as one group of people who are all dealing with a similar thing and that is stress related to COVID, related to political polarization and now related to a level of engagement in war that makes them somewhat nervous but at least many of them feel more comfortable that we're not sending soldiers but still it raises stress. So that's my job to work with them and finding a way to be calm. My job is not to argue with them about what the right position is obviously but to help them get back to a level of life that is more comfortable for them. Terrific, thank you for bringing that up because that's where I want, I'm hoping this program will go. What we've been talking about is the problems that are coming with the coronavirus and this threat of war but what this program really is about and what we hope to communicate to everybody today is how do we deal with this? How do we help people with these problems? And I know that's your strength Daniel and so let's talk about some particulars of how you relieve those that stress with your clients and what the people who are watching this program can do to make themselves feel better and less stressed out and less worried and less polarized. Oh, you want me to tell the secrets of psychotherapy all in 10 minutes. Truly. Well, again, every therapist works differently. I'm more in the here and now so just trying to look at what's happening in their life right now to notice some things that they can do now but also to be ears and to really listen to what they're wanting to express and talk about. And I use a lot of humor but I also will work with people on engaging in practices again that calm one down because you can calm down it doesn't mean you're forgetting about the issue you're very passionate about but you can think about it more clearly and without it making you feel upset later or without upsetting people around you necessarily. So another group of skills I work with people on is what I call refocusing skills because a lot of the problems let's say with depression, I think you mentioned this to me a while back a person who's depressed and I have several people who have lost someone to COVID. So they're going through mourning and some of that is leaking into more of a depressive kind of thing where they feel bad about themselves and not just missing the person. And so I'll work with them on ways to as best they can move away from some of that thinking if it becomes way too much if they need to cope better with it. And so refocusing skills are like meditation, relaxation, some clinical hypnosis things of that sort to help them redirect their attention because it's about the attention if we keep our attention on things that are upsetting it will upset us. And so that's just one thing that I will do along with a lot of humor and other things to suggest that people don't work with them or even just notice what they're already naturally doing. Let's talk about refocusing for a second because that and all the techniques that you talked about I've used in my practice. The problem I find with refocusing is that people can refocus for a minute, two minutes, three minutes and all of a sudden something like the cat yowling or something outside all of a sudden breaks that refocus and the bad things come rushing in the bad feelings with bad thoughts and all of a sudden they're back in that pit. Right. And it's sort of easy to say to refocus and to try to help them but to get that to become sort of automatic or sort of long-term refocusing that's always been the challenge and I was wondering how you dealt with people who come to you and say that worked well for a little bit and then I got lost again. It's a very common misunderstanding when I say refocusing I'm not talking about the results. Ah, okay. Okay, I'm talking about a practice. So when you're driving a car you're not 100% focused but you've done it so long that you're not going to be in a crash. You know, God forbid the odds are you'll drive safely you'll be okay, all right. It's a skill like anything else you have to practice it. So when I'm sitting like you said and I feel let's say I'm just focusing on my breath going in and out and suddenly I think, God, what's for lunch? Okay, so that's a distraction. It's normal. When I'm distracted all I need to do or what I need to do is just refocus back on the breath. That's why I call it refocusing. Quickly three things you do, let's say with meditation. Number one, you let go and relax. So I'm sitting in a seat, I'm letting go of the thoughts. I'm letting them come and go, I'm not purposely thinking them. Number two, I focus on something. Something neutral or positive, a piece of music, my breath going in and out of my belly, watching the waves at the beach, whatever it is. And number three, every time I get distracted which you will, because we have brains and that's what brains do, we will think about things, we will focus on other things. When we get distracted and you notice you're distracted, you just reel yourself back to focus. That's the practice, you're always going, you're never gonna keep it there all the time. But as you do this like driving, you become so good, you'll be able to keep it focused longer. And then that has all kinds of health benefits, physical health benefits as well as psychological health benefits when you do that, including stress relief. Well put, I appreciate that because that's some of the things that I use too. In addition to those techniques, I also used cues if people were having a particular problem and falling away from that refocusing, that rethinking in a different direction. I oftentimes had them wear something that was easily visible. Maybe it was a red paper ring or something. And as they're just falling into that pit and they look down and see that ring, or they see something on their collar or something that they're looking in a mirror, anything that's in their line of vision that says, well, stop what you're doing, let's refocus, let's get back to relaxing and doing all those things that Daniel told us about. So yeah. Absolutely, in fact, you could think that even if you say, I am dedicated to doing these things, we forget all the time. So that cue is a reminder. One form of mindfulness meditation or called thought labeling is, let's say I'm focusing on my breath and when I get distracted, I label it in my mind, oh, thought, and then I come back to focus. Well, it's like putting a flashing red sign on whatever distracts me, because usually it's the same darn thing that distracts me. And so I put that flashing red sign on and the next time it tries to distract me, I get back faster. So the cue that you're mentioning does the same thing on their body. It reminds them, oh yeah, I can do this now. Mm-hmm. Great. Let's carry this a little bit further and go to relationships. Uh-oh. Because some of our relationships the people we're living with can be a tremendous help, you know, as far as refocusing and relaxing in that. And when we start falling into that depressive or anxious pit, our partner, our wife, our husband, or whoever, our son, our daughter can turn to us and say, refocus, refocus. You're losing it, you know, just relax. Everything is okay. I'm here with you, et cetera. And so if you could talk a little bit about how to draw those people that they're in relationships with now that they may be living with now, and also say a little bit about what you can do for people who are living alone either by choice or because of the pandemic who have been separated from the people they're used to being with. All those are things that I would love to hear your thoughts on. And I appreciate you asking. I know you know a lot of these things. Well, first in a relationship to brag for a half a second, my wife and I live in our apartment and we love it. We actually like to see each other all the time but some couples, they need more break. They need more space. So finding ways to give each other more space, okay? Without thinking, oh, I'm being rejected or I'm wrong or anything. That's really big for the couple to sit down and say, okay, let's just acknowledge I need not to see you as much, okay? And then they find a way, if they have a small place, they find a way to give each other that space. Certainly if they come into argument space and they want to try to stay away from that, similar ideas, a cue, a time out word. They make this up before it happens. And if either of them feel uncomfortable in a conversation, they just say, lamb chops. I mean, whatever the word is, the funny or the word, the better. Scrambled eggs, I had clients do that. And that's a signal to stop talking, turn around, walk away from each other, go do something to cool out. So that's just a nice interrupter if the couple can do that. Being alone, I have a number of clients who really feel this is where the pandemic really hit a lot of folks. Is they're afraid, of course, to be around too many people but I work with them to encourage them in safe ways to be around people. But look, when I'm seeing them, I'm seeing you on Zoom, God's gift to the pandemic, okay? That we actually can talk. It's almost like they're in the room, all right? Especially if we are relating like you and I are relating. So finding ways to connect with groups. I often suggest meet up as one way to find groups of people that have similar interests and a lot of them are online or church groups or whatever it is to meet people that way. Terrific. We had a question, Daniel. It just came in from one of our viewers and talks about how we feel about a new variant coming in. I mean, we've seen the original COVID come in. And then it was replaced by Delta. You know, a much more scary variant. And then all of a sudden Omicron comes in and one that is so widespread and so contagious that our numbers just start skying out of sight. And this viewer wanted to know about how we deal with or how we help people who are worried about the next variant coming in and thinking to themselves, there's this big cloud, dark cloud that's gonna come over us with another variant. And how do we deal with this? Yeah, yeah. Again, I don't have all the answers, but one answer that one great psychologist Richard Lazarus would say when they asked him what to do, he would always say, it depends. For some people who can handle learning, they should check with the CDC, check the actual information and not the scary ideas about information. For some people that can be helpful, okay? For other people, sometimes just to stop thinking about it a little bit, which is easy for me to say, but to redirect their attention away from overly focusing on it, but just enough to stay safe, but check in with the facts once in a while to know that Omicron spread like crazy, but it was apparently less lethal for people with vaccinations and boostings. And so to do things to make sure you're safe would be again, a simple way to handle that. And it's a wait-and-see thing. It is hard to predict what we're gonna do. Yeah, it's very hard. It's very hard to put yourself in that person's position and it's one of the very great difficulties that we as therapists have dealing with our clients. On the other hand, it's also very hard for us to deal with it too, because like you said, most everybody is overwhelmed, including therapists and physical and mental health, people who are working sort of round the clock to try to deal with all this. So it's very difficult. And I know we're coming in just to let me invite people, take a few minutes up to 10, 15, 20, if you can to sit quietly and just focus on something pleasant and keep your mind there as best you can. That will help with this. Yeah, absolutely. Daniel, we're running a little short. We're coming down to the three-minute mark. So any last words, any last things that you would like to send to people out in the audience to give them some idea of additional stuff that they could do to help themselves through this, what seems like a never-ending crisis? Absolutely, very quickly, like I just said, give yourself a calming practice of some kind, even if you walk in a beautiful place, whatever it is, and redirect your mind just to where you are and away from all of the tumult of the news. Some people staying away from the news is gonna be helpful more often than not. And certainly if you are feeling a great deal of suffering over this, it would be very helpful if you don't already consult a therapist, to check out a therapist, they can be very helpful in helping you find a way to better cope if you're finding you're overwhelmed. Doing that would be helpful. Thank you for mentioning that, because that's something that I think is very important. This program is not a therapy session. We can't be your therapist. We can only come on and give you some ideas and try to help with all the things that we're facing, both our thoughts and our emotions. And so I really appreciate you saying that, Daniel, and I appreciate you being on the program and sharing your experience with us. It's been very helpful. We've tried to, in this session, focus on sort of the breaking news of the potential of war, the focusing on Russia and the Ukraine, all the anxiety that that brings to the table along with coronavirus. In two weeks, we'll be checking and seeing how this scenario is playing out, but we'll also be probably going back to where we'd hoped to be today and talking about coronavirus and grieving and feelings of loss, which we mentioned just, which Daniel mentioned just a little briefly today. We'll go into that in more in depth, too. But we'll be staying on top of what's happening with the coronavirus and what's happening in the world. And we really appreciate your questions. Anything that you're worried about or concerned about, please email us or check in with us during the session and we'll try to answer everything that you ask because we wanna know where you're at, not simply what we feel everybody's at, we wanna know from you. So thank you very much for everybody listening in. And again, thank you, Daniel, for coming. I know you're busy today with all your clients and I really appreciate you taking the time to join us. It was a privilege. Thank you. Thank you. Thank you so much for watching Think Tech Hawaii. If you like what we do, please like us and click the subscribe button on YouTube and the follow button on Vimeo. You can also follow us on Facebook, Instagram, Twitter and LinkedIn and donate to us at thinktechhawaii.com. Mahalo.