 Hi, good afternoon. Welcome. I'm Lynne Brockington, a librarian here at West Vancouver Memorial Library. Welcome to coping in a time of change and uncertainty, moving from coping to growing. So we have with us today Dr. Marilyn Chotum. She is a registered psychologist with a private practice in West Vancouver. Since 1980, she has worked in community mental health, hospital, psychiatry, and addiction treatment programs. Marilyn sees individuals, couples, and families in her private practice, which is located in the professional building between Amica and Capilano care facility on Clyde Avenue near Park Royal. Dr. Chotum will be talking about coping skills for living in a time of uncertainty and how we can use stressful circumstances for a springboard for growth. So I'll just ask Dr. Chotum to come online now if she'd like to start your video. And I just want to mention to everyone that if you do have questions, she will be answering questions at the end and you can write just type them into the Q&A at the bottom of your screen. And we'll see them there. Thank you. Thank you, Marilyn, for coming and I'm I'm going to turn off my video and mute myself and you can start. Okay. Thank you, Lynn. So I'll just start by telling you a little story. When Lynn asked me to speak on this topic, I reflected on my own reaction to COVID-19 in March when everything shut down. Well, actually it started before March. It started in January and February. We were hearing about COVID and the dangers and how life threatening it was and I tend to get sick easily. So my immediate reaction was I'm going to die by June. I'll get exposed to it. I'll be the one who gets sick and I'll be the one who dies. So I wasn't afraid of dying so much as I was afraid of not having my affairs in order. So I contacted a lawyer and got went through, you know, figuring out a will and and the funny thing is we won't be signing that will until this Thursday. So if I had died, I wouldn't have done any good. Anyways, my next reaction after that initial not panic, but certainty that this is the end was discovering that I was really healthy and it felt good that I was protected. But changing to social distancing, working online and the deluge of new and often contradictory information through my sense of order to the winds. I felt like I had no ground under me and everything felt chaotic and I felt lost. It was very uncomfortable. Thought hard about what would bring back equilibrium. What did I need to feel grounded again? The answer for me was recreating routine. So since then, I started dressing for work and writing my bicycle to work to my office following my regular schedule as I always had. Even though I'm working online and could theoretically be working from home in my pajamas like other people. I continue to ride my bicycle every day, get out in nature, connect with friends and family. I'll be at a two meter distance or online. For the most part, it feels like nothing's really changed, although I'm well aware of my good fortune in the face of the losses and stresses that other people are experiencing. And I worry about our future. We're going to be paying for this for a while, unfortunately. So change and uncertainty are stressors that can cause physical and psychological symptoms. Then in turn, control. Stressors that can cause physical and psychological symptoms. Then in turn, can trigger habitual coping mechanisms that may be adaptive or maladaptive. Stability comes from predictable routines and routine attachments or stable attachments, sorry, as well as stable social networks. What happens when our networks, routines or situations change in profound ways? As in a divorce, loss of a family member or a pet. Or as in our current pandemic. We are living in a time of enormous upheaval with COVID-19 and other world concerns. Such as troubling political systems, elections, systemic racism, global economic concerns, climate change, and please add anything I've forgotten. With COVID-19, there are job losses, financial insecurity, health anxiety, loss of a loved one, or fear of losing a loved one, and potential loneliness from social isolation. If on top of these current global stressors, you are dealing with personal change and uncertainty too, you may be having trouble coping. Too much change and uncertainty all at once can overwhelm our coping capacities and cause symptoms like depression, anxiety, worsening OCD, obsessive compulsive disorder, worsening addictive behaviors, or physical symptoms like headaches and stomach aches, tension, trouble sleeping. So what tools will help us adapt and stabilize in the face of current and future periods of change and uncertainty? Thinking about your own situational stressors and what if any symptoms or reactions you may be having to them? Know that our symptoms are here to inform us. Rather than fighting them, begrudging them, or medicating them, let's reflect on what they're expressing or calling for. If we are hurting physically, is that an expression of emotional pain? Our bodies often feel our emotions, or we feel our emotions through our bodies. If so, labeling the emotion and what is causing it can lead to an understanding of what corrective action could be taken to bring relief. Everyone has different circumstances, a different character, and different needs. And there is no one size that fits all in terms of remedies, but there are recommendations which I'll give you later. So each of you will have your own reactions and needs in the face of your situational stressors. The challenge is to attune to our physical and emotional states, to find what they are communicating to us. This ability to self-attune takes time to develop, but necessity is the mother of invention and pain is the great motivator, if not the best. When we are better able to identify and meet our own needs, we are stronger and more resilient in the face of challenging and changing circumstances. Sometimes our suffering comes from our outlook or beliefs, that is the way we think about things. Can we reflect on the thoughts and assumptions that might be hurting us and change them? For example, if we assume that someone is purposely doing harm to us, we're going to react with hostility, probably, which can harm the relationship when the other person may be having a bad hair day that has nothing to do with us. Rather than making negative assumptions, keep an open mind, be curious, form hypotheses, and gather more information before you make a decision or take action. Another example of an outlook that can cause suffering is believing that you can't do things or that you are helpless. I always liked the children's story, the little engine that could, written in the 1930s. In the case of the little blue engine, she had never been over the mountaintop and knew she had to get the children to the other side. She knew she had the ability to accomplish the task, but wasn't sure she could actually do it until she said, with a smile and determination, I think I can, I think I can, I think I can, and she did. What a great message to anyone at any age. There are many forms of cognitive distortion that can be problematic. Think about some of the self-talk statements that go through your mind that work against you and have really no basis in reality. They're just subjective thoughts, like, I'm not smart enough, I'm not good enough, I'm not pretty enough. Other people have it easier than me. My life is hard. I think I'll go eat worms. In cognitive behavioral therapy, people replace negative self-talk with positive alternatives. Our habitual negative thoughts can harm us, but so can our habitual behaviors. For example, some people have worsening addictive behaviors or compulsions when they are stressed. We all have habitual learned ways of adapting to our circumstances. Whatever the current circumstances are, they offer an opportunity to become more self-aware and to better meet our own needs. When there's a will, there's a way. All change depends on motivation. If we're having an internal battle over doing the things that are good for us, we may not be ready for change. Getting alignment between our healthy selves and our unhealthy habits is key to success when dealing with compulsive, addictive behaviors. It's not about self-will. How do we get to that clarity? It can be through journal writing, mutual support groups, treatment, meditation, reflecting, but I think talking with another person is probably the most helpful. The challenge is to shine a light on the shadow side of ourselves, those parts of ourselves that we may be unaware of. Our defenses protect us from knowing our true feelings and thoughts. Consequently, we don't always know what we need because at some point in the past, it wasn't okay to have that need or to express it. We learn to repress our feelings and thoughts. Through meditation, journal writing, psychotherapy, you can become more self-aware and less ruled by the unconscious. Self-acceptance strengthens our sense of self as agent, you know, empowered to be in charge of our lives in the driver's seat. Curiosity and compassion, as I said before, for ourselves and others allows us to be less reactive, and all of the above processes lead to greater resilience, a reduction in symptoms, both physical and mental. Acceptance of subjective and objective truth can calm visceral and emotional reactivity. When we can identify what we are feeling and trace it to a trigger, we are in a position to change the outcome. Sometimes what needs changing is our way of perceiving or thinking about a circumstance, as I mentioned about earlier. What assumptions are we making? What evidence is there to support? Confirm our assumptions. Sometimes what needs changing is our behavior. What behaviors could we change to make things better? Lastly, can we listen to our own wisdom? What is your gut feeling or intuition telling you? Some people find praying gives them equanimity and insight. Others find meditation can calm their thoughts and allow insights to surface. Others find their meditation through exercise, long distance running, long distance cycling, the mind, quiet and insight surface. To recap, what are our symptoms calling attention to? How are we perceiving our situations? And what are the opportunities in our circumstances? We are creatures of habit because habits are efficient, and we don't need to reinvent the wheel for every new experience. Nevertheless, our habits may be ineffective or even self-defeating or destructive. We have both behavioral and mental habits. For example, people can habitually catastrophize their experiences, creating emotional roller coasters for themselves and those around them. Addictive behaviors can be an habitual coping mechanism. Other people may habitually withdraw or avoid, and others may rage, others may cry. It's how do we typically respond and is there an opportunity to improve? Coming back to the earlier question, what tools will help us adapt and stabilize in the face of current and future periods of change and uncertainty? Here are some stress management tools that can help. I'm calling them balancing tools. These are not in any order. They're not equally important or equally, you know, vertical. They're just a quantity of tools to put in your toolkit. So relaxation, starting with relaxation, learning to calm the mind and body through things like massage therapy, hot epsom salt baths, meditation, slow calming breath, yoga, and sitting still, sitting still in the woods or just sitting in a chair and letting your mind calm. Spending time in nature, taking a walk in the woods, force bathing, can calm the nerves and give you a new perspective. Know your limits. If you're overwhelmed, narrow your focus, prioritize and say no to what isn't a priority. For example, ignore non-essential emails, unsubscribe from solicitous emails that come advertising stuff every day that you don't need and they clutter your inbox. Turn the news off if it's overwhelming you. Not everything is equally important and you can decide what is necessary to attend to, what can wait, and what can be deleted or ignored. Listen to your intuition. Create routines to the best of your ability, maintain or create predictable routines that are realistic for you, given your mental and physical capacities. But do keep putting one foot in front of the other, especially if you were having a depressive episode. With depression, people shut down, they socially withdraw, they lose interest and they lose pleasure. It can be like quicksand, so you don't want to go down with it. You want to put one foot in front of the other, do something, don't isolate, and just follow one foot after another. What often happens is as you get engaged in what's going on around you, it pulls you out of the depression to a win-win. Don't make any major life changes that are not essential until you can restore inner stability. Now the exception to this is if you've had a traumatic event in which case you may need to be close to loved ones who do not live nearby. Outlook changes. Change I can't to I can, or this is catastrophic to I have choices. Don't take assumptions as facts. They're feelings. They're subjective and they're often based on distorted perceptions and assumptions. Attitude of gratitude. Gratitude lifts our spirits. It makes us appreciative of what we have. Reflect on what you have rather than what you don't have and be grateful. Coping messages from the Alcoholics Anonymous. This too shall pass one day at a time and keep it simple. Meditation helps calm the mind and body so that you can think more clearly and problem solve more effectively. It is a process of learning to observe, consider and act rather than reacting to surface perceptions. It's taking the time to be still and observe. Thinking that we're all like icebergs. There's a visible part that's very small compared to the mass that's not visible. Which is another reason for being curious and compassionate with yourself and others that often we shoot on ourselves and the more we shoot on ourselves the more we rebel against the shoulds and that can keep addictions flying high. So it's becoming aware of that and saying, no I have choices. I don't have to do anything and I'll do what's important to me. Journal writing can help with self-attunement by writing out feelings and thoughts, dreams, observations or simply free associating on paper. This is different different from keeping a reporting diary of events that doesn't help you get in touch with Molo's feelings thoughts. Journal writing can be a way to gain insight into the elusive shadow. Exercise releases tension, helps reduce anxiety, improves mood and improves sleep quality. It also regulates appetite for people who may eat compulsively. Regular cardiovascular workouts create a natural high from end orphan production in the brain and these become healthy addictions unless you overdo it. It's always keeping things in balance. Regular balanced healthy meals, nurturing yourself nutritionally can improve your mood and energy. There's also a way of showing yourself that you care about yourself and we need that. We often rely too much on do other people care about us but if we don't care about us the caring of others may not we may not receive it too. Sleep routine, restorative sleep improves your mood and outlook. Have a regular nighttime sleep routine to unwind and prepare for surrendering and letting go of worries and responsibilities from the day or about tomorrow or worrying about the past present and future. Connections, if we think of ourselves as trees our attachments are the roots that keep us standing upright. Remember the people who love you and hold them close to your heart. Keep them in mind and reach out as you are able. If you are feeling socially isolated consider joining a group online or in person but do not isolate. Be curious and compassionate with yourself and others if you are hurting make it okay to say I'm hurting but then see what needs to change in order to stop hurting. If someone else is something that you feel hurt by be curious about why they might have done that was it intentional? Are they having a difficult moment? Know that everyone is struggling with something. Moderate your use of substances or commit to abstinence if you are unable to control the quantities you consume. Alcohol is not the only addiction but it's the most common one and alcohol is a depressant. It also worsens anxiety because it becomes like a fall skin when you stop drinking you become more anxious you're more sensitized to danger and any addiction is depressing. So get support if you were suffering from an addiction or addictive behaviors and I have a list of resources at the end for you. Change starts with awareness then choosing to do things consciously differently until the new practices become habits. Every day brings opportunities for growth instead of begrudging what is look for the opportunity in the circumstance. I used to begrudge headaches so painful why can't it stop and then I realized that when it stops I feel so good that I wouldn't know to feel that good if I hadn't been hurting. Now do that with winter which always brought me seasonal affective disorder and now I just distract myself and get through it and then I'm so grateful when the sun returns in the spring. If things were always good we would become desensitized and unappreciative of what we have so maybe think of the bad times as opportunities to enjoy more of the good times. If we are lucky life is more or less predictable but when change and uncertainty overwhelm us it is time to stop and reflect what are we feeling what are we thinking what are we doing and what are we needing and how are we going to meet that need. Sometimes it's asking someone for comfort and reassurance sometimes it's being kind comforting and reassuring to ourselves are we needing to clear the air with someone important to us are we needing to get involved in a group to reduce our sense of isolation would it be in person with social distancing and masks or online if we are unable to work in our normal job or career what are the ways are there to make money maybe it's time to go back to school or to study a new field or learn a new skill do we need to get professional help if so where and again I have a list for you that will be emailed to you I will I will end with two adages and an email message that I recently received and the first adage is the truth will set you free and the second is to thine own self be true listen to your feelings and symptoms what truth are they revealing and what is the opportunity in your circumstance and now this email is an example of how to reframe things into gratitude I am thankful for the wife who says that's hot dogs tonight honey because she's home with me and not out somewhere else for the husband I'm thankful for the husband who's on the sofa being a couch potato because he's home with me and not out at the bars I am thankful for the teenager who is complaining about doing dishes because it means she's at home and not on the streets I am thankful for the taxes I pay because it means I am employed I am thankful for the mess to clean after party because it means I have been surrounded by friends I am thankful for the clothes that fit a little too snug because it means I have enough to eat I am thankful for my shadow that watches me work because it means I am out in the sunshine I'm thankful for a lawn that needs mowing windows that need cleaning and gutters that need fixing because it means I have a home I am thankful for all the complaining I hear about the government because it means we have freedom of speech I am thankful for the parking spot I find at the end of the far far end of the parking lot because it means I am capable of walking and I have been blessed with transportation I am thankful for my huge eating bill because it means I am warm I am thankful for the lady behind me in church who sings off-key because it means I can hear I am thankful for the pile of laundry and ironing because it means I have clothes to wear I am thankful for weariness and aching muscles at the end of the day because it means I've been capable of working hard I'm thankful for the alarm that goes off in the early morning hours because it means I am alive and finally I'm thankful for too much email because it means I have friends who are thinking of me thank you for taking the time to listen to my talk and now I will answer questions great okay thanks thank you so much Marilyn that was great I I love that last email did someone send that to you yeah friend sent it it's come probably everyone will get it and do time yeah you know it's good because um I think of all of the sort of aspects of this last six months it if you do think about it you realize it does make you very appreciative of so many things we took for granted so that was great um I just I had a question just to kind of start you you mentioned as one of the tools for coping as um meditation and I'm just wondering do you have any suggestions for um tapes like um audiobook kind of um guides to meditation or I know there's um John is it John Kabat Zinn is that his name yeah yeah would you recommend him um I would recommend him I I use Headspace which is an app oh okay and I'm going to put that in the chat so Headspace yeah it's all one word all one word it's a the um the logo is a round orange circle okay and started by Andy Petticombe who I believe spent 27 years on an ashram in India um cutting meditation and um then went back to England and started this um it's very good it's excellent I like it um but there are many others there's calm and John Kabat Zinn is very good and I'm going to cover others online yeah I think I think that's the only one I've used is John Kabat Zinn I just read his book you know he wrote but sometimes I think at some point you want to get beyond that and right now it's kind of hard to find a meditation class so it's going to have to be something online or or a tape that you listen to yeah Tara Brock is a psychologist who also does a lot of meditation Ted talks and I'm pretty sure you could get an online okay great YouTube video of meditation with Tara Brock okay good all right I put those all in the chat so people can see that so um if anyone does have a question they can put it in the Q&A um the um tools that I mentioned that uh Marilyn went over I will be emailing to everybody so you'll be able to have a copy of that and you can look that over um yeah so I don't think that we have any questions okay yeah yeah um so thank you so much that was um that was great I really appreciate it I think um it just adds to our our um as you say the toolkit all the things that we need to be thinking about and it's just it's good to have a a check you know things yeah yeah especially right now with smoky skies it's been seems like we have added things to to be concerned about so that was good tips okay thanks very much Marilyn okay thank you then all right bye bye