 Welcome to coronavirus and our mental health. Today is April 13th, 2022. I'm coming to you. My name is Ken Burtness and I'm coming to you from Haleva on the North Shore. The coronavirus continues to recede and surge, recede and surge. Just today, the CDC came out with an announcement that they are going to extend their mask requirements on all airlines and public transportation for two weeks. Now, they were originally scheduled to start loosening up these requirements and restrictions on April 18th. It is now pushed back until May 2nd until then the mask requirements are in effect. The reason they're doing this is because of a recent uptake in coronavirus positives. That uptake was caused by a very contagious subvariant of omicron. That subvariant is called beta alpha 2. The CDC says it definitely needs more time to study this subvariant and to figure out how to deal with it. Those restrictions are going to be in place for a little more time. To talk about that and a lot of other things, I am very fortunate to have my good friend and colleague Melinda Timmons with us. Melinda is a licensed marriage and family therapist. She helped people for a long time here in Hawaii and currently she is living in the Washington, D.C. area helping the people there. Now in Washington, D.C., it's no longer afternoon, it's nighttime. So good evening and welcome to the show, Melinda. Thank you, Ken. Thank you for having me. Now, I know you, well, let's put it right out there. You're licensed in both Hawaii and Virginia. So you can help people at both ends of the country. And my guess is the populations in both these places is quite a bit different from one another. So I sort of wanted to start the show with asking you major differences you see in people's reaction to all the stress that we've been under the last couple of years with the lockdown, the stress that's now continuing with the war in Ukraine, and other problems that we're having. Do you deal with your clients differently in the D.C. area than you do in Hawaii? Well, first of all, yeah, I'm licensed in both states. I do have the one in Hawaii kind of paused, not expired but paused. So I'm just seeing clients here in the D.C. area. I would say the most standout difference between the two populations is that Hawaii is a collective culture. Asian and Pacific Islanders, the broad Hawaiian concept of Ohana, means that we're looking out for the group, its group identity. And it was very notable to me when I came here that this is very individualistic. So going into not only the pandemic but a really challenging political atmosphere over the last few years, I think people had a harder time in some ways here managing certain pieces of that. Whereas what I'm hearing from my family and Hawaii family and friends, my Ohana, is that while things have been brutal for them, and particularly with Hawaiian populations and Pacific Islanders and just what they faced in terms of the generational piece of, okay, yet another outside disease is coming to harm us. The loss of tourism, ironically, which also harms so many small businesses. I mean, this has been pretty brutal for Hawaii people as well, but they have one another. Not to say that people don't rely on each other here as well, but it's not the same, let me tell you. It is not the same. People feel quite isolated, I would say. I can imagine that. And I love the way you talk about it in reference to the Ohana. I think that's quite telling. The other thing about Washington DC, I mean, here in Hawaii we have sort of a reputation of being laid back whereas I always imagine, and I visited it many times, Washington DC, but I've always imagined it as a pressure cooker. It's much more stressful and quick moving than we are in Hawaii. Do you find that, and is that causing some problems for your clients? Well, personally, I live most of my life in Hawaii, came here to DC about five years ago, and I do have experiences living and being in other cities in the world and in the US. But personally, I tell people it's like coming from what I believe, what feels like to me as the softest cultural edge in our country to the sharpest. And I include New York City, Los Angeles, Seattle, all places that I've lived or been previously, quite sharp. This is a community that is very intense. It's quite power driven. Undercurrents of political stuff is all the time happening. It's been really intense in the last couple of years, especially, but maybe for most of my time here during the last administration. So four out of five years, quite intense, realizing too that the DMV as we colloquial call it here, colloquially call it here, which is DC, Northern Maryland and Northern Virginia. That's one city, really, we look at it as one city. And I see people from all three areas because insurance companies look at it as one city too. But this, it's a blue area in terms of political voting. And then we have, well, basically a somewhat authoritarian regime in place. And most of my population, the most of them are State Department, Foreign Service, government employees, government contractors. So they're all deeply impacted by what is happening. Yeah. Well, having worked for the government, I can certainly understand the pressures that your clientele is from. And I'm also guessing it places a lot of pressure on you too as well. Maybe I think the question I'd like to follow that up with is, given the sharpness and the pressures that the people in your clientele are facing, what are some of the things that you find work best for you when you're helping them and treating them? What's the thing that sort of gets through to them and helps them the most? I'm not going to say that it's in particular different from working with Hawaii populations in terms of what might get through to them. It's still going to be the art of listening and being present and assessing what their needs are. Here, I think me having a bit of an understanding for their context are, are they Foreign Service? Are they State Department? Are they involved in that world has really helped? I make a point of maybe not reading every paper back to back because then I struggle for me these last two years especially, but at least knowing something of what their politically government-linked context is and trying to understand that helps me quite a bit, understand them. I can understand that. And being a good listener is hard. It's stressful on you when your clients are in so much intense problems that they're trying to face. Now, I know a lot of my colleagues here that are still on the island are having big case loads and are feeling the stress themselves. What I'd like to segue in is a lot of the people in the work for the federal government and government in general are in the helping side. They may be connected up with a medical help, they may be connected up with transportation help, all sorts of things that are considered essential. So during the pandemic, while many of us got a chance to sort of take off a little bit, they've had to work through all the whole time. And I know that's been very stressful to them. How do you treat people like that that haven't got a break during the coronavirus who are constantly sort of being pushed to continue their job and continue serving people? I would actually say in my population that I've seen here, I have had a nurse, a physician, and teachers that I've seen to some extent. I would say that yes, the medical community is affected, but they are accustomed to wearing masks. They are like literally trained for this. And I've actually seen that the stresses that they bring to the therapy appointment is more about relationship than it is about COVID. I will say that my teachers are deeply impacted. They were deeply impacted during the shutdown, of course, 18 months of of standing and trying to, I say standing because most of us that do telehealth and teach online are backs hurt. So we're up and down and getting standing desk and all kinds of things, but they're trying to differentiate education for learners who are rolling over and shutting off their video in some cases and just maybe listening via audio, maybe little children who are sitting in front of a monitor for six hours a day. My teachers have been really, really impacted. That's a great follow up into to your area, which I really wanted to focus on marriage and family. Of course, that's the essence, relationships are the essence of that. Plus, so many things that are happening with the children in school. Let's take the focus on the parents first, the difficulties that you've seen parents deal with in this situation and a family situation with not only their children, but working and childcare and all that other, all the other tensions that go with that. Sure. I have several families that are have fairly important positions here, work wise, they're working from home, if you can imagine. So operationally trying to do things that really impact all of us, but also to homeschool three kids from their kitchen at the same time as, yes, as doing all of this. And maybe there's a husband somewhere sitting downstairs doing his government job. This is crazy. This is really hard. I've talked to people who were hiding in their closets to talk to me. Basements, cars, frequently cars still happening with the cars because a lot of people are not back to work yet here. Most people are still working at home, I would say. Some people are going back to a hybrid schedule, maybe a day or two in the office, but still working at home. Now the kids are back in school and that's a whole other story, but they are largely back in school. Parents are really stressed if they're, I do couples as well. And if couples are going into a pandemic stress and then they're isolated in the winter, that's another dynamic we have here is we have winter, then they're going to be struggling even more. Absolutely. Let's talk about that. I look at the coronavirus and couples, as you're talking about, and I see a few that are coming closer together because of that because they're spending more time with each other, but most of them, it's been a very tense and trying change for them. And I call it sort of the coronavirus cage being trapped in with somebody that you're not used to being away from for eight hours a day. Absolutely. And you're throwing together like this. How's that working and how are you helping people with that in DC? Oh my goodness. I mean, is there any help for it? No, I mean, there is help for it. So telehealth, a good piece of that is that I can see folks bring them into a, you know, I use Zoom as well, but bring them into a gallery view no matter where they are. So that's a good piece. So if we have a spouse or partner who is in a car somewhere and one who's somewhere else, at least they can still make their meeting. They can come to couples therapy and I've opened and closed cases completely via telehealth. So that I think that's been a huge support. Actually, some people would prefer to come to the office. I have been seeing people recently last six months or so often on, depending on viral issues live, but mostly they prefer telehealth. And I would say those parents that have children is quite supportive to them to not have to drive. So I think just that piece alone, that they can do that is supportive. And how do I work with that the strains of it? I try to emphasize that, you know, they all they have struggles that might be quite normal. Say adolescents, you have kids that are teenagers and acting out and maybe they're middle age people and they have parents who are struggling or careers that are at peak. And that means they're working very long hours. And then we have a pandemic underlying that a global a global pandemic. And I have clients that have really escalated anxiety. Maybe it's gone into sort of OCD type behaviors. And this has happened for me in the couple's context as well. And it just it becomes a little bit complex. So I do a lot of referring out a typical couples intake these days often involves me with getting support for individual partners for maybe highly high escalation of anxiety OCD behaviors, also doing couples treatment plans, maybe also getting referrals for their kids, maybe eventually doing referrals for medication. I've never done as many before. That's that's for sure a difference. I know that we've talked, you and I have talked about depression and anxiety that what's what's the best way of dealing with somebody who's very anxious about what they're doing about their jobs about the future about the virus about this what's worked the best for you as far as reducing people's anxieties. What has worked the best for me is trial and error. And it's different according to who you're talking to. Absolutely. If we're talking about couples, I think consistency is good. Me being willing to see individual individual couple individual individual couple and doing it along that pattern so that I can get to know each of their individual struggles as well as the struggles of the couple. So being flexible has helped being willing to strategize with them on parenting issues, which is a huge part of COVID as well, because they're home with their kids. Yeah. Right. Not now as much, but for 18, 19 months they were home with their kids. So I've been doing a lot more like in in my treatment plans, I have a lot more parenting strategies than might normally appear in a couple's treatment plan, for example. Yeah. The you've hit on something that's really a important to me and that's individual focus. You know, for many years, I've taught counseling to graduate students. And one of the things I really emphasize to my graduate students is that there is no one single answer to any problem. There is a multitude of answers and you need to know your clients. You need to listen to your clients to figure out what that individual client, that individual family, that individual couple need and give it to them. So, but everybody looks for that magic cookie, whether it's a medication that you just take and whoa, everything is fine. You know, no problem are a particular therapy. You know, you send them off to meditation or you do something where they do yoga or whatever. And that's great for the individual people who respond to that, but that's not everybody. It's not the answer for everybody. And so I really appreciate that that you're, you know, that you look at that way and treat them as an individual, but it makes the job tremendously more difficult for you. It does. And I, you know, because of where I am and because of my past experience, which has seen a lot of Asian and Pacific Islanders, multicultural couples and families, I've attracted a lot of state departments, specifically foreign service folks who are living up there. Yeah, they have Virginia addresses, but they live abroad or they've just come back or one of those dynamics and they, they struggle quite a bit. They struggle quite a bit and in very different ways than one might imagine. I, they're in a hurry to get better. When, when will this happen? I've heard on the fourth session, I'm not feeling any better on the fourth session, on the fourth session, which is to me, it's just like getting to know you, Tyne, especially with a couple, right? Yeah. Yeah. Getting any better on the fourth session. I mean, even with solution focused therapy, I mean, give a six at least, right? So, so yeah, pressure happens across the board here. And I think we also can't lose fact, lose sight of the fact that we also have Black Lives Matter occurring here. We, in 2020, we had January 6 occurring here, right here, two miles from where I'm sitting ish right now. And it didn't impact me physically in terms of fear or anything, but I have clients who were there for both events in terms of professional capacities for both Black Lives Matter and also at the Capitol. And those folks are forever changed. They have post-traumatic stress. They've changed jobs across the board, by the way, for all of those people. They've changed jobs. They've, some of them have left the state. And I think, I think that they're very fortunate to have you there with your experience with multiple cultures and understanding some of those cultural things that are at play here. Yeah. You know, I'd really like to talk about that a lot, because we're running a little short. So I'd like to jump to the kids, because I know that you've got some, you know, some ideas about the kids. And I know from my grandsons, they've been going through a lot of difficulties. Being away from school or being in remote learning that lacking the socializing that they were used to and expecting. So could you talk to us about that, about working with the kids, especially at school, and with their teachers as well? Because like you said earlier, teachers are under a lot of stress. Absolutely. Well, I'll just start with the teachers. I have to say that the teachers that I've seen, they were exhausted and overwhelmed, doing it from home, understandably, I already mentioned that, but going back to having kids come back after 18 months of rolling over and turning on their computers in their jammies and then turning off the video. So we have a group of children coming back to school. Some of them maybe I'm going to speak specifically about high school. Maybe they left off a middle school and they're coming in to high school as a sophomore. They're going from eighth grade to say sophomore, right? That's their first high school experience is super overwhelming for teachers because these kids don't know the rules. They don't know boundaries. Administrations are not willing to enforce said boundaries because they're worried about the kids. So it feels really chaotic. Now from the kids perspective, they are super anxious too. I see a group of teenagers. I seem to attract teenage girls. So I have a number of teenage girls and they were super anxious about going back. I had been seeing them all via telehealth for a while. Some of them did okay going back. Some of them haven't. I have a kid that has refused to take off her mask for fear of COVID. This one is about COVID. Very, very anxious about that even to eat or drink. So pretty severe anxiety. I have another kid who refuses to take off her mask for fear of mask fishing. Have you heard of that? No. Mask fishing is a play on words from cat fishing where people might mask who they really are, what they look like in order to say lure someone in an online dating scenario, for example. So mask fishing meaning, okay, I've had this mask on for two years and people see me from the eyes and they see my eyes and my hair. That's what they see. So if I take it off, they might see I have acne. They might see I have bracelets. They might see that I'm not what they expect. They're going to think I'm a mask fisher. In other words, a fake. Not being real. And so I have that going on and a lot of kids are feeling like that and a lot of kids because they're super group identity no matter where they live, right? They want to be like everyone else. So what I'm hearing is despite that mask mandates have been dropped, nearly all the kids are wearing them to some degree because of that, this feeling of needing to kind of hide and not be fake and not show people who you are. I think we're going into self-image and self-concept here that has really suffered for a lot of people during the coronavirus adults as well as children, but especially I think you're right with children with these kids and especially with the teenage girls you're seeing. How do you help them with that? How do you bolster their self-confidence or their self-image? Actually, I've used actually, I also have really bright kids that I see. Fortunately, they're so intelligent and I've actually talked to them about the concept of gosh, I can't think of adolescent concept where you think everyone is looking at you. I forget what it is, but imaginary audience. So having an imaginary audience, this notion that all teenagers, nearly all of them feel everyone is looking at them but no one is because they're all so self-concerned. So I think that's helped them. I think looking at things incrementally, okay, maybe we can take our mask off for our neighbors. So I've had them practice doing some of that, come to my office and we take our mask, you know, physically come to my office and we take our mask off, not me, but they purtee because I give everyone tea when they come in, herbal tea. So then I have my girl, my female clients, you know, they have to remove their mask to have the tea, right? A little bit of practice in front of someone gradually, one-on-one, people that they feel safer with and then just kind of deconstructing the whole piece that maybe not everyone was looking at them, right? Sounds great. Yeah. You know, that's the other thing about, you know, I'm constantly looking for not only the problems that we face from the coronavirus, but also some possible positive takeaways from coronavirus. And the one thing that I've sort of liked about this whole thing is what you talked about earlier, where they don't come to the office, but they talk to you from various places, places that are theirs, their backyard, their car, you know, it's their turf. I always had a problem when I was practicing that people were required to come to my turf, which is not as comforting or as relaxing as their own place. So I always like to go to their place or meet them in a place that they felt comfortable with. And I got a different picture of them. And I was wondering if you had seen that as well? Absolutely. I've met more pets and kitties and spouses of individual adult clients. I've seen messes, which is great because it gives me an impression of what their environment is like. Absolutely. I think that's been great. And I think another positive silver lining is that I've seen a lot of adults, especially during shutdown phase, playing with their kids outside, which I didn't see so much up here before. So during the shutdown, you know, you'd see parents out there having a glass of wine and sitting on the sidewalk with some chalk. And you don't see that anymore, but I did for a few months. And that was lovely. That's great. I'm getting the signal that we're really getting down to the end. I wanted to ask you one final question before we say goodbye. And I hope that I can talk you into coming back again, because there's so many things that I'd like to talk about with you. But this one last question is, what do you think is the most promising thing as far as helping people on the horizon? What intrigues you the most about maybe a new way to approach this now that we're, you know, in our third year of the coronavirus and having to deal with it for all this time? What looks the most promising on the horizon for you? I mean, in terms of mental health. Yeah. I think accepting our feelings. So not trying to suppress or to push away, but to acknowledge that this is really hard. And sometimes it's really sad. And yes, it can make us really angry. And that feeling belongs, it actually belongs. And it's not to say that we need to live there. But to go ahead and acknowledge that, I think it's really quite helpful. Otherwise, you can't process it. Yeah, absolutely. If you can't acknowledge the problem, if you can't acknowledge the feeling, the thought, you can't deal with it. I'm totally with you on that, Melinda. That sounds, and that's a great way to end. And like I said, I've just really enjoyed having you with me on today's coronavirus and mental health. And I hope that I can talk you into coming back in the future. And I also wanted to thank Jay Fidel and Hallie and Michael and all the people here, I think, Tech Hawaii that have been so much of a help with this this program. So have a great night. The rest of it for you, Melinda. And thank you. Hope to talk to you soon. 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.