Practical Activities for Crisis Support
This month, we’re exploring caring for a loved one or friend during a crisis with practical activities outlined below that will support you in any situation.
As I was thinking about this post, it seemed to break down into three natural phases for me. The first phase is when, as humans, we need to have our ‘basic needs’ met before we fully function on other levels. This is reflected in Maslow's ‘Hierarchy of Needs’. The first level relates to our physiological needs, such as food, drink, shelter, warmth, clothing and sleep. The second level covers our safety needs, such as the need for security and safety and for things to be in order.
Particularly in relation to Maslow’s second need, as humans, we need to experience things that are predictable and controlled in our lives, such as going to school or work, knowing that healthcare provision is available. When these things were suddenly gone at the start of the COVID pandemic, that created a lot of fear for people. However, as unpaid carers, not only did this dismantling of our societies as we knew them create fear for us, it also created fear for the wellbeing and safety for those we cared for.
I will share a personal example of how this unprecedented situation completely changed how I would normally react to challenging situations. So, firstly I am not an overly emotional person and I have spent most of my career dealing with difficult and highly stressful situations, so would consider myself as someone who doesn’t easily become upset or distressed in challenging situations. However, at the beginning of the COVID crisis, before lockdown, like a lot of people, I couldn't get toilet roll for a couple of days. This one particular day, I visited five different supermarkets, one after the other and eventually I managed to get a pack of four toilet rolls. At the time, our local pharmacy was having problems getting my loved one’s medication, but after going to all these different shops, on the off chance they’d had stock come in, I decided to try the pharmacist again on the way home. Fortunately, they had my loved one’s medication, which was such a relief. I returned to my car…then just burst into tears. It really took me by surprise, crying or expressing such overt emotions is not something I ‘do’. However, in hindsight, I think it was just such an intense couple of days, that the relief of getting the basic essentials I needed to keep us both safe, was just a complete emotional overload. Without noticing, the anger, frustration, relief and guilt, which are often present as a carer anyway, built up so quickly and to such a level, that when I managed to find the essential items we needed, the relief was overwhelming.
However, what I did next surprised me even more. When I arrived back home, without even thinking about what I was doing, I shared this event on social media, and was overwhelmed, for the second time in a day, by the response and support from people, some whom I have known for many years, but others I'd only met more recently. Some people who commented on the LinkedIn post I am not even connected with, but they really understood that sense of overwhelm and were really supportive, which was very touching and I'm very grateful for their kindness and support.
The kindness of others continued, with friends checking in with us, making sure that we were okay. But soon after the initial sense of overwhelm subsided, I reverted back to how I would ‘normally’ deal with highly charged situations and I didn't feel comfortable with peoples’ attention and kindness. I am not somebody who accepts help very easily; I am very independent; trying to do everything myself and to be perfect, so the thoughts racing around my head were; Do I deserve this? Can we accept it? That was an interesting time for me and something I’ve thought about quite a lot since. But what about those feelings from the initial phase?
Are they still there?
For me, during COVID, there wasn’t really much of a shift from the life I had prior to lockdown. Due to my loved one’s care needs, I really wasn't able to go out that much, so the tight restrictions had a limited emotional and psychological impact on me. However, it did make me think about my priorities and although very few personal things changed, I did reflect and alter the plans I had previously made for my business and the social enterprise I wanted to start.
We are living in a changed world, because COVID or at least the risk of it, isn’t going to go away anytime soon. However, history can provide some hope for the future, albeit, in the longer term. Globally, although not the same as COVID, humanity has survived many other highly dangerous diseases over the centuries, such as, Cholera, TB, Polio, etc., Although these diseases haven't been completely eradicated, the risk they pose is managed by vaccines and continuing research and development. Moving forward, the world is going to be one where COVID may always exist, but hopefully, science will allow us to return to some level of ‘normality’.
As an individual and a carer, how are you negotiating a way forward for yourself?
Have you thought about what has changed for you?
Or indeed, has anything changed?
Do you have goals or dreams?
Do you now want a different future now?
Or are you now more resolved than ever to grow in the life you have?
In terms of looking to the future as a carers, the 2021 census showed that 43,000 people are juggling caring while learning a new skill or refreshing an old one, is that perhaps something that you're considering doing now? The Carers Week 2023 Report found that 20% of the general public said they're providing unpaid care, that's 1 in 5 adults and equates to approximately 10.6 million people in the UK alone.
How can you reduce or mitigate the effects that additional emotional and psychological stress has on your physical and mental wellbeing?
To try and support you, I have out outlined five practical actions and activities which work best when facing new or overwhelming events. The topics are:
1. Introduction to recognising and managing emotions, particularly relating to what you can and can't control, which will help you to develop psychological flexibility;
2. Discussing the healthy consumption of facts and managing emotional responses to fake and alarmist news;
3. Understanding the differences between self-care and self-compassion and why they are both important;
4. Quickly being able to be present, to better respond to overwhelming or emerging situations;
5. How regularly practising gratitude can help to balance negative environmental bias.
So, let’s get started.
Developing psychological flexibility
When starting to think and understand how you manage situations that you can control and those you can't, having a good source of information such as Stephen Covey's “The 7 Habits of effective people: Powerful lessons in personal change” is a good place to start. He talks about the things that make us uniquely human, self-awareness, imagination, a conscience or values and independent will. One of the interesting things he speaks about is how we react to events or situations. We can either respond to things ‘reactively’ and this is often affected by social and external environments; building emotional lives around other people; allowing other people to control us; blaming others when things go wrong; feeling like being a victim and having no control over things, like over the weather. Covey states that the other side of reactive thinking, is when we think ‘proactively’, when the choices that we make are driven by values; our actions are thought-out, and we take responsibility for those actions. We have differing amounts of control over any given situation, but we have total control over how we respond to it. Thinking differently and changing how you view situations and your responses, can really change the outcomes that you achieve.
One of the most important parts of this is proactive process is ‘personal responsibility’. You might say, “well it wasn’t my fault, it was somebody else's action, they did it, not me” for example, you parked your car, someone crashed into it, didn't leave a note and there's quite a lot of damage. This actually happened to me at a family member's wake, so you can probably imagine how distressing that was and, yes, my initial reaction was anger, blaming who had ever done it. Then I took a deep breath, put the situation into context, where I was and what was happening right now and realised that carrying around that anger wasn't going to change anything and would just upset my family, on an already sad day.
A useful exercise to help demonstrate the difference between the two styles of responses, is to think about something that's happened to you in the past, perhaps something you owned was damaged or something had gone wrong and you didn’t have had any control over any part of it? Then recall and recognise the choices that you made in how you responded to that situation: was it negatively, reactively, blaming other people, not taking responsibility for how you dealt with it? Or did you respond proactively, acknowledging your emotions and feelings in that moment and then thinking about how you dealt with it. The power is in recognising the emotions and feelings for what they are; letting them sit there; not assigning any meaning to them; letting them drift away and then taking positive action to move forward. By acknowledging those emotions and thoughts and identifying and labelling them as they are, takes away some of the impacts that they can have. They are NOT who you are, they do not define you, they are simply a psychological response to an event. When you have thought about a couple of situations and how you responded to them, either reactively or proactively, think about the different ways you can respond to future incidents, with positive steps and releasing the baggage of the negative emotions, thoughts and feeling. Practice responding proactively the next time a negative event happens, then keep practicing until it becomes a learned response and gradually you will build your psychological flexibility.
No news is good news
The healthy consumption of facts and managing emotional responses to fake and alarmist news is vital in this age of information. When the Spanish flu struck 1918, information and particularly misinformation, wasn't as quickly and easily conveyed as it is now. In the 21st century we consume information through a variety of mediums, not just news channels and social media. The quantity of the information that we consume can be overwhelming, as can the negative emotional and psychological effects, as well as the quality of the information, potentially having devastating effects.
A recent academic research study concluded that the initial underplaying of the seriousness of the pandemic on a widely viewed US cable news channel, might have influenced people's reactions to the pandemic early on and it could potentially have led to an increase in the number of cases. It is worth remembering that all research is just that, research, and has to be taken into context. However, it is a powerful reminder about the influence of what we read, and watch can have on our actions, including our emotional and psychological responses and the consequences of the actions we take, or do not take. Another study reflected that it takes just 14 minutes of consuming negatively biased news to increase anxiety and sadness and can also increase the tendency to catastrophise if a person is already worrying or concerned about something.
So, what can you do?
Perhaps not to watch the news or visit Dr Google! However, that is just not practical, as it is important to stay informed about what is going on in the world. One practical step is to choose a reliable source and control the amount of information that you consume. Generally speaking, social media is not a reliable source of information, as tantalizing and interesting is it might seem sometimes. It may seem real, however, before you take something that you see or you read as being the truth, fact check it with an alternative, reliable source of information first. It is also recommended not to consume news after 5 or 6 o'clock in the evening. Watching the news later in the evening means that it will potentially stay on your mind, particularly, if you're very tired or if it's a distressing story and you might dwell on it as you're going to sleep.
Also, if you're alone most of the time or you don't have anyone to discuss the things that you see or hear with, reach out to friends, a trusted source, family member or support group and talk through the concerns and worries that you have. If, however, you feel highly distressed about something that you have seen or heard, there are a wide variety of mental health support organisations available online or through mobile apps. Alternatively consider reaching out to a professional such as your doctor. Links for mental health support in the UK are below.
Self-compassion vs self-care
Understanding the difference between self-care and self-compassion and being able to utilise them both when you need them is essential.
So, what is self-care? It is an activity that we do deliberately in order to take care of our mental emotion and physical health’.
Activities such as eating a balanced, healthy diet; getting enough sleep; getting enough exercise; maintaining physical and psychological health; making space for relaxing; sharing time with friends and family and being kind to yourself and, of course, others. Start by exploring what works best for you and then try and build a routine and stick to it as much as you can. If you try something because somebody says“… you really should be doing this” but it just doesn't work for you or feel right, don't do it. But don’t just give up. Think about an activity you have enjoyed in the past or would like to learn; something that you know will fit in with your life as a carer and what is affordable. Check out your local Carers Trust for activity groups to join online and in person.
What is self-compassion then? This is often confused with self-care, however, self-compassion is quite different and is “showing the same warmth, care and compassion to yourself as you would to someone else” (Kristin Neff), such as to those who you love and care for. Self-compassion helps us to get through a situation, which is important, because there may be no way of getting around it! Self-compassion is a way to relate to our own struggles in a way that helps us. These can be very small actions that we think about to make small changes.
It is important not to judge yourself
Don’t to fall into the drama of something and catastrophise it and
Have awareness of yourself in the moment. Acknowledging that something is hard and perhaps at times, overwhelming, will help you to draw strength during a very difficult event.
There are three main elements to self-compassion and all three need to be present for it to be a useful and stable mindset.
Start to develop a self-compassion routine, you need to be aware that you are struggling, but in a balanced way, not getting wrapped up in the emotions.
Cultivate a sense of common humanity. Events such as the pandemic happen and will continue to happen in different ways, throughout your lifetime. The power comes from accepting that life can be cruel and unfair sometimes and empowering each other to work through the difficult times.
Kindness, which is a motivation. Scholars define compassion as ‘the kindnesses and motivation to alleviate suffering’. Self-compassion is a desire to alleviate your own suffering, paradoxically to be able to do that you have to acknowledge that you are actually suffering and be motivated to want to help yourself; accepting that the event is happening and how you can look to the future to heal and to grow.
A great question to ask yourself is: What can I do differently to make this situation better for me, so I can also help others? Kristin Neff is the lead researcher into self-compassion and in her mindful self-compassion programme, she has developed three short exercises to help you to develop a self-compassion mindset. Kristin’s verbal and written exercises versions are in the Resources section below.
However, it is useful to explore one of them now. This exercise is called ‘How would you treat a friend exercise’. It is a simple exercise to follow and it is a great starting point for identifying how you would treat others versus how you would treat yourself in a challenging situation. You will need a pen and paper, or you can record on your phone or device, just have an open and honest mind.
Firstly, think back to a time when a friend or a loved one has been struggling in some way, then ask yourself:
How would you respond to that?
What would you say to them?
How would you say it?
What questions would you ask them?”
Then write (record) the best version of what you would do in that situation to support your friend. Now think about a time when you have struggled with a similar situation or think of yourself in that situation; write down (record) what your immediate thoughts and feelings are about yourself in that situation.
How do you talk to yourself?
What words, language and tone do you use to describe yourself in that situation?
Lastly, compare the two parts of the exercise and consider any differences between how you would react if it was a friend and how you would react if it was you.
Do you notice any differences? if so, what are they?
What fears are being played out in how you treat yourself compared to how you would treat your friend?
Why do you think that is?
On a fresh piece of paper (recording), write down how YOU would like to be treated.
What words, gestures and behaviours do you feel are more accepting and supportive of your self when you were feeling difficulties?
Use the information you have gathered from the above exercise to think about how you can treat yourself more like you would treat a friend in a difficult situation and the next time something challenging arises, put into practice what you have learned.
Be present in your life
Better respond to overwhelm in a difficult, emerging situation. Jon Kabat-Zinn is the lead in developing the mindfulness-based stress reduction programme and his definition of mindfulness is “paying attention in a particular way, on purpose, in the present moment and non-judgmentally”. Although I am not discussing mindfulness-based stress reduction, the last part of that definition is really important in exploring how mindfulness can help in difficult situations and how it can help you to move forward. But why is that important? Personally, there have been months, even years when I haven’t been present in my own life and there are big chunks of it that I can't even remember and I don’t think I am alone in experiencing this!
As powerful as being mindful or present in your life is, you can't be present all the time, your brain would fill up with way too much information and cease to function efficiently. So, it is helpful to understand the difference between modes of thinking. Professor Daniel Kahnemann, developed what he calls, ‘System 1 and System 2’ thinking (an hour long video but well worth it).
The best way to describe System 1 is like when you are driving your car; you drive to work, to school or the shops every single day…you know the route, you know the problem area and you do it seamlessly, arriving at your destination without any recollection of the journey itself; that is not being mindful or present.
However, System 2 is when you are taking the same journey, day in, day out, and then one day someone suddenly pulled out in front of you, NOW you are suddenly aware that they are there, you have butterflies in your stomach, your heart is pounding and you are shouting at the driver as loudly as you can! That is System 2, because now you are very present in THAT moment; you are aware of everything around you, noises, smells etc. and this is what I am referring to when I talk about being present in your life.
So, how does that help?
Being deliberately conscious or present, being aware of your environment and what is going on is very important when you need to make critical decisions very quickly. By having the ability to be present in your life ‘on demand’, means you can take those decisions in a considered way and make better-informed choices. Combining that with a mindful breath, which I will cover in the next section, provides even more benefits. Deep breathing triggers the Parasympathetic Nervous System (PNS), which is the opposite of the freeze, flight or fight system. Being able to ‘tap’ into the PNS response system, can reduce stress and anxiety and give you that extra time to be focused, to think more clearly and make an informed decision, rather than having a ‘knee-jerk’ reaction.
A quick mindful breathing technique is to use ‘one mindful breath’ when you are facing a distressing or overwhelming situation. I use it regularly and it helps me to take back control when I can feel my mind starting to get fuzzy and I can't think straight. There are various different ways of performing the ‘one-mindful breath’ technique, but the one I particularly like is called ‘7-11 breathing’.
For this technique you are breathing in through your nose for the count of 7, holding that breath for 1 second and then breathing out through your mouth for 11 seconds, really pushing deep when you get to those last few seconds and then just breathing in normally. Breathing out for 11 seconds might seem like quite a long time, but what you are doing is getting rid of all the stale air that sits around in your lungs and doesn't really get changed or used. As you are going to be taking in quite a lot of extra air into your lungs, particularly the first couple of times you practice this technique, it can make you slightly lightheaded. So, do not ever do this while you are driving or carrying out any activity that requires your absolute attention and ability to respond. If an event suddenly occurs, then as soon as you can do so safely, stop, sit in a safe environment and complete the one-mindful breath technique above. If you feel like you need to do another one, that is fine but usually one is enough to ground you, and give you precious time to think about what you need to do next.
Practising Gratitude
Regularly practising gratitude can provide a balance to negative environmental bias, such as negative or fake news. It might seem like a strange thing to add to this list, and you might well be thinking, “what have I got to be grateful for at the moment?” However, there are numerous studies that have found that feelings of gratitude can actually change the state of your brain. It can also be a tool for overcoming depression and anxiety and there are also research studies that found that gratitude can send signals to your heart in a positive way. There are several studies about the benefits of gratitude writing, these often involve letter writing exercises, which you may have come across before.
The gratitude exercise I am going to explore with you today is ‘Three Good Things’ or ‘Three Grateful Things’. In this short video from ‘Action for Happiness’, Martin Seligman, one of the founders of Positive Psychology, explains the exercise well.
Personally, I have carried out this exercise, each night, for several years now, and it often helps me to relax and get to sleep more quickly. However, it is important to remember that you don’t have to be thankful for the things that you are showing gratitude for. They might be events or interactions that, although they might feel negative, they might be things that you can really learn from and will benefit you in the future. By showing gratitude for them, you are assimilating the learning from them and making a positive connection with that learning for the future.
This exercise, or anything similar, doesn’t have to be done at night, this is just the best time for me, you can practice it at any time that feels right for you. The most important thing is to try it for long enough and on a regular basis to really give it a go, so it becomes a habit and is a meaningful part of your day. Even better, if you can practice your gratitude exercise while you are being mindful as well, it can help you to explore what is happening right now or what has happened during your day and can help to put things into perspective.
So, that is the conclusion of the practical activities and exercise to help you when faced with a crisis or overwhelming situation.
Resources
Carer’s Week 2020 Research Report
Stephen Covey – 7 Habits of Highly Effective People (Amazon - non affiliate)
Johnston, W. M., & Davey, G. C. L. (revised 2011). The psychological impact of negative TV news bulletins: The catastrophizing of personal worries. British Journal of Psychology (1997), 88, 85-91
Wood AM, Froh JJ, Geraghty AW. Gratitude and well-being: a review and theoretical integration. Clin Psychol Rev. 2010;30(7):890-905. doi:10.1016/j.cpr.2010.03.005
UK NHS Mental Health Helplines
Downloads
This blog post was written by Lynne, who was a full time carer for four years, including during the pandemic and is now a post carer. Giving up her 25 year career to care for her mother, Lynne retrained as a Coaching Psychologist and used her knowledge and experiences as a carer, to support other carers and post carers navigate the many emotional and psychological experiences carers face each day.
Lynne is now combining her passion for gardening and wildlife to continue her journey to support carers in the future. Wild Ross is a not-for-profit and she will be working with local communities to start or support an existing Social and Therapeutic Horticulture (STH) project(s), focusing on supporting carers to develop their sustainable gardening and wildlife knowledge and skills and be a place to chat and explore nature with likeminded individuals who have a shared experience.
If you would like to know more about Social and Therapeutic Horticulture please visit Thrive, a charity leading STH in England and Wales or Trellis, a charity leading STH in Scotland. If you would like to know more about Wild Ross, STH and regenerative gardening, please contact Lynne enquiries@wildross.org