Help and SupportCOVID-19 is bringing unrivalled challenges for us as individuals, and as part of a wider Irish society. It is important that we all as individuals do what we can to look after ourselves andalso each other as we try to effectively manage this evolving situation.
If we want to check the facts then the best place to get information is from the HSE Websitewww2.hse.ie/coronavirus or www.HPSC.ie where there are regular updates relating toCOVID-19 in Ireland.
We are all facing practical and emotional challenges right now and in an effort to assist withgrounding ourselves in responding as effectively as we can, we have put together a series ofhelp sheets to provide information and steps that might be helpful.
Managing Sleep
Sleep is important forphysical and mental health.While we sleep, we repairphysically and mentally.During times of stress oursleep cycles can becomedisrupted.
Establishing a sleep routineand good sleep hygeine isimportant.
On the following page youwill find some tips to helpwith sleep.
Prepared by Daniel Flynn, Principal Psychology Manager, Cork Kerry Mental Health Services,
Head of Psychology Services Ireland (HPSI) 15.03.2020
Avoid caffeine for at least six hours before going to sleep•
Avoid alcohol, nicotine, and street drugs before going to sleep and throughout the night•
Avoid bright lights, including television, before going to sleep because they are •stimulating
Don’t exercise or eat a heavy meal shortly before going to sleep•
Avoid napping during the day because it will make you less tired at night•
Make your bedroom as comfortable as possible by:•
-> keeping the temperature at a cool and comfortable level
-> keeping your room as dark as possible (use sleep mask if needed)
-> minimizing as much noise as possible (use ear plugs if needed)
Do not use your bed for working, reading, or watching television. This way, your body will•associate your bed with sleep, not with activity.
If you have trouble falling asleep or if you wake up in the middle of the night and can’t fall•back to sleep, get out of bed and do something soothing until you feel tired enough to goback to sleep. Don’t lie in bed thinking about other things; this will just make you feel moreaggravated and make it harder to get back to sleep.
Go to bed at the same time every night and wake up at the same time every morning. Create•a regular pattern of sleeping and waking that your body can predict.
Use some kind of relaxation method before going to sleep in order to calm your body and•mind. For example
-> taking a bath
-> meditating, praying or using relaxation skills
-> writing down your thoughts
If your sleep problems persist, if you can’t stay awake during the day, or if you’re •feeling depressed, contact a medical professional for advice.
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COVID-19: Psychological Wellbeing
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Help and SupportCOVID-19 is bringing unrivalled challenges for us as individuals, and as part of a wider Irish society. It is important that we all as individuals do what we can to look after ourselves andalso each other as we try to effectively manage this evolving situation.
If we want to check the facts then the best place to get information is from the HSE Websitewww.yourmental health.ie or www.HPSC.ie where there are regular updates relating to COVID-19 in Ireland.
We are all facing practical and emotional challenges right now and in an effort to assist withgrounding ourselves in responding as effectively as we can, we have put together a series ofhelp sheets to provide information and steps that might be helpful.
Understanding and Managing my EmotionsEmotions and feelings aren’t good or bad, they just are what they are. The behaviour people engage in, as an expression of their emotions may be helpful or unhelpful. This skill is about helping you know your emotions so that you can deal with them effectively and avoid engaging in problematic behaviour.
Functions of emotions • To communicate to ourselves - What is going on for me right now?
• To communicate with and/or influence others - I am showing others that I am impacted by what is happening and may need support.
• To organise and prepare for action - I may need to do something to change how I think or feel or may need to step away from this situation for a while.
Prepared by Daniel Flynn, Principal Psychology Manager, Cork Kerry Mental Health Services,
Head of Psychology Services Ireland (HPSI) 15.03.2020
What happens when I experience emotions?Emotions are very complex and consist of many parts or different reactions happening at thesame time. Sometimes we find it hard to tune into or sense our body and body changes.Failure to do so can mean we don’t hear our emotions and therefore we often do not respond in a clear or regulated way. To regulate emotions, you have to be pretty good atsensing your body.
External events as well as internal thoughts, emotions and sensations can trigger our emotional response.
Emotions involve
Emotions are expressed through:
Body language – e.g. postural and facial changes eg. Frowning, finger wagging, grit-•ting your teeth, clinching your fists
Words – e.g. “I love you”, “I am angry”,“I am sad” or “I am sorry”•Actions – e.g. kissing, hitting, running toward someone, withdrawing passively, •avoiding, shouting.
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Body changes
Facial muscles•
Body movements and•gestures
Brain changes
Neuro-chemical changessuch as those in the limbic system
Sensing
“Emotional experience”- the noticing and experience of the changesin body and brain
Action urges
The bodies physical urgeto respond to the felt emotion
Steps to letting go of emotional distress
Observe your emotion - acknowledge it, step back •
Try to experience your emotion as a wave, coming•and going
Do not judge it•
Do not cling to it•
Open yourself to the flow of the emotion•
Be aware that you are not your emotion•
Do not act on it•
Do not build a wall around or block your emotion - it•just keeps it around longe
Practice accepting your emotions - be willing to•have them, they have a purpose and are justified
Steps for increasing positive emotions
Attend to relationships Balanced relationships may increase our sense of •happiness
It is important to note here that we should not place all•our happiness on one person or one relationship, stayconnected with family and friend even if using phoneand multimedia at present.
Avoid avoiding Don’t give up! •
No one can build a positive life if one avoids problem solving or avoids doing things that•are necessary
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Mindfulness of positive experiencesBe mindful of positive events that occur. Do the following:•
Focus your attention on positive events that occur, even the small daily stuff•
Refocus on positive parts of events when your mind wanders to the negative•
Knowing when to shift your focusProtect positive experiences. For example, if you find your mind beginning to focus on:
Thinking about when a positive experience will end->
Thinking about whether you deserve it->
Thinking about how much is expected of you now->
Then use the steps for letting go of emotional distress and also the tips from our sheet onDistress Tolerance to help move away from fear or negative thinking and back to a more positive focus.
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Recap: Getting to know and manage my emotions
Determine what is happening in the environment. Figure out what happened in your•surroundings just prior to your current emotional state.
Identify and describe your emotions and feelings in concrete language that is non-•judgemental.
Be grounded in your body. Notice how you experience your emotions and feelings•physically.
Pay attention to your thoughts. Become aware of what thoughts you have when ex-•periencing your emotions and feelings.
How are my emotions and feelings influencing my behaviour? Evaluate if your •behaviour is as effective as it could be. If not, ask yourself what behaviour would bemore effective here?
Think about the potential consequence of thinking, feeling and behaving in a partic-•ular way. If there is a likely negative consequence, are there alternative feelings, thoughtsand behaviours that would reduce or eliminate negative outcomes.
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Follow the 8 daily exercises overleaf, then tick the boxes below when each session is completed. Please complete all 8 exercises twice daily (AM and PM).
WEEK 1 WEEK 2 WEEK 3 WEEK 4 AM PM AM PM AM PM AM PM
MON
TUES
WED
THURS
FRI
SAT
SUN
Simple Exercises from your HSE Physiotherapist for you to do during Covid -19 Cocooning phase
Please complete the following eight exercises twice daily for four weeks. To help you chart your progress, there is a chart on the back page for you to tick each day as the exercises are complete.
• Sit tall in a chair with your back well supported.• Straighten your right leg fully and bring your toes up towards you.• Hold for 5 seconds.• Lower the leg slowly.• Repeat up to 10 times - as you are able.
Knee Strengthening1
(If you have a 1kg weight at home you could strap this onto your ankle and you will get a greater benefit from this exercise)
• Sitting tall.• Hold a tin securely in each hand.• Lift one arm over your head at a time.• Replace onto your lap.• Repeat up to 10 times - as you are able.
Arm Strengthening2
• Put your chair against the wall.• Move your bottom forwards in your chair.• Bring your feet behind your knees.• Lean forwards bringing your head over your knees.• Push off with both hands to stand up.• Step back until you feel the chair against your legs.• Bend in the middle, reaching back for the arm rests and slowly sit back down.• Repeat up to 10 times - as you are able.
Sit to Stand3
(When you get good at this exercise you can try to do it using just one hand or no hands to push yourself up)
A B
C
Let’s begin!
• Stand tall in front of your kitchen sink or the back of a sturdy chair.• Hold on with both hands and look ahead.• Keep your feet hip width apart.• Place your weight onto the back of your foot• Lift your toes and front of your feet off the ground.• Keep your bottom tucked in.• Lower your feet back to the ground slowly.• Repeat up to 10 times - as you are able.
Toe Raises5
• Stand tall in front of your kitchen sink or the back of a sturdy chair.• Hold on with both hands.• Keep the exercising leg straight and the foot facing straight forward.• Lift the leg out to the side slowly.• Return your leg to the starting position slowly.• Repeat up to 10 times - as you are able.
Hip Strengthening6
(If you have a 1kg weight at home you could strap this onto your ankle and you will get a greater benefit from this exercise)
• Stand tall in front of your kitchen sink or the back of a sturdy chair.• Hold on with both hands and look ahead.• Place your feet hip width apart.• Lift up onto your toes slowly.• Lower your heels back onto the ground slowly.• Repeat up to 10 times - as you are able.
Calf Raises4
“ If you feel unwell on any day, don’t push yourself to complete these exercises.”
• Hold onto a sturdy chair or your kitchen sink with two hands and look ahead.• Place right foot directly in front of the left foot.• Hold this position for 10 seconds.• Change feet and hold for 10 seconds.
Balance Heel Toe Standing7
• Hold on to heavy chair or kitchen sink with 2 hands and look straight ahead.• Stand on your right leg.• Hold for 10 seconds.• Repeat on the left leg.
Balance One Leg Stand8
Congratulations! You’ve completed the 8 exercises. Don’t forget to go to the front cover and tick the box!
This brochure is brought to you byHSE PCC Physiotherapy Services Cork
in partnership with
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Help and SupportCOVID-19 is bringing unrivalled challenges for us as individuals, and as part of a wider Irish society. It is important that we all as individuals do what we can to look after ourselves andalso each other as we try to effectively manage this evolving situation.
If we want to check the facts then the best place to get information is from the HSE Websitewww2.hse.ie/coronavirus or www.HPSC.ie where there are regular updates relating toCOVID-19 in Ireland.
We are all facing practical and emotional challenges right now and in an effort to assist withgrounding ourselves in responding as effectively as we can, we have put together a series ofhelp sheets to provide information and steps that might be helpful.
Finding calmThe following tips might be helpful to provide you and your colleagues with steps that mightassist with finding ways to achieve balance and calm in the midst of all that is going on.
A useful way to remember these steps is to use the acronym CALM, with each letter of theword prompting us on what we can do to manage our responses.
Prepared by Daniel Flynn, Principal Psychology Manager, Cork Kerry Mental Health Services,
Head of Psychology Services Ireland (HPSI) 15.03.2020
It is really easy in a modern world of technology consume information from multiple socialmedi sources. Checking our phones and social media frequently increases our threat response and anxiety. It is important to try to limit activities that increase our stress levels. Bemindful of the impact of social media on yours and others mental health.
If we want to check the facts get information from HSE Website for informationwww2.hse.ie/coronavirus or www.HPSC.ie where there are regular updates relating toCOVID-19 in Ireland.
ccept and acknowledge our current emotions
It is understandable that when dealing with something novel and unprecedented that thiswill increase our levels of stress.
It is really important that we notice our emotions and that we validate or accept them whenthey make sense in a given situation.
Our primary emotions ( joy, fear, disgust, sadness and anger) have a function. They commu-nicate to us, they communicate to others and they urge us to take action.
Our emotions have done their job when we listen to them. We check the facts and our levelof emotion goes down.
It makes perfect sense that we would feel some degree of fear or anxiety when we perceivethreat or danger. We can notice and normalise this response, if there is an imminent threat to our wellbeing. However, following guidelines (hand hygiene, coughing and sneezing etiquette, social distancing etc) on keeping ourselves and others safe helps minimise risk.
When people are fearful, they are more likely to spiral into an emotional mind state wheretheir fight/flight response will is activated. When the volume goes up on our emotions wemay become more reactive, more tense and quick to anger. We are all different and uniqueand will have ways that work best for us to regulate or turn down the volume our emotionsand ultimately our anxiety and fear the context of COVID-19 . We call this our Wise mind,where our emotion is balanced by logic and reason.
If we minimise risk, high levels of fear might not be justified.We need to turn down the volume on our Emotional Mind,and turn up the volume on our Reasonable Mind and find a Wise Mind or balanced emotional response to the situation.
Ask yourself:
• What mind state am I operating from in this moment? • Is the emotional intensity justified - check the facts? • Am I balancing emotion with logic and finding a balanced Wise Mind?
et go of our judgements
It is really easy when our emotional volume is turned up to get pulled into judgementalthoughts about what others should or should not be doing. This can be at a local level withfamily or colleagues or at higher levels with management or national government.
Judgements are concepts, our beliefs about how things should be. When we are judgemental,it can turn fear into more intense anger expression (being irritable, snappy and more aggres-sive in our communication), which is often not helpful for us or others in managing thesituation. We call these secondary emotions, or emotions triggered by our primary emotionsfuelled by judgements.
It is really important to remember that we are all doing the best we can in a difficult situation,and choosing to think in this more benign way helps turn down the volume on our secondaryemotions.
indfully manage our response to the current situation
We need to be mindful of our emotions, thoughts and behaviours as we work together tomanage our responses to the impact of COVID-19 on both our work and daily lives. When weare mindful of ourselves we observe what is going on, acknowledge that this is difficult and weaccept we are being as effective as we can be.
When we are mindful of others, we recognise that they will also have emotional responses tothe emerging situation as described above.
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We need to acknowledge how difficult this is for us and for others and make a choice to workas effectively as we can in managing our own emotions and be understanding of others.
Our goal is:
Mindfully RESPONDING rather than REACTING
Here are some tips to increase our sense of personal control: We can use another acronym to help us mindfully reduce our emotional vulnerabilities. Wecan use ABC PLEASE to remind us of the importance of self-care and mindfully managing ouremotions and capacity to respond effectively.
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Watch Staying CALM
A video with practical tips to manage emotional response to unprecedented circumstances
Click here or use this address:http://y2u.be/oLSbA-_ehnM
Help and SupportCOVID-19 is bringing unrivalled challenges for us as individuals, and as part of a wider Irish society. It is important that we all as individuals do what we can to look after ourselves andalso each other as we try to effectively manage this evolving situation.
If we want to check the facts then the best place to get information is from the HSE Websitewww2.hse.ie/coronavirus or www.HPSC.ie where there are regular updates relating toCOVID-19 in Ireland.
We are all facing practical and emotional challenges right now and in an effort to assist withgrounding ourselves in responding as effectively as we can, we have put together a series ofhelp sheets to provide information and steps that might be helpful.
Coping with DistressManaging Stress using Distress Tolerance skills
Distress Tolerance skills are for surviving crises when the crisis cannot be changed right away.The aim is to learn to survive crises, without resorting to any actions which are going to makethings worse. Although we cannot change the fact that COVID-19 has had a huge impact onus personally and in society, we can manage our psychological responses.
When to use Distress Tolerance skills?
• You want to act on your emotions but it will only make things worse• Your emotions threaten to overwhelm you and you need skills to help you through• You are overwhelmed yet demands must be met• Physical feelings of stress and overwhelm are extreme but problems can’t be solved
immediately
The following are some key skills that may be useful if you find that you or a colleague are feeling under emotional stress or pressure.
Prepared by Daniel Flynn, Principal Psychology Manager, Cork Kerry Mental Health Services,
Head of Psychology Services Ireland (HPSI) 15.03.2020
We use this skill when our emotions are starting to overwhelm us.
Stop! Freeze! Do not just react. Do not move a muscle! Your emotionsmay try to make you act without thinking. Stay in control!
Take a step back from the situation. Take a break. Let go. Take a deepbreath. Do not let your feelings make you act impulsively.
Notice what is going on inside and outside of you. What is the situation?What are your thoughts and feelings? What are others saying or doing?
Act with awareness. In deciding what to do, consider your thoughts andfeelings, the situation, and other people’s thoughts and feelings. Thinkabout your goals. Ask yourself what actions will make it better or worse?
Self-soothing refers to comforting, nurturing and being gentle and kind to oneself.
This skill is essential to help you to cope more effectively when you are having a bad day ordealing with a lot of stress. Self-soothing provides both comfort and reassurance. It can helpyou stay grounded in your body and in the present moment and can act as a means of distraction from the difficulties you are dealing with. The goal here is not to fix the problem,but to take some time away from it so that the negative emotional volume goes down.
A way to remember these skills is to think of soothing usingeach of your five senses:
Soothe with what we see: Look at old photos or pictures that make you feel happy or that you associate with positive times in your life. Try to remember how you thought and felt at this time. See it as the antidote to current emotions. Can you focus on just noticing what you can see and attendto the thoughts and emotions you associate with this?
Soothe with sounds: This can be in the form of music or sounds from na-ture. What sounds change your mood? What makes you feel better or createsa sense of calm? Can you access this music or sound via a personal device oronline? Can you focus on just noticing this sound and attend to the thoughtsand emotions you associate with this?
Soothe with smells: What aroma or fragrance do you like. What makes youfeel calm or brings back positive memories, a feeling of comfort or safety.Maybe it is the smell of freshly brewed coffee, herbal tea, home baking oreven chocolate! Can you choose to focus on just noticing this smell and attend to the thoughts and emotions you associate with this.
Soothe with your sense of taste: Can you really notice what somethingtastes like. Can you choose something that you like and really savour thetaste. So often we mindlessly eat our food and miss or don’t give ourselvestime to fully appreciate the taste or how it makes us feel. Can you choose tofocus on just noticing the taste of something and attend to the thoughts andemotions you associate with this.
Soothe with your sense of touch: Really notice what something feelslike. Is something hard or soft, cold or warm. Maybe choose something thatyou like the feel of or that you associate with comfort. It could be a blanket, afavourite piece of clothing or maybe even something like a stress ball thatyou can squeeze!
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3. Distraction Skills When our emotions run high, in the short term, we can use distraction as a way of turningdown the volume on these emotions. Our wise mind will tell us that dwelling on negativethoughts will fuel emotions. A useful way to remember how to distract ourselves is to re-member that wise minds ACCEPTS something needs to change. Check off what might helpyou.
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4. Radical Acceptance SkillsThere are times when things are not as we want them to be. But despite us wishing things tobe different in the moment it doesn’t change the reality of the situation.
Telling ourselves “I don’t like this” and “it should be different” also does not change the situ-ation.
Why do we need to accept reality?Rejecting reality does not change reality.•
Changing reality requires first accepting reality.•
Stress and emotional pain cannot be avoided; it is•nature’s way of signalling that something is wrong.
Rejecting reality turns short-term emotional pain•into longer term suffering.
Refusing to accept reality can keep you stuck in •unhappiness, bitterness, anger, sadness, shame orother painful emotions.
Acceptance may lead to sadness but deep calmness•usually follows.
What we need to accept:Everything has a cause (including events and situations that cause you emotional pain•and suffering).
Life is worth living despite painful events in it. •
It is what it is for now, but this won’t last forever.•
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Remember:
Pain (emotional or physical) + Non acceptance = Suffering
Skills adapted from DBT Skills Training Manual (2nd edition), Marsha Linehan 2015 | Images: Pixabay
