By Dr. Norman Blumenthal
Zachter Family Chair in Trauma and Crisis Response for OHEL
OHEL remains deeply committed to serving the needs of our community, especially at these unprecedented and challenging times of the COVID-19 pandemic.
Managing Anxiety And Worry
Your anxiety should be commensurate with the risk that exists and mobilized to take responsible action. You should be in control of your anxiety and not your anxiety in control of you. Be properly informed, screening for both alarmist and minimizing messages and postings. Make sure you have a handle on the situation before you address it with your children. Be aware that scared children, especially young ones, are more responsive to your body language and voice tone than what you say. Impart caution, but control by how you communicate, not just the words you use. Model proper caution and hygiene. Avoid cynical remarks or jokes that would diminish the importance of this current crisis. Do not get overly angry or overwrought if a child fails to practice proper hygiene or precautions; gently remind him/her. Remind yourself and family that, as has been the case with comparable communal emergencies, this will likely have a beginning, middle, and end. It will not last forever. Try to extract from this hardship lessons in life, future resolutions, or other potential sources of growth in order to at least diminish the tension and pain.
Children under six are most likely to touch one’s face and mouth without washing their hands. Teach them proper hygiene in a more playful fashion using mnemonics, jingles, or many of the coloring book or cartoon like publications that promote such practices. Walk them through and rehearse proper hand-washing, use of tissues, and the like. Children this age do not need more than minimal explanations or rationales for these instructions since they are used to adults demanding of them cooperation for behaviors that don’t necessarily make much sense to them. Heap praise for proper behavior since parental approval is more important to them than the particular reasons for these behaviors. It probably makes little sense to suggest that something is “rare” since these children lack the awareness of the breadth of time and space to understand.
Children about 6–12 can understand the reason for these new precautions and the idea of something being rare but rapidly contagious, posing a potential risk. Most should comply with hygienic practices with some exceptions. They are often most interested in facts and details, which is age typical and should be addressed to the extent that they ask. They also should be assured that there were no culprits or ill-intended individuals who caused this to occur since that would also be typical for this age.
Teens will probably be well-informed and mature enough to be self-motivated regarding hygienic practices. They in particular need to be reminded to keep a perspective on what they read on the internet and social media. They should be cautioned to only trust responsible sources and avoid a hysteria that can be fostered by the relentless repetition and escalation that social media propagates. They may approach the alarming approach with cynicism or doubts. It is best not to get into lengthy debates or arguments but simply highlight the urgency of these times. Tending to be idealistic, they may resonate well with the notion that much of what we are doing is to protect some of the more vulnerable members of our community. It is probably ill-advised to cast this crisis as divine retribution or in a political template as teens may be inclined to do. If they present with such perspectives, it may be best to suggest that such insight is usually best acquired when the crisis subsides.
Children With Special Consideration
Children with impulsive tendencies (e.g. ADHD) will have a harder time with confinement and remembering to pause and apply necessary hygienic practices. For them, repeated simple instruction and role playing would be indicated. Anxious children or those with obsessive compulsive tendencies may exhibit excessive worry or relentless precautionary measures (e.g. hand washing) that are not only unnecessary but even harmful. They have to be strongly curtailed and more assured of the relative safety that still exists. Oppositional children or those not receptive to fear or intimidation need to have the potential dangers and risks more highlighted. Unique situations such as cognitively challenged children or those on the autistic spectrum should consult with their treatment personnel and experts.
Research demonstrates that confinement is a stressful situation, the effects of which can linger beyond the isolation. Stimulation and social interaction is a basic human need, the deprivation of which is potentially harmful. Families should try to maintain as much routine, structure, and remote interpersonal contact as possible. A schedule should be established with planned activities, online school instruction, interspersed with times for unstructured play, exercise, yoga, reading, or the like. Without minimizing the actual hardship and concern, try to maintain an upbeat and loving atmosphere in the home with no more chores or schoolwork than had previously been in place. Adults and children should have scheduled online gatherings during which they can reconnect, share ideas for activities, and even compare art projects and the like. There have been many suggested activities and literature posted online which families should readily but judiciously access. Preexisting conditions or inclinations such as anxiety can get exacerbated by the stress of confinement. Similarly, interpersonal friction such as sibling rivalry can reach a feverish pitch when people are confined. A period of crisis is not a time to cure or remediate these problems. Managing such challenges until the crisis has subsided is recommended, which can include keeping family members separated, temporarily introducing medication, or forms of stress inoculation that can be rapidly and effectively implemented. n
OHEL Children’s Home and Family Services offers a breadth of services that meet the everyday needs of individuals and families. To access more information or services please call 800-603-OHEL, e-mail firstname.lastname@example.org, or visit OhelFamily.
OHEL’s crisis team, led by Dr. Norman Blumenthal and Tzivy Reiter, LCSW, specializes in helping people navigate the social, emotional, and practical consequences of the current health crisis, forced isolation, and disruption in routine.
OHEL’s crisis team is available to provide video-based WebEx or telephone counseling to all those in the community who need it. For updates and videos on COVID-19, please visit OhelFamly.org/COVID19. For an appointment or any questions, e-mail email@example.com.