Core Wellness Practices in Times of Crisis
by. Jane Hart
Registration open for Spring Wellness Weekend, March 19-20, 2022,
which includes 6 virtual workshops in wellness and art practices.
The global COVID-19 pandemic has presented significant new challenges for both clinicians and patients. Disruptions caused by the pandemic have significantly altered the clinician–patient relationship. Stress, anxiety, depression, and isolation have been key issues regarding clinical interactions. Fortunately, integrative clinicians are aware of the fact that complementary therapies are mainstays for addressing issues that have come to the forefront during this time. Basic practices to promote feelings of connection, calm, and safety, along with complementary therapies, can be personally utilized during times of restrictions, isolation, and quarantine. This column covers core practices for clinicians to utilize themselves and, specifically, to strongly consider recommending to their patients to help them cope through rigorous times.
The Basics
In times of crisis, there are basic needs that both clinicians and patients desire. These may include feelings of connection, calm, safety, hope, and feelings of certainty. During challenging times, when uncertainty looms and fear abounds, these are basic needs and feelings that can be difficult to access. There are, however, ways to address these issues to help people better manage their circumstances and things that are out of their control. Here are four important coping skills to consider.
Set a daily schedule. When the days seem to run one into another, experts recommend that setting a daily schedule, no matter how simple or complex, can be very helpful and important. That schedule may include doing some work—either employment or housework; using the Internet to connect with someone for a visit; having a meal with companions either in person, with physical distancing, or virtually; exercising; playing music, an instrument or singing; reading—even if for small amounts of time if concentration is difficult; and walking or playing outside, etc. Writing the schedule down in a journal or planner can be helpful.
Structure the day. Along with setting a daily schedule, discussing the specific structure of the day, especially in households with children, is important. For those with children, talking about the day and how the day will be planned can help everyone in the household. Parents might say to their children, “Today, we will have breakfast, go for a walk, you will attend virtual school, and after school we will plan an art or other creative activity. Then we will eat dinner and watch a television show.” This helps children know how the day will unfold and what to focus on instead of feeling the weight of further looming uncertainty. Fortunately, many schools have provided similar outlines suggesting how to plan a child's day during stay-at-home mandates.
Get outside. As much as is possible and following suggested governmental guidelines, getting outside for walks and exercise, fresh air, and seeing other people out and about truly help meet basic needs of exercise, connection, calm, and oftentimes hope.
Stay connected. People have suggested that it is better to refer to the physical distance that people must keep from each other as physical distancing as opposed to social distancing. In fact, the last thing many people need emotionally and mentally is being distanced socially from family, friends, coworkers, neighbors, etc. However, changes to those relationships are inevitable for some, and it is important to remind people how to stay connected by visiting at a safe distance with others; virtually connecting; taking walks with others with physical distancing; utilizing technology to set up group meeting calls; and driving by and waving to people who are shut in, but have a window or balcony. Staying in touch with others on a regular basis is essential. For those who are alone, checking in with family members, building management, places of worship or grief, and bereavement centers to see how the alone and lonely can be cared for is important.
The point is that planning the weeks out as much as possible can be instrumental for clinicians and their patients and families. Then, adding complementary therapies to some of these basics can truly boost a person's sense of strength and add to his or her coping skills.
Core Wellness Practices
Many complementary therapies can be practiced remotely and in the safety of a person's home during times of physical distancing, sheltering-at-home, or quarantine. As so many clinical appointments are now virtual, clinicians need new ways of sharing information and recommendations with their patients. Here are five key practices that both patients and clinicians can benefit from to maintain emotional, mental, and physical balance. Of course, practices should be recommended based on an individual's capabilities and preferences, and according to current governmental guidelines and restrictions regarding safety.
Yoga
With less access to gyms and fitness centers around the world, the yoga industry along with other exercise venues has quickly adapted by promoting and offering thousands of online classes. Many yoga studios are offering classes for free, and the Internet is already packed with free videos of online yoga instruction—from chair yoga for the elderly to vigorous workout sessions for a more active and younger clientele. Several popular websites with classes include (www.yogajournal.com), (www.gaia.com), and (www.corepoweryoga.com), and there are many more. Yoga offers people the benefits of addressing issues of body, mind, and spirit—all of which may need particular attention during times of lessened physical activity and exercise. Restorative yoga can help people with sleep and relaxation, and gentle chair yoga can be done for those who have less physical capabilities or for people who are of an older age. Active yoga sessions abound for people who desire a vigorous workout. Yoga can help with posture, having a sense of community, blood circulation, staying active, and setting daily intentions, according to Hanna Friess, a certified yoga sculpt and fitness instructor in Cleveland, Ohio, who commented on the benefits of doing yoga during times of sheltering in place or quarantine. She reported:
Working at home. “When working from home people may not have the ideal work environment and for example may be sitting for prolonged periods of time and in awkward positions, which can lead to poor posture. Yoga allows a person to stretch and improve circulation and posture and combat the negative effects of sitting for up to 8 hours per day or more.”
Community. “Taking an online yoga class (or really any fitness class) can help a person feel like they are part of a community and not so alone or isolated. They can look forward to the next class in the week ahead.”
Positive outlook. “Yoga can provide a positive distraction during times of crisis. Often, yoga instructors set intentions for class (and if not, a person can set one for his or herself), which can motivate a person through the class and provide a positive outlook/mindset for life off of the yoga mat. Examples of a daily intention may be: to be in the present moment; focus on your breath; challenge yourself to try something new; or be grateful for what your body can do.”
Exercise. “People are likely getting less activity and movement throughout the day, so 30 minutes to an hour of yoga can make up for some of those lost steps.”
Mindfulness/Meditation
Mindfulness practices and meditation are currently being highly promoted online and can tap into a person's need for finding a way to center and create calm in a chaotic and uncertain environment. Centering exercises such as metta meditation, transcendental meditation, mindfulness-based stress reduction, and other contemplative practices can help bring moments of calm, connection, and clarity. These practices, like yoga, also focus on working with the breath to calm the mind. Clinicians and practitioners who are already familiar with meditation and breathing exercises can lead clients through simple techniques to help them cope and have skills to practice at home. Jon Kabat Zinn, PhD, a renowned pioneer, teacher, and author in the field of mindfulness, has been livestreaming mindfulness practices with interactive sessions with people from around the globe at (http://wisdom2conference.com/live). In addition, apps such as Calm and Insight Timer help people with mindfulness and meditation. HeartMath is another popular program to help people regulate mind and body and reduce stress. Meditative movement such as t'ai chi or qigong can also significantly help people find calm, invigorate, center themselves, and also improve balance.
Exercise
Movement is so important in helping the body and mind regulate. Maintaining an exercise regimen is essential for those already exercising. For many, exercise is a main form of stress reduction and should be continued. How it is continued is another question to address as gyms, pools, parks, and beaches may be closed, preventing people from maintaining their usual exercise regimens.
Walking, as permitted and described by national and local mandates, has become a significant form of daily exercise for many who are allowed to leave the confines of home for periods of time. Running and bicycling outdoors have also increased in popularity and help keep people mentally and physically fit. Again, for those who have access to technology, there are thousands of exercise videos available online to help people maintain their balance. For those who are intimidated by use of equipment in fitness centers, virtual instructors are finding ways to use household items as props such as a canned goods instead of hand weights. People should be advised to start where they are and not overexert themselves if they have been largely sedentary as people can become injured doing at home or virtual sessions just as they can in the gym. Peloton (www.onepeloton.com) has been a popular online resource for people and provides classes in cycling, walking, running, stretching, and more. In addition, there are many apps that track walking and running and provide exercise classes. Local gyms have also been offering online classes, many of which have been offered free of charge. Of course, YouTube is also a rich source of exercise classes.
Nutritional Balance
People may react to stress by eating too much or too little. Others, in this time of crisis, have not had access to enough food to keep their family healthy due to financial strain from loss of work. For those who are able, considering donations to local food banks to help our communities put food on their table is a generous and important act. In fact, generosity is a practice that can help all of us during times of crisis.
It is easy during high-stress time to turn to food for comfort and overeat, or, in contrast, grief and worry can lead to not eating enough. It is important for clinicians and practitioners to inquire as to which end of the scale the person is operating and gently help them adapt to a healthier eating pattern. Clinicians can stress the importance of trying to create a healthy eating regimen to boost immunity, maintain or improve health, and stay in shape both physically and mentally.
Sydney Spoon, MS, RDN, CSSD, LD, a registered dietitian/nutritionist at Spring Valley Hospital, Las Vegas, Nevada, and owner of Spoon Nutrition PLLC, offered some tips for clinicians when discussing nutrition and habits during a pandemic. She commented:
Do not add to patients' stress. “Living amid a pandemic puts stress on our bodies in multiple ways. As a clinician, it is crucial to avoid exacerbating additional stress. It is our job as health care professionals to help patients focus on factors they can control during this time. To that end, clinicians should be gentle with patients about what they are eating. Allow individuals to eat without judgement. With limited access to food, individuals are consuming more shelf-stable products. It is important to acknowledge that nourishing the body is necessary, regardless of food source. In addition, creating food restrictions during a crisis may only cause more stress and will likely lead to binge-eating along with the negative psychological consequences of the restrict-binge cycle.”
Encourage patients to listen to their bodies. “Hunger and fullness hormones are constantly being expressed, but are often ignored. When an individual tunes into their body, it is easier for them to regulate the amount and types of food that are needed for proper fueling.”
Suggest sitting at a table when eating meals and snacks. “It is easy to get distracted by the television, internet, or social media. When distracted, food becomes less satisfying and it is more challenging to be connected with the body's natural fullness signal. Being present while eating increases pleasure from the eating experience and often leaves individuals feeling more satisfied.”
Help patients to move their bodies according to their preferences. “Exercise is a useful stress reliever with many health benefits, but it should also be a time to enjoy movement and appreciate one's body. All forms of movement can be beneficial and people are likely to exercise more frequently if they are getting to choose their preferred form of movement.”
For those with technology, more time spent indoors means that there is time to engage in excellent videos for people to learn more about healthy dietary patterns, which can help them educate themselves and stave off boredom. Here are some resources for more about healthy eating for both clinicians and patients: (www.lifestylemedicine.org), (https://nutritionstudies.org), (www.forksoverknives.com), and (www.truehealthinitiative.org).
Lifelong Learning Modules
If ever there was a time to encourage patients to learn more about wellness practices that can help them not only survive but also eventually thrive, it is now. There are thousands of online resources, materials, and videos regarding healthy living with many free classes to help people improve their lives and sense of well-being, some of which have already been mentioned. This is a time to learn more about areas of interest such as healthy eating, exercise, and the effects of a plant-based diet. But also, there are free courses offered online by Ivy League schools on topics for everything from classical music to aeronautics to theater (www.classcentral.com/collection/ivy-league-moocs). Especially if people are living alone or are not working, online learning is one way to encourage people to spend their time productively.
Conclusion
The pandemic has created challenging times for almost everyone in the midst. Utilizing the mentioned suggestions and resources can help patients navigate the uncertainty and restrictions of the times as well as manage mind–body–spirit issues that arise. Reassurance and encouragement along with solid suggestions and resources can go a long way in helping people cope and remain steady and balanced in difficult circumstances.
Wellness Practices Overview - Saturday, March 19, 9:30am
Join us during Spring Wellness Weekend, March 19-20 for two days of wellness and arts skills training to nourish personal growth, social-emotional learning, and diverse community collaboration, with virtual workshops, a networking session and celebration of the Spring Equinox.
We’ll start with an overview of wellness practices: research documenting wellness practice
to enhance resilience; Bauman Wellness Skills components; 4 primary creative therapies
Then join us for 5 workshops on:
Eating for Health & Visual Arts - Sat. Mar 19, 11:00am
Joyful Movement & Music - Sat. Mar 19, 2:00pm
Meditation & Expressive Writing - Sun. Mar 20, 9:30am
Relationships & Media Arts - Sun. Mar 20, 11:00am
Service & Social Justice Arts - Sun. Mar 20, 2:00pm
All Spring Wellness Weekend workshops will be a SNEAK PREVIEW of content from our NEW Integrative Wellness Core Program for Health Professionals and Individuals/Families launching May 2022!
The Integrative Wellness Core Program is our virtual, facilitator-led skills training for health professionals, individuals/families, and groups. Our aim is to promote improved energy, mood, and resilience. The program is designed to integrate professional development and individual learning in a group environment.
