You Don’t Have to Get Through it Perfectly

A lot of massage therapists have closed their doors to protect themselves and their clients from COVID-19. But not working for people whose main role is helping others has presented a few challenges. We put in a call to Melbourne-based massage therapist and psychotherapist, Tim Clark, to share his wisdom.

AMT Blog: Hi Tim, thanks for chatting with me today. Before I start talking about myself, how are you?

Tim: I’m good today and thank you for asking. Wasn’t great yesterday, but that’s how it seems to go at the moment. It’s so important for us to be checking in with people, and it’s so nice to be checked-in on!

Like most of us, I’ve stopped massaging, which knocks out well over half my income, but I am still able to continue counselling, albeit remotely.

AMT Blog: Ah, so you’re still able to work as a psychotherapist? Great. I hope you don’t mind the impertinence but I have a few questions that a psychotherapist might be able to answer. I’ll put the kettle on while you settle yourself in front of your Zoom app.

Tim: No worries. To be honest, there was no unit in my counsellor training about how best to work with people during a pandemic. In this situation, mental health professionals are in the same boat as everyone else, which honestly makes counselling really tough. But I’ll do my best.

AMT Blog: OK, I have my chamomile*. Shall we get started?

Tim: Let’s.

AMT Blog: I’ve temporarily closed my massage business down and I feel a bit weird about it. I can’t concentrate for long periods and I’m struggling to have a conversation with my family. Why is that?

Tim: Thank you for saying so. I think most of us are feeling like that. But really, is it any bloody wonder?

Look at everything we suddenly have to deal with: not only is it the indefinite loss of an income stream, we’re dealing with a loss of purpose and identity, a loss of connection to others (for us, literally and figuratively), a news cycle filled with panic and negativity, a huge range of limits to our freedom and, as a cherry on top, the risk of contracting or passing on a deadly virus.

This avalanche of threats is unprecedented for most of us. There are threats at every turn. And when our sense of safety feels threatened, as I’m sure you know, our sympathetic nervous system takes over and devotes all of our internal resources to seeking safety. When we’re perceiving threat for an extended period of time, like we are now – wondering how we’re going to be able to pay for food and shelter – we can get stuck in hypervigilance, which leads to exhaustion, fatigue, sleep trouble, inability to concentrate, all that stuff. And that might make it difficult for you to recognise your own needs and be able to express them to the people around you. It’s tough stuff.

One of the things we can do is really tune into our self-talk and treat ourselves with compassion.

What are we telling ourselves about the situation? Are we saying, ‘You’re not going to be able to handle this?’ or maybe ‘This is going to destroy you?’

We can turn it into something more compassionate like, ‘This will be hard, but you’ve gotten through hard things before’ or, ‘You don’t have to get through it perfectly, just get through it’. Whatever works for you, make it a mantra. Repeat it over and over again when things are feeling overwhelming.

“You don’t have to get through it perfectly, just get through it.”

Maybe, too, we’re piling ‘shoulds’ and ‘musts’ on ourselves. (Albert Ellis, who originated Rational Emotive Behaviour Therapy, famously called this ‘musturbation’)

Are you thinking things like, ‘I should be feeling calmer and clearer-headed’ or ‘I must do more to help everyone’?

Challenge your ‘shoulds’ and ‘musts’ at every turn; they’re really preferences, not needs. For example, ‘I would prefer to be feeling clearer-headed, but right now that’s difficult.’

It’s a tricky shift, especially if you’re in the habit of ‘should-ing’ like most of us are. It requires that we focus on the positives – the things we can do – rather than the negatives.

Wherever we can, we have to get practical. If there are things we can change, let’s do what we can to change them. And for the things we can’t change, we have to let them go, at least until our circumstances change (or we finally get to talk to someone at Centrelink). We’re all looking to regain a sense of control because everything seems so chaotic, but sometimes the only thing we can control is how we respond to our circumstances. Easy to say, I know, but it’s the tough truth.

Getting over these habits takes work. Consider devoting some time each day to working on your own mental health. Treat it as your quarantine homework.

AMT Blog: Thanks, that all makes sense – even the homework you’ve set me. Where can I go to get a bit more information on this?

Tim: For a start, ReachOut has this great infographic about steps you can take to improve your self-talk. Try actually writing down some of those thoughts, as it suggests.

Also, the Centre for Clinical Interventions (WA) has a great resource on building self-compassion and another on tolerating distress, which you can work through at your own pace.

A UK group called Psychology Tools came up with this booklet which focuses more on worry and anxiety, the things that might be clouding your thinking at the moment.

AMT Blog: I’m usually OK with my mental health but this is all different. What signs should I look out for to know that I might need some assistance?

Tim: You’re right. This is all different.

For many people, an ongoing, moderate sense of worry will be the healthiest possible response, because it serves the purpose of protecting us from the virus. It’s the voice that reminds us to keep washing our hands and to keep physical distance from others. Such worry is likely to be less harmful than the virus is. The people ignoring health warnings might be feeling indestructible now, but they face far graver risks if infected.

The most adaptive, life-sustaining option is, unfortunately, still not great: we’re forced to self-isolate. This will be very hard for people with pre-existing mental health conditions like depression and anxiety, who will need to take extra self-care measures to manage it.

There will also be people for whom the situation triggers a period of poor mental health. We all need to be on the lookout for the signs in ourselves and our loved ones. You might need to look for some professional help if:

  • your mood is low most of the time
  • you’ve stopped taking pleasure in things you’d normally enjoy
  • your weight or appetite has gone significantly up or down
  • you have trouble getting to sleep, staying asleep or are sleeping too much
  • you feel agitated and restless, or slowed down and easily fatigued
  • you’re having regular thoughts of being worthless, or feeling excessively guilty
  • you struggle to concentrate or your mind keeps going blank
  • you keep thinking about death or dying
  • you’re worrying excessively most of the time
  • you’re unusually irritable; or
  • your muscles are constantly tense.

You don’t need to have all of these symptoms before deciding it’s time to get help; it might be only a handful.

And the other thing is: some of these symptoms, especially things like weight fluctuations, sleep trouble or fatigue, might be due at least in part to the physiological effects of self-isolation, like less exercise and sunlight. There are plenty of places to call if you’re not sure…

AMT Blog: OK, Tim, hit us up with some resources we can use.

Tim: Print out and keep this infographic on the fridge.

If you decide you’d like to look for some ongoing help, there are plenty of ways to find good counsellors and psychologists. It’s always best to have a hunt around and find someone you feel you’ll click with. Most will be making the move to online counselling/telehealth if they haven’t already.

Some of the best ways to find qualified, reliable therapists include:

  • Good Therapy Australia – This has really nice detailed profiles of registered counsellors and psychologists, so you can get a good sense of who the therapist is.
  • PACFA Find a Therapist – Featuring therapists registered with The Psychotherapy and Counselling Federation of Australia.
  • ACA Find a Counsellor – Featuring counsellors registered with the Australian Counselling Association.
  • APS Find a Psychologist – Featuring psychologists registered with the Australian Psychological Society.

If cost is a concern for you (and let’s face it, therapy can be pricey at the best of times), don’t be scared to ask your therapist if they’re able to offer a reduced fee. Many will offer a sliding scale of fees to make it manageable so you can get the most out of it, especially with things as they are.

And, of course, there are tons of self-help resources for dealing with common mental health problems:

  • The Australian Government’s Head to Health website has links to online resources for all sorts of mental health issues. Probably best to search for a key term (e.g. depression, anxiety) to avoid being overwhelmed with options.
  • Smiling Mind has a superb range of mindfulness resources to help people cope with self-isolation, including a brilliant meditation app.
  • The Black Dog Institute has an excellent page of resources, including a link to myCompass, their free seven-week cross-platform program for people with mild-to-moderate anxiety or depression.
  • And Sydney’s St Vincent’s Hospital has This Way Up, with links to a wide range of free online self-help courses on depression, anxiety (and, impressively, mixed depression and anxiety), health anxiety, coping with stress, mindfulness, chronic pain, insomnia and more.
  • The aforementioned Centre for Clinical Intervention in WA has a boatload of other Self-help Resources for Mental Health Problems, including booklets and activities for managing mental health problems such as anxiety, depression, panic, sleep problems and worry and rumination. They’re particularly good if you’d prefer an old-fashioned booklet over a smartphone app.

AMT Blog: What’s the best tip (or tips) you’ve heard on getting through this tough time?

Tim: My instinct is to say: use what works for you. Whatever has gotten you through tough times before will get you through them again.

AMT Blog: This means I can cuddle my teddy bear while binge watching Harry Potter movies, right?

Tim: Absolutely. But, if you want something more definitive, I can combine a whole lot of inspirational memes into one and say: keep laughing, keep moving and keep expressing gratitude for all that you have.

Is that enough canned wisdom for you?

AMT Blog: Sometimes canned wisdom is the easiest to understand. But where can I get some more tips for getting through this?

Tim: Read ‘Man’s Search for Meaning’ by Viktor Frankl. Always good for getting some perspective.

If you need your COVID-19 sanity tips to be entertaining, sweary and to-the-point, 88 Ways to Not Freak the F*ck Out During Isolation (Forge, US) is the guide for you. Lots of good links throughout too.

Oh, and with the whole ‘find what works for you’ thing, Black Dog Institute have this great ‘trial-and-error’ guide to help you find the relaxation technique that works best for you. Might help you get through a wave or two of uncertainty.

AMT Blog: Tim, since there’s just you and me in this video call, I want to share something that’s scaring the bejaysus out of me.

Tim: Please do.

AMT Blog: I’m worried I’ll never work as a massage therapist again. How can I manage the waves of catastrophic thinking?

Tim: Oh, Blog. What a tough question. I’m so glad you were able to ask it.

There are two sentences in your question. The first sentence is about anticipatory grief. You’re feeling like there’s a major loss coming up, and it would be a major loss and I don’t think it’s overstating to call it grief. So much of who we are is tied up in our work and it can feel like we’ve lost a part of ourselves when we’re not working.

Without knowing your particular circumstances, the second sentence suggests that there’s something in you that feels like you might be catastrophising (i.e. predicting a more disastrous situation than what might actually happen). You can challenge catastrophic thoughts by reality-checking and challenging the anxious thoughts, then getting practical, and start problem-solving. Your fear may be realistic, I don’t know. But it sounds like you’re not sure, so it’s really the uncertainty that’s hard to take. In which case, maybe go back to some of those resources I mentioned in response to your first question, especially this one.

SANE Australia has an excellent, concise guide to help you stop catastrophising.

AMT Blog: What else do you think is important for me to remember right now?

Tim: Hmm … well, I’ve been thinking a lot about love over the past few days and wondering how we’re going to hang on to love when we can’t be close to so many people we love, and when fear seems all-consuming. We’ve gotten used to living in a society with little time for honest self-reflection that for some, self-isolation will be like torture. But I hope it gives people time to practise feeling love regardless of who’s around to share in it.

Maybe that sounds like total wank, but I also kind of think love is more important than anything right now.

AMT Blog: You got some resources to go with the love talk?

Tim: You’ve already got ’em! That is, you have a soul, mind and body.

AMT Blog: Thanks for sharing your wisdom, Tim. I feel a lot calmer already.

Tim: Thanks for the chat, Blog. And take care. You’re doing amazing.

****************************

Do you have a question for Tim on managing your mental health during through this pandemic crisis? Stick it in the comments below and we’ll ask Tim to answer in another article.

*It was probably/definitely coffee.

About Tim Clark

Oh god – the bio. That means I have to be funny again. Oh god help us all.

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Comments

  1. Camille Adams
    31/03/2020 - 8:23 am

    Thanks Tim for being real, practical, honest and true!

  2. Angela Hodgman
    31/03/2020 - 3:57 pm

    Loved all the links for follow up reading.
    Thank you

  3. You’re so welcome, Camille and Angela. I’m glad it was useful.

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