Spotlight on COVID-19: In Conversation with Rebecca Alexander, LCSW-R, MPH

Rebecca Alexander (Photo: Genevieve de Manio)
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Almost overnight it seems as though life as we know it has changed… at least for the time being. Almost everyone seems to know — or, at the very least, seems to have heard of — someone who has gotten sick with the novel coronavirus, otherwise known as COVID-19. Those who haven’t gotten sick, and do not know anyone who has become ill themselves, are worried that they — or someone they know — might come down with the virus. Offices, schools, a whole array of shops and restaurants and services are all either closed, or are offering services on a much more limited basis. And now it seems like it may be some time — about 12 to 18 months, based on current estimates from health officials — until a vaccine that is safe and effective can be developed and life can begin to return to normal. With all of this going on, it can all feel a bit overwhelming and it’s no surprise that many of us are a bit on edge (myself, included). It is with that in mind that I recently spoke with author and psychodynamic psychotherapist Rebecca Alexander, to get her advice on what all of us can do to help keep our anxieties in check, the effects this prolonged emergency or crisis state can have on our overall wellbeing and mental health, and when it may be time to consider speaking with a professional. 

Andrew DeCanniere: I think that a lot of the anxiety that people are experiencing stems from all of the uncertainty that surrounds the situation that this country currently finds itself in. And I think it’s safe to say you could double or triple that anxiety (at the very least) for those who are sick, or who have family or friends who are sick, with COVID-19. The closest thing to this that I can think of would’ve been some 102 years ago, with the 1918 Flu Pandemic — and I certainly wasn’t around for that. So, in my mind, I think the big question is what people can do to help manage their anxiety in a time of what is arguably unprecedented uncertainty, the likes of which most of us haven’t experienced. What are some good strategies to help keep one’s anxiety in check, with all of this uncertainty around for some time to come?

Rebecca Alexander: There are a lot of strategies that can be particularly helpful during a time like this — the biggest difficulty is actually employing them. Here are a few of my best suggestions.

We often hear people talk about mindfulness and the importance of “being present”. In fact, we hear about it so much that most people don’t actually know what it means. I like to think of mindfulness and “being present” as a way of slowing down or consciously choosing to remove ourselves from our racing thoughts and the chaos, confusion, and anxiety we find from watching the news, spending time on social media platforms, etc…

Structure is HUGELY important during a time like this. During the week, you MUST create structure for yourself. While you may be catching up on much needed sleep, you must wake up by a certain time and have a schedule and structure laid out for the day ahead of you. Your schedule for each day should be planned and known the day before. 

Many of us aren’t able to spend much time outdoors if at all (particularly those of us living in NYC or metropolitan areas that are more heavily affected by COVID-19). Create time in your day to go outside for a walk (with the appropriate required protective gear for your community, such as a mask and/or gloves). 

There are many creative ways to be active when we are forced to be indoors. For example, cleaning your apartment, your home, or even a particular area of your home requires a lot of physical energy and can make you feel a sense of accomplishment and productivity. I personally move the coffee table and do my own home workout while throwing the ball for my dog — she thinks we are playing when I do this so we both get a workout.

Download a meditation/mindfulness app like Headspace, Calm, Insight Timer, or Deepak Chopra and Oprah’s 21 day free mindfulness app.

Make a realistic list of 2-3 things you need to accomplish each day — cleaning your kitchen, organizing your desk, making important calls to your insurance company, scheduling a telehealth doctor’s appointment. Whatever the list is, make it realistic, make it specific, and don’t make it too long.

Schedule social time with family, friends, or even volunteer to be social with the elderly who are experiencing extreme isolation at a time like this because they are more susceptible. Many organizations are offering free Zoom courses, seminars, and webinars with speakers — take advantage of these commonly free educational and social online events.

Most importantly, limit the amount of news you watch to a specific time or times of day for a finite amount of time. 15 minutes in the morning and 15 minutes in the evening (not before bed) or simply choose one time per day to tune in.

DeCanniere: There is a lot of talk surrounding the virus itself — and with good reason, as it is the biggest threat and is what must be resolved most urgently. Yet, I think there needs to be more of a focus on mental health as well. What’s your take on it and, more to the point, what do you think needs to be done to make sure that all bases — mental health, included — are covered? Also, what are some of the effects that this sort of prolonged emergency or crisis state we’re in could have on overall wellbeing and mental health? 

Alexander: I am personally volunteering as a mental health first responder for the state of New York for medical professionals working on the front lines. There are many services available through each state for mental health that are free to the community and can be found by searching through their state website online. Whenever we experience a crisis like this, it takes time for the impact and the long-term mental health effects to actually be realized and understood. 

People are still operating in crisis mode, which often means that they are taking various steps to deal with their most immediate concerns and anxieties in more superficial or short-term resolving ways, that are not sustainable in the long term when we attempt to return to a more integrated life. I suspect we will likely be dealing with a much higher incidence of substance abuse issues and admitting people to rehab facilities who either needed to go before the crisis but were unable to due to the disruption of care or who will need it because of their ineffective coping strategies developed while stuck at home during this critical time. 

DeCanniere: What are some signs that this whole coronavirus crisis is affecting someone to the extent that it might be time to consider speaking to with a professional? These days those therapy sessions are more likely to be by phone or via video chat than in-person, obviously.

Alexander: There are many different ways in which we all cope with crisis. Some of the most common signs include: sleep disturbances (over sleeping or under sleeping), substance use, obsessively watching the news or spending time on the internet to seek answers during a time of uncertainty, irritability, further imposed isolation, agoraphobia, etc.

Rebecca Alexander, LCSW-R, MPH, is a psychodynamic psychotherapist specializing in individual, couples and family therapy.  She currently maintains her private practice in Manhattan. With over 13 years of experience as an individual, couples, and family therapist, Rebecca holds two masters’ degrees from Columbia University in Public Health (Sociomedical Sciences: Health Promotion Disease Prevention) and Clinical Social Work). 

Rebecca received her post-graduate training at the Institute for Contemporary Psychotherapy and earned her psychodynamic psychotherapy certification from the American Institute for Psychoanalysis. Rebecca is certified in EMDR (Eye Movement Desensitization Reprocessing) and she is fluent in American Sign Language.

Rebecca is a highly interactive, solution-focused therapist. Her therapeutic approach is to provide support and practical feedback to help clients effectively address personal life challenges. Rebecca firmly believes that there is no “one-size-fits-all” approach to therapy and therefore assesses each case on an individual basis to offer a highly personalized approach tailored to each client. With compassion, understanding, and insight, Rebecca works with individuals to help them recognize and build upon their strengths and challenge the ineffective beliefs and behaviors that inhibit clients from living a deeply meaningful life and creating effective change in their lives.

For more information, please visit her website

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