Coping with COVID: Developing resilience

Information about mental health and self-care has been popping up everywhere as we collectively cope with the impacts of the COVID-19 pandemic. Buzzwords keep showing up to describe what people are going through right now: “burnout,” “compassion fatigue,” and “resilience.” Understanding these experiences can help us care for ourselves in the months ahead.

In this episode of our Coping with COVID podcast series, Kira Mauseth, PhD and Doug Dicharry, MD dive into the ingredients of resilience and make practical suggestions for developing resilience in yourself and your family.

Burnout happens when there is an imbalance between what’s filling you up and what you’re giving out. You might be using mental, emotional, and physical resources to meet life’s demands but don’t have enough things energizing you to keep going. When you give so much without being able to take care of yourself, you run out of energy, becoming exhausted and burnt out.

Compassion fatigue is common in people with jobs helping others, like healthcare and social service providers. It happens when you become so emotionally and physically worn out that you can no longer empathize with other people. You might feel indifferent to what others are going through or unable to offer compassion.

Resilience keeps us going

One way to cope with burnout and compassion fatigue is by building resilience. Resilience is how we recover from difficult and painful experiences. It keeps us afloat in stressful situations, and it is a skill we can grow by building on these four ingredients of resiliency.

• Flexibility and adaptability: When we’re able to creatively adjust to our circumstances, we do a lot better in the face of adversity.
• Connection: Adapt to maintain existing connections, and find ways to build new ones. Connections are anything that keeps us from being isolated.
• Purpose: Identify what motivates you, and acknowledge that it may have changed over the last several months. Scale back goal-setting to today or this week, instead of months from now.
• Hope: Continue to look for new opportunities. These may be things you can do that you wouldn’t have considered previously.

To learn more, read our story on becoming more resilient.

Practice REST

After months of challenges related to the COVID-19 pandemic, many people feel burnout or compassion fatigue. These experiences are draining, but there are some things you can do to feel better. Take time to REST with these steps to reduce compassion fatigue and prevent burnout:

• Reward yourself for a job well done. Build in positive reinforcements for success.
• Establish healthy boundaries. Put limits on when and how you deal with your responsibilities.
• Share your feelings, concerns, and stories. Connect with people about your experiences instead of keeping to yourself.
• Trust your support network and reach out if you need to. If you need help getting something done, trust that others will have your back.

Using the REST model and building resilience are important steps you can take to cope with everything going on right now. Even with these skills, it’s normal to not be feeling your best and it’s ok to ask for help. To find more resources or extra support, visit the Washington State wellbeing webpage.

More information

Stay tuned to our blog for more information on how you can help stop the spread of COVID-19. Sign up to be notified whenever we post new articles.

Information in this blog changes rapidly. Check the state’s COVID-19 website for up-to-date and reliable info at coronavirus.wa.gov.

Answers to your questions or concerns about COVID-19 in Washington state may be found at our website. You can also contact the Department of Health call center at 1–800–525–0127 and press # from 6 a.m. to 10 p.m. Monday — Friday, and 8 a.m. to 6 p.m. Saturday — Sunday. Language assistance is available.

Please note that this call center cannot access COVID-19 testing results. For testing inquiries or results, please contact your health care provider.

Transcript

[Announcer] Welcome to a Washington State Department of Health podcast on Coping with the Impacts of the COVID-19 Pandemic. And now, your hosts for the show, disaster psychologist Kira Mauseth, and child and adolescent psychiatrist, Doug Dicharry.

- Good afternoon everybody, thank you for joining us. My name is Kira Mauseth, and I am a clinical psychologist.

- And my name is Doug Dicharry, I am a child and adolescent psychiatrist.

- So, we wanted to start today by sharing some information about some of these terms that are commonly thrown around, and they’re used all the time. You hear a lot about employee wellness, and wellness in general, and burnout, maybe compassion fatigue. Those are just some common terms that are used right now to describe how people are sort of functioning, and how they’re doing, not only in the workplace, but also in the home environment as well. I would really encourage everybody to think about burnout as an imbalance, or, rather the result of an imbalance. So it’s what happens when you have mental, emotional, and physical resources going out that you’re contributing to something, and you don’t have enough coming in. So it really feels like there’s an imbalance of what’s filling you up, versus what you’re contributing. And that, again, can be at work or at home. And it doesn’t feel good, right? The more that you have going out, you run out of steam. You run out of energy to contribute to things, and that’s what results in burnout. And then compassion fatigue is sort of described as the inability, at some point, that people experience when they can’t empathize any longer with another person’s story. It’s frequently used to describe an experience that happens for healthcare providers, but it’s not unique to healthcare providers. Parents can experience it, and people who are working in public-facing jobs, human service jobs where you’re just dealing with other people frequently, can also experience compassion fatigue. Is there anything that you’d like to add, Doug, on sort of how those two things are thought about in today’s experience?

- Well I think particularly with children, it’s important to keep in mind that even they can experience some form of burnout or compassion fatigue, depending on their situation.

- Yeah. Yeah that’s true for adults too, and people sort of come into things with a naturally occurring level of resilience, and that’s based on a variety of factors that they’ve experienced in their lives for sure, but one of my favorite aspects of what resilience is, and how we can develop it is that, you know, one you identify what the ingredients are, so to speak, you can work on intentionally growing your own level of resilience, and really sort of making it stronger within yourself, so, even if kids and adults are coming to the scene with COVID with different levels of resilience to begin with, it is something that everybody can learn how to do more of, for sure.

- Good point, good point.

- So, the definition of resilience is basically thoughts, feelings, and behaviors that allow us to adapt or to sort of do well in the face of a disaster, or a tragedy, or a trauma, or some kind of an adversity. When we have significant stress that we experience, resilience are the factors that sort of keep us afloat. They keep us going. And that’s what we want to be focusing on developing. So, in today’s podcast, we’re gonna be talking about how to operationalize resilience, and how we can intentionally develop those factors. Doug, is there anything else that you’d like to add about kids and families in terms of opportunities that kids can have to work on these aspects of developing resilience?

- Well I think it’s important, the idea of flexibility and adaptability. We know from the research that there are kids, for example, that can undergo a great deal of stress, and even trauma in childhood, and emerge from it successfully. We also know that there are children that have all of the benefits of a good home life, and still have difficulty coping. So, it’s important to kind of individualize how we approach this and for each of us to recognize our own level of resilience and ability to cope with stress.

- Yeah. So, because you brought that one up, let’s just start with that one as an ingredient. So, flexibility and adaptability is one of the main ingredients. I don’t know why I like to use food metaphors all the time, but I do. So flexibility and adaptability are a main ingredient of resilience. And there’s lots of ways that both kids and adults can sort of develop their ability to adjust and to kind of roll with things and kind of to cope. When I’m doing some training in this concept, in other places in the world, we talk about using the model of a tree to represent resilience. And the flexibility and adaptability is the sort of strength that the tree has, the trunk of the tree, to move in the storm. So a rigid tree that stands against the storm is likely to split in half and fall over. And if a tree is flexible and adaptive, that means the trunk is able to sway with the storm to sort of adjust to the weather conditions and survive. And people are much the same way. I know the metaphor only extends so far, but when people are adaptive and can adjust, rather than being rigid, they actually do a lot better in the face of adversity.

- That’s a great concept. And, for younger children, this is often illustrated in stories, for example. Fairy tales, how characters may adapt and may be flexible in certain situations. How they can cope with stresses that come up along the way. And these can be good teaching tools for resilience.

- So for those of us who are sort of trying to work about, working at home, navigating the difficulties of parenting with the demands of our job, being flexible and adaptive is really probably the most difficult piece of what we’ve been through in COVID so far. And because everything is something we’ve had to adapt to. It’s about how to be creative in your physical space at home, how to figure out, where is my work space, and where is my home space? And for kids, too, how are they gonna just, where are they gonna physically work for school? When is the dining room table a dining room table, and not a school table? And how to make those adjustments. How to, you know, respond to emails and take care of work things, maybe at off hours that you wouldn’t have considered doing. I do think it’s important here to also recognize that when you’re trying to operationalize being flexible and adaptive, it doesn’t mean that you don’t have boundaries. That they actually go really well together. So it’s important to be flexible and adaptive, but then to put structure around those new changes that you make. So to make the changes that you need to to adjust, and then put boundaries and structure around that, just for health purposes. You know, if we don’t put healthy boundaries around our new school and work schedules, we will tend to burn out even more quickly.

- Right. And it’s important to set aside time for enjoyment with the family, for example, getting back to basics. I mean, one great way to do that is just simple board games, that you’re away from the technology, the social media, and you’re having interactive time. We no longer, in a sense, we don’t have homework anymore, because everything is homework for kids in a virtual learning environment. So that’s one way that we’ve had to become more flexible and adaptable.

- That’s right.

- And with work schedules, and so forth.

- Yeah. The next ingredient, if we move forward from flexibility and adaptability, the next ingredient in resilience is about building connection. And connection is something that has really suffered for most of us, in the context of COVID. And that’s because we don’t have the opportunities that we used to have to just sort of chit chat, sort of connect socially with people, whether they’re our colleagues or even our family members, we’re a little bit more isolated now than we used to be. So that does require some creativity. But connection, operationalizing connection takes two forms. And it’s about maintaining existing connections that you had before, and trying to figure out how to adapt them in a safe way. And then also learning how to develop new connections in this weird kind of an environment that we’re living in. So those are the two pieces. But connections can be anything. They can be, connections can be anything that keeps us from being isolated, right? And again, for kids or adults. So that can be a connection to a higher power. Connection to a social cause, or a group, a service group. Connection can be to family members, or friends, or an individual person, or pets. Pets are a great way to experience a sense of connection. And that’s, we know that pet adoptions have gone up quite a bit in the last several months, so.

- Those are great ideas, and, especially for children, it’s a critical time in the early years to develop friendships and if you can find opportunities for them to stay connected, it may be through social media, to stay connected with their friends, it may be through set up special kind of Zoom calls or play dates that they’d have an opportunity to spend time with friends, those are important events, and important developmental markers, so.

- Yeah, absolutely. There really are more opportunities than we think there might be. And it’s hard to sometimes identify what those are, but they are there, for sure. If you find yourself, also, like in a managerial role or in a workplace situation, where you have the opportunity to facilitate a casual lunch, like an open Zoom where there’s no agenda, the only rule is that you can’t do business, you can’t do work business. You can have a rotating host open lunch, and I know that you know, screen fatigue is a really big thing, but doing that kind of thing, it facilitates that water cooler talk. That, you know, how’s your family? How are things going? And, you know, how’s your life right now? And you know, what are you struggling with, and what’s going well, and those are the kinds of things we miss the opportunity to do when we’re going from meeting to meeting to meeting. So that’s one way for teams and organizations to consider developing connection as well.

- Great point.

- The third ingredient of resilience is purpose. And that is, that’s a tricky one. Because, it requires sort of a reevaluation of what motivates us, why we’re getting out of bed in the morning. So chances are, for most of us, what we were motivated by in 2019 or even earlier this year, to January and February, before the pandemic, is not the same thing that motivates us now. We could have other priorities in our life. We could have other things that are kind of more important. And identifying what motivates us by what we’re getting the most out of right now, so what contributes to compassion rewards is a key piece of identifying purpose, and sort of enhancing purpose. So what do we get something back from to help avoid burnout? Right, where do we get those good feelings? Where do we get the thank yous and the congratulations? Or just the, you know, I appreciate you. Or, what are the pieces of our jobs, whether that’s at home with our kids, or other kinds of work where we feel good about what we’re doing? Because those things, identifying those things helps to increase a sense of purpose.

- You know, if you think about the things that you’ve always wanted to do, if you’re stuck at home, there may be opportunities. There may be opportunities in this.

- Yeah, and really consider that with your goal setting, right? So those opportunities can turn into concrete goals. But one of the issues that we’re kind of all managing right now is the difference between large scale goal setting and long-term goal setting, and short term, small scale. So, what I mean by that is that, you know, prior to the pandemic, we were thinking, most of us were thinking, you know, six months, end of the year, this big vacation, you know whatever. Things that we had way out in the future. And there are so many unknowns that are happening with the pandemic in general right now, that it’s really sort of our purpose, our sense of purpose and our sense of goals are taking a hit right now, because we don’t have a lot of the information that we might need to be successful in achieving those goals. So one of my recommendations for folks generally is to not think too long-term or too big picture. Think about what it is you want to accomplish this week, or even today. And just next week. And if you’re thinking a few months ahead, I would suggest that that’s too far right now. It can feel really overwhelming, and it can feel really daunting. And it can affect your sense of purpose when it doesn’t feel achievable. So to narrow your scope, and to change the scale of you expectations for success and outcomes, and just make it small. Just keep it small, keep it bite-sized right now, and that is a way to have more experience of success. And that goes for kids too, I would think.

- That’s a great point, yeah. Especially for kids, and you have that opportunity to make that connection and stay in the moment, and develop that relationship at a deeper level with your family.

- Yeah. So I was using the idea of a tree earlier to describe the idea of resilience and how we can operationalize it, and our flexibility and our adaptability was the trunk swaying in the storm. And then the connection for the tree are the roots. They keep it nourished, they keep it grounded, they keep it connected to the earth, and give it what it needs, and that’s the same for people, right? And then the purpose is the fruit of the tree. What does it grow? What is it producing? What are you doing? And those are the goals that we can all sort of look to and sort of reevaluate in our lives. And the fourth ingredient of resilience is a little bit, it’s a little bit harder to pin down, but it’s the idea of hope, being hopeful. And you know, we’ve talked a lot, in the context of resilience about opportunity. And I really like to think of hope as being akin to opportunities. It’s about looking for new opportunities in things, and finding ways to sort of creatively assess where opportunities may lie for the rest of this year, 2020, and then also heading into 2021, that you would never have had the opportunity to do before. Whether it’s relationships, or things, or, you know, like learning a new language, or trying something else. And hope is really akin to identifying opportunities for ourselves, I think.

- So I’ve heard you talk about the REST model, Kira, could you say something about that?

- Yeah, absolutely. The REST model is just an acronym. I’m a big fan of acronyms. I can’t help it, and the REST model is about ways that you can specifically reduce compassion fatigue and avoid burnout. So the four letters stand for Reward, Establish, Share, and Trust. So the R is the reward, and that’s about building in positive reinforcements for things that we’re doing. The trick with rewards is that, they need to be in the healthy zone, right? So a handful of chocolate chips is a great reward. Half a bag of chocolate chips is probably not the best reward, so. Positive reinforcements are great. They work for kids, they work for our partners, and our family members, and they work for ourselves. So keep rewarding ourselves for good stuff. And then the E in the rest model stands for establish healthy boundaries. So boundaries, boundaries established. When you are not working, you’re not working. And it’s about putting parameters around when you are responsible to be responding to other people, and when you’re not. And everybody needs to have boundaries, you know. For kids, and for parents. This is an essential thing.

- Right.

- The S in REST stands for share, and that’s about not bottling it up, and not internalizing or keeping it to yourself when you have a negative interaction with somebody. So an example for that would be you know, if you get cut off by somebody, and there’s like a road rage kind of a thing. Or you have an encounter with a stranger at the grocery store that’s unpleasant. Or anything, right? It can be an email exchange with a colleague. Don’t keep that to yourself. If you struggle with sort of those emotion responses that you have to that situation, don’t keep that to yourself. Share that with other people. Continue to participate in things, continue to engage. And then the last letter in the model for T, is to trust. Trust your network and reach out for support when you need it. When you are too tired, when you’re compromised, when you just can’t, it’s okay to say no. And trust that your family, your friends, your colleagues, you know other people will be there. And when you have a week that’s better, you can pick up some slack for them. But part of this process and this culture shift that we all need to do right now is trusting the networks of which we are a part to be there for us as well, so. I guess that’s sort of to recap, reward, establish healthy boundaries, share, and trust. That’s the REST model for helping increase resilience and avoiding burnout and compassion fatigue.

- Great ideas. Thank you for that.

- Yeah. I think that’s about it for today. We’ve talked a little bit about the key ingredients of resilience, so flexibility and adaptability, and connection, and purpose, and hope. And we’ve shared the REST model. And we hope that you can find some ways in your own lives to go about really practicing, and even in the smallest ways, it all adds up. One grain of sand at a time. It adds up to make us all a little bit more resilient, heading into the next few months. So, thank you for joining us today.

- Thanks for listening. Hope you can join us next time.