Coping with COVID: Healthy communication

During the December holidays in the COVID-19 pandemic, there are many opportunities for tough conversations with family and friends. We may have differing opinions on how to celebrate the holidays while keeping ourselves and our families safe, and it can be hard to share those opinions when you want to keep the peace.

In this episode of our Coping with COVID podcast series, Kira Mauseth, PhD and Doug Dicharry, MD discuss what’s happening with our emotions and behaviors, and skills for having challenging conversations during stressful times.

The stress of living through a pandemic influences the way we communicate. Having tough conversations can feel draining, especially with everything else going on right now. Because of the long-term stress we are experiencing, regulating emotions can feel challenging. We might find ourselves snapping at others but wondering later why we reacted so strongly. Under stress, any conversation with disagreement or strong feelings can feel overwhelming.

It’s ok to feel worried about having hard conversations with loved ones, especially during a disaster. Fortunately, there are skills you can build for healthier communication that can make these conversations easier.

Practice active listening

While it may not come naturally to many of us, active listening is one of the most important things people can do to support each other. Active listening is listening to someone with the goal of understanding and caring about their experience instead of offering solutions. Usually, when someone tells us about the hard things they are going through, we have the natural urge to give them tips to make things easier. But often people don’t want solutions or tips, and they might have problems that are too big to be solved with just a conversation. What they really want is to be heard and understood.

There are three things you can do to practice active listening with people in your life:

1. Just listen. If you find yourself giving advice and problem solving, pause and really listen to what the other person has to say. Shift your mindset and listen with a goal of understanding what they are going through.
2. Ask open-ended questions. To better understand the other person, ask open-ended questions about what they are going through. Open-ended questions are questions that need more than a one- or two-word answer and give the person an opportunity to share their thoughts. Instead of asking “Are your kids doing their schoolwork?” try, “How are the kids doing?” or, “What’s going on with the kids?”
3. Get clarification. Make sure you understand what the other person is sharing. You can summarize or paraphrase what they share. For example, “It sounds like you’ve been feeling stressed about virtual schooling and it’s causing some anxiety?” Or ask clarifying questions like, “It sounds like you’re feeling really anxious about work. Is that right?”.

Sometimes the best thing is just to be there for the other person. Sit quietly and be in the moment with them. Being able to talk through a problem and feel understood can help someone feel better, even if there is no obvious or immediate solution to the problem.

Set boundaries

You might not be comfortable talking about some topics, or you might worry that someone may react strongly to what you want to share. Conversations about some issues can get so heated that others may not be willing to hear your opinion. It’s important to know how to step away when a conversation gets uncomfortable. Setting boundaries is a good way to keep relationships intact when you disagree with someone’s opinions or actions.

To set a boundary, be direct and focus on expressing how you feel. You can say “I don’t feel comfortable talking about this” or “Let’s talk about something else” or just “No, I won’t do that.” Being direct keeps your boundaries firm and helps avoid going deeper into a disagreement.

Boundaries are important all the time, but especially during COVID-19. Setting boundaries can help you protect your physical health during the pandemic, avoid heated discussions about hot button topics, and take care of your mental health. It’s ok to set a boundary and say no to things that make you feel unsafe.

Regulate your reactions

When we’re under stress, it’s easy to react without thinking and respond quickly and emotionally to what others say or do. It’s easy to snap back at someone who doesn’t share the same opinions or values, but this can be hurtful and damage a relationship.

Pay attention to what you are feeling and know when to pause before reacting. Sometimes knowing when to bite your tongue can prevent hurt feelings and save a conversation.

Own your mistakes

It’s normal to have a hard time pausing to slow down an emotional reaction. It’s ok to react strongly to what others say or do when under a lot of stress. But pay attention to the way you react and take responsibility if you say something harsh or hurtful. Own your mistakes and apologize when needed to keep your relationships strong.

Don’t be afraid to ask for help

Healthy communication can be especially tough during disasters like the COVID-19 pandemic. When you listen actively, set boundaries, regulate your reactions, and own your mistakes, you can have a healthy relationship with loved ones even when you disagree. Practicing these skills can help your kids learn them too, giving them the opportunity to have healthier relationships even in times of stress.

Even with these skills, it is normal to need more help taking care of yourself and your relationships. Coronavirus.wa.gov/wellbeing is a good place to start for more resources for mental and emotional well-being. Visit coronavirus.wa.gov/gatherings for tips and ideas to gather safely during the December holidays. And if you need someone to talk to about what you’re going through, call the WA Listens support line at 1–833–681–0211.

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.

- Welcome to our show today. I’m Kira Mauseth.

- And I’m Doug Dicharry.

- Today we’re going to be talking about how to have difficult conversations. Not that any of us are really jumping into those on purpose, but there is sure a lot of opportunity these days, it seems like, to be involved in a difficult conversation. So, we’d like to share a little bit about how to navigate that and what’s going on that makes conversations these days particularly challenging.

- That’s right, Kira. And what this means is that many of us find ourselves having really tough conversations with people in our lives who are really important to us, so there’s naturally a tension there because we’re trying to maintain these important relationships while we also have different opinions on a variety of issues.

- And in the context of where we are all in the disaster in the disillusionment phase, it becomes incredibly emotionally taxing to do all of that, to have those conversations and to try to maintain relationships while we’re all feeling so tired and so exhausted. There’s just so many things going on with people right now that really influence the way we perceive information and the way we communicate, for sure.

- Right. So, maybe we could talk first about just what people are experiencing.

- Yeah, absolutely. Probably the most common things that I’m hearing from clients right now are related to sort of those odd mood swings where you just kind of snap and react and then you catch yourself thinking, “Why did I say that?” or, “why did I do that?” just kind of this emotional dysregulation and not really being able to track kind of what’s going on. And then in addition to that, I’m hearing a lot of people talk about how they just can’t kind of stay on top of themselves, they can’t stay organized, they can’t stay focused on things, they find themselves distracted and forgetting all kinds of stuff. And our brains are just really tired right now, which certainly influences how we communicate with other people.

- Yeah, I hear people talking about, well, it happens in our own household where we forget what day it is, we might forget appointments, it’s very common these days. And kids, you might notice, cope with it in different ways, depending on their age. So children that are — say, for example, preschoolers — you might notice that they’re acting differently, they might regress some, they might start sucking their thumb, they might start wetting the bed, or being really clingy. You might notice that they’re having difficulty sleeping or changes in appetite, or they might start showing fears that they didn’t before, like fears of the dark. Whereas older children, say, elementary school, it may show up in different ways. You might notice that they’re a little more irritable or aggressive, they may be experiencing nightmares, you may notice that they’re avoiding their schoolwork or having difficulty concentrating, or just not participating as much with friends or activities. And again, with adolescents, it could be another set of symptoms, like sleeping and eating problems, or increase in conflicts or physical complaints. Main thing to keep in mind is they’re really normal reactions to an abnormal situation. But if they’re persistent, if there’s something that lasts more than a couple of weeks, you should bring it to the attention of your healthcare provider.

- Yeah, I agree. And I just want to echo, I’ve heard that a lot from some of my teenage clients that I’ve worked with about the sleeping and eating stuff. That’s a really important thing to keep in mind. Either kids are feeling really anxious and they’re just not eating much, unfortunately, maybe on the other side of that, where I’m snacking all the time in an effort to sort of feel good and feel comfortable. And then people’s sleep is being disrupted all over the place. I’m hearing from a number of clients that it’s usually one of two things, it’s either lying in bed at night and you can’t turn your brain off, it’s like the hamster wheel is just spinning, and spinning, and spinning, and you’re physically exhausted but you just can’t turn your brain off, or, you just fall asleep instantly because you’re exhausted but then you wake up and your — your brain is on at two o’clock or three o’clock in the morning when it really shouldn’t be because you’re not actually fully rested. So, people are really struggling with sort of those physical symptoms as well right now, and, like you mentioned, very common. For sure.

- Right. Right. And I think everyone wants to know, what do we do about it? How do we cope with these kinds of issues?

- Right. So, in the context of challenging conversations and sort of difficult issues that are coming up for families and even within family members, what I think we would want to talk about first is something called active listening. In my experience as a disaster responder, I would say the active listening is probably the most underused and undervalued intervention of all of the things that we can be doing right now to help support each other. And it’s really not very tricky, it’s actually pretty simple. But it’s not something that we do very easily, kind of, from a cultural perspective. It’s something that we have to think about doing and sort of focus on, so I think we’d like to share a little bit about how to do active listening and what that is exactly.

- So, I would break it down very simply by just explaining that active listening is listening to someone else with the intention of understanding and caring about whatever it is that they’re experiencing. Most of our conversations, typically, again, from a cultural sort of level perspective, are about problem solving. It’s about what’s the issue, what’s going on, and how do we fix it? And we don’t usually listen to other people with the intention of understanding and caring, but in fact, especially in a disaster situation, that’s exactly what we need to be doing. It’s really powerful for someone to feel heard on that level. And the other sort of data point about active listening and why it’s so effective in disasters is that people’s problems right now are really big, and they’re in fact, too big often to be solved just by having a conversation with another person in the dialogue. And because these COVID problems are so large in our lives, the experience of being able to talk through what you’re going through with someone else actually makes the situation feel better, even if a problem hasn’t been solved.

- So, if you find yourself in a situation where you are responding to someone and you’re thinking, “I think you should do this,” or, “I think you need to,” that’s when you need to stop and think, and listen.

- Yeah, I mean, jumping into a conversation with the intention to add your piece or to say your thing, or respond to whatever the other person is saying, that’s not active listening. And again, it takes a little practice, it takes some effort, but it actually makes the listener feel good too because it connects them, it connects them to that other person. And we need connection because connection is part of resilience. So, it’s good for the listener, it’s good for the speaker, it’s a really, really good active thing. And one simple way to start with active listening, if it’s not something that you’re familiar with, is just to ask open-ended questions. “How are you doing?” — things that people don’t really say yes or no to, right, so, “How are you doing these days? What’s going on with your kids? What’s it like with such and such, or other?” There’s lots of ways to ask those things, but the who, what, where, when, why, how, are good examples of how to start open-ended questions.

- Right. And another piece of that is giving feedback, in other words, making, I think, making clear that you understand what the other person is saying. So for example, “What I’m hearing you say is that you’ve been feeling down, you’ve been feeling depressed about this situation, but that it’s not anything serious. It seems to come and go, is that right?” So clarifying, giving some feedback, is part of that active listening.

- Yeah, yeah. And I think the temptation on all of our parts really is to jump in and make suggestions, right, “Here’s what you should do.” And like you mentioned earlier, that’s not the direction we want to go with active listening. It’s not about offering ideas, or suggestions, or leading people in a particular direction, it’s just about understanding.

- Right. And sometimes the most important thing that you can do — particularly this applies to situations of grief as well — is just simply be there, to be there quietly with the person, it can mean a lot. And that’s really a form of active listening just when you’re able to, to have your presence there without actually having to make suggestions or to offer something, a different direction for the person, unless they’re asking for it. Yeah.

- Yeah, absolutely. So having said that, and recognizing the value inherent in active listening, really, there are going to be things that come up that people really aren’t comfortable talking about and aren’t comfortable just listening and understanding. There’s so many kind of hot topics and hot-button issues right now. And I don’t know, do you have any suggestions for kids and adults really about what to do, or how to disengage, potentially, when a subject comes up, or there’s some way that the conversation is going, that makes people uncomfortable or it doesn’t seem like a good idea to continue?

- Well, you need to be clear about your boundaries. And I think it’s important just to be direct. The important thing is to focus on expressing how you feel in the sense that you say, “I really don’t feel comfortable talking about this right now,” or, “Let’s talk about a different subject,” so that you don’t go down that path where it gets deeper and deeper into a conflict. So, clarify those boundaries. And pay attention to what you’re feeling because it’s important that you modulate your own reactions. Often we may — it’s kind of a knee-jerk reaction — you may be quick to respond to what your cousin is saying, or you need to pay attention to what you’re feeling, in common terms, be able to bite your tongue sometimes and set those boundaries.

- Yeah. And what’s interesting is that in the context of COVID, the boundaries aren’t just sort of figurative and concepts, they are literal too. I mean, in terms of physical space and in terms of saying no to invitations, not going to people’s houses, so boundaries are really important these days in all of those kinds of ways. I mean, there’s boundaries around not engaging on Facebook with Aunt Millie or whomever that’s saying these things, but there’s also boundaries around saying, “I’m sorry I don’t feel comfortable attending a gathering or an event as usual because it’s not usual.” And if there’s something that you’re being asked to do or to be participate in that makes you feel unsafe, then there’s a boundary there that needs to be upheld as well.

- Right. Right. And as far as children are concerned, I just have a couple of points. It’s important to be a role model, be what you would like to see in your children because children observe, they’re very careful observers and they tend to imitate what they see, so they’ll definitely follow what you do. So, it’s important to be a role model. Try to maintain your calm. Demonstrate ways to relax. I mean, for example, you can create a deep breathing game where kids can deescalate and calm down. Encourage them to talk about their feelings, give them accurate age-appropriate information. Younger kids don’t need as much detail as older kids, but it’s important to address their concerns. And for children, especially it’s important to maintain a routine, keep that routine so that it helps them feel more secure. And if you can focus on the positive, there are always positives in the situation that you can focus on.

- Yeah. The point that you’re making about sort of practicing and preparing ahead of time, I really think that’s important for adults, too. It goes along with these difficult conversations like we’ve been mentioning about really paying attention to your own reaction and taking responsibility for those things, and recognizing that how you respond when you’re put in a difficult spot is also something that kids will see and copy, for sure. And if they can see you saying, “You know what, I didn’t handle that very well,” or, “I’m gonna just step away and take a break,” or, “I apologize for saying this thing in such a way.” So, it is really an opportunity to try and model for kids how to own your reaction, how to take responsibility for mistakes, and how to have those healthy boundaries with family members and friends right now.

- Right. Right. So, we’ve touched on several strategies that can help you navigate difficult conversations with important people in your life, and we also have some resources that can help. The first one is the Safer Gatherings website which has tips and ideas for safer gatherings this holiday season. And you can find that at coronavirus.wa.gov/gatherings.

- Yeah. The other website that we recommend people check out is coronavirus.wa.gov/wellbeing. Okay, so coronavirus.wa.gov/gatherings, and then same website, /well-being. And those are your options for lots of — I mean, there’s more than that out there — but those are a good place to start for resources that might help you work through some of these other challenges that we’ve been talking about today. Lots of different things on there for behavioral health, for sure. There’s also the Washington Listens line. You can call and just talk to somebody about some of the stuff that’s going on, some of those concerns that you have, some of the things that you’ve been dealing with, and they can help also connect you to other professional resources in your area. And that Washington Listens line is +1 833–681–0211.

- Right, and as always, talk to your healthcare provider if you’re concerned about mental and behavioral health of yourself, or your children.

- That is it for our show today, thank you for joining us. And we’ll see you next time for the Department of Health behavioral health podcast on coping with COVID.

- So long.

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