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Self-Care: What have I done for me lately?

36:33
 
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Manage episode 304038402 series 2991648
المحتوى المقدم من Dana Jonson. يتم تحميل جميع محتويات البودكاست بما في ذلك الحلقات والرسومات وأوصاف البودكاست وتقديمها مباشرةً بواسطة Dana Jonson أو شريك منصة البودكاست الخاص بهم. إذا كنت تعتقد أن شخصًا ما يستخدم عملك المحمي بحقوق الطبع والنشر دون إذنك، فيمكنك اتباع العملية الموضحة هنا https://ar.player.fm/legal.

The science tells us we feel AND do better when we attend to our own nutrition, physical activity, and mental health. So, what have you done for yourself lately!

Dr. Marney White, clinical psychologist and Associate Professor at the Yale School of Public Health, joins us and she's going to tell us what we need to know about self-care!

Especially now that parents are home with children all day due to the COVID-19 closures. We are scheduling like crazy but are we scheduling the right things? Those things you call a guilty pleasure could be what clears your head and opens your mind.

Relevant links Article on Dr. White's self-care class https://medicine.yale.edu/news-article/23577/

Psychology Today offer a "find a therapist near you" option for those looking for support https://www.psychologytoday.com/us

Dr. White's online class, Foundations of Health Behavior Change https://www.coursera.org/learn/health-behavior-change

TRANSCRIPT (not proofread)

SUMMARY KEYWORDSpeople, stress, students, parents, children, work, therapist, talk, engage, telehealth, care, experiencing, point, mental distress, self care practices, find, mental health, behaviors, small, recommend

SPEAKERSDana Jonson, Dr. Marney White

Dana Jonson 00:02

Hello, and welcome to need to know with Dana Jonson. I'm your host, Dana Jonson and I'm here to give you the information you need to know to best advocate for your child. I'm a special education attorney in private practice, a former special education teacher and administrator, a current mom to four children with IEPs. And I myself have ADHD and dyslexia. So I've approached the world of disability and special education from many angles. And I'll provide straightforward information about your rights and your schools obligations, information from other professionals on many topics, as well as tips and tricks for working with your school district. My goal is to empower you through your journey. So if there's anything you want to hear, comment on, join our Facebook group, it's aptly named need to know Dana Jonson, or you can email me at Dana at special ED dot life. Okay, let's get started. Okay, so today we are meeting with Dr. Marnie White, who is a clinical psychologist and an associate professor at the Yale School of Public Health. Thank you for joining us, Marnie, thank you so much for having me. I wanted you to come on and talk to me, because I know that you do a class on self care at Yale. And one of the things that I have been telling my parents consistently for the last feels like 4000 days, is that you have to engage in self care. If you are not okay, you can't help your kid. Correct? Yeah. So I think sometimes people have a hard time wrapping their brain around that. And I hear a lot, well, I have to take care of the kids, I have to take care of the kids. And I think if you're losing your mind, that's not helpful. So first, before we get into self care too much, I do want to give a little background on you and what you do and why you are the person I want to talk to about this, how you got here, how Why are you going to about self care?

Dr. Marney White 02:00

Absolutely. So this is actually kind of an evolving story about a class that I teach in the graduate program, the Master's in Public Health Program, the School of Public Health, and it evolved probably from my position as being both in public health and in psychiatry. As a psychologist, my research has been focused on prevention and prevention of mental health problems. And also, another side interest is just on dissemination of telehealth therapies actually trying to get affordable mental health treatment, and also education to individuals for whom it might not otherwise be accessible, either by geographic distance, or, you know, as we're seeing with the current catastrophe, due to various health conditions that would preclude someone from engaging in face to face treatment. So that's how I ended up being in public health in the first place was about prevention work. And then over time, I started noticing what I felt was an epidemic of mental health problems among students in higher education. Because of I was one of the few psychologists in that school, a few clinicians, students would very frequently approached me about referral sources, places that they could get mental health treatment and that kind of thing. And it occurred to me that this really intense levels of stress and anxiety and depression, and really significant rates, significant increases over the past generations. And it seemed to me this, that it might be something really about the lifestyle that was making people who are, you know, otherwise functioning quite well, especially vulnerable to the onset of significant clinical mental distress. So when you talk about the amount of stress that these students are carrying, are you talking about, from an academic perspective, because they're in a highly competitive university, or? Absolutely, that as well as many other lifestyle factors. So certainly, the the stresses of academic strain, but also some of the things like the need, it's almost a badge of honor, sometimes for students to talk about pulling all nighters or how they're managing their research and their classwork and so on. And so I mean, I know many of us who have had lengthy educational histories can relate to that somewhat, you know, you kind of you get to, the more stressed you are, the more work you're doing, the more highly you're commended for these.

Dana Jonson 04:30

Well, there is something and I don't know if it's true, so you tell me, but I think that there is something to some people handle stress a little bit better, but then they're more prone to take on way more.

Dr. Marney White 04:39

Yes. Yeah, I think that's certainly likely a bit of a snowball effect there. Right. So, you know, I just sort of observing these things for a couple of years and wondered whether or not it was possible to create an intervention of sorts to essentially force students or give them the option to encourage them strongly let me put it that way to engage in various self care practices. And I really want to intervene on a multiple levels because again, like we were talking about not only is it to be academic strain, but there are other factors about the graduate student experience that make it an especially stressful time going to make a parallel quickly to the Coronavirus epidemic. So that, I think, because I think that essentially we are, we're all kind of living in this very extreme situation that has many commonalities with what I was trying to create for the students themselves. So, for example, things like financial strain, social isolation, separation from primary support groups, or loved ones, poor nutrition, lack of physical activity, or lack of adequate physical activity, perhaps substance or alcohol misuse, all of these things can create a perfect storm for the development of significant mental health problems. Or even those are just a, you know, a decline from from normal. So I think that right now we're seeing at the population level, people engaging in many of these health behaviors, or perhaps just letting some of their typical routines or health behaviors slide. And this, then, you know, raising the vulnerability for the onset of mental distress. And I ever go thing that you just mentioned, is something that parents of children with disabilities is experiencing right now, every single thing. Because most of them, I shouldn't say most of them, there are a lot of kids who went home and went to this kind of learning, I have one of them and was like, this is fantastic. I'm in, I don't ever need to leave the house, this is great. If you have a child who has social skills, issues, it's not as great as they think. But there are a lot of parents who, you know, their children have a lot of support at school, and now they're home, and they're juggling a job, or they're juggling, not having a job and deal with that. And then trying to get that done while you know getting the kids together. And when you talk about students using that as a badge of honor, I kind of laugh because I think parents of children with disabilities do too, we tend to, you know, it's, everything is constant, you're you're non stop, there's always something to do, you're always more and more stressed, and more, whose to do list is longer. And I have more therapy appointments to get to than you do. So I don't wanna hear you complain, or, you know, stuff like that. And, and you do see it, I mean, I think that is in our society, it is a badge of honor to be able to push through being sick and not rest, or to work until you're unconscious, you know, we just have this drive that doesn't seem to be healthy. So telling parents, you know, you can do that oxygen mask mask on the airplane. And I've heard allergy so many times, I've got to find a new one. But it is you have to take care of yourself, if you're stressed out, it doesn't matter what you're doing with your child, because it's not, it's not going to work, right. And then they will absorb that as well. You know, so that's, that's something that I myself use, when trying to motivate or employ the exact same strategies that I encourage for students, it's still difficult, we are human, and it is very difficult to kind of nudge ourselves into doing things that are good for us, even though we know it will feel good. But something that at least works for me or is helpful for me as a parent is to say, No, I have to engage in these stress reduction techniques, because otherwise my child will be the end of the line recipient of of all of the stress and anxiety that I've been absorbing. And so that that little mantra for me is like I need to do this for him. I have to do this for him, because otherwise he's going to suffer.

Dana Jonson 08:37

Right? What are the things that that anyone can do to identify? Because I think sometimes people don't recognize this? No, I'm not stressed because again, that mentality that it's okay, to be stressed, you have to be a certain level of stress, right? If you haven't hit the high level of stress, then you can't take a break.

Dr. Marney White 08:55

Yeah, that's a great, this is where the public health angle comes in. Because typically, when we think about the medical model and the clinical model, we're usually talking about intervening at the point of significant distress or significant sickness or, you know, presentation of, of symptoms. So even just thinking about the medical model, when do we go to the doctor, we go to the doctor when we have a fever, or we're experiencing some kind of physical sign or symptom. And then the same kind of holds for when people tend to seek out mental health services when there's some clinically significant, highly distressing or interfering level of symptom presentation. But for this self care stuff, I like to encourage the public health approach which is seeking some kind of blanket intervention that's applied to the entire population, meaning ourselves even in a state of wellness, so it's taking a clear Prevention's standpoint, meaning engaging in these daily activities mostly focus probably on physical health and well being and getting enough rest or engaging and relaxation exercises or stretches to specifically unwind and protect our mental and emotional well being. And I think now more than ever, it's critical to engage in these at least daily, potentially multiple times a day and potentially even in a variety of domains.

Dana Jonson 10:16

And that's a good point. Because I think that when you talk about preventative health, I love that we, you know, my four children all are in therapy all the time. And I remember somebody said to me, like, oh, well, they all have all these issues. And I was thinking, not this week, no, but I don't want my kids to think you have to wait till you have a crisis.

Dr. Marney White 10:35

Right? Right.

Dana Jonson 10:37

Having a therapist in your life is normal. And sometimes you see them more frequently than others. But you know, I want them to understand that that is a normal state of being and that if you're always engaged in it, sometimes you need it more than you do other times. But it's always a sense of normal, we don't have a society that values it in that regard, yet.

Dr. Marney White 10:58

I agree. And I really liked that approach as well. And something that I'd like to even encourage or use as another sort of cliche or release mantra is to try to conceptualize mental health services as as even when they're applied in like a state of wellness as something like a spa treatment for the emotions or for the soul. And knights, you know, when we think about preventative health, most people are okay with going to their physician for a regular checkup and getting the standard physical health screenings as recommended, but we have not as a culture have been able to embrace mental health care in the same manner. And it's a real shame.

Dana Jonson 11:38

Are you seeing a trend in that either going up or down

Dr. Marney White 11:41

from the stigma with respect to mental health services? I what I'm observing a little bit is that following education, about mental health, the prevalence of mental illness, and the effectiveness of mental health treatments, as well as the effectiveness of mental health prevention programs, are actually able to see that following education surrounding these issues. Stigma does diminish over time, at least among students. So whether or not that generalizes to the overall population, I certainly cannot say but that would certainly be a dream of mine. Like every time we get close to sort of embracing that mental health component. We have something that catapults us into another crisis, where we have to up our game again, and we there to start with. Yeah, I mean, potentially, as it is, it's a silver lining of some of the Coronavirus catastrophe is that we are now in a position where telehealth is the only mental health service available, at least for right now. And so clinicians as well as clients are potentially much more open minded to that medium. It's something that's been researched and studied for decades now that we know that telehealth can be every bit as effective as the traditional face to face that Yeah, yeah. And there are treatments already available. And even some of these apps that have come out in recent years are very effective and teaching people the same skills that would they would ordinarily be taught and the empirically supported treatments for mental health.

Dana Jonson 13:15

So what are some ways that families parents or students can identify that, and I hear what you're saying about preventative and we should all be doing this every day. And I would promote that as well. But I think the reality, at least today in this chaos, not sure where we're gonna go. And so just kind of reacting. But we're going to get a little more settled, and we're going to get to that place. But until you're in a place where you can have that, that pre emptive routine and incorporate something into their lives. How can they identify? Or do you have strategies for someone to identify when they might be more stressed than they think they are? Or they might be reacting in a way in a negative way and not identifying it?

Dr. Marney White 13:57

Yeah, I mean, I think the the clinical the textbook answer to that is when there is interference, interference with social or occupational functioning, when you're no longer you know, when you're snapping at people, for example, or when you're no longer able to fulfill your family or work obligations. The problem right now is Hi, guess what, that's pretty much everyone, the entire population is no longer functioning right, you know, with respect to their typical or their normal behavior patterns in terms of how they're interacting with their families or their jobs if they're able to work during this time. So it's very difficult to tease that apart right now. Which leads me back to my original point. Everyone is suffering socially, and occupationally. And so this is the time I think that everyone is in significantly elevated vulnerability for experiencing mental health issues. And the data of course are not out on that but I think that everyone in the field and everyone At home, I think that everyone knows this is a super vulnerable time for experiencing mental distress. And so to that end, blanket recommendation, engage in these behaviors, it is critical, because the last thing you want to do is start that snowball down the hill that up to a point that you can no longer catch it or stop it.

Dana Jonson 15:20

Well, and particularly since we are in isolation, right? You don't have that audience around you to say, hey, Marnie, you're having a really bad day, what's going on? You don't have those. You don't have that barometer around you. And for some parents, their only barometer right now is their kids, single parents at home with multiple children, trying to just how do you recommend that? You know, for somebody who's like, I don't really need it, or it's not me, or I can't fit it into my life? What kinds of things do you advise?

Dr. Marney White 15:50

Well, I'm sure that you've mentioned routines pretty consistently throughout your podcast. Same applies here. You know, I recommend starting with very small, but measurable goals. So really using that same kind of behavioral terminology with which I think everyone is quite familiar these days. But even using, you know, a very specific goal, whether it's, you know, setting a standard wake time on having a first meal of the day, some small behavioral modification, five minutes of stretching, using a breathing app four times a day, where you actually do deep breathing for 30 seconds and choosing a measurable small something and you know, that 30 seconds of breathing of closing your eyes and breathing, administered a few times throughout the course of the day, setting a prompt on your phone, to remind you, those small things can be remarkably beneficial. In terms of maintaining your stress, I even chose during this time to set a daily goal of walking my dog once around the block, and which, you know, there are certainly some days when I'm like, I just don't feel like it. I'm tired, I've worked hard all day, I just don't even want to. And then he gives me the sweet puppy dog eyes, like, okay, and sure enough, you know, before I'm even halfway around the block, I'm already feeling better. There is just something about protecting even a few minutes of time to attend to your own well being that is remarkably beneficial. And the other thing about it tends to heighten self efficacy, which is our optimistic belief in our ability to meet challenges. And so that kind of pattern of encouraging people to engage in a very small, something for your own well being a couple of times a day or once a day, is enough to contribute to boosts and self efficacy and mental wellness overall.

Dana Jonson 17:52

I'm curious about this, because I've heard this several times, particularly teenagers with anxiety, and I hear the parents say, well, they won't engage in meditation, or they won't engage in breathing because it raises their anxiety. What is that about? What is it raise?

Dr. Marney White 18:09

No, I don't actually know exactly what that's about or why that would be. So so much as I know that to be true. For some people, it is just not a good connection, or it

Dana Jonson 18:22

thoroughly that everyone will benefit from this particular exercise, right? You have to find.

Dr. Marney White 18:27

Yep, you have to find the the niche that's right for you. And so I would recommend trying out a variety of these. And so what like when I just shared that I walk my dog every day as one of my I actually I've walked my dog among several other things. And if I'm not willing to walk him, then I will stretch for 10 minutes instead. Because there have been some rainy cold days. And I'm like, I'm not doing that it was too overcast to go for a walk the other day. Exactly. And this is exactly why pointing like we're human, even though we know we will enjoy it, it's still very tough to kind of push over that motivational hurdle. And so that's why I think it's a good idea to have a couple of these like a toolkit, if you will, of strategies that you can try so that if the weather does prevent your your morning walk, or if you get a late start or if there's some other curveball, because let's face it, there are going to be a whole lot of curveballs and obstacles, that you have something else that you can grab and do. And then over time of being able to implement these on a regular basis over time, they do become intrinsically rewarding. And that's really the ideal, right?

Dana Jonson 19:32

It's to make that habit once it becomes a habit actually, it's funny because I tell parents now we're asking parents to document everything for what I'd like to think are very obvious reasons. But we you know, when we get back to whatever we're going back to, we're gonna have to figure out where all these kids are some asking parents to document and I've had a few parents say, well, like you I don't have time I can't do it. And I've said if the only thing you write down is today sucked, that's okay. It's just work there. Yeah. And and eventually writing in that book once a day will become habit, and then you'll do it more than once a day, and then it'll, you know, grow. So it's, it's the same thing with mental health, right? If you're, if you force yourself to take those five minutes, that's what I've been telling parents five minutes, I don't care what you do for five, lock yourself in a room go sit in your car, what makes you chill for five minutes?

Dr. Marney White 20:24

Right? Right. And then, you know, I even recommend employing behavioral strategies. So going beyond the just tell yourself, but setting prompts setting, you know, setting the alarm on your phone. Okay, now this is the time for me to go take that five minute break, leaving reminders, even employing reinforcement principles or behavioral principles like that.

Dana Jonson 20:46

Right?

Dr. Marney White 20:46

Yeah,

Dana Jonson 20:47

it takes a walk, I don't get my pint of ice cream.

Dr. Marney White 20:50

Exactly. Yeah, or the I mean, you know, the, the thing that I've shown there was once a once upon a time, in order to try to incentivize my own physical activity, my own working out, I told myself, well, I just wouldn't have a glass of wine with dinner if I hadn't done my exercise. And then very quickly, I learned that the wine just wasn't reinforcing enough, I didn't care. And so I have to set a different contingency for myself. So I then started watching my trashy television while working out on an exercise bike. And it turns out that that concurrent reinforcement of you know, I will continue to pedal for access to horrible reality TV was what kept me going until it got to the point where it became intrinsically rewarding. And now it is actually, you know, part of my lifestyle, but it took some trial and error. And I absolutely use these behavioral principles in shaping my own health behavior, and self care. So I recommend that these are things that we're all masters of as parents, but again, it's a little bit tricky to try to apply them to yourself.

Dana Jonson 21:53

And it goes back to do as I say, not as I do, right, because another, we're all very much like that, too. Because we recognize we don't need the same boundaries our children do, but our children don't recognize that. So it comes around. I love the consequence for yourself for the reward for yourself. I went through a phase where I wouldn't shower unless I'd worked out.

Dr. Marney White 22:13

Oh, my goodness. All right. That's a little

Dana Jonson 22:17

extreme.

Dr. Marney White 22:20

Effective, though, so

Dana Jonson 22:22

because I wouldn't allow myself to shower unless I had worked out. And that was apparently what I needed to do to get myself to work.

Dr. Marney White 22:31

And now you probably enjoy working out and

Dana Jonson 22:33

Right, exactly. Some of the strategies you talked about physical health walking?

Dr. Marney White 22:38

Uh huh.

Dana Jonson 22:39

The thing trashy television?

Dr. Marney White 22:41

Yeah.

Dana Jonson 22:42

I think that sometimes people think that if they're doing something healthy, it has to be kind of highbrow.

Dr. Marney White 22:47

No. Certainly, no, no,

Dana Jonson 22:52

if I'm watching, you know, The Housewives of New Jersey, then maybe that's not really time for myself. Maybe that's just wasted time.

Dr. Marney White 22:59

But you get a predictable ego boost. So every time you watch it, and think you know what I'm doing great.

Dana Jonson 23:05

I'm doing great. I like to watch on that that reality show and I'm couples counseling. Honey, get in here we're back. Get an award.

Dr. Marney White 23:17

Yeah, no, I have the I think that what ever will protect or boost one's mood, or has the potential to, to help others through distraction, or even just any sort of stress release. I mean, I certainly have had students who have protected time to listen to comedy on Pandora, because we know that laughter is an enormous detective for subsequent stress, as well as actually does release stress. So it works both ways as a stress relieving function, and also as a buffer. So there's really a lot to be you know, turning on Pandora or one of the free streaming services and listening to comedians would be an excellent wellness.

Dana Jonson 24:02

Yeah, that's so funny. Because when this first started, and there are six of us here, and when it first started, we were locked in we watched a stand up comic every night, I didn't do it on purpose. I was just like, This is what's happening.

Dr. Marney White 24:13

And you know, laughter there's something to that, but home laughter is the best medicine thing. There's actually a huge body of literature about the stress relieving properties of laughter neuro chemically, and and on just, you know, subjective perceived outcomes. It's very great.

Dana Jonson 24:30

That's awesome. We have parents and children all stuck in it. Well, everybody's stuck at home and whoever you're stuck with, should we be encouraging people to take that time by themselves? Or should we be encouraging parents to do it as a group with their kids? Or?

Dr. Marney White 24:45

I don't know, there's any clear answer for that. I think it's it's all going to be individual preference. And I don't know that would be consistent across days, either. Some people who might have ordinarily labeled themselves as extroverts are suddenly finding that actually they are Okay, not being in large groups of people all the time. And people who might otherwise enjoy a whole lot of family togetherness are finding that they need a little bit more privacy than they would have otherwise predicted. I don't think there's any right answer. And I think that this is going to be variable throughout the course of this. And it might require some experimentation, and yeah, just some, some incorporating various different strategies to see what works and what works this week might have been very different from what would have been effective six weeks ago.

Dana Jonson 25:27

I like that, because I've seen that where we have one day where walking the dogs is perfect for everybody. And everyone had a great day and another day where nothing works. And I think I'm hearing a lot. You know, we've got all these webinars, everyone's being bombarded with information on how to handle being at home, and how to handle your kids. And I mean, there's just so much coming from everywhere, that I want parents to understand, too, that there is no one exercise, there is no one thing because I hear people saying, well, you have to do breathing, or you have to do morning meeting, or you have to do you have to do you have to do and you don't you do take the time, right to figure out what works for you that day. And then make it work.

Dr. Marney White 26:12

Yeah. And that's why I'm recommending this toolkit approach to because I think that, you know, circumstances are highly variable. You know, if someone had a nightmare in the middle of one night, guess what, people are gonna be a little bit more sleep deprived. And the strategy that might have worked under ideal conditions might no longer be what's most readily available, or even possible

Dana Jonson 26:33

daughter and her therapist came up with, since you said toolbox, an actual box.

Dr. Marney White 26:38

Oh, how cool,

Dana Jonson 26:39

actual box of things that calms her down, like a coloring book, a pig, or a stuffed animal. And so when she takes her break, she can go get her box if she wants and pick something. I love that. Yeah. So that's what they came up in their sessions. So that could apply to adults to write the group of things you'd like to do and just be like, here are my five things I can pick from, then you've got variety. When you first get married, I remember no, not married when we had kids. And I remember, everyone's like, you have to go out on a date. And you have to do it this way. And you have to so we did. Yeah, we did. At least everybody told us and we were like, we still don't want to be here. Oh, can we just go do something else? It wasn't, you know, that wasn't our thing as a couple that whatever it was we thought we had to do wasn't something we'd ever done before. So why leave the right thing? Yeah, yeah, I think it's really important for parents to remember that. Now what about for there's the day to day stress, there's the extra stress we're all experiencing. But then we get into a clinically dangerous place. Sometimes for some people, how can parents help identify that within themselves or their children, if they are beyond a breathing exercise or toolkit, and actually seek professional help? What would science for that?

Dr. Marney White 28:02

Well, I mean, of course, it'll depend on the specific problem, whether it's somewhere, but I'm going to go with what's likely to be like the most prevalent right now, which would be somewhere in the depression and anxiety realms. So when we're talking about anxiety, and and, and depression to being clinically significant, some kind of markers would be inability to fall asleep, or have sustained sleep or waking up very early, a lot of times these begin to take on physical indicators. So feeling as though you're not able to unwind ever and just kind of noticing within yourself whether or not you know, kind of starting to feel like you're not yourself or when friends or family members would say that you're not really behaving as you typically do. And then again, kind of coming back to that interference with social and occupational functioning. So when you're really noticing that you're not able to fulfill your general work or family obligations, and that it's sustained, it's likely that in this time, people will demonstrate a great deal of resilience and following the various other kinds of tragedies, people do tend to experience high levels of distress. But in many cases, their existing supports and strategies do kind of help them persist or kind of get through the critical period. But I always kind of take a much more liberal approach with these things. Or I guess you could consider a much more aggressive approach of sort of, I like to catch things very early, again, because it's not only easier to treat, but it also has better outcomes for the for the long term. So this isn't it's kind of debated among clinicians and among specialists and there is no completely clear demarcation either. So

Dana Jonson 29:56

that's a really good point because we are in a situation where we are now Seeing our doctors, right? Right, we are not physically going to see our therapists. You know, I know, as I said, in my house, all four of my children have their own therapist, and they're maintaining those appointments. But it's also very easy. Sometimes I recognize that oh, one of them only scheduled for two weeks from now, not one week, or we're not seeing them in person. So one was on a phone, someone else is doing zoom and different levels of attention. I think you and I were talking before about kids in class on their computers, they do that during the therapy session, too, right? Talking to their therapist, and, you know, laughing at their texts. So I worry. And I also think that I also don't want to panic parents, because kids are out of their element right now. So yes, there's going to be anxiety. And yes, there's going to be depression. But if your child wasn't attending to the computer screen to start with, the fact that they're not attending now might not be a negative sign. Yes, very good point. But so were we are in a place where we're not going to see our doctors. And so for somebody who wants to seek professional help, where do they go? I mean, we're at home. Yeah,

Dr. Marney White 31:06

there are a lot of good resources for finding a therapist. Psychology Today is a database that's free for searching and find and you can search by geographic area or zip code. But they now have a different level of allowing to search for clinicians based on whether or not conditions are set up to provide teletherapy. So and some states have even opened up with respect to reciprocity for licensure. So typically, one could only seek out a therapist who is licensed in their state. But some of that has become more variable or is opened up. There are also lots of research centers that would ordinarily enroll participants from the community who are now able to provide free treatments to a much broader catchment, because all of the interventions are being provided online through telehealth,

Dana Jonson 31:54

right. That's great. That is such a wonderful thing. And I, a couple years ago, I'd asked a friend of mine, because I couldn't find a therapist for my son, he's, he's LGBTQ. And we couldn't we just didn't find somebody who was matching what he needed. So a friend of mine had said, he's like, Well, telehealth is not a bad thing. And I remember thinking, ooh, online therapy? I don't think so. And now I think it's great. That was two years ago. But at two, he'd said that, you know, that was the direction that this was going anyway. So I think this catapulted us in?

Dr. Marney White 32:27

Yeah, no, absolutely. And that's that's kind of another silver lining of of this is that I think that now services will be much more readily available to people who might not have otherwise been able to access them, both because they can be delivered more affordably. And even just to geographic distance now. So when we come out of this, it is my hope that not only will the therapy be more accessible, but possibly education as well.

Dana Jonson 32:52

That would be amazing. The takeaways that I've got here are preventative medicine is always the best. Don't wait till you're in a crisis. But if you find what works for you, it's not one size fits all, find what works for you, and start slow. Eventually, it'll become a habit. And if you need real help, we can get it now online without leaving your house. And I'm going to put the Psychology Today, Lincoln websites in the show notes. So anybody listening to this, who wants to go find that information can? And is there anything else that you'd like to leave us with?

Dr. Marney White 33:28

I guess just the the one conclusion would be that we've actually done research on these self care practices.

Dana Jonson 33:37

It's a really good point.

Dr. Marney White 33:38

Through the class that I that we've been teaching, which is colloquially called the self care class, but in formal practice is actually called health behavior change or foundations of health behavior change. And we've tracked the students the Enrolled Students experience and depression, anxiety and stress as well as their overall perception and their physical health and well being, and have found that just engaging in these self care practices, which are self identified, they're variable across days, students set their own goals with respect to health improvement projects of engaging in small behavior every day, and it predicts improvements and all of those domains depression, anxiety, stress, and general physical well being. I know it's very exciting. And that's, of course, compared to students who were not enrolled, but in the same in the same graduate program. They're just experiencing improvements in all those. So it's very exciting. And then recently, actually, in March, Yale partnered with Coursera, which is an online massive online education community, where individuals anywhere can can sign on and take this distance learning class. And so it is now available to anyone. And right now there are a few 1000 Students taking it and posting their daily behavior change goals and getting kind of community support and doing it than any outcomes yet as to whether or not it's as effective as the the Yale version. But every indication would be that it shouldn't be because it's the exact same class.

Dana Jonson 35:17

Oh, wow. No, that is good. And I'm glad you did say that. Because I do always say that we just happen to not say the words that there's science behind this. This is not just some hokey, we think this will work. There is actual science behind it. You can change your behaviors and improve your quality of life. And you just got to start small and start slow.

Dr. Marney White 35:38

Yes, yes. Yeah,

Dana Jonson 35:41

fantastic. Well, if you give me the links for that, I will have that in the show notes. The links for where to find professional help if you need it. And check that out and check out Dr. Marney White. Thank you so much, Dr. White.

Dr. Marney White 35:54

Oh, thanks for having me. Have a lovely day.

Dana Jonson 35:57

Thank you so much for joining me today. Please don't forget to subscribe to this podcast so that you get notifications when new episodes come out. And I want to know what you want to know. So join our Facebook group also named need to know with Dana Jonson or you can email me at Dana at special ED dot life. But definitely reach out with your comments and questions and I'll see you next time here on need to know with Dana Jonson Have a fabulous day

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المحتوى المقدم من Dana Jonson. يتم تحميل جميع محتويات البودكاست بما في ذلك الحلقات والرسومات وأوصاف البودكاست وتقديمها مباشرةً بواسطة Dana Jonson أو شريك منصة البودكاست الخاص بهم. إذا كنت تعتقد أن شخصًا ما يستخدم عملك المحمي بحقوق الطبع والنشر دون إذنك، فيمكنك اتباع العملية الموضحة هنا https://ar.player.fm/legal.

The science tells us we feel AND do better when we attend to our own nutrition, physical activity, and mental health. So, what have you done for yourself lately!

Dr. Marney White, clinical psychologist and Associate Professor at the Yale School of Public Health, joins us and she's going to tell us what we need to know about self-care!

Especially now that parents are home with children all day due to the COVID-19 closures. We are scheduling like crazy but are we scheduling the right things? Those things you call a guilty pleasure could be what clears your head and opens your mind.

Relevant links Article on Dr. White's self-care class https://medicine.yale.edu/news-article/23577/

Psychology Today offer a "find a therapist near you" option for those looking for support https://www.psychologytoday.com/us

Dr. White's online class, Foundations of Health Behavior Change https://www.coursera.org/learn/health-behavior-change

TRANSCRIPT (not proofread)

SUMMARY KEYWORDSpeople, stress, students, parents, children, work, therapist, talk, engage, telehealth, care, experiencing, point, mental distress, self care practices, find, mental health, behaviors, small, recommend

SPEAKERSDana Jonson, Dr. Marney White

Dana Jonson 00:02

Hello, and welcome to need to know with Dana Jonson. I'm your host, Dana Jonson and I'm here to give you the information you need to know to best advocate for your child. I'm a special education attorney in private practice, a former special education teacher and administrator, a current mom to four children with IEPs. And I myself have ADHD and dyslexia. So I've approached the world of disability and special education from many angles. And I'll provide straightforward information about your rights and your schools obligations, information from other professionals on many topics, as well as tips and tricks for working with your school district. My goal is to empower you through your journey. So if there's anything you want to hear, comment on, join our Facebook group, it's aptly named need to know Dana Jonson, or you can email me at Dana at special ED dot life. Okay, let's get started. Okay, so today we are meeting with Dr. Marnie White, who is a clinical psychologist and an associate professor at the Yale School of Public Health. Thank you for joining us, Marnie, thank you so much for having me. I wanted you to come on and talk to me, because I know that you do a class on self care at Yale. And one of the things that I have been telling my parents consistently for the last feels like 4000 days, is that you have to engage in self care. If you are not okay, you can't help your kid. Correct? Yeah. So I think sometimes people have a hard time wrapping their brain around that. And I hear a lot, well, I have to take care of the kids, I have to take care of the kids. And I think if you're losing your mind, that's not helpful. So first, before we get into self care too much, I do want to give a little background on you and what you do and why you are the person I want to talk to about this, how you got here, how Why are you going to about self care?

Dr. Marney White 02:00

Absolutely. So this is actually kind of an evolving story about a class that I teach in the graduate program, the Master's in Public Health Program, the School of Public Health, and it evolved probably from my position as being both in public health and in psychiatry. As a psychologist, my research has been focused on prevention and prevention of mental health problems. And also, another side interest is just on dissemination of telehealth therapies actually trying to get affordable mental health treatment, and also education to individuals for whom it might not otherwise be accessible, either by geographic distance, or, you know, as we're seeing with the current catastrophe, due to various health conditions that would preclude someone from engaging in face to face treatment. So that's how I ended up being in public health in the first place was about prevention work. And then over time, I started noticing what I felt was an epidemic of mental health problems among students in higher education. Because of I was one of the few psychologists in that school, a few clinicians, students would very frequently approached me about referral sources, places that they could get mental health treatment and that kind of thing. And it occurred to me that this really intense levels of stress and anxiety and depression, and really significant rates, significant increases over the past generations. And it seemed to me this, that it might be something really about the lifestyle that was making people who are, you know, otherwise functioning quite well, especially vulnerable to the onset of significant clinical mental distress. So when you talk about the amount of stress that these students are carrying, are you talking about, from an academic perspective, because they're in a highly competitive university, or? Absolutely, that as well as many other lifestyle factors. So certainly, the the stresses of academic strain, but also some of the things like the need, it's almost a badge of honor, sometimes for students to talk about pulling all nighters or how they're managing their research and their classwork and so on. And so I mean, I know many of us who have had lengthy educational histories can relate to that somewhat, you know, you kind of you get to, the more stressed you are, the more work you're doing, the more highly you're commended for these.

Dana Jonson 04:30

Well, there is something and I don't know if it's true, so you tell me, but I think that there is something to some people handle stress a little bit better, but then they're more prone to take on way more.

Dr. Marney White 04:39

Yes. Yeah, I think that's certainly likely a bit of a snowball effect there. Right. So, you know, I just sort of observing these things for a couple of years and wondered whether or not it was possible to create an intervention of sorts to essentially force students or give them the option to encourage them strongly let me put it that way to engage in various self care practices. And I really want to intervene on a multiple levels because again, like we were talking about not only is it to be academic strain, but there are other factors about the graduate student experience that make it an especially stressful time going to make a parallel quickly to the Coronavirus epidemic. So that, I think, because I think that essentially we are, we're all kind of living in this very extreme situation that has many commonalities with what I was trying to create for the students themselves. So, for example, things like financial strain, social isolation, separation from primary support groups, or loved ones, poor nutrition, lack of physical activity, or lack of adequate physical activity, perhaps substance or alcohol misuse, all of these things can create a perfect storm for the development of significant mental health problems. Or even those are just a, you know, a decline from from normal. So I think that right now we're seeing at the population level, people engaging in many of these health behaviors, or perhaps just letting some of their typical routines or health behaviors slide. And this, then, you know, raising the vulnerability for the onset of mental distress. And I ever go thing that you just mentioned, is something that parents of children with disabilities is experiencing right now, every single thing. Because most of them, I shouldn't say most of them, there are a lot of kids who went home and went to this kind of learning, I have one of them and was like, this is fantastic. I'm in, I don't ever need to leave the house, this is great. If you have a child who has social skills, issues, it's not as great as they think. But there are a lot of parents who, you know, their children have a lot of support at school, and now they're home, and they're juggling a job, or they're juggling, not having a job and deal with that. And then trying to get that done while you know getting the kids together. And when you talk about students using that as a badge of honor, I kind of laugh because I think parents of children with disabilities do too, we tend to, you know, it's, everything is constant, you're you're non stop, there's always something to do, you're always more and more stressed, and more, whose to do list is longer. And I have more therapy appointments to get to than you do. So I don't wanna hear you complain, or, you know, stuff like that. And, and you do see it, I mean, I think that is in our society, it is a badge of honor to be able to push through being sick and not rest, or to work until you're unconscious, you know, we just have this drive that doesn't seem to be healthy. So telling parents, you know, you can do that oxygen mask mask on the airplane. And I've heard allergy so many times, I've got to find a new one. But it is you have to take care of yourself, if you're stressed out, it doesn't matter what you're doing with your child, because it's not, it's not going to work, right. And then they will absorb that as well. You know, so that's, that's something that I myself use, when trying to motivate or employ the exact same strategies that I encourage for students, it's still difficult, we are human, and it is very difficult to kind of nudge ourselves into doing things that are good for us, even though we know it will feel good. But something that at least works for me or is helpful for me as a parent is to say, No, I have to engage in these stress reduction techniques, because otherwise my child will be the end of the line recipient of of all of the stress and anxiety that I've been absorbing. And so that that little mantra for me is like I need to do this for him. I have to do this for him, because otherwise he's going to suffer.

Dana Jonson 08:37

Right? What are the things that that anyone can do to identify? Because I think sometimes people don't recognize this? No, I'm not stressed because again, that mentality that it's okay, to be stressed, you have to be a certain level of stress, right? If you haven't hit the high level of stress, then you can't take a break.

Dr. Marney White 08:55

Yeah, that's a great, this is where the public health angle comes in. Because typically, when we think about the medical model and the clinical model, we're usually talking about intervening at the point of significant distress or significant sickness or, you know, presentation of, of symptoms. So even just thinking about the medical model, when do we go to the doctor, we go to the doctor when we have a fever, or we're experiencing some kind of physical sign or symptom. And then the same kind of holds for when people tend to seek out mental health services when there's some clinically significant, highly distressing or interfering level of symptom presentation. But for this self care stuff, I like to encourage the public health approach which is seeking some kind of blanket intervention that's applied to the entire population, meaning ourselves even in a state of wellness, so it's taking a clear Prevention's standpoint, meaning engaging in these daily activities mostly focus probably on physical health and well being and getting enough rest or engaging and relaxation exercises or stretches to specifically unwind and protect our mental and emotional well being. And I think now more than ever, it's critical to engage in these at least daily, potentially multiple times a day and potentially even in a variety of domains.

Dana Jonson 10:16

And that's a good point. Because I think that when you talk about preventative health, I love that we, you know, my four children all are in therapy all the time. And I remember somebody said to me, like, oh, well, they all have all these issues. And I was thinking, not this week, no, but I don't want my kids to think you have to wait till you have a crisis.

Dr. Marney White 10:35

Right? Right.

Dana Jonson 10:37

Having a therapist in your life is normal. And sometimes you see them more frequently than others. But you know, I want them to understand that that is a normal state of being and that if you're always engaged in it, sometimes you need it more than you do other times. But it's always a sense of normal, we don't have a society that values it in that regard, yet.

Dr. Marney White 10:58

I agree. And I really liked that approach as well. And something that I'd like to even encourage or use as another sort of cliche or release mantra is to try to conceptualize mental health services as as even when they're applied in like a state of wellness as something like a spa treatment for the emotions or for the soul. And knights, you know, when we think about preventative health, most people are okay with going to their physician for a regular checkup and getting the standard physical health screenings as recommended, but we have not as a culture have been able to embrace mental health care in the same manner. And it's a real shame.

Dana Jonson 11:38

Are you seeing a trend in that either going up or down

Dr. Marney White 11:41

from the stigma with respect to mental health services? I what I'm observing a little bit is that following education, about mental health, the prevalence of mental illness, and the effectiveness of mental health treatments, as well as the effectiveness of mental health prevention programs, are actually able to see that following education surrounding these issues. Stigma does diminish over time, at least among students. So whether or not that generalizes to the overall population, I certainly cannot say but that would certainly be a dream of mine. Like every time we get close to sort of embracing that mental health component. We have something that catapults us into another crisis, where we have to up our game again, and we there to start with. Yeah, I mean, potentially, as it is, it's a silver lining of some of the Coronavirus catastrophe is that we are now in a position where telehealth is the only mental health service available, at least for right now. And so clinicians as well as clients are potentially much more open minded to that medium. It's something that's been researched and studied for decades now that we know that telehealth can be every bit as effective as the traditional face to face that Yeah, yeah. And there are treatments already available. And even some of these apps that have come out in recent years are very effective and teaching people the same skills that would they would ordinarily be taught and the empirically supported treatments for mental health.

Dana Jonson 13:15

So what are some ways that families parents or students can identify that, and I hear what you're saying about preventative and we should all be doing this every day. And I would promote that as well. But I think the reality, at least today in this chaos, not sure where we're gonna go. And so just kind of reacting. But we're going to get a little more settled, and we're going to get to that place. But until you're in a place where you can have that, that pre emptive routine and incorporate something into their lives. How can they identify? Or do you have strategies for someone to identify when they might be more stressed than they think they are? Or they might be reacting in a way in a negative way and not identifying it?

Dr. Marney White 13:57

Yeah, I mean, I think the the clinical the textbook answer to that is when there is interference, interference with social or occupational functioning, when you're no longer you know, when you're snapping at people, for example, or when you're no longer able to fulfill your family or work obligations. The problem right now is Hi, guess what, that's pretty much everyone, the entire population is no longer functioning right, you know, with respect to their typical or their normal behavior patterns in terms of how they're interacting with their families or their jobs if they're able to work during this time. So it's very difficult to tease that apart right now. Which leads me back to my original point. Everyone is suffering socially, and occupationally. And so this is the time I think that everyone is in significantly elevated vulnerability for experiencing mental health issues. And the data of course are not out on that but I think that everyone in the field and everyone At home, I think that everyone knows this is a super vulnerable time for experiencing mental distress. And so to that end, blanket recommendation, engage in these behaviors, it is critical, because the last thing you want to do is start that snowball down the hill that up to a point that you can no longer catch it or stop it.

Dana Jonson 15:20

Well, and particularly since we are in isolation, right? You don't have that audience around you to say, hey, Marnie, you're having a really bad day, what's going on? You don't have those. You don't have that barometer around you. And for some parents, their only barometer right now is their kids, single parents at home with multiple children, trying to just how do you recommend that? You know, for somebody who's like, I don't really need it, or it's not me, or I can't fit it into my life? What kinds of things do you advise?

Dr. Marney White 15:50

Well, I'm sure that you've mentioned routines pretty consistently throughout your podcast. Same applies here. You know, I recommend starting with very small, but measurable goals. So really using that same kind of behavioral terminology with which I think everyone is quite familiar these days. But even using, you know, a very specific goal, whether it's, you know, setting a standard wake time on having a first meal of the day, some small behavioral modification, five minutes of stretching, using a breathing app four times a day, where you actually do deep breathing for 30 seconds and choosing a measurable small something and you know, that 30 seconds of breathing of closing your eyes and breathing, administered a few times throughout the course of the day, setting a prompt on your phone, to remind you, those small things can be remarkably beneficial. In terms of maintaining your stress, I even chose during this time to set a daily goal of walking my dog once around the block, and which, you know, there are certainly some days when I'm like, I just don't feel like it. I'm tired, I've worked hard all day, I just don't even want to. And then he gives me the sweet puppy dog eyes, like, okay, and sure enough, you know, before I'm even halfway around the block, I'm already feeling better. There is just something about protecting even a few minutes of time to attend to your own well being that is remarkably beneficial. And the other thing about it tends to heighten self efficacy, which is our optimistic belief in our ability to meet challenges. And so that kind of pattern of encouraging people to engage in a very small, something for your own well being a couple of times a day or once a day, is enough to contribute to boosts and self efficacy and mental wellness overall.

Dana Jonson 17:52

I'm curious about this, because I've heard this several times, particularly teenagers with anxiety, and I hear the parents say, well, they won't engage in meditation, or they won't engage in breathing because it raises their anxiety. What is that about? What is it raise?

Dr. Marney White 18:09

No, I don't actually know exactly what that's about or why that would be. So so much as I know that to be true. For some people, it is just not a good connection, or it

Dana Jonson 18:22

thoroughly that everyone will benefit from this particular exercise, right? You have to find.

Dr. Marney White 18:27

Yep, you have to find the the niche that's right for you. And so I would recommend trying out a variety of these. And so what like when I just shared that I walk my dog every day as one of my I actually I've walked my dog among several other things. And if I'm not willing to walk him, then I will stretch for 10 minutes instead. Because there have been some rainy cold days. And I'm like, I'm not doing that it was too overcast to go for a walk the other day. Exactly. And this is exactly why pointing like we're human, even though we know we will enjoy it, it's still very tough to kind of push over that motivational hurdle. And so that's why I think it's a good idea to have a couple of these like a toolkit, if you will, of strategies that you can try so that if the weather does prevent your your morning walk, or if you get a late start or if there's some other curveball, because let's face it, there are going to be a whole lot of curveballs and obstacles, that you have something else that you can grab and do. And then over time of being able to implement these on a regular basis over time, they do become intrinsically rewarding. And that's really the ideal, right?

Dana Jonson 19:32

It's to make that habit once it becomes a habit actually, it's funny because I tell parents now we're asking parents to document everything for what I'd like to think are very obvious reasons. But we you know, when we get back to whatever we're going back to, we're gonna have to figure out where all these kids are some asking parents to document and I've had a few parents say, well, like you I don't have time I can't do it. And I've said if the only thing you write down is today sucked, that's okay. It's just work there. Yeah. And and eventually writing in that book once a day will become habit, and then you'll do it more than once a day, and then it'll, you know, grow. So it's, it's the same thing with mental health, right? If you're, if you force yourself to take those five minutes, that's what I've been telling parents five minutes, I don't care what you do for five, lock yourself in a room go sit in your car, what makes you chill for five minutes?

Dr. Marney White 20:24

Right? Right. And then, you know, I even recommend employing behavioral strategies. So going beyond the just tell yourself, but setting prompts setting, you know, setting the alarm on your phone. Okay, now this is the time for me to go take that five minute break, leaving reminders, even employing reinforcement principles or behavioral principles like that.

Dana Jonson 20:46

Right?

Dr. Marney White 20:46

Yeah,

Dana Jonson 20:47

it takes a walk, I don't get my pint of ice cream.

Dr. Marney White 20:50

Exactly. Yeah, or the I mean, you know, the, the thing that I've shown there was once a once upon a time, in order to try to incentivize my own physical activity, my own working out, I told myself, well, I just wouldn't have a glass of wine with dinner if I hadn't done my exercise. And then very quickly, I learned that the wine just wasn't reinforcing enough, I didn't care. And so I have to set a different contingency for myself. So I then started watching my trashy television while working out on an exercise bike. And it turns out that that concurrent reinforcement of you know, I will continue to pedal for access to horrible reality TV was what kept me going until it got to the point where it became intrinsically rewarding. And now it is actually, you know, part of my lifestyle, but it took some trial and error. And I absolutely use these behavioral principles in shaping my own health behavior, and self care. So I recommend that these are things that we're all masters of as parents, but again, it's a little bit tricky to try to apply them to yourself.

Dana Jonson 21:53

And it goes back to do as I say, not as I do, right, because another, we're all very much like that, too. Because we recognize we don't need the same boundaries our children do, but our children don't recognize that. So it comes around. I love the consequence for yourself for the reward for yourself. I went through a phase where I wouldn't shower unless I'd worked out.

Dr. Marney White 22:13

Oh, my goodness. All right. That's a little

Dana Jonson 22:17

extreme.

Dr. Marney White 22:20

Effective, though, so

Dana Jonson 22:22

because I wouldn't allow myself to shower unless I had worked out. And that was apparently what I needed to do to get myself to work.

Dr. Marney White 22:31

And now you probably enjoy working out and

Dana Jonson 22:33

Right, exactly. Some of the strategies you talked about physical health walking?

Dr. Marney White 22:38

Uh huh.

Dana Jonson 22:39

The thing trashy television?

Dr. Marney White 22:41

Yeah.

Dana Jonson 22:42

I think that sometimes people think that if they're doing something healthy, it has to be kind of highbrow.

Dr. Marney White 22:47

No. Certainly, no, no,

Dana Jonson 22:52

if I'm watching, you know, The Housewives of New Jersey, then maybe that's not really time for myself. Maybe that's just wasted time.

Dr. Marney White 22:59

But you get a predictable ego boost. So every time you watch it, and think you know what I'm doing great.

Dana Jonson 23:05

I'm doing great. I like to watch on that that reality show and I'm couples counseling. Honey, get in here we're back. Get an award.

Dr. Marney White 23:17

Yeah, no, I have the I think that what ever will protect or boost one's mood, or has the potential to, to help others through distraction, or even just any sort of stress release. I mean, I certainly have had students who have protected time to listen to comedy on Pandora, because we know that laughter is an enormous detective for subsequent stress, as well as actually does release stress. So it works both ways as a stress relieving function, and also as a buffer. So there's really a lot to be you know, turning on Pandora or one of the free streaming services and listening to comedians would be an excellent wellness.

Dana Jonson 24:02

Yeah, that's so funny. Because when this first started, and there are six of us here, and when it first started, we were locked in we watched a stand up comic every night, I didn't do it on purpose. I was just like, This is what's happening.

Dr. Marney White 24:13

And you know, laughter there's something to that, but home laughter is the best medicine thing. There's actually a huge body of literature about the stress relieving properties of laughter neuro chemically, and and on just, you know, subjective perceived outcomes. It's very great.

Dana Jonson 24:30

That's awesome. We have parents and children all stuck in it. Well, everybody's stuck at home and whoever you're stuck with, should we be encouraging people to take that time by themselves? Or should we be encouraging parents to do it as a group with their kids? Or?

Dr. Marney White 24:45

I don't know, there's any clear answer for that. I think it's it's all going to be individual preference. And I don't know that would be consistent across days, either. Some people who might have ordinarily labeled themselves as extroverts are suddenly finding that actually they are Okay, not being in large groups of people all the time. And people who might otherwise enjoy a whole lot of family togetherness are finding that they need a little bit more privacy than they would have otherwise predicted. I don't think there's any right answer. And I think that this is going to be variable throughout the course of this. And it might require some experimentation, and yeah, just some, some incorporating various different strategies to see what works and what works this week might have been very different from what would have been effective six weeks ago.

Dana Jonson 25:27

I like that, because I've seen that where we have one day where walking the dogs is perfect for everybody. And everyone had a great day and another day where nothing works. And I think I'm hearing a lot. You know, we've got all these webinars, everyone's being bombarded with information on how to handle being at home, and how to handle your kids. And I mean, there's just so much coming from everywhere, that I want parents to understand, too, that there is no one exercise, there is no one thing because I hear people saying, well, you have to do breathing, or you have to do morning meeting, or you have to do you have to do you have to do and you don't you do take the time, right to figure out what works for you that day. And then make it work.

Dr. Marney White 26:12

Yeah. And that's why I'm recommending this toolkit approach to because I think that, you know, circumstances are highly variable. You know, if someone had a nightmare in the middle of one night, guess what, people are gonna be a little bit more sleep deprived. And the strategy that might have worked under ideal conditions might no longer be what's most readily available, or even possible

Dana Jonson 26:33

daughter and her therapist came up with, since you said toolbox, an actual box.

Dr. Marney White 26:38

Oh, how cool,

Dana Jonson 26:39

actual box of things that calms her down, like a coloring book, a pig, or a stuffed animal. And so when she takes her break, she can go get her box if she wants and pick something. I love that. Yeah. So that's what they came up in their sessions. So that could apply to adults to write the group of things you'd like to do and just be like, here are my five things I can pick from, then you've got variety. When you first get married, I remember no, not married when we had kids. And I remember, everyone's like, you have to go out on a date. And you have to do it this way. And you have to so we did. Yeah, we did. At least everybody told us and we were like, we still don't want to be here. Oh, can we just go do something else? It wasn't, you know, that wasn't our thing as a couple that whatever it was we thought we had to do wasn't something we'd ever done before. So why leave the right thing? Yeah, yeah, I think it's really important for parents to remember that. Now what about for there's the day to day stress, there's the extra stress we're all experiencing. But then we get into a clinically dangerous place. Sometimes for some people, how can parents help identify that within themselves or their children, if they are beyond a breathing exercise or toolkit, and actually seek professional help? What would science for that?

Dr. Marney White 28:02

Well, I mean, of course, it'll depend on the specific problem, whether it's somewhere, but I'm going to go with what's likely to be like the most prevalent right now, which would be somewhere in the depression and anxiety realms. So when we're talking about anxiety, and and, and depression to being clinically significant, some kind of markers would be inability to fall asleep, or have sustained sleep or waking up very early, a lot of times these begin to take on physical indicators. So feeling as though you're not able to unwind ever and just kind of noticing within yourself whether or not you know, kind of starting to feel like you're not yourself or when friends or family members would say that you're not really behaving as you typically do. And then again, kind of coming back to that interference with social and occupational functioning. So when you're really noticing that you're not able to fulfill your general work or family obligations, and that it's sustained, it's likely that in this time, people will demonstrate a great deal of resilience and following the various other kinds of tragedies, people do tend to experience high levels of distress. But in many cases, their existing supports and strategies do kind of help them persist or kind of get through the critical period. But I always kind of take a much more liberal approach with these things. Or I guess you could consider a much more aggressive approach of sort of, I like to catch things very early, again, because it's not only easier to treat, but it also has better outcomes for the for the long term. So this isn't it's kind of debated among clinicians and among specialists and there is no completely clear demarcation either. So

Dana Jonson 29:56

that's a really good point because we are in a situation where we are now Seeing our doctors, right? Right, we are not physically going to see our therapists. You know, I know, as I said, in my house, all four of my children have their own therapist, and they're maintaining those appointments. But it's also very easy. Sometimes I recognize that oh, one of them only scheduled for two weeks from now, not one week, or we're not seeing them in person. So one was on a phone, someone else is doing zoom and different levels of attention. I think you and I were talking before about kids in class on their computers, they do that during the therapy session, too, right? Talking to their therapist, and, you know, laughing at their texts. So I worry. And I also think that I also don't want to panic parents, because kids are out of their element right now. So yes, there's going to be anxiety. And yes, there's going to be depression. But if your child wasn't attending to the computer screen to start with, the fact that they're not attending now might not be a negative sign. Yes, very good point. But so were we are in a place where we're not going to see our doctors. And so for somebody who wants to seek professional help, where do they go? I mean, we're at home. Yeah,

Dr. Marney White 31:06

there are a lot of good resources for finding a therapist. Psychology Today is a database that's free for searching and find and you can search by geographic area or zip code. But they now have a different level of allowing to search for clinicians based on whether or not conditions are set up to provide teletherapy. So and some states have even opened up with respect to reciprocity for licensure. So typically, one could only seek out a therapist who is licensed in their state. But some of that has become more variable or is opened up. There are also lots of research centers that would ordinarily enroll participants from the community who are now able to provide free treatments to a much broader catchment, because all of the interventions are being provided online through telehealth,

Dana Jonson 31:54

right. That's great. That is such a wonderful thing. And I, a couple years ago, I'd asked a friend of mine, because I couldn't find a therapist for my son, he's, he's LGBTQ. And we couldn't we just didn't find somebody who was matching what he needed. So a friend of mine had said, he's like, Well, telehealth is not a bad thing. And I remember thinking, ooh, online therapy? I don't think so. And now I think it's great. That was two years ago. But at two, he'd said that, you know, that was the direction that this was going anyway. So I think this catapulted us in?

Dr. Marney White 32:27

Yeah, no, absolutely. And that's that's kind of another silver lining of of this is that I think that now services will be much more readily available to people who might not have otherwise been able to access them, both because they can be delivered more affordably. And even just to geographic distance now. So when we come out of this, it is my hope that not only will the therapy be more accessible, but possibly education as well.

Dana Jonson 32:52

That would be amazing. The takeaways that I've got here are preventative medicine is always the best. Don't wait till you're in a crisis. But if you find what works for you, it's not one size fits all, find what works for you, and start slow. Eventually, it'll become a habit. And if you need real help, we can get it now online without leaving your house. And I'm going to put the Psychology Today, Lincoln websites in the show notes. So anybody listening to this, who wants to go find that information can? And is there anything else that you'd like to leave us with?

Dr. Marney White 33:28

I guess just the the one conclusion would be that we've actually done research on these self care practices.

Dana Jonson 33:37

It's a really good point.

Dr. Marney White 33:38

Through the class that I that we've been teaching, which is colloquially called the self care class, but in formal practice is actually called health behavior change or foundations of health behavior change. And we've tracked the students the Enrolled Students experience and depression, anxiety and stress as well as their overall perception and their physical health and well being, and have found that just engaging in these self care practices, which are self identified, they're variable across days, students set their own goals with respect to health improvement projects of engaging in small behavior every day, and it predicts improvements and all of those domains depression, anxiety, stress, and general physical well being. I know it's very exciting. And that's, of course, compared to students who were not enrolled, but in the same in the same graduate program. They're just experiencing improvements in all those. So it's very exciting. And then recently, actually, in March, Yale partnered with Coursera, which is an online massive online education community, where individuals anywhere can can sign on and take this distance learning class. And so it is now available to anyone. And right now there are a few 1000 Students taking it and posting their daily behavior change goals and getting kind of community support and doing it than any outcomes yet as to whether or not it's as effective as the the Yale version. But every indication would be that it shouldn't be because it's the exact same class.

Dana Jonson 35:17

Oh, wow. No, that is good. And I'm glad you did say that. Because I do always say that we just happen to not say the words that there's science behind this. This is not just some hokey, we think this will work. There is actual science behind it. You can change your behaviors and improve your quality of life. And you just got to start small and start slow.

Dr. Marney White 35:38

Yes, yes. Yeah,

Dana Jonson 35:41

fantastic. Well, if you give me the links for that, I will have that in the show notes. The links for where to find professional help if you need it. And check that out and check out Dr. Marney White. Thank you so much, Dr. White.

Dr. Marney White 35:54

Oh, thanks for having me. Have a lovely day.

Dana Jonson 35:57

Thank you so much for joining me today. Please don't forget to subscribe to this podcast so that you get notifications when new episodes come out. And I want to know what you want to know. So join our Facebook group also named need to know with Dana Jonson or you can email me at Dana at special ED dot life. But definitely reach out with your comments and questions and I'll see you next time here on need to know with Dana Jonson Have a fabulous day

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