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How Does CBT Help with Social Anxiety Disorder?

How Does CBT Help with Social Anxiety Disorder?

In Singapore alone, 10% of the population is plagued by anxiety disorders – one of which includes Social Anxiety Disorder, or SAD for short. And on a global scale, approximately 4.5% of the world’s population – 273 million people – are estimated to experience anxiety disorders as of 2010. Commonly misunderstood to be merely an over-exaggerated form of shyness, Social Anxiety Disorder is much more than that. Individuals with SAD experience symptoms of anxiety or fear under particular or all social situations, depending on the severity of their condition. For some, even doing the simplest day-to-day activities in front of others can cause extreme worry of being judged, humiliated or rejected. However, some research has also suggested that SAD may be especially manifested in individuals that have ongoing medical, physical conditions such as Parkinson’s Disease, obesity, facial or bodily disfigurement (including amputees), and any other sort of conditions that may cause one to look different from the norm.

What are the symptoms of SAD?

When people with Social Anxiety Disorder are surrounded by others or have to carry out a particular action around them, they may:

  1. Feel nauseous, experience an increase in heart rate, tremble, blush or sweat profusely.
  2. Be unable to make eye contact with others, move and act rigidly, or speak in an overly soft tone.
  3. Feel extremely self-conscious, as though others are judging their every move.
  4. Easily feel awkward, embarrassed and stressed out in social situations.
  5. Find it extremely difficult to be themselves around others, especially strangers.
  6. Have anxious thoughts such as, “I’m sure they won’t want to talk to me again,” or “Do I look plain stupid right now?”
  7. Apologise excessively, even when there is nothing to apologise for.
  8. Avoid conversations, such as by using their mobile devices or plugging in their headphones. 
  9. Avoiding situations where one might be placed at the centre of attention.

The list of symptoms above is not exhaustive, but we need to recognise that they may cause extreme distress to these individuals. For them, it can be tremendously helpful and relieving for them to seek treatment for their condition, more specifically through Cognitive Behavioural Therapy (CBT).

Cognitive Behavioural Therapy is a well-known form of therapy in the mental health profession. Considered to be a form of short-term therapy, CBT is usually delivered in a time-limited manner, often over the course of 8 to 12 sessions (although this may vary from person to person). Once the symptoms are reduced and the individual is well-equipped with the necessary skills to cope with anxiety triggers or social situations in general, treatment can be finalised. As it is not possible to change or alter emotions directly, CBT aims to tackle any maladaptive, limiting thoughts and behaviours that fuel or contribute towards agonising emotions. This, therefore, lowers the extent of anxiety that one goes through and instead, developing a sense of self-efficacy.

First off, CBT encourages individuals to open up and to be truthful regarding their automatic, instinctive (negative) thoughts so that they can work hand-in-hand with therapists to analyse the logic behind them. During the sessions, therapists will work to identify the assumptions (and their validity) that these people hold, which might be causing unnecessary anxiety or fear. Proper reasoning and clearing up of assumptions can be done by asking clients to do some self-assessment and to provide possible reasons as to why they maintain such assumptions. By doing so, therapists can then assess the situation and present evidence contrary to their beliefs. 

Another aspect of CBT includes ‘Decatastrophising’. One common thinking pattern found in people who suffer from anxiety issues is ‘Catastrophising’, which is the act of imagining the worst-case scenario and magnifying the bad in any given situation. CBT helps to counter such a mindset by helping these individuals prepare for the feared consequences, as well as to cope with their unhealthy ways of thinking. For example, therapists and clients will go through certain ‘Challenge Questions’, such as:

  • “Has anything this bad ever happened before? How likely is it to happen now?” 
  • “What makes you confident that your feared outcome will actually come true?”
  • “What is the best outcome that can happen in this situation?”

These are just a few examples of ‘Challenge Questions’, but they can certainly be beneficial in helping to ease feelings of anxiousness and to calm the individual. In some way, this can also decrease an individual’s inclination to avoid seemingly triggering social situations. 

Tying in with ‘Decatastrophising’, another technique introduced during CBT is ‘Reattribution’. ‘Reattribution’ is a method which challenges the negative assumptions held by the individual by considering the possible alternative causes of events. This is particularly advantageous for people who, in most situations, perceive themselves to be the cause of problem events. For example, this can mean having a discussion on the evidence which proves that the individual is/is not the cause of the problem. Eventually, this will help to tackle ‘Automatic Negative Thoughts’, excessive self-blame and worry.

Of course, in order for the treatment process to be carried out more effectively, some therapists do assign “homework” to their clients. This is to say that clients are encouraged to apply CBT principles in between sessions, and are tasked to self-monitor and focus on implementing tips and processes when dealing with actual situations. By monitoring their emotions and making a conscious effort to calm themselves through methods discussed during sessions, these individuals will eventually develop the much-needed skillsets to cope with emotionally-draining social environments.

 A combination of cognitive and behavioural therapeutic approaches, CBT has been proven to be an extremely effective treatment method for anxiety disorders, including SAD. In fact, the skills you learn in CBT are practical and highly applicable, and hence can be incorporated into everyday life to help you cope with future stresses more effectively.  As such, if you or a loved one is struggling with SAD, do seek treatment as it will ultimately benefit you in the best way possible. 

 


References: 

  1. https://www.mentalhealthacademy.co.uk/dashboard/catalogue/using-cbt-with-social-anxiety-disorder/chapters/1 (Accessed 3/11/2020)
  2. http://psychcentral.com/lib/social-anxiety-overview (Accessed 3/11/2020)
  3. https://www.nimh.nih.gov/health/publications/social-anxiety-disorder-more-than-just-shyness/index.shtml (Accessed 3/11/2020)
  4. Photo by Luke Porter on Unsplash
Understanding Childhood Emotional Neglect 

Understanding Childhood Emotional Neglect 

As a child, how did adults around you react whenever you expressed your feelings? Did you grow up receiving that subtle message to wall up your emotions so they don’t get the better of you, or become anyone else’s burden? Childhood Emotional Neglect (CEN) is a topic often overlooked, and many fail to realise that it can eventually manifest into mood disorders or anxiety disorders if not dealt with appropriately. 

Childhood Emotional Neglect occurs when our caretakers or parental figures fail to respond to our affectional needs suitably during critical stages in our development. An individual who grows up experiencing emotional neglect may experience a pattern of having his or her emotions being disregarded, invalidated or downplayed by others. While many of us may wonder, “What kind of parent doesn’t pay attention to a child’s emotional needs?” In reality, some parents may not actually realise that they have been shutting their child(ren) out emotionally. In Asian societies in particular, some parents are commonly labelled as “authoritarian” or “tiger parents”. These people may in fact perceive themselves to be giving the absolute best to their child, enforcing strict discipline and ensuring that their offsprings are well-equipped with the best skills to succeed in life. However, young children and teenagers may instead be overwhelmed by such demands, and feel as if their feelings were never considered or understood. Whilst we mentioned its prevalence in Asian societies, it is key to note that it is not merely limited to these children – many worldwide experience it too, making it an exceptionally important subject. With emotional neglect being a common feature in the childhood of many, it can become an undesirable shadow that follows us throughout our lives – eventually leading to undermined happiness and the lack of an authentic sense of self.  

Delving into the matter at hand, Childhood Emotional Neglect (CEN) can come in two forms – active and passive CEN. Active CEN is when parents or caregivers actively act in a way that dismisses or denies the child’s emotions. For instance, a boy is sent to his room for crying over the death of his pet fish, and his parents complain of having an overly-dramatic son. When the child is being denied of his sadness and is receiving the message that his behaviour is unreasonable, this forces the child to grow up hiding his feelings, and at times struggling with fear and shame of his own emotions. On the other hand, passive CEN occurs when parents show a lack of care or validation regarding the child’s emotional needs. When parents fail to notice when the child is angry, upset, hurt or anxious, this gives off a subliminal message to the child that his feelings are irrelevant or not worthy of note. In any case, both forms of CEN are clearly detrimental towards one’s mental health. 

Albeit not having a test or questionnaire that can help with a diagnosis for CEN, there are certain “symptoms” of CEN that may surface, be it in the later parts of one’s teenage years or adulthood.\

For one, individuals who have experienced CEN may find it difficult to prioritise their wants and needs, even if it’s something that would bring them great joy. It is innate for us to have desires and to just be aware of what we want and need. However, for someone who grows up having his feelings invalidated and cast aside, it could become a natural thing for him to keep his desires to himself. As such, even if opportunities do come along, these people would often fall through the cracks, most probably due to their inability to request for it upfront, or by allowing others to seize it instead. 

CEN also causes one to start projecting any feelings inward, regardless of whether they are negative or positive ones. People who have experienced CEN are particularly predisposed to turning feelings of anger inwards, as they never learnt how to be comfortable with their emotions, nor how to handle them in a healthy manner. It is often said that nothing good comes from bottled-up feelings, and that is absolutely true. 

Having pent-up feelings also mean that these individuals are not likely to seek help or lean into their support systems whenever things get tough, making them feel all the more isolated and vulnerable. Even at times when they are feeling deeply challenged by certain life events, they find themselves trying to cope all on their own, leading to unhealthy stress levels and anxiety. Unsurprisingly, the constant feelings of shame and inability to get in touch with one’s emotions will eventually lead to one losing sight of his or her strengths as well. As a result, poor self-esteem is sometimes a consequence of CEN.

While many individuals, including adults, fail to recognise the impacts of childhood emotional neglect on their lives due to its subtle nature, it is important that they get themselves back on track – to regain true happiness and greater self-esteem. You might have grown up devoid of your own emotions, but you need to recognise that facing them head-on will ultimately help you to cope with life events and for you to regain your sense of self. 

Learn to start getting in touch with and embracing what you feel – both the good and bad. Identifying what you feel in certain situations will be a good step towards helping yourself cope with your environment and daily life. When challenges seem overwhelming, don’t feel afraid or ashamed of reaching out to your friends and family for help either. Even more so, if you ever feel like you’re losing control of your life and are derailing emotionally, seek professional help as soon as possible. While not everyone who grows up with emotional neglect ends up with mood disorders such as depression or anxiety disorders, there are certainly people who do. Don’t deny yourself of your emotions any longer, therapy might just be the solution to helping you learn the vital life-coping skills you never learnt as a child.  

 


References: 

https://www.straitstimes.com/singapore/how-emotional-neglect-during-childhood-affects-ones-mental-health (Accessed 07/10)

https://blogs.psychcentral.com/childhood-neglect/2018/09/the-2-types-of-childhood-emotional-neglect-active-and-passive/  (Accessed 07/10)

Photo by Isai Ramos on Unsplash

 

Burnout and How to Heal from It

Burnout and How to Heal from It

It is an undeniable reality that life, in general, is busy. With long work hours and bills to pay, there are so many things going on that we must and are expected to do. With the increase in pressures and demands in daily life, it is very common for people to feel exhausted and burnt out.

Burnout is a state of exhaustion caused by chronic stress. According to the World Health Organisation, it is classified as “chronic workplace stress that has not been successfully managed”. It is characterised by 3 dimensions: Feeling exhausted or devoid of energy, being mentally detached from your job and being less efficient in work. Employee burnout in Singapore is among the highest worldwide, where work is a vital cause of high-stress levels, and where almost one in eight employees cannot cope with their stress. There are many potential causes of chronic stress in the workplace, such as having too many responsibilities, having a negative view of yourself and the world, or a perceived lack of control over your life and work. All of these factors could cause one to burn out easily.

Let us recognise the signs that indicate a burnout. Physical signs include exhaustion, change in sleep habits or diets, frequent illness and headaches; Emotional signs include lack of motivation or enjoyment towards life events and feeling negative emotions such as anger, anxiety or depression; Behavioural signs include adverse coping mechanisms such as overconsumption of alcohol, withdrawal from responsibilities, taking out your frustration on others and reduced work performance. If you are currently experiencing these symptoms, then it is very possible that you may be burning out from work.

Now, you may ask, if busyness in work is inevitable, then how do we overcome this seemingly unmanageable stress? Below are 4 tips that could help you manage stress and prevent burnout:

  1. Turn to other people

It is extremely beneficial to have a social circle or support network, such that there are people that you can rely on for support, encouragement and a listening ear. Friends or family members can recognise maladaptive patterns in your behaviour, identify your burnout signs, and offer you constructive feedback or advice. Through doing that, you can work towards overcoming burnouts. Likewise, if your loved one is going through a burnout, engage her in a conversation and let her open up about what she is going through, while staying patient and understanding. Confiding in and spending time with loved ones would serve to reduce stress and strengthen your relationship with them as well.

If it is possible, try befriending your colleagues. With a similar job scope, your colleagues can better understand your stress at work and everyone can draw support and motivation from one another. Additionally, good relationships with your colleagues enable you to work faster and better while reducing your work’s monotony. Thus, a more positive work environment keeps you energised and productive, countering the effects of burnout.

 

  1. Live a healthy lifestyle

Healthy lifestyle habits such as sleeping, exercising and healthy eating can have a huge impact on your mood and energy, helping to reduce stress and prevent burnouts. Exhaustion or a lack of rest often worsens burnout through causing you to think irrationally, and can take a toll on your energy and emotional balance. Thus, getting a good night’s sleep energises you and improves your mental state, ultimately improving your productivity at work.

What you consume can greatly impact neural circuits in your body that control emotion, mood and motivation. As such, eat food that can elevate your energy and mood such as fruits, vegetables and food that is rich in whole grains; and reduce consumption of food with lots of caffeine, sugar, chemical preservatives and hormones.

Exercising also enables stress relief. While engaging in exercise, you can focus on your body rather than your thoughts, and how your body feels as you move (feeling the sensation of the wind against your cheek can be strangely calming!). However short or simple, any form of rhythmic exercise is beneficial as it can increase your energy while simultaneously relaxing your mind and body. Ultimately, a healthy lifestyle does wonders to your wellbeing.

 

  1. Find ways to relax and unplug from work

We often burnout due to lack of time for ourselves. Thus, give yourself a chance to slow down, rest and heal. Set time aside for activities that are not work-related and do activities that make you happy and relaxed. This includes your personal hobbies, interests or a passion project such as photography, baking or exercising. Doing these activities can make you feel rejuvenated and accomplished, and helps you rediscover joy and meaning in your life outside of work.

Additionally, reserve some time to disconnect from technology. In today’s day and age, smartphones cause us to “carry an office in our pocket”, and make us psychologically connected to our work all the time. Hence, it is a good idea to limit your phone time after work, to prevent yourself from checking your emails or calling your office; such that you can spend quality time with yourself and your loved ones. Through these regular breaks, you are given an opportunity to restock your mental energy and engage in self-care, which can increase your happiness and quality of life.

 

  1. Re-evaluate priorities and set boundaries

Lastly, reflect on the cause of your burn out and consider what makes you feel stressed and anxious. Ask yourself, Is my work making me stressed? Exactly what aspects of work are making me stressed? Do I spend enough time for myself? Through this self-reflection, you can find ways to reduce this burnout. A good solution is to set boundaries for yourself and re-evaluate priorities, such as knowing how much time to allocate to work and relaxation (possibly placing more importance on rest and less importance on work) and learning how to say “no” to tasks. Do not stretch yourself beyond what you can handle or commit to. If you struggle with this, remind yourself that saying “no” enables you to say “yes” to tasks that you find more fulfilling. Through re-prioritising your commitments and tasks, you are able to find balance in your life and focus on parts of life that bring you joy, meaning and satisfaction (even beyond your job).

If possible, you can also identify or consider which aspects of your job you enjoy and find the most fulfilling. After doing so, you could ask your supervisor if you can focus on these tasks as they are more aligned with your responsibilities and strengths. Doing this helps you find value and regain a sense of control in your work, giving you a positive outlook and attitude towards your tasks.

 

Healing from a burnout definitely is not easy, and takes lots of time and commitment to overcome, but it is possible. Take the effort and steps necessary to manage your time and reduce stress, and keep to it. It may be difficult to adjust and keep to these new changes, but ultimately, it will prove effective in preventing burnouts and will improve your physical, emotional and mental well-being.


References:

https://www.helpguide.org/articles/stress/burnout-prevention-and-recovery.htm

https://hbr.org/2015/04/how-to-overcome-burnout-and-stay-motivated

https://www.who.int/mental_health/evidence/burn-out/en/

https://www.pacificprime.sg/blog/employee-burnout-in-singapore/

https://www.fairview.org/patient-education/85169

https://www.helpguide.org/articles/sleep/getting-better-sleep.htm

https://www.inc.com/john-rampton/8-ways-to-get-over-job-burnout-without-leaving.html

Managing Grief

Managing Grief

There isn’t consensus in the scientific community about whether Kubler-Ross’ five stages of grief is rooted in empiricism. Although much vaunted in popular culture, if you’ve experienced grief and resolved it in your own way, you’ll know that grief is an organic process that is by no means neat or orderly. It’s deeply unique to each individual, and this article is designed to hopefully help you through whatever loss you have experienced in the recent past.

The five stages of grief, which Kubler-Ross first postulated that terminally ill patients experience are: Denial, Anger, Bargaining, Depression and Acceptance. Denial in this context encapsulates a perfectly normal response to a tragedy, and is exactly what you would imagine – it’s simply a refusal to believe that “this bad thing is happening to me”. After reality sets in, and the sobering realisation that the tragedy has occurred is impossible to ignore, Kubler-Ross observed that people often display frustration, which culminates in Anger. Once that Anger has dissipated, people often move on to Bargaining, which is the hope that they can somehow extricate themselves from their dire straits and obtain the balm of a different circumstance. Notwithstanding the success of the earlier bargain, Depression follows, which is self-explanatory. The final stage of Acceptance is the sanguine realisation that nothing will change their situation.

If you are currently going through your own grief and taken a step back to evaluate how you are processing it, you might have noticed some incongruencies between the model and your experience. That’s perfectly natural because there has been some criticism levelled at the Kubler-Ross model in that there is confusion over description and prescription. This means you shouldn’t take it as a rule, no, or feel inadequate or “bad” that you aren’t “properly” grieving. We hope that what follows in this article will provide you with some breathing room to let your grief take its own course, and helps you handle a tragedy with the right tools.

Grief is a loss. It’s your prerogative to define what grief is to you, and even something as banal as losing a cherished item from your childhood can precipitate feelings of loss. So, you shouldn’t wall up these feelings behind what society has proscribed as appropriate. We’re talking about you here, not anyone else. It bears repeating that your grief is unique because of a multitude of factors, for those of you who don’t want to accept that it is your right to give yourself the breadth to grieve – your upbringing, your culture, your faith, your parents, the list is endless. So give pause and slip into your own rhythm of grieving.

To help ensure that you do not slip into the common fallacies that can disrupt your grieving process, we’re going to list some of the pitfalls that ensnare people and prevent therapeutic processing of grief. 

1) If you don’t show an outward display of grief such as crying, you aren’t “sad”

Just like the shortcomings of Kubler-Ross’ model, while crying is seen as a “socially acceptable” way of demonstrating sadness, it isn’t applicable to everyone. You may have been brought up to avoid tears at all costs, perhaps due to tough parenting or some childhood trauma, or you may not wish to “affect” others with your grief. No matter the reason, you should know that physiological responses to grief vary widely depending on your circumstances. Shock, numbness, anger, even hysterical laughter – just about anything is permissible in the initial, very private stages of your grief. 

2) If you don’t “get over it” within an “acceptable timeframe”, you aren’t good enough

Although your family members or people in your community may react to and resolve their grief earlier than you, you need to know that it is by no means healthy to affect the fragility of such a process by introducing the pressures of comparison. Some people simply have better coping-skills than others or are more inured to unhealthy thought processes that hold them back from the therapeutic management of their grief.

3) You feel like you need to “protect” loved ones from your grief, so you turn inwards

We keep emphasizing that grief is individual to everyone – this should tell you that there is no circumscription to how you handle it. Even though it might feel selfish to display your feelings openly because you think less emotionally able loved ones shouldn’t have to deal with your pain, remember that there is nothing shameful about the old adage, “Shared joy is double, shared sorrow is halved”. 

There are some simple coping mechanisms that you can use to help yourself through the process. Although the low mood is a given after the heartache of a tragedy or loss, and you might not feel willing or able to pick yourself up and carry on, remind yourself of the wisdom of eating and sleeping right. Drugs and drink might seem the most accessible ways to insulate yourself from poor mood, but these indulgences, in the long run, are hindrances to sustaining your mental well-being.

If you feel like the person you have lost needs to be remembered, you can do so in the solitude of creative expression, or you can choose to gather loved ones to laugh about cherished memories. If there’s one scenario where laughter in the face of loss is wholly acceptable – here it is! Whether communal or solitary, there are many ways you can raise someone up in loving memory – honouring them and helping yourselves. 

Find solace in your old routines. If you’re hurting after the failure to gain acceptance into a school of your choice, it may help to remember all the things you did well before that gave your life meaning and structure. At the worst of times, it helps to fall back on old patterns if only to hang on to some stability.

Lastly, know that there is a difference between clinical depression and the normal response to grief. You should be aware of critical signs or symptoms in both yourself and your loved ones that may indicate depression. For example, if you notice that your loved one isn’t eating or sleeping properly after a long period of time, or is displaying reckless tendencies such as driving dangerously or overindulgence in addictions, it may be time to seek professional help. Although many people can get through grief without the help of a mental health professional, when it all gets too heavy to handle, you may consider seeking grief therapy. Some of our clinicians are specifically trained in grief therapy, such as Joachim Lee or Winifred Ling.

 


Photo by Claudia Wolff on Unsplash

An Interview With Dr. Mark Toh – Coping with Video-Conferencing Fatigue 

An Interview With Dr. Mark Toh – Coping with Video-Conferencing Fatigue 

Dr Mark Toh is a Consultant Clinical Psychologist @ Promise Healthcare.

Is there a reason why these virtual meetings are so exhausting? How is video calling different from face-to-face meetings in terms of mental load?

There have been many changes placed on us as a result of the government’s attempts to create social distancing between one another in response to the threat of COVID-19 in Singapore. For the employed, perhaps the most significant change involves having to work at home instead of working out of our regular workplaces away from home. Accordingly, the necessary attempts to communicate at work have now to be moved online since face-to-face meetings at work have been prevented. The result of having to conduct our regular conversations and discussions previously in the workplace to the online format means that facing the laptop to attend to vocational as well as social in one location becomes the common practice instead. There are certain characteristics of this practice which leaves users of video-conferencing fatigued: 

(a) Previously at a regular meeting often at a conference site, the meetings carry a bigger social bearing. At a virtual meeting, this social bearing is reduced to what is visible only on a screen. Instead of the opportunity to scan the room previously which allows our eyes to adjust and therefore cope with eye strain, virtual meetings mean our gaze is now focused only on what is confined within this screen. We have to stare at this screen and then process everything we hear or see often over a protracted period within a certain frame. As a result, there can be visual overload and mental strain.

(b) Virtual meetings also require more effort than face-to-face meetings. We have to work harder to process non-verbal cues such as facial expressions, the tone and pitch of the voice, and body language. In contrast to face-to-face encounters, virtual meetings require more effort to assess social and personal meaning because of the context. According to Dr Gianpiero Petriglieri, an associate professor of Organizational Behavior at INSEAD, there is a dissonance that emerges during virtual meetings because during this interaction between participants in this format, “our minds are together when our bodies feel we’re not.” This dissonance or disconnection causes people to have conflicting feelings which add to the fatigue. This makes it difficult for people to relax into the conversation naturally. 

(c) Dr Marissa Shuffler, an associate professor of industrial/organizational psychology also describes the fatigue that can come from being watched because the camera is physically and constantly focused on us. In natural social settings, this does not happen. During virtual meetings, people can feel they are on stage and therefore, they feel the social pressure and are expected to perform. The larger the group, the stronger the pressure.

(d) There is also the stress that comes from delays on phone or conferencing systems or when the screen freezes. Glitches in the application of technology put pressure for the participants to ensure that relevant or significant information is not missed out, or to avoid misunderstanding information from what has been communicated. This becomes harder to slow down to clarify when there is a group meeting out of concern that questions could be seen as interference within a tenuous electronic connection.

(e) Visual overload and fatigue that comes from constant online viewing occur not only if meetings are long or frequent with its inherent stresses. The restriction to home has also placed reliance on engaging other activities online, eg. taking classes, ordering food, maintaining social connections outside the immediate family. If there is a practice of over-reliance on the computer screen to attend to other interests, the physical effort to position ourselves at a prolonged period in front of this screen can also create fatigue.  

(f) The strain that comes from virtual meetings can be accumulative when meetings are arranged close to one another. Since the worker is already confined at home, virtual meetings can easily be scheduled one after another. The meetings can appear to be executed efficiently. But there may not be any mental breaks in between.  

(g) Dr Petriglieri also noted that meeting online creates stress from being reminded that the familiar context has been disrupted by the pandemic. We are all coping within a crisis that has taken the lives of the elderly and the vulnerable in society and endangers our well-being. It is also stressful in the fact that we are used to separating different relationships such as family, friends or colleagues. But now they are all happening within the same space. The self-complexity theory posits that individuals have multiple aspects about themselves –context-dependent social roles, relationships, activities and goals–and we find this healthy. When we find this variety reduced, we become disoriented and become more vulnerable to negative feelings. Over a prolonged period of the self-quarantine, he notes the effect: “We are confined in our own space, in the context of a very anxiety-provoking crisis, and our only space for interaction is a computer window.” 

How do you alleviate the exhaustion that comes with virtual meetings? Are you able to share a few tips or suggestions?  

In light of the stresses and strains of increased virtual meetings as outlined, I would suggest the following:

(a) limit the video calls to only what is necessary; this implies that it is important to take breaks from electronic devices, in general, to avoid over-reliance on them and the subsequent emotional effects from excessive use,

(b) allow for the option to turn off cameras on yourself to be involved and/or face the screen off to one side so that you can concentrate without feeling the pressure to be on camera,

(c) plan breaks in between virtual meetings so that the body and mind have a chance for a break, eg. getting the body to move and stretch increases blood flow and reduce mental fatigue,

(d) if virtual meetings are unavoidable and long, learn to practice the 20-20-20 rule: every 20 minutes, takes 20 seconds to look at something 20 feet away. Remember that the electronic devices are our tools and not our master. 

 

What can bosses or organizers of these meetings do to facilitate these meetings so people don’t leave the meetings feeling exhausted? (While taking into consideration, the time spent on these meetings, or the feelings of the attendees)

It may help to start the meeting by quickly checking in to each other’s well-being. Being ready to acknowledge that the virtual meetings are unusual and that working at home means having to accommodate other family members inconvenienced by the pandemic invites everyone to be mindful about coping collectively with the current disruption. Secondly, consider if virtual meetings are the best way to work. To prevent information overload, would sharing files be more effective? Or the use of the phone to communicate may be a better device in many cases if there is only simple information to share. Thirdly, it may help if the meeting agenda is clearly defined and the end of the meeting is outlined at the start to reduce mental fatigue. Can the meetings be brief knowing that other meetings may be required? If meetings are prolonged, plan for breaks.

 

What can attendees/employees do to reduce the number of hours spent on video calls? (for example, what they can say to their bosses, or to keep track of the time so everyone is on track)

There needs to be increased education all around related to this topic of fatigue that comes from increased video-conferencing. It is a condition exacerbated by changes at work because of the pandemic. Employees should know their limits. If they recognize when fatigue sets in from excessive computer use, they should limit themselves from relying on their electronic gadgets throughout the day. Research has already shown that excessive computer use is correlated with depression. With more apps available online, there is an increased potential to become more dependent on electronic devices already. During this pandemic, the pressure to depend on the computer through increased virtual meetings is intensified. It is times like this when the wise among us would learn to separate the benefits of computer use from its downsides.

In light of this knowledge, employees can be more proactive to define the perimeters in which they would like to have virtual meetings conducted. If they recognize when fatigue will set in because of prolonged virtual meetings, they can ask to clarify (or specify) to their managers how long the meetings will take to monitor their mental and physical strain. In cases when prolonged virtual meetings are unavoidable, they can clarify if permission can be given to practice adjustments such as moving around as a way of coping with eye strain or from limited mobility experienced during the meetings, avoid the direct exposure to the camera, mute the calls to focus on listening or take breaks after every hour. At times, a person may have to prepare for any interference from young children who find it hard to ignore the presence of the parent at home.  

 

How do we instil positivity in our working lives, when the line between work and home is so blurred right now?

The pandemic and the subsequent quarantine is experienced as a period of adversity to some people. The emotional distress that comes from being quarantined has been recognized as common during this period. Common symptoms of this distress include fear, sadness, numbness, insomnia, confusion, anger, stress, irritability, post-traumatic stress symptoms, depressive symptoms, low mood, emotional exhaustion and emotional disturbance (eg. paranoia, anxiety). More specifically, people are faced with the disruption to the routines they have set up to cope with their stressors before the imposition of the quarantine. Distress is experienced because of the effect of the disruption on their autonomy, their sense of competence (being in charge of their lives to cope with their lives), their connectedness and their sense of security. It is a test on our resilience and ability to cope.

At the same time, the very challenge of this situation also provides us with the opportunity to develop our resilience. The first step is to understand and remember that these circumstances are temporary and not permanent. Pandemics happen but they are not frequent in history. Secondly, realize that there is a way to cope with the circumstances. As such, coping with this current situation is priority. I would suggest the following:

(a) Establish a routine for yourself (and that of your children). By creating a structure to attend to work and recreation, you start to organize and occupy yourself with addressing your daily needs as well as that of your family.

(b) Be as active as possible to maintain a fitness level physically, mentally and relationally for yourself and with your family. This also helps to battle against boredom. There are exercise videos online which you and your children can participate together to exercise as well as bond together. Also, for a personal project, you can ask yourself, “What will it take for me to become physically and mentally and relationally stronger as a result of this crisis?” Be curious about how to grow your resilience and to nurture the best version of yourself. Or as a parent, create a project to help your child develop resilience in their own lives and ask, “How can I help my children become physically, mentally or relationally stronger as a result of this crisis?”

(c) Deal with boredom by creating projects that self-nurture, eg. start a hobby or clean out your closet. Competing personal tasks provide a sense of purpose and maintain a sense of competency despite the external circumstances. Creating plans daily offer a focus on accomplishing what is important to your well-being.

(d) Communicate more to avoid isolation as well as cope with boredom. This can be an opportunity to nurture relationships if you are in quarantine with family and to strengthen social bonds with them, or with your support group. Remember that kids may be stressed too from this experience. More time together can provide opportunities for increased play to increase bonding. Games are useful means to bring fun into your relationships and to develop socially besides your entertainment. It can also become a reminder that the family is safe and coping together.

(e) Be informed without being overwhelmed to cope with the anxiety that comes from the unknown. The Straits Times newspaper provide a useful daily update so that you can monitor the threat of the virus rather than obtaining information from cable news. There is much information on the virus today locally and globally so be careful not to become obsessed with the topic.

(f) If you find that your distress is becoming more intense, consider support for your mental health. Your mental health is very important for your daily and long-term functioning. Different places may offer telehealth support where you can consult a therapist or mental health professional. Some services are available online and they can be reached through email, phone calls, texts or video calls.

 


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