Skip to 0 minutes and 0 seconds Uh, so. I haven’t started therapy sessions online. Just. I’m not ready but. The service was in touch. My therapist says that even though I don’t want therapy, he can be in touch every couple of weeks and, yeah,
Skip to 0 minutes and 22 seconds he is making more of a difference than I thought, actually. Then being flexible too and I am feeling proud of myself for being able to reach out to them. Like, it’s not just a quick call when it comes but it’s knowing that there’s a plan in the diary and they email with a list of dates that they’ll call and some links to online stuff like a few courses and crisis numbers if things get bad. But. Yeah, having that written down helps.
Skip to 1 minute and 6 seconds And I think it would have been easy for me to have turned it down ‘cause it is still, like, just awkward and difficult over the phone, but I tried one of the online forums that they suggested and that was good actually. A couple of people in a similar situation. I gave someone some advice so,
Skip to 1 minute and 31 seconds yeah, I I don’t want to suggest that, uh, everything is, like, rosie, far from it, but not by a long way like it’s. I’m still feeling.
Skip to 1 minute and 45 seconds Yeah. I had a bad night last night feeling panicked. Just. Don’t know what’s going to happen months down the line but, this feels OK for now, like. Maybe it’s just more of a sticking plaster than a cure. I mean, I don’t want to sound ungrateful ‘cause it is a good sticking plaster. But yeah, maybe, it’s just like it’s still in limbo, isn’t it?
Coping with mental health conditions during COVID-19
Let’s think more about what has shifted for Kevin this week. In Week 1, from your responses, it was clear that Kevin’s video really affected many of you. Through his video, something within Kevin’s distress, which he had been carrying by himself, was conveyed in a way that you really felt at a visceral level.
Many of you hoped he was okay and wanted to offer support. This transition from carrying overwhelming feelings alone to having them thought about by one or several other people is one of the most therapeutic aspects of any form of mental health support.
It can happen in a therapy session, on the phone with a friend, or as you make dinner side by side with your partner.
Recall our discussions about newsfeeds in the previous step?
Well, for those of us who struggle with our mental health, the internal newsfeed can be quite overwhelming. A host of hostile characters appear, convincing us that our distress and vulnerability are not to be taken seriously or are too much for others.
We can convince ourselves rationally this is not the case, but these ideas are felt at a deeper level. For individuals with mental health difficulties, they can be taken for granted almost as powerfully as our expectation that day will follow night.
So, we find other ways to manage. We avoid others, we enter fight or flight whenever our body registers vulnerability, we use drugs or alcohol, we develop habits, rituals, and routines to keep emotions at bay. Overall, we carry our distress by ourselves.
Let’s try to appreciate why it is such a big deal that Kevin has reached out, and why it is so difficult for us to change our behaviours.
We are fighting here against ingrained habits:
- Try writing with your other hand
- Try remaining silent over dinner if you usually speak
- Or being the first to talk if you usually don’t
- Try making use of any of this article content when you are in the middle of an argument tomorrow
- Try getting a society to follow the rules of lockdown
Making the transition from intentions to a change in behaviour is difficult. What we expect from others and how we behave in the world is largely habitual. This includes how we treat and respond to our emotional states. Kevin expects others not to hear his concerns, or to attack or ridicule him for them, so to protect himself he avoids and isolates.
Before lockdown, however, he had managed to find an accepting peer group and was engaging in therapy – these are promising steps. It may be that these small initial steps, alongside the follow-up call by a familiar voice at his mental health service, helped Kevin to be bold and join and comment on a forum.
You’ll see how this begins to challenge some of his taken for granted assumptions, such as that others will ridicule him, or that he is alone. His reaching out has provided him with some new information about the world that he would otherwise not have gained.
No amount of planning or talking intellectually can be a substitute for such an experience. Kevin has found somewhere, albeit online, and we’re not sure for how long, to share his distress.
Currently, we are thinking about what Kevin has done this week. However, support is a two-way street, and we will soon hear more about the concept of containment and the importance of the therapeutic setting.
You may have noticed that it is no longer midnight in Kevin’s video. This is due to another promising change which we will hear more about when we think about families.
© Maudsley Learning © Tavistock & Portman NHS FT