Author: Coronado Psych

Processing Grief And Loss Of A Loved One During The Pandemic

Many Americans are struggling with economic anxiety, medical problems not being addressed, kids missing school, an uptick in drug addiction, and fear, just to name a few. One of the worst results of the pandemic is that hundreds of thousands of Americans and more around the world are coping with grief and loss right now. Losing a loved one at any time is stressful and requires fortitude, but processing grief and loss of a loved one during the pandemic takes a new kind of resilience and endurance.

Continue reading “Processing Grief And Loss Of A Loved One During The Pandemic”

How to Help Your Child Cope with COVID-19

We are, without a doubt, living through uncertain times. Like most parents, you probably never expected that schools would shut down and you would be forced to homeschool your child(ren).

Homeschooling, distance-learning, and hybrid learning have all been a big adjustment for families, and many parents have lost their jobs or have been stripped of time during the day to work and fulfill household duties.

The sudden change to distance-learning has resulted in many children struggling to remain engaged and learn effectively. The “parent becoming the teacher” model has led to a high degree of parental stress, as parents try to help their children overcome the many challenges connected with this pandemic.

It can be hard to keep track of all the ways in which your children might be affected. Below, I outline the three main areas of concern I consider when thinking about the effects of our “new normal” on our children, and tips on how you can help them cope.

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How is the pandemic affecting my child?

It can be overwhelming to think of all the ways in which the pandemic can affect your child. As a child/teen therapist and counselor, there are 3 main areas I look at when considering a child’s mental health:

1. Academic Performance

Many parents have been helping their child learn at home by reviewing school work, set up a reasonable pace for completing work, and providing assistance with turning on devices, reading instructions, and typing answers.  Yet you may still be concerned that your child is struggling to be actively engaged or keep up with school work through online/at-home learning. 

*For parents of children with diagnosed learning differences or other special needs (e.g., ADHD, autism, intellectual disability), all of this stress can be that much more magnified! Your child might not be receiving the required Individualized Education Program (IEP) or other specialized learning or behavioral services (e.g., social skills training, occupational therapy, and speech/language therapy) in the online/at-home learning environment. 

Children covid school

2. Social Development

Social distancing guidelines and quarantines have likely impacted the way or degree to which your child interacts with their friends. You may be worried that your child or teen struggles to stay connected with their friends or that it will be difficult for them to adjust when they return to school for in-person learning.

Because not all children and teens respond to stress the same way and the adjustments vary by a child’s age group, the task of meeting your child’s social needs is not an easy task as the pandemic continues.

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3. Mental Health

Lastly, your child or teen might be experiencing any number of mental health issues related to the outcome of COVID-19.

Changes in your child’s behavior such as a decline in grades, avoiding school, irritability, excessive worry, depressed mood, stomach aches, headaches, difficulty concentrating, unhealthy eating habits, difficulty sleeping, or substance use (e.g., alcohol, tobacco, marijuana, etc.), can show that your child may be struggling to cope; and are especially important to watch closely during these unusual times.

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What Can I Do to Help My Child?

As the pandemic rages on, families around the world are finding more creative ways to cope. Below are some tips to help you find what will work for you and your family.

School Performance

If you are worried about your child’s school performance, it may help to work with your child’s teacher or other school administrators directly to address your specific areas of concerns.

These types of conversations are really important if your child relies heavily on school-based services that are only available at school.

If you are struggling to identify exactly what services or support your child may need, you may consider consulting with a psychologist.

A psychologist or counselor who is trained in working with children/teens to help you learn how to best advocate for your child during this difficult time.

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Social Development

If you are a parent who is worried bout your child’s social development, you might consider multiple solutions based on their age and specific needs.

Moms and Dads of very young children (i.e., under the age of 5) can help their children pick out uncomfortable feelings (e.g., anger, fear, anxiety) and stay connected to friends by reaching out to other parents and hosting online playdates.

Parents of elementary school-age children might consider having an open chat about their feelings about social isolation and how the school will look different when they return (e.g., the layout of desks, staying in during lunchtime, etc.).

When your child returns to school, consider talking to them about their interactions with classmates, and assure your child that any feelings they have are normal.

Talking about such matters with your child or teen is not always easy and can feel uncomfortable, at which time you might consider meeting with a therapist about how to ease such conversations. 

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Emotional Well-Being

Parents worried about their child’s emotional well-being can help them cope with feelings of anxiety and depression by answering any question they may have about the virus.

You may also choose activities for your children to take part in such as listening to music or playing a game (e.g., Scrabble, Uno, Charades).

Ultimately, if you are unsure about how your child is coping emotionally, you might consider reaching out to a mental health provider for additional support and guidance.

Activity Pacing on the “Good Days” and “Bad Days”

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Activity pacing is an important skill to have when coping with chronic illness, recovering from an injury, or managing other health problems. As you work to juggle your physical symptoms with your daily activities and responsibilities, it can be hard not to overdo it. Learning how to pace yourself, even on your “good days,” can be crucial in limiting the physical and emotional lows of your “bad days,” and allow you to take back a sense of control over your life.

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Why do I need to pace myself?

When coping with a physical illness, it is common to experience “good days” and “bad days.” Sometimes you may wake up feeling energized with minimal pain or discomfort, and on other days, you may wake up feeling sluggish, achy, and all around uncomfortable. It is only natural that on the “good days,” you may feel the need to “take advantage” of your energy to complete tasks or engage in activities—and  it can be very easy to “overdo it.”

Doing too much during a “good day” often leads to a big crash or burnout and can make you more susceptible to longer bouts of “bad days,” as your body recovers. At the same time, it is easy to do get in the habit of over-limiting your activities because of your fear of a bad crash. Activity pacing can keep you from burning out and help you find the balance between doing too little (under-activity) and doing too much (over-activity) by teaching you how to effectively listen to your body as you go about your everyday life.

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How do I pace myself?

Activity pacing requires you to actively monitor your physical symptoms and mindfully gauge how you are feeling as you plan your activities. It may take some time to understand how much you can or cannot do, without risking feeling worse later. Here are a few tips that may help you to find a balance that works for you:

  • Write down your schedule ahead of time.
  • Make sure to include things you have to do, things you like to do, and time for rest.
  • Plan what you can skip if you are starting to feel too tired.
  • Troubleshoot how you may complete the tasks you have to do, if you begin to feel worn down (e.g. asking for help or finding alternative solutions).
  • Use a daily planner to schedule your activities and track how you are feeling. 
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By taking the time to pace yourself, you can increase in the odds of having another “good day” rather than knowing there will be a burnout and crash afterwards that could last days/weeks. It can also encourage you to safely stay active and engaged, even when you aren’t feeling your best. Activity pacing can be hard to do at first, especially if you feel you have been stuck in an endless cycle of “good” and “bad” days for a long period of time. Health psychologists can help you begin to manage your days so you can regain a sense of control in your life.

Baby Blues v. Postpartum Depression: What’s the difference?

Becoming a parent is a major life transition. Although it can be a joyful experience for families, it also comes with a significant amount of physical and emotional changes. The transition to parenthood is challenging, regardless of whether you are welcoming your first child or your last of many. With this blog post, we hope to shed some light on the difference between the “Baby Blues” and Postpartum Depression, and how you can find help.

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Baby Blues v.  Postpartum Depression: What’s the difference?

Any new parent can be affected by the “Baby Blues” or Postpartum Depression. For the birth parent, there are many obvious physical and hormonal changes that happen right after the birth of a child.

Bringing a new child home can be stressful, however, for everyone in the family, as it often requires major adjustments in life activities, including sleep schedules, work, diet, exercise, and changes in daily routines.  There are also adjustments that relate to the family dynamic or how the family relates to one another as everyone, including siblings, adjust to a new family member.

Often, communication can break down and there can be an increase in worry about the health and safety of the infant and mother. All of these aspects are natural experiences, adjustments, and stressors of what it means to become a parent. It is not uncommon for people to wonder if they are suffering from Postpartum Depression or if instead it is the “Baby Blues.”

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Postpartum Depression is classified as a mood disorder that can affect how people feel after their first child is born. Often, people can experience a range of symptom severity and can have prolonged (more than 2 weeks) symptoms that include a low mood, irritability, difficult sleeping, fatigue, feelings of anxiousness, difficulty forming a bond with the newborn, and reservations about the ability to care for the new baby. When experiencing this type of depression, it can interfere with daily activities and make it increasingly difficult to complete various tasks.

If Postpartum Depression is untreated, it can worsen and interfere with a person’s life significantly. This does not only prevail right after the birth of a child, but may come surface weeks to months after the child is born.

In comparison, the “baby blues” is what many parents also experience, but it differs from Postpartum Depression because it is more moderate and short-lived. The “baby blues” typically leads to feelings of being overwhelmed, anxious, or unhappy, but it does not last for an extended period of time. Often, it is considered “normal” in the transitioning stage to looking after a newborn. Eventually, the “baby blues” will fade and parents will adjust while Postpartum Depression does not.

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While an accurate diagnosis is outside the scope of this blog post, if you believe you are suffering from Postpartum Depression, it can be highly beneficial to seek help from a trained mental health professional. 

on what you may be feeling. The obstacles are inevitable in becoming a new parent and it can be hard on everyone. It is so important that new parents are able to take care of themselves before looking after another life.

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How do I get help?

Many parents are able to benefit from the treatment that is offered for a Postpartum Depression diagnosis which includes psychotherapy, medication, or a combination of both. If you believe you or someone you love are currently in a suffering state of Postpartum Depression, you can reach out to family and friends for support, lean on your supportive partner, join a new moms support group, or seek psychotherapy services. There is a significant amount of resources aimed at helping parents who are struggling and it can be comforting to be aware at the very least of all the resources that are available.

Please see the links below for more information about Postpartum Depression:

https://www.nimh.nih.gov/health/publications/perinatal-depression/index.shtml

https://www.apa.org/pi/women/resources/reports/postpartum-depression

How to Enjoy Activities While Feeling Depressed

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Along with low mood, prolonged loss of enjoyment in pleasurable activities is one of the hallmark symptoms of depression. When depressed, it can be difficult to do the things that make you feel good. This disengagement can then worsen depressive symptoms and make it that much harder to cope. It may feel impossible or “pointless,” to engage in pleasurable activities when feeling depressed. Nevertheless, many find that this strategy can help them find relief when they need it most.

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What is Behavioral Activation and How do I do it?

When depressed, it is very easy to think of reasons why you can’t or don’t want to engage in pleasurable activities. In Cognitive Behavioral Therapy (CBT), we sometimes ask people to practice “Behavioral Activation” to stop the cycle of disengagement in pleasurable activities. Behavioral activation asks you to re-engage in the things that made you happy or to explore other activities that may make you feel better. Here are some strategies that can help you become behaviorally activated:

1) Make a list of all the activities that used to make you happy or might make you happy today.

  • NOTE: Activities can vary in type (e.g. talking to a friend, going for a walk, or picking up a new hobby) and duration (e.g. listening to a favorite song or going on a vacation).

2) Choose an activity from the list that you CAN and LIKE to do.

3) Make specific plans to do it

  • Identify place/time/who will be involved

4) Plan for possible barriers to plans

  • What are possible obstacles? What are the alternative plans if you face such obstacles?

5) Be mindful of how you feel before and after engaging in the activity.

  • Remember that it is okay if the activity does not feel the same as before. Many find that engaging in the planned activity was not actually as bad as they thought, and with some practice find that this is an important coping strategy for managing their mood.
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How can I get help?

Although behavioral activation is conceptually relatively simple, it can be very hard to implement on our own—especially when we are feeling down. Supportive friends or family can hold you accountable and help troubleshoot challenges that may arise as you plan to engage in pleasurable activities.

Moreover, mental health professionals trained in CBT can also help you find ways to cope with low mood and loss of enjoyment by tailoring such strategies to your specific needs and concerns.

What is Guided Imagery Relaxation Therapy?

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Guided imagery is a relaxation strategy that can help to reduce symptoms of anxiety and depression, by helping us to find a sense of calm in both our minds and bodies. Through guided imagery, we can access the calming qualities of our real or imagined “happy” places by systematically imagining how these places feel through our 5 senses (sight, smell, touch, sound, and taste).

Although it may take some practice at first, guided imagery can be a powerful tool to find relaxation and calm wherever we may be. This relaxation strategy can lower blood pressure, reduce pain, and decrease feelings of worry or sadness.

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Guided Imagery: Getting Ready

Because guided imagery exercises ask us to vividly imagine our “happy” places through all 5 senses, to maximize your experience, it is important to take a moment to prepare for the exercise before diving in. Prior to engaging in guided imagery, we want to be sure to do the following:

  1. Choose your real or made up “happy” place.
  2. Write down how you have felt or would feel in the place you have chosen, making sure you focus on describing how this place feels with all 5 senses.
    1. What do you see? What do you hear? What do you smell? What do you taste? What are you touching?
  3. Find a quiet place and a comfortable position to close your eyes and relax for 10-15 min.
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Guided Imagery: The Script

Most people who are just starting to practice guided imagery do so with the help of a live or pre-recorded script (Click here for a good example: https://www.youtube.com/watch?v=35ch88kmlls). Below, I have provided an example of a script that I use when introducing this skill to clients in order to further clarify what guided imagery can be like.

  1. With your eyes closed, imagine a beautiful, quiet, and peaceful place where you feel at ease and safe.
  2. You may stop at any time if you feel uncomfortable.
  3. Take a moment and look around.
  1. What can you see? What colors do you see? What else can you see?
  2. What do you hear? Can you hear waves or wind? Take a moment to listen to the sounds in this place.
  3. What can you smell? As you breathe in, let the smell of this place enter your body. Take a moment and focus on what you can smell.
  4. What do you taste? Is the taste sweet or sour or something else? Focus on what you can taste in this place.
  5. What is touching you and your skin? Perhaps you can feel the breeze on your skin or the sand between your toes.
  1. Take as much time as you need in this place. Relax and allow your body to feel safe. You can come back to this calm place in your mind any time.
  2. When you are ready, return to the present time and place. Take a deep breath, stretch your arms and legs, and slowly open your eyes again. 
  3. Take a moment to reflect on how you felt before the exercise and notice how you feel now.

With practice, guided imagery can be an extremely useful relaxation tool with many benefits to those suffering with anxiety, depression, or other health issues.

What is Progressive Muscle Relaxation?

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Progressive Muscle Relaxation (PMR) is a relaxation tool that asks you to systematically tense and relax your muscles, in order to destress. By first noticing the tension in your muscles, you can more easily replace the tension with relaxation, and ultimately reduce your physical symptoms of anxiety and depression.

Progressive Muscle Relaxation (PMR)

PMR: Getting Ready

It is important to take a moment to get ready for the exercise in order to maximize your experience. Prior to engaging in PMR, we want to be sure to do the following: 

  1. Find a convenient time in your day to practice PMR, so you don’t feel rushed.
  2. Get comfortable in a position and close your eyes, but try not to fall asleep.
  3. Remember to flex each muscle so that you feel some tension, but NOT to the point that you feel pain.
  4. Stop if you ever feel uncomfortable during the exercise.
Progressive Muscle Relaxation (PMR)

PMR: The Script

Most people who are just starting to practice PMR do so with the help of a live or pre-recorded script (Click here for a good example: https://www.youtube.com/watch?v=86HUcX8ZtAk). Below, I have provided an example of a script that I use when introducing this skill to clients in order to further clarify what PMR can be like. 

  • While keeping the rest of your body relaxed, clench your right hand into a fist. Hold this fist for a few (5) seconds. Feel the tightness in your fingers, wrist and, forearm.
  • Now relax.
    1.  Notice the contrast between tight muscles and loose ones. Focus on your muscles as they completely relax. You may notice a pleasant sort of burning feeling that occurs when the muscles relax. Let go of the last bit of tension in these muscles. (Pause).
  • Repeat this process for the following muscle groups: Hands & forearm (right & left), bicep muscles (right & left), forehead, jaw, neck and shoulders, stomach, back, upper legs, calves & shins.
  • You may experience a feeling of heaviness in your body as the relaxation deepens. Or you may notice the sensation of lightness of your muscles. Whether you feel heaviness or lightness, enjoy this sensation.
  • Take a deep breath, and as you exhale the last bit of tension will leave your body. Experience this feeling of being at rest.
  • I’m now going to count backwards, from five down to one. With each number, you will slowly begin to feel more alert. 5. Starting to feel more alert. 4. Beginning to sit up. 3. Slowly opening your eyes. 2. Feeling more alert. And 1. Feeling relaxed and refreshed.

With practice, PMR can be an extremely useful relaxation tool with many benefits to those suffering with anxiety, depression, or other health issues. If you would like to learn more about Psychotherapy services at Coronado Psych, please contact us.

What is Autogenic Relaxation Training (ART)?

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Autogenic Relaxation Training (ART) is a relaxation strategy that asks you to focus on feelings of warmth and heaviness within your body to create a deep sense of physical and mental relaxation.  ART can help to reduce physical symptoms of anxiety and depression such as lowering heart rate, breathing rate, and muscle tension and can be practiced wherever you are, at home or in your therapist’s office.

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ART: Getting Ready

To maximize your experience with ART, it is important to take a moment to prepare for the exercise before diving in. Prior to engaging in ART, we want to be sure to do the following: 

  1. Find a quiet environment, free from distractions and noise
  2. Find a comfortable position to sit or lie down. 
  3. Take a few deep belly breaths in and out.
  4. Know that your mind may wander during the exercise—this is normal. When this happens, you can gently bring your attention back to the feelings of warmth and heaviness in your body.
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ART: The Script

Most people who are just starting to practice ART do so with the help of a live or pre-recorded script (Click here for a good example: https://www.youtube.com/watch?v=E_sdaDwa2Ek&t=141s). Below, I have provided a general outline of a script that I use when introducing this skill to clients in order to further clarify what ART can be like. 

  • In your comfortable position, begin by taking a few deep breaths. 
  • Now turn your attention to your right hand.
    1. Feel the palm of your right hand becoming warm and relaxed. Feel the warmth in each finger, and on your palm, spreading to the back of your hand, to your wrist.
  • Feel your right arm becoming warm. As the warmth spreads in your right arm, it feels very heavy, very heavy and warm, and very relaxed. Your right arm is warm, heavy, and relaxed.
  • [Repeat script for left hand, legs, knees, hips, face, etc.]
  • Feel the heaviness in your entire body. Your body is warm, heavy, and relaxed.
  • Enjoy this calm, relaxing feeling. Notice your smooth, even breathing, relaxed and deep, drawing you even deeper into relaxation. Your body feels very heavy, warm, and relaxed. Enjoy the relaxation for a few more moments.
  • Now slowly begin to bring your attention back to the present. Keeping your eyes closed, notice the room around you. Notice the surface that you are lying or sitting on. Hear the sounds in your environment.
  • Gently start to reawaken your body. Wiggle your fingers and toes. Move your arms and legs a little, stretch if you like.
  • When you are ready, open your eyes and become fully alert.

How to Communicate Effectively When Feeling Anxious or Stressed

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Effective communication is a crucial component of maintaining healthy relationships. When we communicate well with those around us, including family, friends, and coworkers, we can help strengthen our relationships and feel adequately supported.

However, low mood, anxiety, or anger, can disrupt our abilities to communicate and make us feel increasingly isolated from those around us. In these moments, it can be helpful to remind ourselves of the different ways we can communicate with each other and to practice strategies to increase the odds of being heard and understood by those around us.

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What are the different styles of communication?

Generally, there are 3 different styles of communication: passive, assertive, and aggressive.

Passive

With passive communication, opinions, feelings and wants are withheld and go unexpressed. Passive communication often leads to increased feelings of loneliness or isolation.

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Assertive

Assertive communication results in clear expression of opinions and needs, without stepping on people’s feet or crossing boundaries. This type of communication often results in greater mutual understanding and strengthened bonds.

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Aggressive

Aggressive communication also results in an expression of opinions, feelings, and needs, but results in crossing boundaries to other people’s detriment. Aggressive communication does not often lead to mutual understanding but can leave people feeling hurt and weakening relationships.

 Assertive communication allows for us to express ourselves and our needs while keeping the needs of others in mind. By practicing assertive communication, we can increase social support, improve self-esteem and mood, lower anxiety, and help make and keep meaningful relationships.

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What does assertive communication look like?

There are many skills that can help us communicate assertively. Here are a few strategies to help us state how we feel without hurting others.

  1. Use “I” statements such as “I think” or “I feel.” Such statements help us to avoid making accusations or assumptions about the people with whom we are talking.
  2. Focus on the problem situation, not the problem person. Communicating what we would like the outcome to be and not what the other person is doing wrong can help to prevent the other person from becoming defensive.
  3. Practice active listening. Repeating what was said and asking clarifying questions can help us better understand each other and prevent misunderstandings.
  4. Express empathy, validation, and support. Expressing that we understand how the other person feels, regardless of whether we agree with them, can go a long way in allowing our own thoughts and feelings to be heard, while being mindful of where others stand.
  5. Consider time and place. Choosing an appropriate time and place to have difficult conversations can set the tone for a better and more productive conversation. 
  6. Learning to say no. It is okay to decline activities that are unnecessary or unfulfilling. It is also almost always reasonable to ask for more time to make decisions. Also, we do not need to defend our answer with an explanation.

When we practice assertive communication, we can enjoy the many benefits of meaningful relationships, and feel supported through our most challenging moments. Communication is not easy, especially when we are feeling distressed, but when we practice and learn to effectively communicate, it can be highly beneficial for everyone involved.

How to Find Emotional Support

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Social connections are an essential part of the human experience and play an important role in maintaining our mental health and well-being. However, when we are feeling anxious or depressed, it can be hard for us to reach out.

Feelings of loneliness and isolation can limit our ability to identify sources of social support and our desire to connect, even when we know it can benefit us greatly. A helpful first step when struggling to reach out can be to evaluate the different kinds of emotional support available to us to help guide us in our efforts to get the help we need.

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What are the different kinds of emotional support we can give each other?

There are 3 main categories of emotional support that are helpful to consider when assessing how to reach out for help:

1.“Toolbox”/Practical Support

Practical support is typically action-oriented and involves some sort of problem-solving or advise giving. For example, you may choose to call a friend after your car breaks down on your way to work. A friend who is offering practical support may offer to call a car towing service. This type of support can be crucial for situations where our anxiety or depression may make it hard for you to see solutions in a timely or effective manner.

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2.“Tissue”/Sympathy and Empathy

A “tissue” is someone who is willing to listen to how you are feeling and supports you in coping with your distress. Following the previous example, a friend offering sympathetic support may empathize with your distress about running late to an important meeting, as a result of your car breaking down.  Sympathetic supports validate your distress and help you feel less alone as you cope with stressful situations.

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3.“Bucket”/Holding Space

Sometimes we just need someone to listen and provide space to hold our distress. The process of unloading our emotions is often referred to as “venting,” and can be extremely helpful in relieving distress. In the example of your car breaking down, a “bucket” can simply listen to you describe everything that happened to you that day. Having a space to “vent” can help clear mental and emotional space to begin to assess what is most important for you to focus on to move forward.

How can I use this to get better help?

By evaluating our social support network using the three categories described above, we can start to be more mindful of how and who we ask for help. Not everyone is built to provide all 3 categories of support and often, we do not need all of them at once. Taking a step back and thinking about what you need in terms of a “toolbox,” “tissue,” or a “bucket,” can help you identify who to reach out to and what to ask for. With practice, we can become more effective in how we ask for support and start to uncover the different ways we are supported in our lives.