When most of us think of grief, we think of losing a loved one or the end of a relationship. Does it make sense to have a sense of grief in the coronavirus crisis, even if you haven't lost anyone?

On Isolation and Grief With Psychiatrist Swapna Vaidya

According to psychiatrist Dr. Swapna Vaidya, yes. Grief is caused by loss, and many of us have lost at the very least a sense of security and our predictable routines. Others may have lost jobs, opportunities, and of course, loved ones.

But we're all in this together, and the potential for unity and for providing one another with support, globally, has never been greater. 

In this podcast, Dr. Swapna Vaidya speaks with Gennev Director of Health Coaching Stasi Kasianchuk about the nature and course of grief and how to be kinder to everyone going through grief and isolationincluding yourself.

To watch the video of this webinar, visit the Gennev YouTube channel. And subscribe to be sure you get notified of every new webinar. 

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Dr. Swapna Vaidya is a psychiatrist and Executive Medical Director in the MultiCare Health System.

Stasi Kasianchuk is a Sports Dietitian, Exercise Physiologist and Gennev Director of Health Coaching.

 

Practical, medical, and encouraging support with a menopause expert: Gennev is telemedicine for women. Learn more.

 

TRANSCRIPT

Coach Stasi Kasianchuk

So welcome everyone to our wellness webinar. This is a really great one today on a great topic that's pretty relevant right now—the topic of grief. So I am Stasi Kasianchuk. I am a registered dietitian, nutritionist and the director of health coaching here at Gennev. So, Swapna, I'd love for you to give your background, introduce yourself to our audience. And yeah, let us know who you are.

Dr. Swapna Vaidya

Oh, okay. I’m Swapna Vaidya. I'm a psychiatrist. I currently work at Multi-Care Hospital. But I have had an extensive background in consultation psychiatry. So what that means is that I have had a background dealing with psychiatric issues with patients, who are going through medical problems or are going through trauma. And I was in New York actually during the 911 time and so I have personal experience working on the ground for disaster psychiatry. So this is where my background is and here I am today trying to sort of connect with all of you to share some of the experiences that helped us back then and to talk a little bit about grief.

Coach Stasi Kasianchuk

Yeah, absolutely. Yeah. Thank you so much for joining us. And I'm interested too because we do hear a lot about some comparisons from what we're experiencing now with the COVID 19 pandemic to 911. So your experience, your insights from that experience to now will be really great and during this this webinar. You mentioned that topic of grief and we've seen more some more publications on grief right now and there's some, you know, just this feeling that even when I'm talking with my clients through Gennev of, of just there's something different, there's something in almost in the air, but individuals are trying to work through this. Can you give us a brief description of what is grief from your from your background and what do you see or how is it maybe playing out for people right now in this situation?

Dr. Swapna Vaidya

Yeah, thank you. You know, Stasi, because this is really an important issue to discuss right now and you nailed it. Like a lot of people are trying to draw comparisons between what happened in 911. And you know, I've a lot of friends back in New York who are psychiatrists and they are all just saying that this sense of loss, this sense of grief is even much more than what they experienced when 911 happened because of the fatalities, you know, which are being just immense. So that being said, you know, what is grief? Grief is a sense of loss and that's actually the best way I can describe it. And you know, normally when we look at grief, we say, okay, this is connected to bereavement, that you lost somebody. But right now what everyone is experiencing is a big sense of loss, missing the way life was.

Missing what was the normal. Missing the fact that you could just pop up and go to a restaurant and have dinner. That's grief. So grief is a normal human response. To any kind of loss. So I'm going to get a little technical and I'll talk about the stages of grief and how it's pertaining to this pandemic, if I may.

So, yeah, so you know, Dr Elizabeth Kubler Ross, she was the pioneer who did a lot of research on grief and she talked about stages of grief. So the first stage is denial. And then we connect this to the pandemic right now that are personal levels of grief, local levels, and then on a national level of denial. So on a personal level, you know, I mean, I'm sure a lot of people who are this, Oh, I'm never going to get this virus or that I'm young, this is not going to happen to me or not to my family.

So that's a personal level. On a local level, the denial is that, Oh, well you're not gonna follow social distancing, that doesn't really apply to me. And then on a national level, we've seen various forms of denial as to how we first denied it and then we accepted it and now we know what it is. Then we look at anger. So the next day just anger. Now, once we deny it and we know, okay, this is really happening, then we get mad. You're really angry. And how do we express the anger? Towards the people who we are living with. And that is why I'm really concerned a little bit about on the other side is the rise of domestic violence and anger towards children. So this is a huge important issue. How we need to deviate from anger and go towards acceptance. And the other issue of anger is the social media. I mean I'm sure you've seen the rantings and the ravings and you're right and I'm wrong.

So this is a way people are trying to clutch onto any sense of control. Then the third stage is bargaining. Then we are trying to bargain with each other. They're saying, okay, maybe if I do social distancing for a week or maybe if I just stop it, you know, perhaps for I wouldn't go to this place or that place and then this would be, this would be done. Or I can see X, Y, Z friends because guess what? I've been seeing them so they will not be infected. So this is bargaining and then sadness. Finally we are sad, we are demoralized, we are depressed. And then acceptance. Then we say, and that is the stage we have to arrive at. But you know what? Everybody takes time to arrive at that stage. So in a way, what I'm trying to say is that it's okay, these are the feelings you’re feeling, but the ultimate stage that you want to come to is acceptance. You know, there's that serenity prayer. We can change things, but some things we got to accept, you know, and this is one of those hard life lessons. So this is a what I would suggest in terms of grief as well as how it's pertaining personally and locally with us.

Coach Stasi Kasianchuk

Yeah, you brought up a lot of good points there, Swapna. Several things come to mind. The first one that I had, you mentioned these layers, the personal layer, the local layer, the national layer. We might even, I don't know if we can add a global layer on to that. From your perspective, do those layers … Does that add add more grief or does that make it heavier for the individual knowing that it's not just in their personal bubble? There's layers upon that. Do you see that effect with people?

Dr. Swapna Vaidya

Yeah, it actually can be dual, you know, in a way how human being how we are social creatures. So when we know that we are not alone in this, then knowing that it's a global pandemic somehow helps. But then on the other hand it can become a very worrisome thing. So this is how we have to set our acceptance and set what we can do and how we can control things that are in our control. So for instance, ruminating about it and worrying about it to a certain extent is just going to be destructive, but understanding that we are not in this together, we are not in this alone and there is all this rush of vaccines being studied and antibodies being studied and all that, gives us hope. So I would tend to go on the side of hope to say that we are all in this together and hence we are all connected on a personal level, local level, national level. And then as you explained, Stasi, even the whole world, pandemic.

Coach Stasi Kasianchuk

Yeah, no, that's such a good point of finding ways to, to shift the thought process to shift from a maybe a more pessimistic thought to a more to a more optimistic thoughts to be supportive of what we're going through. The, another question that I thought of too when going, you talked about this process being normal, so is it, is it normal to go through these stages in order, or do people tend to go to one stage, skip, come back? Is there a what, what do you usually see or what is considered normal?

Dr. Swapna Vaidya

You said such a good point. Yes. There are no ways that, you know, one person reacts well situation. It's not such a sort of like a single mold will fit everybody. So there are some people who would probably go towards acceptance, you know, maybe because they've been traumatized before. A lot of the folks that I've seen, you know, the psychiatrist or my friends or colleagues that I've talked to in New York have said that, that they reach the stage of acceptance pretty quickly because they had gone through it before. So they had already experienced it before. And when they knew that what happened then they couldn't control what happened. And what's happening now is not something they can control. But on the other hand, perhaps people who have never experienced this in lifetime, like, you know, the young kids, teenagers, maybe the millennials, they have never seen this.

And this might be a very, very difficult time. And that's why I talked about the local level. I talked about the denial there. A lot of young people were saying, Oh, this can't affect me. But we are now seeing like a huge demographic of young people with no preexisting health issues also getting sick by this virus. So that's something that the mind frame had to shift to understand that this is actually happening to everybody. Maybe our older and our elderly population are more susceptible and they may have a very devastating course of the illness, but that doesn't spare even the younger, the middle aged folks that we have. And hence I think that it depends on where at the stage. If you been if you've had experience before, if you had some amount of training in trauma and acceptance or understanding that can actually help how you can switch. So something to see.

Coach Stasi Kasianchuk

Yeah. You know, silver lining, I guess to having have gone through something similar to this that perhaps you're more resilient, resiliency or experienced is built. Would you agree with that?

Dr. Swapna Vaidya

I agree. And actually, you know, I was going to talk about resilience. I came across a very good article about resilience and you know, I was reading about Sheryl Sandberg and her Option B and I think she's going to come up with much more material about it. But there was some things which really stuck with me from that article. She talks about resilience, but she talks about three Ps, the three Ps, the letter P that are bad for you. So may I? So number one, she says, number one is personalizing it. Number two, saying this is a permanent thing, you know, and number three saying it's pervasive, meaning it's affecting everything that I do. So these three Ps are destructive. So how would you personalize this? You personalize this by saying, Hey, you know what? I did something wrong. Oh, I got this virus and I gave it to my mom or I gave it to my, you know, things are not in your control.

So self-compassion is something you should practice. You shouldn't blame yourself. Second thing is permanence. The thing that, Oh, this is uncertain, I am never going to go back to normal. This is forever. But we know things are not forever. We know this too shall end. The thought and the last important thing that she talked about was pervasiveness. It doesn't mean that every aspect of our life is affected. We still have some silver linings, as you said, you have a time to call your friends, your childhood friends. I mean, I hadn't connected with them for God knows 25 years and now we have like this WhatsApp group when people are sharing things and it's really nice to listen to, you know, your childhood friends and what they are going through and how connected the world has become. You know, so we cannot say that everything about this is horrific and horrible. Try to find some silver lining, whatever that may be.

Coach Stasi Kasianchuk

Yeah, I like that. I had not been familiar with those three Ps, but I think that gives, to add another one, gives perspective on just how, where you're and allows that reflection, that mindfulness to piece to reflect on how am I internalizing this and what am I doing with the information and how can I change the story a little bit or reframe to be able to support to support myself.

Dr. Swapna Vaidya

Right. I think reframing that, that aspect. You talked about cognition, you know I'm so sorry. I just got caught up cause I was on my phone so that one was fine to call me. Another thing, I'm, I'm still on call in the hospitals, so I'm sorry if there are like, you know…

Coach Stasi Kasianchuk

Oh, thank you for doing, for being on the front lines right now.

Dr. Swapna Vaidya

Exactly. And I really thank my doctors and my healthcare workers. And that's such an important thing too, you know, sort of like connect with right now, this is where I say that when you talk about how can you help in the stand and make like people feel helpless, but there is a way — you can work as a community, you can work in your home, you can take care of your elders, your children, and at the same time you can actually try to do something good for the community such as health care workers. Our essential workers were going and putting their lives at stake. You know like some doctors are getting meals for the patients, for their staff, for their nurses, for their healthcare workers. And, and that way some doctors are actually cleaning the rooms in the ICU so that the cleaning lady doesn't have to go in. I mean, I thought that was tremendous. I mean, I've reading been reading about these things on a Facebook and I think that's such a, humanity is in, in its best best way. So resilience doesn't really mean that you have to reject your unpleasant emotions. You absolutely accept them. You accept them, you feel them, you go through them, but you don't let them control you. That's the key. And that's the hard, hard part. You know,

Coach Stasi Kasianchuk

I think, I like that you, you made that distinction of being able to experience your feelings but also not letting them then sweep you away. I've been talking a lot with clients about giving permission, having them give themselves permission to most of it's around more on self care, giving permission to take a nap if you're feeling tired, giving permission to giving permission to, you know, maybe take a little bit more time for yourself. So whether it's a little separating, finding space in your house where you can have some time alone and being okay with taking that time, it can be a hard thing to, to feel emotions, to give permission. Do you have recommendations for people on how to best, how to best feel emotions if that's not something they're comfortable with?

Dr. Swapna Vaidya

You know? Exactly. And again, everybody's going to be different, right? Everybody's emotions and reactions are going to be different. But what I would recommend, I like what you said about how you give yourself permission. So I will give you my example, I have a five year old, right? And I want to kind of sometimes get away. I tell my husband, you know, like, listen, I'm going to be in the terrace or something, you know, just doing, I need 20 minutes. I just need some time to focus on myself because there is so much going on work-wise, so much going on community wise, you know? And then with his needs, I want to be the best version of myself, the best way I can. But you know what, there are times that I am the thing that my emotions are somewhat on the show. You know, like being very shocked and bored sometimes and I have to collect that, not be accepting own it, you know, but I, I don't need to be pervasive and permanent about it.

You know, I don't need to think that this is the way I am always going to be. So what if I falter? I have another chance, you know, and my boy is going to grow with me and he's growing up also understanding this, he himself is adapting. So we have to kind of carve out a new normal, I think the best advice I can give you or give anybody is to be kind to yourself. Self criticism. I mean, to certain extent is good, but try to forgive yourself. Forgiveness is the key. But then you're forgiving your spouse or your you know, friends or you know, your son. That sensitivity factor has become such a huge issue. And I feel like, especially now since we were all confined and we are becoming, you know, kind of like, what is this? When can we get out? And that's the time to recognize, let's try to be compassionate and kind first.

Coach Stasi Kasianchuk

Yeah. That and that comes with perhaps try to when we have those feelings of anger or frustration, you have to turn those down a little bit and try to make that kindness and compassion forefront, which can isn't always instinctual when we're in these situations dealing with grief.

Dr. Swapna Vaidya

You know, I mean, when I was sort of like preparing for this talk, I think a lot of the things that I read resonated with me. So it's, it's just important to realize that even though maybe I'm a psychiatrist and I can, I've studied this, but to adapt to this as a person, as a human who's going through this, it's equally hard. So this is this. I think I would tell everybody that once you get this knowledge or you'd read about it, you know, it's okay to go back and then sort of ruminate and say, Oh, maybe this didn't work for me. Maybe I'll try something different. You know, for instance, when I say to people, “meditation,” they're like, Oh, come on, I'm so anxious. I'm not going to meditate. But even anxiety can be meditation. Why? Because you're actually feeling that anxiety, processing it and understanding it.

One good thing about that would be to maintain a journal. Write down, write down those anxious thoughts. Why are they coming? Are they rational, you feel? Are they irrational? Can you do something about it? And even then, let's say you acted in a certain way, you're not proud of yourself, then write down about that and say, okay, what could I have done different? If I have another opportunity, can I do something different? Apologize. You know, forgiveness, as I said, is, you know, I think it's going to be a much needed, much needed gift that we all can give each other because we all have to say, I'm sorry. You know, I may have acted out of anger and I, you will see the other person absolutely identifies and says, you know what, even me, I'm also going through this. And then you move on and that's the best you know sort of like advice that I can think of for people.

Coach Stasi Kasianchuk

Yeah, taking that step and having the courage to call those feelings out I think is so important. Can be hard. But like you said, oftentimes when you are saying you realize that the other person's also feeling the same. So then there's, there's a moment of bonding and that over anger.

Dr. Swapna Vaidya

That's the thing, you know, when you resonate and when you say, we're in this together, you know, this is affecting me in XYZ way, this is affecting you in another way. But guess what? It's affecting all of us. Not a single person that we can talk to today would say, Oh, this is all great and you know, I have found my way out of it, not a single person. And so then knowing that gives you hope because you know that, you know, you're not the only one struggling. Yes, you are struggling, but there are others many more. And then it gives you that appreciation of how, what can I do to be productive and help them.

Coach Stasi Kasianchuk

Yeah. And that's the doing things a lot of times when we feel this place of grief or helplessness, doing something can help maybe move us through the stages. You recommended helping healthcare workers or contributing to your community in certain ways. Anything else that you can think of? You know, even what about for that the individual themselves? What can they do themselves?

Dr. Swapna Vaidya

Absolutely simple things, you know, try to sort of find out that recipe that, let's say you miss going to the restaurant sites. So try to Google the recipe that you actually actually miss and see if you can make it. It may not turn out great, but at least you tried. That would be one thing. Find out what your interests are, you know, like, do you like to garden or do you like to paint maybe or play games? Maybe, you know, like you could have people are doing Facebook games, you know, sort of like FaceTime or, you know having interactive games with each other. What can you do? You can have a virtual happy hour with somebody. Just be careful with how much you're drinking because that's a rather slippery slope. So, you know, things such as that. And you will find that you have developed these hobbies or that you had neglected these hobbies because you didn't have time.

Reach out to that old friend of yours that you always meant to call, but never had the time. You know, and if you have kids, I mean, try to kind of, you know, be at their level and try to learn at their level and help them out and, you know sort of try to see yourself in a different light than just that you're in this pandemic. But there are many ways to self-soothe, heal oneself you know, like give yourself a mini spa at home, you know, put a face mask on, watch your favorite movie, right? I mean there are many perks of working from home also in that sense, cause you don't have to travel. So you at least have the time that you can save yourself and say, okay, let me do something to make my spirit lift up.

Whether it's for 20 minutes or something, go for a stroll. You know the weather's getting better. Go for a walk, maintain social distancing and soak in the sun. And then always have this attitude, that this too shall pass. They will be sometime there is going to be time. This is not an easy fix. I think you mentioned at one state, it's like running a marathon, not a sprint. So you did like, so I am using that exactly what you said. And I would say that that's what you can do one step at a time, one moment at a time, one breath at a time and knowing that this too shall pass and you're going to appreciate how we’re spending our present because our present is important. You know, we don't have to wait in the past and we don't have to project the future.

We can still enjoy things right now. Maybe a limited wat, but there are ways to appreciate what's right and good for us. You know, I was reading about this and I, I found out like in London, some people actually having parties of their driveways, dance parties. So they're maintaining social distancing, they're blaring music and they're all dancing. And then in New York, my friend when I had connected with her, said she was having, these healthcare workers were, you know, walking and there was applause from people. So you know, I was on the phone with her and she actually made me hear it and it was amazing. So some of those things.

Coach Stasi Kasianchuk

That gives me chills just thinking about that. And I've, I've seen in some other countries too where at certain times of day everyone comes out and applauds or plays music for their healthcare workers. And it's just, I mean, that type of unification is something we wouldn't experience otherwise. So there's definitely power in that.

Dr. Swapna Vaidya

Well, yeah, I heard it. I mean, even though like, you know, she had the phone close to a window and it was just amazing. Even though I wasn't there, I felt like, wow, this is such a great appreciation and the whole world, the city is coming together.

Coach Stasi Kasianchuk

Yup. Exactly. Yeah. That unification piece. Well we have a question that came in from one of our viewers and it says what if you need to be the cheerleader or positive force for others? Can you be honest about how worried or down you feel? This person feels fear of pulling them down when they're, when I feel fear pulling them down when they're leaning on me for leadership or security. So how do people balance that?

Dr. Swapna Vaidya

You know, that's such a great question. You know, how do you balance when you are supposedly this leader, but even leaders can experience insecurity and fear. You know what’s worked for me, transparency, always be transparent about your emotions. You know, say that, you know, I'm having a hard time right now. What can I do? You know, like lean on others. Sometimes it's okay to lean on others, even for the leader or even for this most optimistic person because you want to do that. If that makes any sense.

Coach Stasi Kasianchuk

Yeah. No it does. And, and I think again, it comes back to we're all in this together and we need to support each other. So, and that give and take where we all may be going through these ebbs and flows or flowing through the stages of grief. When I am feeling like I need support, I need to be able to lean on someone to say I need support right now. And then when you need support, come to me, there’s strength in that.

Dr. Swapna Vaidya

It's going to be reciprocal. So leadership can be at local level, family level and community level. Again, national level. And I go back to these levels because it's important to know that none of us are going to find the right answers. There will be times we fall, totally stumble, we are doing our best. Recognizing that and having self compassion. You know, often cheerleaders, they kind of have this whole burden on their shoulders thinking that this is really my thing and I have to own it. No, this is a collective thing. Let's all own it together.

Coach Stasi Kasianchuk

Yeah. And then here's another question that's something else that I see is and I've actually been reading about, and I'd love to get your take, is this comparative grief where people might say, I feel they feel guilty complaining about their situation when others have it so much worse. What are your thoughts on that when we say, well, you know, your, you have a family member in the hospital, I'm, I shouldn't feel bad for not being able to leave my house. What are your thoughts on that?

Dr. Swapna Vaidya

So remember when I went back to resilience and I talked about those three bad Ps, the first P was personalization. This is falling exactly there because you are not allowed to, you know, feel guilty. Everybody's circumstances are different. Granted that, you know, on a level, you might see that this is much more catastrophic than what you're going through. But that doesn't diminish your grief. That doesn't diminish your feelings of loss in any which way. And I think it's important to own that, to say that you can't feel guilty about the way you're feeling because then you will not practice self-compassion. And if you don't practice self-compassion, you're not going to be helpful to others. Because again, I think I have mentioned it before, but it's like going in that aircraft and you don't put that oxygen mask on yourself. You're not going to be good to anybody. So please I think that is a fine line. I think between being selfish, it's not being selfish, it's actually being compassionate towards yourself. And that's okay. Right? So then when people compare and say, Hey, you got it better than me, or I go to see this happens everywhere. But that doesn't mean you need to personalize it and express it as like, this is my problem or this is my guilt. So that, that we personalize. Let's take that away.

Coach Stasi Kasianchuk

That's such a good point. And you're right, that it gets in, gets in the way of that compassion and, and even, you know, the feeling of guilt. You know, working with clients even before this, guilt, oftentimes it would come up, especially with working moms, you know, balancing work and family and guilt would sometimes come up and it can be a feeling that's, that weighs people down. And it's almost like it, it creates a knot or it creates this rock in people. So having them really turn that guilt into compassion or eliminating the guilt and transitioning more to that compassion can open up possibilities.

Dr. Swapna Vaidya

Oh, absolutely. Because you know, the more you're self destructive and thinking you have done so many wrongs in your life, you're not going to be able to come up to a level that you can be useful, let alone to yourself, to others. So that's a very important thing to talk about.

Coach Stasi Kasianchuk

Great. Yeah, no, thanks for sharing that and say, we have another question here that said I have started to enjoy the slowness of sheltering in place. In some ways we're developing good and new habits. I worry about losing things when things do get back to normal. How do we hang onto the good changes that are happening right now?

Dr. Swapna Vaidya

You know, such a good point because you know, I myself am experiencing that and I feel like what do I do now that I recognize that slowing down a bit was so good for me? So I think that registering that and making sure that once we step back to this new other normal that we may have to, to continue to understand what helped us and to nurture our soul with all the positive habits that we have gained from this particular pause that life has given us. So it's so important that this, in a way look at it as a learning lesson. You know, really we kind of learned a lot about ourselves, about our friends, about our family, about what we could do which could enhance our lives even after we are able to step out. So it's a very important and an excellent question.

Coach Stasi Kasianchuk

And I think that's where maybe some of the journaling could come in. We should be writing down right now everything, all the joyful things, all the things we like about sheltering in place. I could say I've had clients that have been wanting to do more meal planning and now the situations you have to meal plan because you can only go to the grocery store so often. Things like that where they're learning those habits. Other clients that have had really a long commute, so maybe three or four hours a day they're spending in the car now they can do an exercise class at home and they can sleep in without setting an alarm. And so other things that they're noticing, Oh, there is a tradeoff here that you know, you don't have to, maybe your getting-dressed routine is a little bit less. If you don't have to be on camera, you don't have to attend meetings you can save time there. And the gift of time, the gift of time is really really something we have right now.

Dr. Swapna Vaidya

And I think, yes, exactly. So for the commute part, you know, I used to go through three, four hospitals at times. I recognize this is great to do zoom meetings and then, you know, the other thing is the wardrobe. You can always have pajamas and then you can dress up, you know. So yeah, there are ways to kind of like recognize the freedom that this gives you and the novel ways that you can still continue to work. You know, even in our healthcare industry maybe are having TeleSign tele apps, everything has gone on telly and remote and you know what you're finding, guess what we’re finding — the no show rate is zero because you're…. Figure that out, that there is no no show rate!

And the reason for that is that we actually have patients, you know there and you are here. And at the same time, what I'm seeing from my psychiatric colleagues is that a lot of patients who haven't opened up to them in the past are able to open up to them in the confines of their home. Isn't that something? Because they feel comfortable in their homes. A lot of the adults and patients are showing their child psychiatrists, their rooms, their favorite things and this is such a great way to connect and develop therapy, therapeutic plans for the patients. So good, good side of that tele tele apps and all came up also.

Coach Stasi Kasianchuk

Yeah, yeah. Yeah. And I think that's such a good point too of we don't know what we don't know. And that unknown can be scary and our instinct is to think of the unknown as scary and bad and negative. When reframing it again can help to say what about, because it's unknown. We can also paint a landscape of opportunity. You know, there could be, you know, the idea of going to tele-health, there was concerns about are you going to be able to have that same connection with people? And you're talking about maybe advancing therapeutic practices down the line based on what we learned from this. Absolutely. Yeah. Yeah. No, that's such great, great insights. Well, with going back to the stages of change, you know, we talked about that at the beginning or stages of grief, sorry. So with the stages of grief, what would you say? Why is it important for people to understand those? Or to, to at least know that those stages, how, why is that important for people to know right now?

Dr. Swapna Vaidya

You know, because knowledge is important. When you know what you're feeling and when you know that there is something that has, someone has done research on those feelings, you know, that this is not abnormal. This is not something out of the way and this is something that you can then resonate and understand. Once you understand your feelings, then it's easier to try to kind of like, you know, work through them. If you don't know what you're feeling, then you feel like, what is this odd feeling? Am I the only one? You know, why am I feeling like this? So things such as that.

Coach Stasi Kasianchuk

Excellent. Yeah. Having that understanding and the framework to work through that. Yeah. Yeah. That can be helpful for people to know. Okay, I'm feeling this. I'm noticing habits of denial. All right. I can expect the next, Anger. That was next?

Dr. Swapna Vaidya

The next one's anger. Yes, absolutely. First is denial, anger, bargaining. Then you are feeling sad and then finally you accept it. So it takes a while.

Coach Stasi Kasianchuk

Yeah. And that's and that's a good to be aware. Okay. Anger might be coming next. Sadness might be coming next. That can give you a little bit of a, you know, versus that anticipation of the unknown. Like this could be coming as a way to cope and to, yep. Yeah. Excellent. Well what about looking at… you also mentioned that this could be different for different people. So if some people are going through this and especially if they've had experience, they've had other times that they've had to practice this grief, they might go through it faster. How do you recommend people acknowledging their own process? They're giving themselves the time, to not be looking at their watch, like, I should be feeling angry now.

Dr. Swapna Vaidya

You know, I think I'm going to say like what Dr. Fauci said, only like he said, only the virus decides it. So in this case it's only your feelings that’ll decide it and your feelings are the only feelings that are important. How you feel doesn't mean if XYZ is feeling it in a different way and they've reached the stage of acceptance, etc. You don't know about their journey, you don't know about their internal struggles, you only know about your own internal struggles. And the other thing is that stress is, is paramount. It is going to happen. There is going to be a significant amount of PTSD from this, a significant amount of anxiety from this. So it depends if you've experienced it before, you might have had some tools, you might have worked with somebody and you know, or maybe that's how you arrive at the accepted stage faster.

But you know, if you've not, that's okay. Now you know that this is what people go through in a wave and we describe grief or stress and there are coping mechanisms. So there are so many different things that are there and what one tool doesn't fit everybody. Some people would like something like more about CBT, behavior therapies. Some people say mindfulness helps them more. So whichever modality or combination of it might help you, you know, and some cases it might be so severe, might need medications and at that point in time you should consult your psychiatrist.

Coach Stasi Kasianchuk

Excellent. Yeah. No, and I think that's a great point to also recognize that it's personal. Because it is personal, what works for one person might not work for the other. So being open to finding the strategy that works best for you. One other question we had here is how much emotion like grief and fear is it okay to show in front of your own children?

Dr. Swapna Vaidya

Yeah. That's interesting. You know, so I think we do the best, but at the same time they might be things that you know, you hear about and you are emotional about. I know child picks up on it. So the way and I consulted my friend, she’s a child and adolescent psychiatrist and she's like, talk to them in a language that they know, that they understand. Okay. Because your child knows something is going on, meet them at the level they are. So for my five-year-old, for instance, they know that this is a virus, they've been taught in school, they have an online class on sources. They know about that. And you know, he watched the story board, there was like the storyboard to talk about virology, the T-cells, the helper cells, the killer cells. And I'm like, Oh my God, this is too much.

And he was like, Oh my God, mom, mommy, I get a killer cells and I can kill the virus. And I said, okay. But it became a sort of an educational moment and also something that we connected on all day. It was funny. And you know, so he knows that this is new, normal. He knows mommy makes me wash my hands gazillion times. He gets mad, but he understand. And you know, so those are the kinds of things you can involve. I think you have to be transparent to them with some to some degree. Yeah.

Coach Stasi Kasianchuk

Yeah. No, that's a good point. And I like talking to bring it to meet them where they are. And so that it's in their terms that they can understand.

Dr. Swapna Vaidya

Yeah, exactly. And then, you know, so this way they don't feel like, Oh, mom and dad are having some secrets from us or that, you know, this is, that makes them even more nervous. Knowing that, you know, mom, dad are experiencing gets with us, like that's okay. So it's just something, sorry, I was on call and again, I want to talk about to log onto my computer so that this way I can, you know, I just don't, I didn't realize I was on call today, sorry about that.

Coach Stasi Kasianchuk

That's okay. Well with, you know, having that transparency, I think with everyone, like you talked about, we want to know and that that makes sense for kids. They're curious and they're human and they want to know as well. And so being able to be as transparent as possible is a good thing. Another question here is, when do I know my emotional state is bad enough that I should seek professional help?

Dr. Swapna Vaidya

So, you know, I would say that couple of things. When you feel that the stress is so much that you cannot stop talking about, I mean ruminating about it to the point that it interferes with your sleep, your appetite, and you start getting some very dark thoughts wherein you’re kind of thinking it's not worth going on. I want to kind of end this. Those are the times to really seek professional help ASAP or then to say if you're not sleeping well or to having some consistent symptoms that you feel you need some guidance to how to kind of like get yourself back on a, you know, somewhat even keel. Then to talk to somebody about it. So a professional help can differ to different people. Some people it might mean just talk therapy. Some people it might mean medication. Some people it might mean, you know, being admitted depending on the level that they are at. But it's important to, I think that's a great question. And it's very, very important to kind of like be connected with your feelings like this and to talk to people. Yeah.

Coach Stasi Kasianchuk

And would you say in general, if someone, if you are feeling that you need just additional support that it can't hurt to reach out for that help?

Dr. Swapna Vaidya

Yes, I wouldn't, I would say that if you're needing additional support doesn't help but doesn't absolutely doesn't hurt, you know that there are many programs right now. There are a lot of like people doing some online outreach is also, I think that in Washington State, there are programs and you can sort of meet, you know, kind of like connect to call. If, if really things are dire call 911. I know people don't want to go to the hospitals as such, but maybe they can promote and you know, kind of give an idea as to where they can be seen or they can get some help. So yeah, things such as that. Absolutely. Yep.

Coach Stasi Kasianchuk

Another question that came from this person mentioned, they feel like they've gone through the stages of grief, gotten to acceptance, but then the longer it goes on, they get anxious again. Am I still in the stages of grief or am I going, going back. So the question that we had was this person feels like they've moved through the stages of grief, gotten to acceptance, but then as things go on, they feel more anxious again. Are they still in the stages of grief or are they, or is it possible to go backwards in the stages?

Dr. Swapna Vaidya

So it is possible to go backwards. I mean, you know, you could probably think, okay, you're doing well and you're feeling that this is working, and that you finally got a grip on it. But there might be something that happens. There might be a memory that triggers it. There might be an incident that kind of like makes you feel okay, I'm not feeling that great. I'm not feeling, you know, as if I am gone to that stage of acceptance. I'm kind of coming back to anger. I'm coming back to bargaining. This is, this is very common in grief and this happens for a while until you reach the stage where you understand that you know what, you struggled, you bargained, and you cried. You were sad, you denied. And now the only emotion and the only thing that's really left is acceptance. And we all go through it in different, different ways and we can, you know, kind of jump from one to the other. That's very normal.

Coach Stasi Kasianchuk

Excellent. Yeah, no, that's, I'm glad that you explain that it's not linear. It's not completely linear. So

Dr. Swapna Vaidya

It's absolutely not linear because, you know, the thing is that each day comes to different emotions and different information and we've seen that, you know, we've seen that how it's being fed in the media, how are being sort of like we, we hear about loved ones, we hear about struggles going through the, you know, kind of like jumped back from one to the other. A lot of people are saying, okay, it's only gonna be until April end. Then we hear, no, we're going to be socially isolating more. So each day the information comes at us in different ways and from different angles. So then, you know, it definitely becomes difficult to stick to one stage.

Coach Stasi Kasianchuk

Well, a couple other questions here. One is when people are sharing their stress or their worries, how should how should I respond? I tend to be the silver lining person, but I don't want to dismiss what they're experiencing. So how do we honor what they're feeling while also not maybe not getting into that if it is, if it is more down and negative.

Dr. Swapna Vaidya

Excellent question. And you know, I think that the best advice, the answer I can give you is to be very authentic about how you're feeling, why you're trying to help the person. So acknowledging what you're feeling and understanding that there might be some things that may not be the right thing to say to the person. That's fine. Sometimes people are just talking to us for looking for validation. All we really want to do is to validate each of those feelings and to recognize that everybody's going through this differently.

So I think one of you mentioned about being the cheerleader and that's fine, but if you feel that this person is not ready to accept that, you know, silver lining or the cheerleading advice, then meet them where they are at. And sometimes, as I said, like just listening, empathetic listening helps tremendously. But you have to protect your own feelings because if you try to get mired in somebody else's experiences, then you distance yourself from your own feelings. So it's a very fine line to balance, but understand that how you feel, how you’re dealing with this virus, that is the best thing and the only thing you can really do while helping others.

Coach Stasi Kasianchuk

Excellent. Yeah. Remembering to, again, it's putting that oxygen mask on.

Dr. Swapna Vaidya

I keep saying that, but it's so true. I mean, if you think about it, if you cannot help yourself, I mean, how good are you to help anybody else? So, you know, there are times that we can even we talk to each other, our friends, our psychiatrist friends, we have a group, we talk to each other for our own, you know, de-stressing and debriefing and we hear sometimes heated arguments and comments and then we'd say to each other timeout, you know, I think it's best now. Let's just go watch a movie individually and then come back and kind of argue that point out. But that's important to understand that, that it might not be something that there might be a solution to every question.

Coach Stasi Kasianchuk

Yeah, no, I like that. Where there really is, again, coming back to that balance and we all have to take care of ourselves in this. Or like you said, I mean, what if we can't take care of ourselves that it's just going to be half-hearted efforts to take care of everyone else.

Dr. Swapna Vaidya

And that's it exactly, I feel like that is the most important thing you can do and while you take care of yourself, you understand your limitations. So for instance, if you ask somebody that is not able to be there 100% for whatever reason, that's okay too. If you're feeling that you're getting too stressed, hearing your friend talk about catastrophic events, it's okay to say that I need a moment, you know? And then I kind of, I'm not feeling that I can be helpful because I'm feeling overwhelmed by whatever you're saying to me. So, you know, and then come back to it when you feel ready and say, Hey, you know what? I feel like now I could probably help you out if you still want my help. Just because you, you don't have to step up, you know, there is no such hard and fast rule that you have to step up, that you have to shoulder, must, you know, these kinds of objectives you should take away from your life. You really just try, try your best. That's all you can do.

Coach Stasi Kasianchuk

Yeah, I think that's a great way. And right now we have an opportunity that the best we, because we don't know what the best is, what, what, like the ideal is. So if everyone's doing the best they can, then that's all we can ask.

Dr. Swapna Vaidya

Agreed. And I think that a, well as I said, the collective, a sense of knowing that we're all in this together, that is the one thing that will get us get, you know, all of us through this. Because, you know, I think it's important to realize that this has happened before. Remember the Spanish flu happened in 1918 and yes, it came in waves and it took about 1920 for it to completely disappear. And I know when I say it, it sounds like, Oh my God. Two years? What is she saying? What I'm trying to say is that things… after all, crises will end, things will stop, there might be a new normal, but there will be a new normal. So we'll all go through this. We are all going to go through this collectively as a world together and then everyone will have to figure out how we fit back into the world, how we start our world back together. But we've gone through tragedies and we know that this too shall pass. It has to pass. When it'll pass, well, that only time will tell.

Coach Stasi Kasianchuk

Exactly. Exactly. Oh, one more question here. And actually I'll, we do have about 10 more minutes. So anybody else that has questions feel free to post them away. But this one says we are all in such confined spaces these days with different stages of grief. I'm finding in my family that some, someone may be in acceptance, another's in anger and others in denial all within one hour. How does how does one navigate that as the head of the household when you're managing different people in different stages?

Dr. Swapna Vaidya

Well, you know, all I can say from my experiences, just give time out to everybody at some point because it helps, you know, you just think distance. And I can say that, you know, when I find myself going towards the stage of anger or lashing out, I have to take time out and I have to say that. And it took some time to understand what and where I was being impulsive. And the same goes with, you know, other people in my household, my husband, my child. And we recognize that we really need to be open about our feelings. So when you're open and you call out those feelings, that's when you ask for help. But when you lash out depending on those feelings, then you hurt. So when you say, Hey, look, I'm really feeling angry. I'm feeling frustrated. I don't know why. I don't know what's going on. I really need some time out. And then you do that. You come back, you come back refreshed. Or then, you know, me and my husband, we have what is called as like a text fights. Don't lash out, just text to each other. Text what you want to text, don’t fight, text emojis. And then come back and say, Hey, you know, yeah, I'll be a humans before though. And do the best that you can do. Don't blame yourself. That's my advice.

Coach Stasi Kasianchuk

Excellent. Yeah. And that comes back to giving permission, giving yourself permission to feel that anger, but also give the space to do it and give yourself credit for not wanting, not wanting to hurt other people with the anger. That's not the intention of the anger.

Dr. Swapna Vaidya

And, and, and get, say you did, then go back and apologize. Yes, forgiveness is a big thing and you apologize. The other person feels validated. So validation of the feelings, that's important. Validate and say, I know you're feeling this way because guess what, last you know, yesterday I was feeling this, sharing that same similar feeling gives you an ability to connect and empathize.

Coach Stasi Kasianchuk

One other question here is, can we prepare for grief? Is there any preparation? Is there ways to do that besides, besides experiencing it previously?

Dr. Swapna Vaidya

You know, that's, that's a very good point. I mean, grief comes in so many different forms and so many different modalities that it's so hard to prepare for something which we really don't know is in the future and in how, in what ways it’s going to affect us. Now we've been primed a bit because of the nature of this pandemic to recognize that we’re all so vulnerable, that given that this virus is pretty virulent. And, and, and again, not just because of physical travesties it's because of the emotional travesties having to isolate, having to be confined. I think that the way that I would look at it as your past experiences will prepare you for grief. How have you been through before dealing with these traumatic events in your life will prepare you for grief. And this is where resilience comes in point because resilience is what actually helps build a core. I mean, resilience builds those you know, sort of the code of your mental stability or structure to know that you kind of use some constructive mechanisms, constructive ways, constructive thought processes to deal with what's actually happening in terms of the grief.

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Coach Stasi Kasianchuk

Ah, that's excellent. Yeah, it's interesting. The part part of the grief is the fact that it is unknown, right? Yeah. There's a connection there.

Dr. Swapna Vaidya

And yet, you know what we all, as a collective human experience, go through grief because we've all sort of like not going very philosophical or spiritual, but you know, when we know… we’re born, right, we always go through stages and we know that there is going to be at some point an end for life existence and this is called, this is something, it's universal. And so grief has been there, it's been present since decades and decades and decades. And what we need to understand is how we are going to step up and look at it and undergo it and experience its emotions. You have to experience it to you know, be able to then take a distance from it and say, okay, now I can kind of like, you know, deal with what's going on in the way I would function back in my life. But that the emotions are so very important to experience.

Coach Stasi Kasianchuk

Yeah. I like that. That's a good, good wrapping up of just, you know, being willing to experience the emotions and knowing that it's okay, it's normal. And it will happen. It will happen to all of us in some way, shape or form during this time.

Dr. Swapna Vaidya

Yes. And again, my apologies for the technical errors, but there you go. Not going to personalize it, you know, thank you, Stasi for conducting this and I thank the team of Gennev and Jill for giving me the opportunity to participate today.

Coach Stasi Kasianchuk

Perfect. Well, thank you so much for your work that you're doing right now and all the best to you, your family. And any last, any resources or recommendations you have for the listeners?

Dr. Swapna Vaidya

You know, there are a couple of recommendations and resources that I think I have sent to Shannon that, you know, would be the best way that maybe we can distribute it to our listeners. There are some local resources, some national resources, some booklets, meditation, mind, mindfulness apps so many different ways. And hopefully Shannon can compile that and then we can you know sort of send it over to our listeners so that they can see what is useful for them.

Coach Stasi Kasianchuk

Excellent. No, that's great to have your credible resources. There's a lot of things out there right now, so we appreciate you providing those. We will send those to our listeners. And then just a reminder if anybody is interested, we, you do have our HealthFix program, so that is working with a health coach, a registered dietitian nutritionist. It can be a great way if you're looking to figure out how do you establish that routine, how do you incorporate meditation or mindfulness, what does that look like in your day? How do you set those boundaries so you can have time for yourself wanting to get a little bit more exercise or meal planning tips. Those are all things that we can help you with. And then we do have our telemedicine providers as well. So right now, while obviously COVID 19 is one is a priority, we can't neglect our health and other areas.

So, especially women's health. We do have some States that are offering primary care services and that's listed on our website. And then we do have our extensive OB GYN services for even more States. So take a look at that if you're interested. It's a great way to have tele tele-health provided without having to go to a doctor's office right now and we're, we're here for you for that. All right, well thank you every much everyone for your participation. It's been great talking with everyone. Thank you again Swapna for your time and have a great rest of your week, everyone.

Dr. Swapna Vaidya

Thank you, Stasi. Thanks again.

Coach Stasi Kasianchuk

And just a reminder for everyone that our next webinar will be this same time next Thursday and we're going to be talking about, it's going to be a combination of hydration, socialization, and then how does alcohol fit, and what to drink, what not to drink and how to, as Swapna indicated, sometimes those zoom happy hours when no one has to drive, might get a little out of control. So we can we'll provide recommendations on how to keep that moderate. And, and where alcohol fits from a hydration standpoint.

Dr. Swapna Vaidya

Wonderful. Thank you Stasi so much, and see you all the next time.

Coach Stasi Kasianchuk

All right. Take care. Bye now. Bye.

If you're experiencing grief for any reason, you don't have to deal with it alone. Our online communities are a great place for finding support and help from others who understand what you're going through. 

 
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