Letter to My Therapy Clients During the COVID-19 Pandemic.

“High Country” by Martin Stensaas and Sunny Strasburg


Sunny Strasburg, LMFT 3/2020

It is an understatement to say we are living in a unique, and yes for many a stressful, time. There are a few ideas I would like to offer as a psychotherapist specializing in trauma and PTSD/C-PTSD. I hope you find them helpful. 

1. DON’T BLAME YOURSELF FOR YOUR FEELINGS: I find that it’s helpful to have information about how my physiology works…. When we are triggered in fear, our nervous system goes on autopilot in fight, flight or freeze. The “smoke detector”( the amygdala in our brain) fires up and warns us of danger, but sometimes our rational mind (our frontal lobes) are unable to process the information logically. It can lead to shallow breathing which deprives the brain of oxygen and disregulates the vagus nerve. This creates a negative feedback loop which can create extreme anxiety. This is not your fault, it is your physiology. We must find ways to soothe the nervous system in these situations to break the anxiety cycle. ALL of your feelings about what is going on are valid. We can have a myriad of responses. Be patient and kind with yourself as you observe them all. I know…I know…. when someone tells you to take deep breaths when you have anxiety is annoying. But breathing a long, slow inhale to the count of ten…. Holding three seconds….. and slowly exhaling 10 to 1…and then holding at the bottom of the breath for 3 seconds. This will calm the sympathetic nervous system.

The Buddhists have a great metaphor for not getting swept up into emotional reactivity…..Step back like a person meditating on a beach watching the waves crash in and out, ebb and flow. The waves are your emotions. You sitting back on the beach is your Higher Self or Inner Observer. From that space, you don’t try to control the waves by pushing them back or pulling them in. Optimally and with practice, you can learn to observe them with curiosity and centered awareness (see meditation section below). Here’s a lot more information on the polyvagal system: https://www.youtube.com/watch?v=8AnHlx3qZ30&feature=youtu.be

2. EMOTIONAL CONNECTION: First of all, during the period of social isolation to reduce the spread of the virus, it is important to remember physical isolation is not the same as emotional isolation. Connect with people! Reach out to your community, to your family and friends. It is vital to check on people who live alone or who are at risk, either due to financial hardship, physical disabilities or advanced age. Humans are wired to be social. We are wired to be comforted by one another. Use this opportunity to step out of your comfort zone and connect. Let people know if you are struggling. 

I suggest Zoom or Skype, Facetime and the app Marco Polo, which allows for video messaging. Texts, phone calls, emails, social media forums are all great too (if used for direct and personal connection, not fear scrolling…see below). I have a group of close friends who have a Marco Polo thread going. Every day, we check in several times to process, be silly, cry, offer support and practical advice. We have also been meeting on Zoom video conferencing twice a week to do group meditation. This has been a lifeline for our mental health and resiliency!

2. LEARN HOW TO SCAN YOUR BODY FOR FIGHT, FLIGHT OR FREEZE RESPONSES. Check in regularly with your body and learn its emotional patterns. Ask yourself, “What does my body do when I am afraid?” Is it a racing heart and sweaty palms, a knot in the gut? “What happens when I reach emotional overload?” Get to know this so you can remove yourself from the trigger whenever possible and self soothe.

3. AVOID NEWS OVERLOAD: While it is necessary to stay informed, it is not necessary to be overwhelmed by the news. As stated above, scan your body regularly. Remove yourself from triggers whenever possible. A heightened trauma response will pull you out of being rational and calm. No matter how much you are driven to go into being captivated by the news, pull yourself away, even for a few moments to breathe and settle. Get news and information from reputable sources, check the validity of anything you read before reposting. Remember, fear is the lowest common denominator and all news outlets depend on feeding fear to keep you paying attention to them.  Check in with your body every time you watch the news or scroll through social media. If you notice fear…a fight, flight or freeze response, get off the media and self soothe (see more tips how to do that below).

4. IF YOU DO NOT ALREADY HAVE A DEDICATED MEDITATION PRACTICE, NOW IS A GREAT TIME TO DEVELOP THE SKILLS: What better time than when you are in social isolation mode, stuck and working from home than to develop a sweet meditation practice?! Even 10 minutes of quiet inward focus and deep breathing is helpful (see number 1). Apps like BrainWave and Insight Timer offer guided meditation and binaural beats (wear headphones for maximum effect!). There are thousands and thousands of free meditations on YouTube. Mindfulness meditations, spiritual prayer, reading tarot cards…..there are a million ways to connect with oneself and go within. I recommend at least 10 minutes daily, 30-60 is ideal. 

I am hoping to have a few recorded meditations for my clients in the coming weeks. Watch for them.

It’s important to remember, you can’t do this wrong. You only need to dedicate the time. And now you probably have a lot more of it 😛

5. BE A HELPER: Mister Rogers said, “When I was a boy and I would see scary things in the news, my mother would say to me, ‘Look for the helpers. You will always find people who are helping.’ To this day, especially in times of ‘disaster,’ I remember my mother’s words and I am always comforted by realizing that there are still so many helpers—so many caring people in this world.” 

Study after study tells us that humans are hardwired to feel good offering acts of kindness and altruism. Be a leader, be a source of loving compassion. We receive a big dose of happy neuro chemicals when we are generous to those who are less fortunate. I have witnessed people hosting Zoom happy hours, teaching Qi Gong, taking garbage cans to the curb and picking up food from grocery stores for elderly neighbors. Even offering something as small as a warm smile and compassionate eye contact to a stranger is a big gift to someone who feels alone and afraid. This reduces fear in our collective and is helpful for us all. This is as much for you as for the other person. The times we are in call for kind leadership and cooperation. This is you! We need YOU! 🙂

6. SELF CARE: There are many ways to replenish your energy and restore your nervous system. These resiliency techniques help you take care of yourself and others, and build your immune system. Allow ALL of your feelings. Learn how to observe them without getting swept away and overwhelmed (see points 1 and 5). Feelings are just visitors. They change moment to moment as our core Self watches them ebb and flow. 

  • Make sure to move your body every day. Walk your dog, go for a run, stretch, nap, do yoga. 
  • Take baths
  • Journal
  • Garden, lie in a hammock outside. Eat lunch or have tea in the sunshine. 
  • Sing out loud, dance in your bedroom. 
  • Read books, listen to audio books on www.audible.com
  • Make Art! Crafts, paint, write poetry, make music, crochet. 
  • Learn a new language or how to pop and lock or belly dance online (or a fusion of both?)!
  • Write that novel. Write physical letters to lonely people in nursing homes. 

This collective pause creates an opportunity to do all the things (the ones at home at least)  you haven’t had time for all of these years.

7. THIS TOO SHALL PASS: Humans aren’t great with the unknown. It is essential to remember this won’t last forever. This, like everything in history, will pass. Hopefully, we can all learn from it and be better to one another and to the earth once this is over. 

8. HUMANS ARE HARD-WIRED TO PULL TOGETHER: Many social psychology studies have shown that humans tend to pull together in times of collective crisis and natural disasters. (https://www.scientificamerican.com/article/how-the-stress-of-disaster-brings-people-together/)

9. TRY TO FIND HUMOR AND PLAYFULNESS WHEREVER YOU CAN: This doesn’t have to be all languishing sadness, suffering and dread. I have found the people in my circle who are finding humor (even a little dark humor goes a long way for me) and staying playful are godsends right now to keep us all sane. Watch videos, comedy movies, or stand-up. Laughter is excellent for the immune system.

9. I AM HERE FOR YOU: Please remember, although we may need to get creative, rearrange a few appointments, or switch to teletherapy on Zoom or Skype, I am here to help my therapy clients. Being a supporter of your emotional wellbeing is my intention. I have many techniques, from mindfulness meditations to EMDR methods to support you in this challenging time. Take excellent care. You all matter deeply to me and know I am thinking about you and your loved ones in this time.