Start with Yourself: Tools and Strategies for Coping With

Stress and Trauma During the Pandemic

April 22, 2020

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Today’s PresenterDenese Shervington, MD, MPHDr. Denese Shervington has an intersectional career in public health and academic psychiatry. She is the President of The Institute of Women and Ethnic Studies (IWES), a community-based translational public health institute in New Orleans. She is also the Chair of Psychiatry at Charles R. Drew University. Dr. Shervington has held Clinical Professorships in the Departments of Psychiatry at Columbia University and Tulane University. A graduate of New York University School of Medicine, she also received a Masters of Public Health in Population Studies and Family Planning from Tulane University School of Public Health. She completed her residency in Psychiatry at the University of California San Francisco and is certified by the American Board of Psychiatry and Neurology. A Fellow of the American Psychiatry Association, in 2018 she received the Award for Excellence in Service and Advocacy; prior to which she received the Jeanne Spurlock Minority award. Dr. Shervington is also a member of the American College of Psychiatrists. In July 2019, Dr. Shervington testified before the Congress of the United States House of Representatives’ Committee on Oversight and Reform on Childhood Trauma. She also co-chairs the New Orleans City Council (R-18-344) Children Youth Planning Board Taskforce on Childhood Trauma. She has authored several papers in peer-reviewed journals addressing health disparities, the social determinants of health and resilience in underserved communities. Her recent publication is Healing Is the Revolution, a guide to healing from historical, intergenerational, interpersonal and community trauma. She also hosts a podcast on trauma. She is the proud parent of two amazing children, Kaleb and Iman, and grandchildren Ayelet and Haddassah.

Equanimity in the Age of

COVID-19: Starting with

SelfDenese O Shervington MD, MPH

Beauty

The Beast - CV

Create Physical Safety

Clean your hands often – wash hands with soap for at least 20 seconds especially after

being in public, blowing nose, sneezing or coughing

If soap and water not available, use a hand sanitizer that contains at least 60% alcohol

Avoid touching your eyes, nose and mouth with unwashed hands

Avoid close contact with people who are sick

Put distance between yourself and other people – at least 6 ft. apart

Stay home if you are sick

Cover your mouth and nose when you sneeze or cough with a tissue or use the inside of

your elbow

Throw tissues away in the trash

Immediately wash your hands after coughing or sneezing

Create Psychological Safety

– Psycho-education Normalize and accept heightened emotional

responses – fear, anger, denial

“A normal response to an abnormal situation”

biological response to threats to survival –activation of

the hypothalamic-pituitary axis – increase circulating

levels of stress hormones – Epinephrine, Norepinephrine

and Cortisol - fight or fight response –

Creating Psychological

Safety - Calm Practice Body – Mind Relaxation techniques

Mindfulness

strengthening the capacity to be aware, attentive in the present moment

being able to recognize and clearly comprehend what’s happening in the moment – clearly recognize what something is, versus generalization and judgment (especially with catastrophizing or minimization)

Recognizing the specificity of what is happening – what’s actually happening - see clearly

Quieting the mind from conceptual thinking – settling the dust form conditioning to deal with the root issues of one’s existence-

Purposive movement with breath

Yoga

Tai-Chi

Zumba

Drumming

HOW

INCREASE MINDFULLNESS - PRESENCE

Keeping the Body’s Rhythm –

Maintaining Physical fitness

Create Psychological Safety:

Self-Efficacy and Collectivity Trust your capability to exert control over that which is

controllable

Doing the very best you can in any given circumstance

Avoid interpreting social distancing as loneliness,

reframe and experience as befriending solitude

Create intentional opportunities for social interaction

(virtual or social-distanced): Instillation of hope

Universality

Imparting Information / interpersonal learning

Altruism

Create Psychological Safety

– Hope / Optimism Adopt ‘tragic optimism - Victor Frankl (1959) –

Psychiatrist, Holocaust survivor

Ability to remain optimistic in life’s darkest moments

as antidote against suffering

Choosing one’s attitude in any given circumstance

Learn lessons and find meaning in suffering – so as

not to suffer

Secondary Traumatic Stress “The natural consequent behaviors and emotions

resulting from knowledge about a traumatizing event

experienced by a significant other.”

Stress resulting from helping someone else with

their stress

Helper develops symptoms of PTSD

Hyper-arousal

Avoidance

Intrusion

Preventing STS - Self

Compassion Set boundaries - awareness of ‘Edge States’ –

when you can no longer lean into another’s suffering without suffering yourself:

Interrogate how your boundaries connected to your sense of power, comfort, altruism

Familiarize self with your edge state – burnout space – feeling disconnected and empty

Protect empathic self from entering another’s suffering – “empathic distress”

Avoid pathologic altruism

Quiet / soften the mind – accept the truth of impermanence / inconsistency – liberation from grief

Compassion Defined Com – coming together

Passion – suffering

“Suffer together”

Notice – being aware

Feel – emotional concern

Act – taking action to relieve suffering

Empathy in action

Self Care – The Journey Back to Self:

Befriending Mind, Body, Soul

WHAT IS SELF CARE?

A journey of self discovery and

nurturance of authentic self. Living on the inside from our

authentic self and

Living on the outside with

compassionate connection and

loving kindness towards others –

recognizing our shared humanity

and one-ness

Being mindful of our self in

relationship to others and the

universe

Find the balance between

solitude and communion -

retreat and return

Go from multiplicity of life

to simplicity

Focus on being, not doing

Open the heart space –

first to selves, next to

others

Live from a mystical space

of wonder and love, not

fear and evil

HOW?

CREATIVITYbringing the beauty of imagination into our sensations- creative

fantasies

ACCEPTING EXISTENTIAL GIVENS: Minimizing Anxiety

FREEDOM

One is solely responsible for self-

choices – life is groundless

ISOLATION

No one can fully share

one’s experience of consciousness

MEANING

Why do I live?

DEATH

Inevitable end toconscious being

FREEDOM

ISOLATION

MEANING

DEATH

Existential Pondering Meaning – I cannot fully pierce the mystery of why I

exist? How do I make meaning of my life and make purpose?

Isolation – I was thrown into the world alone and will die alone– I alone experience my being – Do I cling and try to fuse with others or can I befriend my solitude?

Freedom - I am solely responsible for self – to create my life story - freedom is boundless – how do I make choices to be?

Death – When I die, all of who I was, my unique experience of life, will perish alongside despite my desire to continue to be - Death is certain – the time is uncertain! How do I live in each moment?

“Between life and death, the boundary is very thin - It is a hair-split second; a thin sheet of paper between who lives

and who dies.”

Soul - Making

Psyche- soul!

Exploring the mysterious –

imaginal journeys – bringing

meaning from the unconscious and

the unknown

Living from the heart-space

LOVE AFTER LOVE: ODE TO BEING AT HOME IN OURSELVES

– DEREK WALCOTT

The time will come when, with elation

you will greet yourself arriving at your own door, in your own mirror.

And each will smile at the other's welcome, and say, sit here. Eat.

You will love again the stranger who was your self.

Give wine. Give bread. Give back your heart

to itself, to the stranger who has loved you

all your life, whom you ignored

for another, who knows you by heart.

Take down the love letters from the bookshelf,

the photographs, the desperate notes,

peel your own image from the mirror.

Sit. Feast on your life.

References Figley CR. 1999. Compassion Fatigue: Towards a

new understanding of the cost of caring. In BH

Shannon [Ed] Secondary Traumatic Stress: Self

care issues for clinicians, researchers and

educators (2nd ed. Pp 3-28). Lutherville, MD: Sidran

Press

Questions

https://communityactionpartnership.com/events/category/webinars/

April 29: 2020 Community Action Month Toolkit Release WebinarMay 13: Facilitating Successful Workforce Development Programs in the New Normal

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For more information or questions contact The Learning Communities Resource Center Team:• Tiffney Marley, Director of Practice Transformation

tmarley@communityactionpartnership.com• Renetta Davis-Armstrong, Project Director for Whole Family Approaches

rdarmstrong@communityactionpartnership.com• Hyacinth McKinley, Senior Associate for Learning & Dissemination

hmckinley@communityactionpartnership.com• Lindley Dupree, Senior Associate for Research

ldupree@communityactionpartnership.com• Courtney Kohler, Senior Associate for Training & Technical Assistance

ckohler@communityactionpartnership.com• Aimee Roberge, Program Associate for Learning Communities Resource Center

aroberge@communityactionpartnership.com• Lauren Martin, Program Associate for Training & Technical Assistance

lmartin@communityactionpartnership.com

This presentation was created by the National Association of Community Action Agencies – Community Action Partnership, in the performance of the U.S. Department of Health and Human Services, Administration for Children and Families, Office of Community Services Grant Number, 90ET0466. Any opinion, findings, and conclusions, or recommendations

expressed in this material are those of the author(s) and do not necessarily reflect the views of the U.S. Department of Health and Human Services, Administration for Children and Families.

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