How to Keep Relationships Strong During COVID-19 with Dr. Scott Bea

Podcast Transcript

Deanna Pogorelc:  Hi, and thanks for joining us for this episode of the Health Essentials Podcast brought to you by Cleveland Clinic. I'm your host, Deanna Pogorelc. We are broadcasting virtually today because at this time many of us are under a stay-at-home order to help reduce the spread of the 2019 novel coronavirus.

Deanna Pogorelc:  So for some of us, that means being at home with our spouses, our kids, our parents, or other family members, way more than we're used to. For others, this means spending more time apart from the people we love. So with us today is psychologist, Dr. Scott Bea, and he's going to share some ideas about how we can keep our relationships strong during these unusual times. So hi, Dr. Bea. Thanks for being here.

Dr. Scott Bea:  Thanks for having me, Deanna. Happy to be here.

Deanna Pogorelc:  So for our listeners, please remember this is for informational purposes only and is not intended to replace your own physician's advice. So Dr. Bea, under normal circumstances, being around our families more, being at home sounds really great, but I get the feeling that it's not quite going so nice and easy for a lot of people. So why is this time especially challenging for a lot of people right now?

Dr. Scott Bea:  I think you're right there, Deanna. It's something we say we value and we want a little bit more balanced or time with our family members, but I think we're thrown into a brand new set of circumstances. And human beings are creatures of habit, we love habits and we are forced to change all sorts of habits right now. So it is really testing our brains by activating stress responses and we don't have great templates for all this togetherness.

Deanna Pogorelc:  Can some of the fear and uncertainty that's swirling around right now, can that affect our moods and how we behave towards our loved ones?

Dr. Scott Bea:  No question about it. Working with a lot of patients who experience anxiety, the thing that drives anxiety is uncertainties. The way people relate to uncertain times or ideas about the future, and we have this uncertainty descend upon us. I would say to patients routinely that uncertainty is always around us. It's just not on our radar screen very much. This is on our radar screen.

Deanna Pogorelc:  So what kind of strain can all have these forces and this forced togetherness put on our relationships?

Dr. Scott Bea:  It's certainly challenging the way we live with each other, the way we manage conflict, the way we communicate with one another. If we struggle in any of those areas, all of it is getting amplified right now and we're dealing with our own physiologic reaction. I think we're experiencing stress hormones rolling around in our body a bit more frequently. We don't have outlets available to us that we use as tension reducers very commonly. So it's a real taxing, stressful time for nearly everybody.

Deanna Pogorelc:  So you mentioned how we're wired towards habits, and I think being out of our routine, out of our normal habits, can be really tough for people and especially for kids who might be home from school right now. So do you think it's helpful for families to establish maybe a new routine for this new normal that we're in right now?

Dr. Scott Bea:  No question about that, Deanna. I think human beings really do well with structure. And as you say, we're creatures of habit and there's some research that says it takes about 66 days to form new habits. We're all in this process of forming new habits. Now we can either let them happen to us, based on how our brains differently operate, or we can start shaping them and forming them so that they're a little bit healthier or a little bit more effective, and a little bit less stress inducing. And we ought to be mindful that that's exactly what's going on right now. And yes, structure and routine, it doesn't always sound real appealing, but it really helps our brains a lot and helps us flourish.

Deanna Pogorelc:  So what about those parents out there who are probably feeling a lot of pressure? Maybe the kids are home from school, maybe they have some new duties dumped on their plate to help these kids do school from home. What advice can you give to parents who might be feeling really overwhelmed by this or not sure they're going to be able to really do it all?

Dr. Scott Bea:  The feeling of being overwhelmed is legit. You have lots of great company. And I think you can only really influence or govern certain things, behavioral choices and our attitudes. And so if we could put some energy into forming attitudes, while this is not ideal it is within our capacity. And actually having that belief, supporting one another, if you're sharing this experience and having to redesign your work life, your home life, become a great educator, all simultaneously.

Dr. Scott Bea:  I think having an attitude that it is manageable, to recruit some assistance where you need assistance, and to dare to be imperfect. Because we are not going to be able to pull this all off wonderfully and we're going to have to tolerate some of the bumps, bruises and snafus that are bound to occur. If you can do it with a little bit of an attitude of humor, that would be ideal. If we can laugh a little bit along the way. And draw our kids into the process too, to try to, if they're old enough, to take some responsibility and accountability for a straight way to teach that to our children right now.

Deanna Pogorelc:  So another thing I think is really important right now is patience. So do you have any tactics or any advice for people to maybe not lose their cool when things get crazy and hectic at home?

Dr. Scott Bea:  It takes practice. Patience is a virtue they say, but it also is a skill. And I think we can develop skills through practice. So what sorts of practice? Like a relaxation practice or effort, or maybe even as a family, having a little relaxation time. There are plenty of good relaxation recordings, even some sponsored by the Cleveland Clinic. A mindfulness practice in really be useful.

Dr. Scott Bea:  There are some ways that we can actually rehearse being more patient, and that's a little more complicated, but I'll try and be succinct. It's also a way that you can manage frustration and anger. If there are predictable stressors that tend to upset you and have you discharging anger and it's really not your ideal, you can try this little four step process. It's called rational emotive imagery. It was designed by a smart gentleman named Albert Ellis, it works like this.

Dr. Scott Bea:  You can imagine a worst-case provoking scenario that really fires up your anger. It doesn't have to be anything that's actually happened, but just maybe something that's reminiscent of what might be occurring in your household now. So image this as clearly as you can, then image your haywire response to it as vividly as you can. The arousal of your body, maybe a surge of anger, maybe clenched fists or a clenched jaw. Maybe stomping around, shouting platitudes or discharging your tension. However that might occur.

Dr. Scott Bea:  Third step is to set that haywire image aside and image yourself responding a little bit differently. In the face of the same provoking event, trying to image your body, staying calm, trying to notice calm thoughts, words, and then behaviors that diffuse conflict and diffuse tension. And then the final step is practice talking to yourself in a way that tries to normalize or make the situation seem a bit more tolerable and rational.

Dr. Scott Bea:  That's a four step process that takes about 60 seconds once a day. If you practice that, you will get better. The problem is we don't practice new emotional responses. Our emotions are reflexive and if we can practice these responses before we have to be in the heat of battle, we might be able to actually display more patience across time. And look less hotheaded, which is really a nice thing.

Deanna Pogorelc:  So what about self-care for parents? As a parent you might often put yourself on the back-burner anyway, especially right now when all these ... You have more duties at home. How can parents prioritize self-care?

Dr. Scott Bea:  It's going to be a real tough challenge. I think you might have to put it on the schedule. I do advocate a lot something that psychologists call activity scheduling. Again, it doesn't sound very appealing, but we do very well if we create schedules. And if you can create space and time that you set aside in advance, where you're going to engage in a self-care habit. Maybe you have to get out and take a walk around the block on your own, or engage in some hobby or activity in solitude in order to just reduce your tension.

Dr. Scott Bea:  If you do that spontaneously or make a request spontaneously, it puts a demand on people that they're not expecting and that's not always met real wonderfully. So if we can create these schedules, we can be looking forward to the time when we can recover. We can also maybe get space and permission from others to go do our thing, and that may be the best we can do. It's not going to be easy, but if we can schedule that in a little bit, I think it sets it up for it to be less tension-producing, or really what we're trying to do is reduce tension.

Dr. Scott Bea:  And it's harder to exercise. It's harder to move our bodies, finding ways, novel ways to do that now becomes a challenge and again, putting that somehow on a schedule and getting endorsements from those in the households that it's okay to go do that, to take care of ourselves. Of course, we get better versions of ourselves if we're allowed to do that, but it is going to be one of the real challenges we face.

Deanna Pogorelc:  Well, that's a good segue into my next question, which is about just spousal relationships. Maybe just a couple in a household and you have a lot more time together right now. What's a good way to ask for maybe alone time or a break? How can we do that eloquently without hurting feelings or anything like that?

Dr. Scott Bea:  I think those conversations are best had when our emotions are low, our temperaments are even. Again, I wouldn't enter into those at times of high emotionality. But I think you can enter into it by having a discussion about personal values, goals and ideals. And it's not a disservice to your partner if you need some alone time. If one can speak about how that is valuable, how that reduces tension, how that allows them to be a good partner and teammate, then I think we get better permission for that sort of thing and if we can make that allowance for the other person as well.

Dr. Scott Bea:  And sometimes we're in really cramped spaces, and sometimes that alone time might involve putting on headphones, which seems like a dropout completely, but it may be the best you can do if you're in really confined or tight spaces.

Deanna Pogorelc:  So I wonder if maybe some people are finding that they have a little bit of a shorter temper in these tight spaces or are more likely to be easily annoyed. What are some ways that we can let off steam or frustration when we're living in a lockdown right now?

Dr. Scott Bea:  I think people have to consider the ways that they might have done that in the past. Some people do it through vigorous physical exercise, we know that's a great tension reducer. Again, developing new habits. Mindfulness practice is a lovely thing, that YouTube videos on simple mindfulness practice. Learning how to watch thoughts rather than being overly involved in thoughts. Because a lot of our attention is actually driven by how we relate to thought, so learning how to be very present.

Dr. Scott Bea:  I would also say challenging the negative bias that every brain has. We all notice what's wrong first. It's just the way brains are designed. It has some adaptability when we're physically threatened, but it's just the way we look at the world. Cajoling ourselves into some other habits, keeping a gratitude journal, praising each other at alarmingly high rates. Really looking hard for what's right about our partner, the condition of our house and the lives we created and speaking about that liberally, might be a really good way to address that.

Dr. Scott Bea:  It's almost impossible for us not to be annoyed. Try not to take yourself or your annoyances too seriously. We have a strong complaint orientation in America, rarely do they get rectified. And try hard to limit your complaint as best [inaudible 00:12:48].

Deanna Pogorelc:  Great advice. One of the unique tensions that I think might be happening in some households right now is maybe some folks in your household aren't taking this social distancing thing seriously and versus some are. Is there any appropriate way to discuss that with a family member?

Dr. Scott Bea:  I really like the idea of really inquiring first what sorts of thoughts and ideas they have about social distancing ideas and advisements. And if you can enter that world first and get a sense of it, then you might be able to address it and you could ask permission yourself to share some ideas that you have. You can then endorse the value of that human being, their health and wellbeing. The importance of that person in your life and their longevity, offer to take a burden away from them if you can. And if you can enter it from a compassionate concerned point of view, then we don't get in a scuffle.

Deanna Pogorelc:  Yeah, I like that a lot. I also want to ask about folks who are living alone right now because this can be, I think, especially easy for your mind to wander when you're alone and to maybe go into these negative thoughts and thinking about all the things that could happen. So how can folks who might be alone right now keep their mind from slipping into these negative thoughts?

Dr. Scott Bea:  For some people really like being alone. It's interesting, I've talked to certain folks who find this to be much to their advantage. But our brains can also be a really scary place. We can frighten ourselves, we can have all sorts of ideas about the now or this futures that are frightening or upsetting. So I think creating obligations to communicate with others, to check out one's reality with other people, not to do that in isolation, but to share these ideas with safe people, people that might not judge would be ideal.

Dr. Scott Bea:  We have so many ways now. I mean the crisis is completely challenging, but we also have these technologies that help us get in touch with one another in very real ways. As a psychotherapist, I was concerned, can I form alliances with people in the virtual world? I find it's absolutely doable. We ought not neglect it. And if you're alone, don't stay alone. And then really, if those connections are important to you, reinforce the value that those connections have to the people that you're reaching out to. That reward will make sure that they'll do it again and keep those lines of communication open.

Deanna Pogorelc:  Absolutely. So for all of us, what are some things we can be doing to keep our moods and our spirits high? Get those feel good chemicals going in our brains.

Dr. Scott Bea:  Connections. The one chemical is the compassion chemical, oxytocin. It's the thing that bonds us to one another, so endorsing each other. If you're talking to a sibling, tell stories from childhood, things that made you laugh. If you sat down and actually told somebody and have the time to actually tell your life story from your earliest recollection to the present day, you would have a very bonded connection. You would understand each other very carefully, that would produce a lot of oxytocin.

Dr. Scott Bea:  I think the other feel-good chemical is dopamine. It's the chemical that gets released whenever we do anything that is joyful for us. So finding ways to laugh, that's wonderful medicine. To move our bodies vigorously also produces dopamine. And find novel ways to connect with people. People are having virtual happy hours and virtual experiences of all forms. So find ways to do that, those connections can produce those good brain chemicals.

Deanna Pogorelc:  So you did talk a little bit about technology and staying in touch with those outside of our household. Do you have any other proactive steps that we can all take to be keeping our relationship strong with those people who we aren't able to be around right now?

Dr. Scott Bea:  Well, I think anything that you do that suggest to others that they're important to you, makes a difference. And I'd say if you want to be proactive, put that on a schedule. Make certain that you have agreements with people to be with them at particular times and with some consistency. I'm seeing this actually fairly consistently with folks I'm working with and even people that I'm personally related to, folks who are reaching out to folks that they have not spoken to a long time, endorsing each other's value.

Dr. Scott Bea:  I think it's a great time to look each other in the eye even if virtually, and really say all the things that are important before it's too late. I think we have a sense that there's an urgency to let people know the value they have for us and we ought to do that liberally. We're not shaking hands, I'm not sure we'll ever shake hands again. But any other connection, virtual hugs, in any way that you can communicate that would be ideal.

Deanna Pogorelc:  So Dr. Bea, for people who have maybe family members or loved ones who live alone and they are not able to help take care of them right now. Do you have any ideas for staying in close contact with these folks and what people can do to be supportive of their relatives?

Dr. Scott Bea:  I think it's ideal if we're mindful of everybody and their circumstance, and particularly for folks who might be older or living alone, showing them special attention. Reaching out to them very consistently and carefully inquiring about their needs, sharing ideas about the technology and the services that are available for them to keep them safe. Even simple things like having groceries delivered or having them picked up. Any burden that you can remove from that person is worthwhile.

Dr. Scott Bea:  And again, just a consistent way of reaching out and inquiring directly about what they need and doing what you can to fulfill it, can make all the difference for individuals. And keeping them a little bit informed if they're not able to keep up with the absolutes of what's happening in the news, to share information, but not to overdo it at the same time. All of that shows real appropriate concern for our loved ones that might be older or alone.

Deanna Pogorelc:  Excellent. Well, is there anything else that we haven't talked about that you would like to share with our viewers or listeners?

Dr. Scott Bea:  No, Deanna, Health Essential is does a really good job at formulating these segments and interviews. I think we covered everything that people are likely facing, or a good amount of what people are facing these days. I will say that we're all in this together. If you're feeling isolated, reach out because there's someone else out there that's feeling what you're feeling. And I think it's a great time to share our real sentiments. Be as accepting as we can of how human beings are experiencing this. Try not to judge it too much.

Dr. Scott Bea:  And practice, practice these new skills. We're forming all these habits and skills, let's pick out healthy ones. Let's do it deliberately, and let's see if we can make some of them stick

Deanna Pogorelc:  And you did say, right, that a lot of our mental health professionals are practicing virtually right now, so if things get overwhelming that could be an option too.

Dr. Scott Bea:  Incredibly, we're practicing virtual. Right now it's what we're doing solely. All of our visits are virtual visits right now. We want to keep people safe and healthy and we're really committed to the mental health and wellbeing of all the people that we come in contact with.

Deanna Pogorelc:  Thanks Dr. Bea for being with us today. And if you would like to schedule an appointment with Cleveland Clinic's Center for Behavioral Health, please call two, one, six, six, three, six, five, eight, six, zero. For the latest updates on COVID-19 from the Cleveland Clinic, please visit clevelandclinic.org/coronavirus.

Deanna Pogorelc:  You can listen to more of our Health Essentials podcast with Cleveland Clinic experts by subscribing wherever you get your podcasts or visiting Clevelandclinic.org/hepodcast, and follow us on social media @ClevelandClinic, one word, for health news, tips and information. Thanks for joining.