Coronavirus – UNICEF Q&A with Dr Lisa Amour: Protecting a family’s mental health

Published on 02-04-2020 at 08:45

Parents and children are facing major life disruptions with the outbreak of coronavirus disease (COVID-19), says children’s charity UNICEF. School closures, physical distancing, it’s a lot to take in and it’s difficult for everyone in the family.

UNICEF asked Dr Lisa Damour, expert adolescent psychologist, best-selling author, monthly New York Times columnist and mother of two, to talk about how families can support each other and make the most of this ‘new normal’ situation facing everyone.

UNICEF: How can teenagers and parents take care of their mental health during the coronavirus disease (COVID-19) outbreak?

Dr. Damour: The first thing that parents can do is actually to normalize the fact that they [teenagers] are feeling anxious. Many teenagers have the misunderstanding that anxiety is always a sign of mental illness when in fact, psychologists have long recognized that anxiety is a normal and healthy function that alerts us to threats and helps us take measures to protect ourselves. So it’s very helpful for teenagers if you say, “You’re having the right reaction. Some anxiety right now makes sense, you’re supposed to feel that way. And that anxiety is going to help you make the decisions that you need to be making right now.” Practicing social distancing, washing your hands often and not touching your face — your anxiety will help you do what needs to be done right now, so that you can feel better. So that’s one thing we can do.

Another thing we can do is actually help them look outward. Say to them, “Listen, I know you’re feeling really anxious about catching coronavirus, but part of why we’re asking you to do all these things — to wash your face, to stay close to home — is that that’s also how we take care of members of our community. We think about the people around us.”

And then give them further things to do that may be of help: perhaps dropping off food to people in need or going shopping for them or figuring out what areas of our community need support and doing things to support the people around them while maintaining social distance. Finding ways to care for others will help young people feel better themselves.

And then the third thing to help with anxiety is to help young people find distractions. What psychologists know is that when we are under chronically difficult conditions — and this is certainly a chronically difficult condition that’s going to go on for a while — it’s very helpful to divide the problem into two categories: things I can do something about, and then things I can do nothing about. There’s going to be a lot in that second category right now, where kids are going to have to live with a pretty difficult situation for a while.

Researchers have found that finding positive distractions can help us deal with that second category: we do our homework, we watch our favourite movies, we get in bed with a novel. That is a very appropriate strategy right now. There’s probably a lot to be said for talking about coronavirus and anxiety as a way to seek relief, and there is also a lot to be said about not talking about it as a way to seek relief. Helping kids find that right balance will make a big difference.

UNICEF: On distractions, it’s going to be tempting for a lot of teenagers to bury themselves in screens right now. How can parents and teenagers best handle that?

Dr. Damour: I would be very up front with a teenager and say, “Okay, you and I both know you’ve got a heck of a lot of time on your hands, but you and I both know that it’s not going to be a good idea to have unfettered access to screens and/or social media. That’s not healthy, that’s not smart and it may amplify your anxiety. We really don’t think you having a social media free-for-all is a good idea under any condition. So the fact that you’re not in school and your time isn’t being taken up by classes doesn’t necessarily mean that all of that time should be replaced with social media.” But I think you just say that in a very up-front way which acknowledges that, naturally, there’s no way that the time spent in school will be entirely replaced with being online.

And then ask the teenager, “How should we handle this? What should our plans be? What do you propose in this new normal or new short-term normal. Your time is no longer structured in the ways you’re accustomed to, come up with a structure and show me the structure that you have in mind, and then we can think it through together.”

UNICEF: Is structure key to maintaining a sense of normalcy?

Dr. Damour: Kids need structure. Full stop. And what we’re all having to do, very quickly, is invent entirely new structures to get every one of us through our days. And so I would strongly recommend that parents make sure that there’s a schedule for the day, that there’s a plan for how time will be spent — and that can include playtime where kids can get on their phones and connect with their friends, which of course they’re going to want to do. But it also should have technology-free time, time set aside to help with making dinner, time to go outside. If you can be outside you should. We need to think about what we value and we need to build a structure that reflects that, and it will be a great relief to our kids to have a sense of a predictable day and a sense of when they’re supposed to be working and when they get to play.

I would say for kids under the age of 10 or 11, the parent should come up with a structure and then negotiate from there with their child and see if there’s any feedback that makes good sense.

For children 10 and 11 or older, I would ask the child to design it — and give them a sense of the kinds of things that should be part of that structure, and then work with what they create.

UNICEF: What tips would you give parents who are building a structure for younger children?

Dr. Damour: “I think we have to recognize that younger kids actually do sit in class for periods of the day and tolerate the interruptions and annoyances of a lot of kids around them, and they won’t have to tolerate those when they’re at home. Which is to say that I don’t think we should underestimate their ability to work in a focused way from home.

“That said, every family knows their child best and it may be ideal, depending on who is supervising them (I realize that not every parent is going to be home to do this), to structure their day so that all of those things that need to get done get done before anything else happens: All of their schoolwork, all of their chores, all of their have-to-do activities versus get-to-do activities. For some families, doing that at the start of the day will work best for kids.

“Other families may find that it works well to start the day a little bit later, to sleep in, to enjoy a longer breakfast together, and then get rolling at 10 or 11 in the morning. Every family gets to do it their own way. I also want to add something that some people may be reluctant to voice: We’re stuck with this, so to the degree you can enjoy it — you should. If this means you’re making pancakes as a family for breakfast and that is something that was never a possibility on a normal school day and that’s something that makes everybody happy, enjoy that.

“Here’s the bottom line: Kids need predictability — as much predictability as you can offer in a situation like this. So don’t wake up every day and figure out the schedule. Try a schedule, or maybe try a provisional one for a week as a family and then review it at the end of the week.

UNICEF: How important is a parent’s own behaviour in a time of crisis?

Dr. Damour: Parents, of course, are anxious too and our kids know us better than we know ourselves. They will take emotional cues from us. I would ask parents to do what they can to manage their anxiety on their own time – to not overshare their fears with their children. That may mean containing emotions, which may be hard for parents at times especially if they’re feeling those emotions pretty intensely. I would want for parents to find an outlet for their anxiety that’s not their children. We should remember that they are the passengers in this and we are driving the car. And so even if we’re feeling anxious, which of course we will be, we can’t let that get in the way of them feeling like safe passengers in our car.

UNICEF: Should parents ask their children how they’re feeling on a regular basis or does that bring up more feelings of anxiety?

Dr. Damour: I think it depends on the kid. Some kids really keep to themselves and so it may be valuable for a parent to say, “How are you doing?” or “What are you hearing?” Other kids are going to be talking and talking and talking about it. The way we want to approach these things is to find a good balance between expression and containment. You want some expression and feeling, especially at a time when we should expect kids to have some pretty intense feelings, but you also want those emotions to feel contained. So if your kid is high on expression, you’re going to work on containment, if your kid is high on containment you’re going to help them with a little bit of expression.

UNICEF: Children may worry about catching the virus, but not feel comfortable speaking to their parents about it. How should parents approach the topic with them?

Dr. Damour: Parents should have a calm, proactive conversation with their children about the coronavirus disease (COVID-19), and the important role children can play in keeping themselves healthy. Let them know that it is possible that [you or your children] might start to feel symptoms at some point, which are often very similar to the common cold or flu, and that they do not need to feel unduly frightened of this possibility. Parents should encourage their kids to let them know if they’re not feeling well, or if they are feeling worried about the virus so that the parents can be of help.

Adults can empathize with the fact that children are feeling understandably nervous and worried about COVID-19. Reassure your children that illness due to COVID-19 infection is generally mild, especially for children and young adults. It’s also important to remember that many of the symptoms of COVID-19 can be treated. From there, we can remind them that there are many effective things we can do to keep ourselves and others safe and to feel in better control of our circumstances: frequently wash our hands, don’t touch our faces and engage in social distancing.

UNICEF: There’s a lot of inaccurate information about coronarvirus disease (COVID-19) out there. What can parents do to help counter this misinformation?

Dr. Damour: Start by finding out what they are hearing or what they think is true. It’s not enough to just give your kid facts. If your child has picked up something that is inaccurate or picked up news that is not correct they will combine the new information you give them with the old information they have into a sort of Frankenstein understanding of what’s going on. So ask them, “What are you hearing? When you see kids on social media or when you were last at the playground, what was being said?” Find out what they already know and start from there in terms of getting them on the right track. From there, adults should strongly encourage kids to trust and use reliable sources [such as UNICEF and the World Health Organization’s websites] to get information, or to check any information they might be getting through less reliable channels.

UNICEF: How can parents support their children who are experiencing disappointment due to cancelled events and activities?

Dr. Damour: Let them be sad and don’t try to guilt them out of it. Don’t say, “Other people have this worse than you.” Now your kid feels sad and guilty! That doesn’t make it better. Say to them, “You are having the right reaction. This really stinks. You’re not going to get to be with your friends. You’re not going to get to spend spring on college campus. You’re not going to get to go to this convention that you spent six months preparing for.” In the scope of an adolescent’s life these are major losses. And the other thing adults have to remember is we’ve never seen anything like this, and we’ve been around for a long time. They’ve never seen anything like this and they’re much younger. The disruption of four months in the life of a 14-year-old is a very great percentage of their time they remember being alive. This is bigger for them than it is for us.

A year in a teenager’s life is like seven years in an adult’s life. So, we have to have really high empathy for how big these losses feel. This is their one high school graduation for their whole life, this was their one sophomore spring on campus for their whole life. These are large-scale losses. Even if they’re not catastrophic, they’re really upsetting and rightly so to teenagers. So I would ask parents to expect and normalize that teenagers are very sad and very frustrated about the losses they are mourning and all kids are mourning losses right now. I happened to be around six teenagers yesterday who were leaving school who were deeply sad, and I said, “Go be sad. This is really yucky and this stinks, and you have every right to be sad.” When it comes to having a painful feeling, the only way out is through. When we allow people to feel sad, they usually feel better faster. So, empathy, empathy, support, support. Our kids deserve it. Our job as adults is to provide it. They’re having the right reaction. This is not what any of us would want.

UNICEF: What recommendations do you have for teenagers who are feeling lonely and disconnected from friends and activities?

Dr. Damour: This is where we now may appreciate social media in a whole new way! While adults can have such a jaundiced view of adolescents and social media, teenagers want to be with their friends. Under social distancing conditions: tada! They can be with their friends! Further, I would never underestimate the creativity of teenagers. My hunch is that they will find ways to play with one another online that are different from how they’ve been doing it before. And so I would not hold a dim view of all social media right now. I would just make sure that it’s not a wall-to-wall experience for kids because that’s not good for anybody.

UNICEF: What are some of the outlets teenagers can use to work through these difficult feelings and take care of their mental health?

Dr. Damour: I think every kid is going to do this in a different way. Some kids are going to make art, some kids are going to want to talk to their friends and use their shared sadness as a way to feel connected in a time when they can’t be together in person. Some kids are going to want to find ways to get food to food banks. I would just say know your kid, take your cues from your teenager, and really think a lot about balancing talking about feelings with finding distractions and allow distractions when kids need a relief from feeling very upset.

UNICEF: Some children are facing abuse at school or online around the coronavirus outbreak. What should a child do if they are experiencing bullying?

Dr. Damour: Activating bystanders is the best way to address any kind of bullying. Along these lines, all parents should tell their children that if they witness bullying, they should reach out to the victim or find an adult who can help.

UNICEF: How can parents make the most of the situation? If you’re able to be with your kids, how can you have fun together while you’re stuck at home?

Dr. Damour: In our house — I have two daughters — we’ve decided that we are going to have a dinner team every night. We’re going to create a schedule of who’s in charge of dinner and sometimes it’ll be me and my spouse and sometimes it’ll be me and one of my daughters. We’ll mix it up in pairs, and my older daughter is a teen and my younger daughter is elementary-school age, so there will be nights where the two girls are in charge of things. And so, we rotate who is in charge of making dinner for the family. We often don’t get the time to make dinner as a family. We don’t usually have the time in the day to enjoy cooking together, so we’re doing that.

“I have been making a list of all of the things I want to do with myself: the books I want to read and the things that I’ve been meaning to do — I’ve been meaning to teach my younger daughter how to knit and she’s been asking, so if she’s still interested we’ll be knitting! We’re thinking about having a movie night every three or four nights and we were thinking that the dinner team gets to choose the movie. Every family has their own rhythm and culture and the challenge right now is to invent structures — to pluck them out of thin air. But we can do that, and it’s what our kids need.”

Interview by Mandy Rich, Digital Content Writer, UNICEF. Edited for brevity and clarity.